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This article provides structure to developing, implementing, and evaluating a successful coaching program that effectively meets the needs of learners. We highlight the benefits of coaching in medical education and recognize that many educators desiring to build coaching programs seek resources to guide this process. We align 12 tips with Kern's Six Steps for Curriculum Development and integrate theoretical frameworks from the literature to inform the process. Our tips include defining the reasons a coaching program is needed, learning from existing programs and prior literature, conducting a needs assessment of key stakeholders, identifying and obtaining resources, developing program goals, objectives, and approach, identifying coaching tools, recruiting and training coaches, orienting learners, and evaluating program outcomes for continuous program improvement. These tips can serve as a framework for initial program development as well as iterative program improvement. [ABSTRACT FROM AUTHOR]

Background: Leadership is a critical competency for medical professionals, yet it is often neglected in medical training. For ObGyn residents, leadership training is particularly crucial as it significantly impacts both maternal and newborn outcomes, as well as the operational efficiency of healthcare teams. The main objective of this study was to assess the perceptions of obstetrics and gynecology residents who served as group leaders in the emergency team at the Department of Gynecology, Ward 3, Dr. Ruth K.M. Pfau Civil Hospital Karachi. Methods: A Cross-sectional survey was conducted with purposively sampled 28 year-4 residents who worked as group leaders during last 3 years (from 2018 to 2020) of their residency program at the emergency team in the department of Gynecology Ward 3 Dr Ruth KM Pfau Civil Hospital Karachi. The perceptions on leadership were assessed on 25 items scale sent through a questionnaire on email. Grading of responses was done using a 4-point ordinal scale where 1 meant little importance and 4 was regarded as having great importance. Data was summarized with relevant descriptive statistics and was analyzed on SPSS version 22. Results: The mean age of residents was 30.36. The mean leadership scores of the group of residents were calculated to be 77.50 (SD ± 9.57) while 14(50%) residents showed good and 14 (50%) showed excellent leadership skills based on cumulative scores. Of the 25 traits examined in this study, the highest reported trait was humility 3.82 (± 0.39) followed by empowerment 3.68 (± 0.77) and effective communication 3.68 (± 0.77). While responding about learning experiences, 89.3% of participants felt that the experience enhanced their decision-making skills and boosted their confidence in dealing with emergencies. Conclusion: Our study highlights the critical importance of leadership development in the training of ObGyn residents, particularly in high-pressure emergency settings. The findings reveal that residents value leadership traits such as humility, empowerment, and effective communication, which are essential for building teamwork and ensuring optimal patient outcomes and patient satisfaction. [ABSTRACT FROM AUTHOR]

Burnout, stress and overwork are highly prevalent amongst junior training physicians worldwide, which explains the widespread phenomenon of physicians leaving the field and organised protests/strikes for better working conditions. Back in 2003, the mandatory duty hour restriction was a landmark intervention rolled out by the Accreditation Council for Graduate Medical Education that formally mandated limiting working hours of trainee residents to no more than 80 h per week, and not exceeding 24-h shifts with 6 added hours for education and handover. Nonetheless, 20 years later, this measure continues to be subject to multiple debates on its purported efficacy in achieving its intended objectives and fails to adequately prevent physician burnout and exodus. In our view, the current duty hour restriction model is, in and of itself, inadequate for combating burnout amongst medical residents for several reasons, including insignificant reduction in duty hours with suboptimal adherence/reporting, failure to account for off-site clinical and non-clinical duties, as well as nature of clinical work which typically involves high work intensity in less-than-optimal/unconducive work environments and significant psychoemotional stress. In this article, we offer our perspectives on pursuing a balanced approach towards both meaningful quantitative reduction in working hours as well as practical qualitative improvement in nature of clinical and non-clinical work that could collectively address resident burnout and improve work and training outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The adverse effects of physician stress on health system performance are well documented. Financial stress is a notable cause of anxiety in medical residents; however, most residency programs lack formal, comprehensive financial education programs. Early single-center studies link financial education interventions to improved immediate fiscal well-being, but programs evaluating its long-term effects are lacking. METHODS: Fifty (50) Emergency Medicine and Internal Medicine resident physicians from CommonSpirit Health's St. Joseph's Medical Center in Stockton, CA and Mercy One Medical Center in Des Moines, IA participated in a virtual 8-hour financial education course in April 2022. Participants completed pre-, post-, and 18-month follow-up course surveys to measure financial confidence in seven financial domains and six markers of stress of financial origin (SOFO). RESULTS: Forty (40) of 50 residents (80%) completed the pre-and post-course surveys and 19 (38%) completed pre-, post-, and 18-month follow-up surveys. Immediately after the course, there was a statistically significant increase in financial confidence in all seven course domains (p < 0.01) and a significant reduction in SOFO markers (p < 0.01-0.02). At 18 months, financial confidence markers remained increased in most course domains, except related to debt and mortgage, passive income, and taxes. There was a strong association between financial confidence and SOFO immediately post course. Residents with low financial confidence were 15 times as likely to experience SOFO than those with higher financial confidence (p = 0.02). These associations did not persistent at 18 months. CONCLUSION: Financial stress is a major contributor to anxiety among physician trainees. Our financial education program demonstrated a significant impact on financial confidence and markers of SOFO, especially in the short term. This offers promising results for personal finance education to serve as a feasible intervention to address physician stress but suggests the need for longitudinal education to maintain its beneficial effects. [ABSTRACT FROM AUTHOR]

Background & Objective: The coronavirus disease brought worldwide uncertainty, and Iran was affected by it as well as many other countries in the world. Halting face-to-face education due to social distancing and resident re-employment in clinical wards leads to defective education. The aim of this survey was to evaluate the advantages and disadvantages of modifications made in pathology residency education in Iran. Methods: This online survey was conducted on all pathology residents in Iran. An online 30-item questionnaire was developed and used in this study. Results: Sixty residents (88.3% female) participated in this survey. The majority (70%) of the residents were over 30 years old. Fifty percent of the responders reported that their personal life was influenced by the pandemic. Skyroom and Adobe Connect were the most common platforms for online education with overall satisfaction of 65%. The webinars were considered suitable by 51.7% of the responders. Concerns at work were reported by 48.3% of the residents, while 78.3% reported being exposed to the disease and 55% reported being infected. Concerns about transmission of the disease to family members were reported by 90% of the responders. Conclusion: This study showed that the pathology residency modifications were successful in providing education. However, their social and educational life characteristics might affect their satisfaction with online education. [ABSTRACT FROM AUTHOR]

Background: Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training. Methods: This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents. Results: The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting. Conclusions: Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care. [ABSTRACT FROM AUTHOR]

Background: Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency. Methods: We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire. Results: All residents had at least one painful site on the WPI (range 1–11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = − 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents. Conclusion: WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians. [ABSTRACT FROM AUTHOR]

Background: A death certificate is an official certificate signed by a doctor that states the cause of a person’s death. In most teaching hospitals, resident physicians complete the filling out of death certificates. Materials and Methods: In this research study, we conducted a cross-sectional study on 300 resident physicians from subspecialties, such as internal medicine, emergency medicine, and surgery, at King Khalid University Hospital, Riyadh, Saudi Arabia. The residents responded to a self-administered questionnaire. Both male and female physicians voluntarily participated in the study upon providing electronic consent. The Statistical Package for the Social Sciences(SPSS) version 25 was used to measure the statistical significance of the retrieved responses. Results: The study conveys that in the last 12 months, 8% of the study participants had not filled out any death certificates. Moreover, in the last 3 years, 74.6% of the resident doctor participants had filled out a significant number of death certificates, while only 4.3% had not dealt with this document. Only 16% of the doctors filled out a death certificate for patients for whom they were the primary caregivers in most of the cases. Conclusion: The data generated through this study indicated the reasons why some inaccuracies occur in the process of filling out death certificates, which are based on the reasons accepted by the system, the language barrier, and the training received by the residents on the matter. Given these study results, we have made various recommendations for a training program based on the documented challenges and inaccuracies in filling out death certificates, irrespective of any prior training in the subject. [ABSTRACT FROM AUTHOR]

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Background: Methylphenidate (MPH) and other stimulants may be misused, mainly as cognitive enhancers and recreational drugs. Data regarding misuse among medical residents are scarce. This study aimed to evaluate the prevalence of and main reasons for methylphenidate (MPH) use and misuse among Israeli medical residents. Methods: In this cross-sectional study, we sent an online questionnaire to medical residents who had completed their first residency exam and specialists with up to 2 years of experience. We asked about the use of MPH before and during residency and attitudes toward the use of MPH as a cognitive enhancer. We also added the Adult ADHD Self-Report Scale (ASRS) questionnaire, a validated tool used to screen for the presence of attention deficit hyperactivity disorder (ADHD). Users and misusers were classified based on self-report of use and formal ADHD diagnosis. Logistic regression analysis was used to evaluate factors associated with MPH misuse. Results: From March 2021 to August 2021, 370 physicians responded to our questionnaire (response rate 26.4%). Twenty-eight met the exclusion criteria and were not included. The respondents' average age was 36.5 years. Women comprised 63.5% of the respondents. Of the participants, 16.4% were classified as users and 35.1% as misusers. The prevalence of misusers was 45.6% among surgery and OB/GYN physicians, 39.4% among pediatricians and internists, and 24% among family physicians (P < 0.001). Misusers had a more liberal approach than others to MPH use as a cognitive enhancer. Factors associated with misuse of MPH included not being a native-born Israeli (OR-1.99, 95% CI 1.08, 3.67) and type of residency (OR-2.33, 95% CI 1.22, 4.44 and OR-4.08, 95% CI 2.06, 8.07 for pediatrics and internal medicine and surgery, respectively). Conclusion: Very high levels of MPH misuse during residency may be related to stress, long working hours, night shifts, and the academic burden of the residency period. We believe that our findings should be considered by healthcare policymakers as they make decisions regarding the conditions of medical residencies. The use of MPH as a cognitive enhancer should be further studied and discussed. [ABSTRACT FROM AUTHOR]

Shift work disorder (SWD) may affect medical residents because their workload, academic demands and extended work hours. This condition set residents at risk of more sleep disorders. The study compared parasomnias among residents with and without shift work disorder (SWD) and weighed their relative risk (RR) for each parasomnia. One hundred twenty-six residents participated in the study. The Munich Parasomnia Screening questionnaire and the Barger Questionnaire for SWD were used for the screening of parasomnias and SWD, respectively. Means and percentages of studied variables were compared between groups. Relative risk (RR) was calculated for each type of parasomnia. The more frequent parasomnias in residents with SWD the RR (and 95% confidence intervals) were: sleep terrors, 5.60 (1.84–17.01); confusional arousals, 3.73 (1.84–7.56); sleep paralysis, 3.27 (1.53–6.93); hypnagogic/hypnopompic hallucinations, 2.55 (1.03–6.28); somniloquies, 2.45 (1.21–4.92); and nightmares, 2.01 (1.54–2.62). Our data suggest that residents who experience SWD may be at risk of having lower threshold for the occurrence of rapid eye movement (REM) and non-REM (NREM) sleep parasomnias. Additional research is needed to confirm these results, and to further identify the contribution to this association. [ABSTRACT FROM AUTHOR]

Dyspnea is a frightening and debilitating experience. It attracts less attention than pain ('dyspnea invisibility'), possibly because of its non-universal nature. We tested the impact of self-induced experimental dyspnea on medical residents. During a teaching session following the principles of experiential learning, emergency medicine residents were taught about dyspnea theoretically, observed experimental dyspnea in their teacher, and personally experienced self-induced dyspnea. The corresponding psychophysiological reactions were described. Immediate and 1-year evaluations were conducted to assess course satisfaction (overall 0–20 grade) and the effect on the understanding of what dyspnea represents for patients. Overall, 55 emergency medicine residents participated in the study (26 men, median age 26 years). They were moderately satisfied with previous dyspnea teaching (6 [5–7] on a 0–10 numerical rating scale [NRS]) and expressed a desire for an improvement in the teaching (8 [7–9]). Immediately after the course they reported improved understanding of patients' experience (7 [6–8]), which persisted at 1 year (8 [7–9], 28 respondents). Overall course grade was 17/20 [15–18], and there were significant correlations with experimental dyspnea ratings (intensity: r = 0.318 [0.001–0.576], p = 0.043; unpleasantness: r = 0.492 [0.208–0.699], p = 0.001). In multivariate analysis, the only factor independently associated with the overall course grade was 'experiential understanding' (the experimental dyspnea-related improvement in the understanding of dyspneic patients' experience). A separate similar experiment conducted in 50 respiratory medicine residents yielded identical results. This study suggests that, in advanced medical residents, the personal discovery of dyspnea can have a positive impact on the understanding of what dyspnea represents for patients. This could help fight dyspnea invisibility. [ABSTRACT FROM AUTHOR]

Background: The important central theme in the career is one’s professional self-concept based on attributes, beliefs, values, motives, and experiences regarding the professional identity. Recently, there has been a growing interest in how a physician’s professional identity is shaped by education and experience. Objectives: This study aimed to illuminate the role of experience in shaping the professional identity of Tehran University of Medical Sciences medical residents. Methods: Eighteen 26 - 40 years old residents (male and female) in four Major specialty groups, including obstetrics and gynecology, surgery, and internal medicine, participated in this qualitative content analysis study. Sampling was done in four specialty hospitals of Tehran University of Medical Sciences. Data were gathered through semi-structured in-depth interviews and analyzed by conventional content analysis. Results: Results showed four main categories of effective experiences in Shaping of residents’ professional identity formation, including interpersonal communication experiences, independent professional work, general medical education course, knowledge, and educational background.in this study also, sub-categories extracted from the findings were: (1) forced scheme; (2) symbolic events; (3) learnt competencies of GP; (4) beneficial reforms and integration in general medical education; (5) the education quality level among families; and (6) the education quality level among schools and institutes. Conclusions: This study demonstrated that the previous unique constructive experiences of assistants are one of the most important underlying factors in shaping their professional identity. Interpersonal communication experiences, independent professional work, general medicine training courses, and knowledge and educational background are the unique experiences of any assistant. By creating constructive experiences, it is possible to positively affect the formation of the professional identity of the assistants so that they can be accountable to society. [ABSTRACT FROM AUTHOR]

Background: During the Novel Coronavirus disease (COVID-19) pandemic, medical residents were deployed to help with managing patients in a wide range of settings. Unlike other COVID-19-related topics, the psychological impact of the pandemic on medical residents has received little attention. Objective: This study aims to assess the impact of the COVID-19 pandemic on medical residents' well-being, depression, and stress levels. Methods: A cross-sectional study was conducted in the Emirate of Abu Dhabi. A total of 597 medical residents were identified and with the aim of a sample size of 300 participants; 242 responses were collected during the period between November 2020 to February 2021. Data were collected through an online survey utilizing Patient Health Questionnaire and Perceived Stress Scale. SPSS software was used for data analysis. Results: Most of the residents in our study were females (73.6%) and single (60.7%). Around 66.5% were depressed, 87.2% were under low-moderate stress, and 12.8% were under high stress. Majority (73.5%) of the single residents were depressed (P = 0.016). Being male has been found to lower the risk of developing depression (P = 0.042). The need to relocate for family protection increased the risk of developing depression (P = 0.022).Residents who were living with their friends/roommates were found to be under a high level of stress (P = 0.001). Surgical specialties' residents were found to be the most under high stress (P = 0.044). Conclusion: Female gender, single status, and changing housing were risk factors for depression. Conversely, living with friends/roommates and working in surgical specialties were contributing to high-stress levels. [ABSTRACT FROM AUTHOR]

Background: Although shared decision making is championed as the preferred model for patient care by patient organizations, researchers and medical professionals, its application in daily practice remains limited. We previously showed that residents more often prefer paternalistic decision making than their supervisors. Because both the views of residents on the decision-making process in medical consultations and the reasons for their 'paternalism preference' are unknown, this study explored residents' views on the decision-making process in medical encounters and the factors affecting it. Methods: We interviewed 12 residents from various specialties at a large Dutch teaching hospital in 2019–2020, exploring how they involved patients in decisions. All participating residents provided written informed consent. Data analysis occurred concurrently with data collection in an iterative process informing adaptations to the interview topic guide when deemed necessary. Constant comparative analysis was used to develop themes. We ceased data collection when information sufficiency was achieved. Results: Participants described how active engagement of patients in discussing options and decision making was influenced by contextual factors (patient characteristics, logistical factors such as available time, and supervisors' recommendations) and by limitations in their medical and shared decision-making knowledge. The residents' decision-making behavior appeared strongly affected by their conviction that they are responsible for arriving at the correct diagnosis and providing the best evidence-based treatment. They described shared decision making as the process of patients consenting with physician-recommended treatment or patients choosing their preferred option when no best evidence-based option was available. Conclusions: Residents' decision making appears to be affected by contextual factors, their medical knowledge, their knowledge about SDM, and by their beliefs and convictions about their professional responsibilities as a doctor, ensuring that patients receive the best possible evidence-based treatment. They confuse SDM with acquiring informed consent with the physician's treatment recommendations and with letting patients decide which treatment they prefer in case no evidence based guideline recommendation is available. Teaching SDM to residents should not only include skills training, but also target residents' perceptions and convictions regarding their role in the decision-making process in consultations. [ABSTRACT FROM AUTHOR]

Objective The present study aimed at measuring the level of public speaking anxiety (PSA) among medical residents in Riyadh, in addition to identifying the factors influencing public speaking anxiety from the perspective of the medical residents. Method A cross-sectional survey was conducted over a sample of 203 medical residents in Riyadh. The study adopted the questionnaire as a data collection tool. The questionnaire consisted of a demographic data part, PSA scale (17 items) and a third part concerned with the factors influencing public speaking anxiety among medical residents. Results The results of the study revealed that medical residents in Riyadh had a low level of public speaking anxiety (47.3±11.32). The participants had a low PSA score on all scale domain; cognitive (23.28±5.43), behavioral (10.45±4.16), and physiological (13.54±3.44). Moreover, the findings of the study showed that stuttering (91.1%), negative perceptions of individuals' own voice (77.8%), and language barriers (76.8%) were the main factors influencing the public speaking anxiety among medical residents. Finally, we found through linear regression analysis that PSA is not significantly predicted by participants' living region, marital Status, gender, residency level, type of pre-college school, age or being previously diagnosed by a mental health issue. Conclusion There is a low level of public speaking anxiety among medical residents in Riyadh. In addition, the study concluded that stuttering, negative perceptions about voice and language barriers are negatively influencing the public speaking anxiety among medical residents in Riyadh. [ABSTRACT FROM AUTHOR]

Objectives. Human resource management is the most important function in the management of organizations and significantly affects the quality of work-life (QWL). Recently, the health sector started to be interested in the QWL among doctors. The study aim was to assess the QWL among Polish medical residents. Methods. The questionnaire for the medical residents was prepared using data acquired from a review of the international literature. In October 2017, the questionnaires were completed twice by 10 residents with a 2-week interval to assess the inter-rater reliability. The online questionnaire was distributed between April and May 2018. Results. A total of 243 doctors responded, over one-third of whom were men. The QWL was very high for 2.06% of the participants, high for 23.87%, moderate for 27.16%, low for 38.27% and very low for 8.64%. Among the factors that significantly relate to the QWL are the number of working hours per week (p = 0.007) and the general quality of life (p = 0.000). Conclusion. Low QWL is the result of inadequate management in Polish hospitals and residents' QWL still needs to be improved. We propose to conduct such a survey periodically among all young medical doctors to systematically improve their QWL. [ABSTRACT FROM AUTHOR]

Introduction: The optimal treatment plan for patients with cancer is discussed in multidisciplinary team meetings (MDTMs). Effective meetings require all participants to have collaboration and communication competences. Participating residents (defined as qualified doctors in training to become a specialist) are expected to develop these competences by observing their supervisors. However, the current generation of medical specialists is not trained to work in multidisciplinary teams; currently, training mainly focuses on medical competences. This study aims to identify barriers and facilitators among residents with respect to learning how to participate competently in MDTMs, and to identify additional training needs regarding their future role in MDTMs, as perceived by residents and specialists. Methods: Semi-structured interviews were conducted with Dutch residents and medical specialists participating in oncological MDTMs. Purposive sampling was used to maximise variation in participants' demographic and professional characteristics (e.g. sex, specialty, training duration, type and location of affiliated hospital). Interview data were systematically analysed according to the principles of thematic content analysis. Results: Nineteen residents and 16 specialists were interviewed. Three themes emerged: 1) awareness of the educational function of MDTMs among specialists and residents; 2) characteristics of MDTMs (e.g. time constraints, MDTM regulations) and 3) team dynamics and behaviour. Learning to participate in MDTMs is facilitated by: specialists and residents acknowledging the educational function of MDTMs beyond their medical content, and supervisors fulfilling their teaching role and setting conditions that enable residents to take a participative role (e.g. being well prepared, sitting in the inner circle, having assigned responsibilities). Barriers to residents' MDTM participation were insufficient guidance by their supervisors, time constraints, regulations hindering their active participation, a hierarchical structure of relations, unfamiliarity with the team and personal characteristics of residents (e.g. lack of confidence and shyness). Interviewees indicated a need for additional training (e.g. simulations) for residents, especially to enhance behavioural and communication skills. Conclusion: Current practice with regard to preparing residents for their future role in MDTMs is hampered by a variety of factors. Most importantly, more awareness of the educational purposes of MDTMs among both residents and medical specialists would allow residents to participate in and learn from oncological MDTMs. Future studies should focus on collaboration competences. [ABSTRACT FROM AUTHOR]

Background: This study was carried out to identify and explore the difference in coping strategies for dealing with stress; adopted by medical residents in surgical and nonsurgical specialties. Methods: A mixed methods approach, was chosen for this study. In phase one (quantitative); data were collected by a web-based survey, using a structured questionnaire. This survey was carried out in five major teaching hospitals of Rawalpindi & Muzaffarabad in 2020. Purposive sampling was done and data were analysed using SPSS, recording frequencies and major trends. In phase two (qualitative); six focus group discussions were carried out with 24 participants, using semi-structured questions and prompts. Convenient sampling was done from the cohort of phase 1. These focus group discussions, explored the various coping strategies adopted by medical residents. Later, the data were analysed manually for development of codes, sub-themes and themes. Results: Out of 250 (100%) participants, 146 (58%) participants responded to the online survey. Surgical residents had a higher response rate (60%, n = 87) than nonsurgical residents. Moreover, female participation (54%, n = 79) was greater than male participation (46%, n = 67). The Mann-Whitney U test was statistically significant only for seeking medical advice to cope with stress (P =.029). There was no statistically significant difference found between the coping strategies, employed by medical residents. In focus group discussions, female involvement was more (58% n = 14) than their counterparts. Four main themes were developed after data analysis: self-regulation, tailor-made strategies, educational focus and support system. Finally, minor differences were obtained qualitatively; like, socializing is preferred by surgical residents whereas, spiritualism is chosen by nonsurgical residents. Conclusion: Quantitatively, no significant differences were found between the coping strategies of medical residents, against work-related stress. However, minor differences were obtained qualitatively due to difference in job demands and level of burnout between these two specialities. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests empathy, an essential component of holistic patientcare, may be declining amongst medical students and residents. Yet there are only a few qualitative studies, mostly from West, exploring this phenomenon. Objective: This is a qualitative study of the learning environments of a tertiary care hospital of Pakistan, aimed to understand how junior doctors perceive and develop empathy and articulate the challenges faced by them. Methods: This case study adopted constructivist theoretical perspectives and was conducted from January 2019 to June 2019. Data was gathered from three focus group discussions and analyzed by thematic analysis. Patterns were identified and reported to generate codes, basic and organizing themes. Results: The participants were cognizant of empathy and its significance in patient management. Seniors as role models, first-hand knowledge of patients' plights, active involvement in patient care and witnessing illnesses in dear ones were facets positively influencing empathy. Salient hindrances included enormous work load, gender bias, past negative experiences, language and literacy barriers. Some participants felt like devising their own strategies to cope with workload and providing empathetic care. There is pivotal role of workplace based learning; enabling junior doctors to handle multi-dimensional doctor-patient relationship. Conclusion: Clinical environments are significant for junior doctors' grooming in attainment of empathetic patient care. Exhibiting empathy may be different in eastern and western diaspora. Faculty development could promote refined understanding of empathy and strategies to convey empathetic patientcare ensuring safe medical practice. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbances among medical staff are common serious entities with devastating consequences. Numerous studies have analyzed the effects of residency on the quality of sleep of the medical trainees in various specialties, but only few studies were conducted in Egypt. Results: One hundred fifty medical residents from various medical and surgical specialties who work in the hospitals of Ain Shams University, Egypt, agreed to participate in our study. Sociodemographic and work-related data were collected by a semi-structured sheet. Sleep quality was assessed by self-administered questionnaire—Pittsburgh Sleep Quality Index (PSQI). According to the PSQI, 96.7% of the residents had poor sleep quality with mean PSQI score of 10.4 ± 2.5. No statistically significant difference was detected among the different specialties. Poorer sleep quality was more frequent among senior residents who spent longer duration in residency. The number of hours of sleep before residency and the number of days off during residency were the main predictors of total PSQI score and determinants of sleep quality Conclusions: Poor sleep quality is highly prevalent among medical residents and is associated with work-related factors. It is necessary to consider residents' sleep estate and conduct more analyses to diagnose, treat, and improve their sleep quality. [ABSTRACT FROM AUTHOR]

Objective: Occupational burnout occurs more often among doctors than among those working in other sectors. It is an indisputable fact that medics whose work requires almost continuous contact with people are more prone to burnout. It is noticed that the burnout syndrome affects doctors at all stages of their careers - from residents to experienced practitioners. Methods:. This paper performs a literature review on the frequency and causes of professional burnout among resident doctors. Results: The results of numerous large-scale studies are conclusive that the intensive workload of doctors, including night shifts and overtime, and the lack of work-life balance, due to the numerous resident duties, are the most common predisposing factors for the development of burnout syndrome in resident doctors. Another important conclusion from these studies is that a high level of BOS is mainly associated with depression and inadequate patient care. Conclusions: Professional burnout syndrome among resident doctors is an ongoing issue. It is then required that additional subjects, such as building skills to recognize and combat stress and implement strategies to overcome it, should be included in resident doctors training programmers. [ABSTRACT FROM AUTHOR]

Background: Residents receive a numeric performance rating (eg, 1-7 scoring scale) along with a narrative (ie, qualitative) feedback based on their performance in each workplace-based assessment (WBA). Aggregated qualitative data from WBA can be overwhelming to process and fairly adjudicate as part of a global decision about learner competence. Current approaches with qualitative data require a human rater to maintain attention and appropriately weigh various data inputs within the constraints of working memory before rendering a global judgment of performance. Objective: This study explores natural language processing (NLP) and machine learning (ML) applications for identifying trainees at risk using a large WBA narrative comment data set associated with numerical ratings. Methods: NLP was performed retrospectively on a complete data set of narrative comments (ie, text-based feedback to residents based on their performance on a task) derived from WBAs completed by faculty members from multiple hospitals associated with a single, large, residency program at McMaster University, Canada. Narrative comments were vectorized to quantitative ratings using the bag-of-n-grams technique with 3 input types: unigram, bigrams, and trigrams. Supervised ML models using linear regression were trained with the quantitative ratings, performed binary classification, and output a prediction of whether a resident fell into the category of at risk or not at risk. Sensitivity, specificity, and accuracy metrics are reported. Results: The database comprised 7199 unique direct observation assessments, containing both narrative comments and a rating between 3 and 7 in imbalanced distribution (scores 3-5: 726 ratings; and scores 6-7: 4871 ratings). A total of 141 unique raters from 5 different hospitals and 45 unique residents participated over the course of 5 academic years. When comparing the 3 different input types for diagnosing if a trainee would be rated low (ie, 1-5) or high (ie, 6 or 7), our accuracy for trigrams was 87%, bigrams 86%, and unigrams 82%. We also found that all 3 input types had better prediction accuracy when using a bimodal cut (eg, lower or higher) compared with predicting performance along the full 7-point rating scale (50%-52%).Conclusions: The ML models can accurately identify underperforming residents via narrative comments provided for WBAs. The words generated in WBAs can be a worthy data set to augment human decisions for educators tasked with processing large volumes of narrative assessments. [ABSTRACT FROM AUTHOR]

Background: Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya's largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. Methods: We sampled 338 residents belonging to 8 different specialties using self administered questionnaires in this cross-sectional survey between October 2019 and February 2020. Questionnaires included: sociodemographics, the Centres for Epidemiology Depression Scale - Revised, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Alcohol, Smoking and Substance Involvement Screening Test, and Postgraduate Hospital Educational Environment Measure. Bivariate and multivariate linear regression were used to assess for risk factors for depression. Results: Mean participant age was 31.8 years and 53.4% were males. Most residents (70.4%) reported no to mild depressive symptoms, 12.7% had moderate, and 16.9% had severe depressive symptoms. Most residents had high social support (71.8%) and moderate stress (61.6%). The educational environment was rated as more positive than negative by 46.3% of residents. Bivariate analyses revealed significant correlations between depressive symptoms, perceived stress, substance use, perceived social support, and educational environment. Multivariate analysis showed that depression was strongly associated with: fewer hours of sleep (β = − 0.683, p = 0.002), high perceived stress (β = 0.709, p < 0.001) and low perceived social support (β = − 2.19, p < 0.001). Conclusions: Only 30% of medical residents in our study had moderate and severe depressive symptoms. Most residents in our study reported high levels of social support, and moderate levels of stress. Though their overall appraisal of medical residency experience was positive, mental health support and self-care skills in the training of medical professionals needs prioritization. [ABSTRACT FROM AUTHOR]

Introduction. Medical specialty residents have become a high-risk population for mental health disorders, mainly due to long working days, limited time for rest and recreation, problems inherent in the work environment, and substance use. Since all these factors not only alter the training of future specialists, but also the care they provide for people, the study of an intervention in this population is of interest to the health system and human resource training in the health sector. Objective. To evaluate the mental health status, prevalence of work exhaustion and associated psychosocial and work factors in medical residents in the Guadalajara Metropolitan Area. Method. This was a cross-sectional, observational, descriptive, and comparative study, in which, through a digitized survey on the Google Forms platform, the GHQ-28, ASSIST, and Maslach Burnout Inventory scales were administered to medical specialty residents from various health institutions in the Guadalajara Metropolitan Area. Results. The total sample comprised 306 residents, representing 11.23% of the total residents in the Guadalajara Metropolitan Area (2,724). Female physicians had a higher percentage of participation with 61.4% (n = 188), with male physicians accounting for 38.6% (n = 118). The average age was 28.9 years and 84.9% (n = 260) were pursuing a clinical specialty, and 15.1% (n = 46) a surgical one p = 05. On average, they worked 74.1 hours per week, whereas in surgical specialties they worked another 10 hours (82.63 ± 23.40 vs. 72.67 ± 19.76, p = .002). 72.5% (n = 222) showed a high risk of developing burnout. 9.2% (n = 28) obtained scores compatible with severe depression, which was related to a higher number of hours worked per week and heavier alcohol consumption than residents without depression, 21.24% (n = 65) of respondents frequently thought about dropping out, 22.5% (n = 69) felt dissatisfied with their work, while 14.05% (n = 43) of the residents had recently noticed that they had had frequent thoughts of taking their own lives. Discussion and conclusion. The higher number of hours worked per week, surgical specialties, and the presence of workplace harassment were recognized as psychosocial and occupational factors associated with mental health problems in resident physicians, such as depression, thoughts of death, burnout, and psychoactive substance use. In a country like Mexico, where medical residents are a crucial pillar of the public health system, it is necessary to ensure their well-being, and seek to improve the working and academic conditions of medical residencies to ensure that this is reflected in the quality and safety of patient care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to examine the association between coping strategies, resilience, optimism and different mental health outcomes like stress, anxiety, and depression among the medical residents' during the COVID‐19 pandemic, with consideration of different factors like seniority, frontliner, gender, and coping style. Methods: An electronic survey was sent to all medical residents in Qatar. Depression, anxiety, and stress were assessed by the DASS‐21. Professional quality of life was measured by the ProQOL scale. The coping mechanisms were assessed with the Brief‐COPE, and resilience was measured by the Brief Resilience Scale. Results: The most commonly used coping strategies were acceptance, religion, and active coping. The avoidant coping style scores were higher among junior residents (p =.032) and non‐COVID‐19 frontliners (p =.039). Optimism LOT‐R score was higher in senior than in junior residents (p <.001). Lower avoidant coping scores, higher optimism, and higher resilience were associated with lower stress, anxiety, and depressive symptoms. Conclusion: It seems that avoidant coping styles can exacerbate depressive, anxiety, and stress symptoms in medical residents amidst the COVID‐19 pandemic. Strategies promoting optimism, resilience, and approach coping styles can decrease the mental health burden of the pandemic on medical residents. Avoidant coping styles can exacerbate depressive, anxiety, and stress symptoms in medical residents amidst the COVID‐19 pandemic. Strategies promoting optimism, resilience, and approach coping styles can decrease the mental health burden of the pandemic on medical residents. [ABSTRACT FROM AUTHOR]

Background: Work-related stress among healthcare professionals poses a serious economic and healthcare burden. This study aimed to investigate the prevalence of burnout as well as anxiety, depression, and stress in medical residents from different majors, and assess the effects of an online psychological intervention on the mental health status of medical residents with a high degree of burnout. Methods: We conducted an online survey that collected information on the demographics, mental health, and burnout conditions of medical residents from Shengjing Hospital. The mental health condition was assessed by the Depression, Anxiety, and Stress Scale (DASS)−21. Further, burnout was assessed by the Maslach Burnout Inventory (MBI). Medical residents with a total MBI score between 50 and 75 were selected to receive online psychological intervention for 3 months. Results: Two-hundred and ten medical residents completed the questionnaire, of whom, 63 residents with an MBI score between 50 and 75 received the 3-month online psychological intervention. Anesthesia residents showed the highest level of depression, anxiety, and stress, and presented with a lower sense of personal accomplishment, higher emotional exhaustion, and higher depersonalization. Furthermore, pediatric residents had the second highest DASS and MBI scores following anesthesia residents. Following the online psychological intervention, negative emotional states and burnout levels were significantly lower among anesthesia and pediatric residents. There were no differences in the level of stress and sense of personal accomplishment pre- and post-online psychological intervention among the different majors. Conclusion: Our findings revealed high levels of burnout, as well as depression, anxiety, and stress symptoms in medical residents, with marked differences among different majors. The online psychological intervention effectively improved emotional exhaustion, and depersonalization, and relieved the psychological problems such as anxiety and depression in medical residents. [ABSTRACT FROM AUTHOR]

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Objectives: To assess the attitudes, knowledge, and experiences of Brazilian resident physicians regarding religiosity/spirituality (R/S), factors associated with addressing this issue, and its influence on clinical practice. Methods: We report results of the multicenter "Spirituality in Brazilian Medical Residents" (SBRAMER) study involving 7 Brazilian university centers. The Network for Research Spirituality and Health (NERSH) scale (collecting sociodemographic data, opinions about the R/S-health interface, and respondents' R/S characteristics) and the Duke Religion Index were self-administered. Logistic regression models were constructed to determine those factors associated with residents' opinions on spirituality in clinical practice. Results: The sample comprised 879 resident physicians (53.5% of total) from all years of residency with 71.6% from clinical specialties. In general, the residents considered themselves spiritual and religious, despite not regularly attending religious services. Most participants believed R/S had an important influence on patient health (75.2%) and that it was appropriate to discuss these beliefs in clinical encounters with patients (77.1%), although this was not done in routine clinical practice (14.4%). The main barriers to discussing R/S were maintaining professional neutrality (31.4%), concern about offending patients (29.1%), and insufficient time (26.2%). Factors including female gender, clinical specialty (e.g., internal medicine, family medicine, psychiatry) as opposed to surgical specialty (e.g., surgery, obstetrics/gynecology, orthopedics), having had formal training on R/S, and higher levels of R/S were associated with greater discussion of and more positive opinions about R/S. Conclusion: Brazilian resident physicians held that religious and spiritual beliefs can influence health, and deemed it appropriate for physicians to discuss this issue. However, lack of training was one of the main obstacles to addressing R/S issues in clinical practice. Educators should draw on these data to conduct interventions and produce content on the subject in residency programs. [ABSTRACT FROM AUTHOR]

Background: Medical residents usually suffer from work overload and experience both personal and professional distress, which affects their level of the empathy to patients. Psychological capital (PsyCap) is a psychological resource that is negatively associated with indicators of distress. Objective: This study explored the potential mediating effect of PsyCap on the relationship between distress and empathy, which may help healthcare professionals in their defense of empathy erosion due to distress. Design: A total of 620 first-year residents were recruited for this cross-sectional survey. Empathy and PsyCap of residents were assessed by the Chinese version of the Jefferson Scale of Physician Empathy and the Psychological Capital Questionnaire, respectively. In this study, both personal and professional aspects contributing to resident distress were investigated by the Satisfaction with Life Scale and an occupational distress scale. T-tests and one-way ANOVA were used to test differences in empathy of residents. Pearson's correlation was used to examine correlations between distress, PsyCap, and empathy. Structured equation modeling was used to conduct the pathway analysis to test the mediating effect of PsyCap on the association between distress and empathy. Results: 537 residents (86.6%) completed the survey. Distress, empathy, and PsyCap were significantly correlated (P <.01) and in the expected directions. The first step analysis showed that as distress increased, the empathy of residents significantly decreased (P <.01), with the direct effect coefficient being 0.265. When PsyCap was included, the direct effect coefficient decreased to 0.033. This indirect effect was significant (P <.01). The variance accounted for was 81.14%, which indicated a partial mediating effect of PsyCap. Conclusions: PsyCap may serve a significant protective role against the impact of distress on the level of empathy of medical residents. In addition to reducing distress, PsyCap development could be considered in empathy decline prevention and empathy cultivating strategies. Abbreviations: PsyCap: Psychological capital; JSPE: Jefferson Scale of Physician Empathy; PCQ: Psychological Capital Questionnaire; SWLS: Satisfaction with Life Scale; VAF: Variance accounted for; SD: Standard deviation. [ABSTRACT FROM AUTHOR]

There is evidence of a higher depression rate among resident physicians compared to the general population. This study aimed to estimate the prevalence of depression and assess its severity and predictors among physician residents in Jeddah, Western Saudi Arabia. A cross-sectional survey was conducted using the self-administered Patient Health Questionnaire (PHQ-9). This study included 149 medical residents. More than half (53%) were female and 43% were married. A diagnosis of depression (mild to severe) was identified in 75.8% of the participants (mild in 35.6%, moderate in 34.2%, and severe depression in 6.0%). Residents in surgery and emergency programs were at an increased risk for moderate-to-severe depression (OR 2.60, 95% CI 1.13, 5.98; OR 4.90, 95% CI 1.08, 22.20; respectively). Mental health programs for resident physicians would facilitate the early detection of depression and mental disorders. However, adequate mentoring, managing workloads, and social off-duty activities are always vital. [ABSTRACT FROM AUTHOR]

Introduction: Medical residents report high levels of stress, with many work-related demands contributing to their experience of heightened stress. Mindfulness training has been suggested as a beneficial strategy for stress management with residents; however, many mindfulness programs are time-consuming, and compliance with conventional mindfulness training programs becomes challenging given the intense, competing time commitments of residency. The present study sought to evaluate the acceptability and perceived effectiveness of a single-session, mindfulness-based stress management workshop for medical residents. Methods: Residents (n = 142) from family medicine, internal medicine and general surgical residency programs participated in a 1.5-hour mindfulness workshop in 2016 and completed: a measure of workshop satisfaction immediately post-workshop; a measure of adherence to suggested strategies 4-6 weeks post-workshop; and measures of stress, mindfulness and positive and negative affect immediately post-workshop and 4-6 weeks post-workshop. Results: Results revealed high levels of satisfaction with the workshop. Participants who used the recommended strategies over the 4 to 6-week post-workshop period reported significant increases in mindfulness and significant decreases in stress at follow-up. Conclusions: Results suggest single-session mindfulness training can be beneficial for residents who use the strategies effectively; however, ensuring strategy use following training is challenging. Future research is needed to investigate facilitators and barriers to strategy use. [ABSTRACT FROM AUTHOR]

Background: Shared Decision Making (SDM) is as ideal model for resident-patient relationship which may improve medical outcomes. Nevertheless, predictive psychological factors influencing residents' perspective regarding SDM are unclear. The current study investigated the relationship between two psychological factors, mental health and personality traits, and residents' views toward SDM. Method: In a cross-sectional study, 168 medical residents of the Babol University of Medical Sciences studying in 13 field specialties were recruited. The residents completed three questionnaires including Shared Decision-Making Questionnaire (SDM-Q-Doc, physician version), General Health Questionnaire (GHQ-12), and Big Five Personality (NEO-FFI). Results: Residents had an overall agreement of about 88% regarding SDM with patients. There was no significant difference between male and female residents in terms of the degree of agreement for SDM. Concerning SDM, there was no significant relationship either between residents' views and neuroticism, extraversion, agreeableness, and conscientiousness. In multivariate regression, mental health did not predict the SDM, but openness to experience negatively predicted residents' views concerning SDM (β = − 0.388, p < 0.001). Conclusion: The residents' personality trait of openness to experience was a significant negative predictor of SDM with patients. A better understanding of how psychological factors relate to residents' perspectives may help clinicians properly discuss the treatment options with the patient thereby encouraging them for SDM or to consider their own preferences. [ABSTRACT FROM AUTHOR]

Background: Clinical trials are an important tool to test the efficacy of new treatment modalities for cancer patients. Physicians, including medical residents, should play a major role in carrying out clinical trials to generate a strong body of evidence to determine the best available treatment for their patients. Carrying out clinical trials demands adequate understanding of the research phases and requirements including ethical standards as well as presenting positive attitudes toward the clinical research. Hence, evaluating the knowledge and attitudes of medical residents toward running clinical trials is essential to assess their preparedness and willingness to participate in future studies. Methods: This study was a questionnaire-based observational study. It involved medical residents from various specialties who served cancer patients admitted at King Abdullah University Hospital during the period from June 1 to August 15, 2017. Results: A total number of 83 respondents completed the questionnaire. Of them, 56.7% and 53.0% of the respondents reported either current or previous participation in clinical trials research, respectively. Only 10 residents (12.0%) had previous participation in clinical research where a new investigational cancer treatment was tested. While, 91.6% of respondents believed that physicians should be involved in running clinical cancer research, only 25.3% had previous experience in writing a cancer clinical trial protocol and 28.9% wrote a scientific manuscript on cancer clinical trials for publication. Moreover, 67.5% of residents knew when informed consent should be obtained and 62.7% were aware of the clinical equipoise concept in clinical trials. Conclusion: Much remains to be done to improve knowledge and attitudes of medical residents toward cancer clinical trials and the main ethical principles that should be followed to assure having an ideal research environment, which will pave the way for the generation of high quality clinical cancer research and reliable evidence-based clinical practice for cancer management. [ABSTRACT FROM AUTHOR]

Current evidence shows that telemetry monitoring is commonly overutilized for 'non-cardiac' diseases such as COPD exacerbation, pneumonia, pulmonary embolism and sepsis. This issue has not been addressed clearly in the recent American Heart Association (AHA) guidelines and no standard recommendations on the use of telemetry in non-cardiac conditions exist; therefore, clinicians continue to make such decisions based on personal preferences. As medical residency is an important phase during which young physicians develop clinical skills and habits for their future practice, the aim of this study was to understand the prevalent trends related to inappropriate telemetry use amongst the medical residents at a community hospital and the associated factors which influence the use of telemetry monitoring in non-cardiac patients. All the residents undergoing internal medicine training at a community hospital were surveyed with the help of a questionnaire regarding the utility of telemetry in non-critical patients admitted with non-cardiac conditions. Survey was completed by 37 residents. Analysis of the responses showed that despite the frequent use of telemetry in non-cardiac conditions, majority of the medical residents are unaware of the correct indications. Seventy-three percent choose 'continuous' telemetry when placing the order while only 16% (often or always) discontinue telemetry after 24 hours of uneventful use. Although 84% residents admitted that telemetry is overutilized, still 49% felt that it leads to better patient care while 70% considered it superior to frequent vitals monitoring for early detection of hemodynamic instability. Possible causes of inappropriate use included 'Lack of knowledge about the related literature' and 'Following trends set by the peers'. Majority of the medical residents overutilize telemetry in non-cardiac conditions due to lack of knowledge, perceived sense of security and inappropriate trends set by their colleagues. In order to abolish these tendencies, we propose the provision of adequate educational resources to the clinical staff at every level along with other system-based strategies. [ABSTRACT FROM AUTHOR]

Background: Burnout is a common issue among residents across the globe. Although several attempts were made to propose better working hours for residents, burnout is still prevalent as depicted by several studies. Objectives: The aim of the paper is to review several worldwide studies related to burnout in residents and propose potential suggestions. Methods: The following paper summarizes studies pertinent to burnout in residents from different countries categorized into three main regions: North and South America, Europe, and Middle East. The studies were collected from February 2018 to March 2019. Results: Numerous studies across the world have revealed high rates of burnout in residents during the last decades. Conclusions: Various awareness and wellness programs, as well as professional counseling sessions, are proposed to help residents overcome burnout. [ABSTRACT FROM AUTHOR]

Objectives: It has been reported that South Korea ranked as one of the longest‐working nations among OECD countries. This study sought to examine the association between long working hours and musculoskeletal pain among Korean medical residents. Methods: We analyzed a cross‐sectional survey of 1,077 medical residents in South Korea. Working hours per week were categorized as follows: <60, 60‐79, 80‐99, and ≥100. Musculoskeletal pains (ie, upper limb, lower limb, and low back pain) over the past 3 months were categorized into three groups: no pain, pain without interfering with work, and pain interfering with work. Multinomial logistic regression was used to examine the association between long working hours and musculoskeletal pains after adjusting for covariates. Results: We found that the average working hours of medical resident was 85.6 hours per week in South Korea. Compared to the medical residents working <60 hours, those working ≥100 hours per week were more likely to have upper limb pain (PR: 1.77, 95% CI: 1.37, 2.30) interfering with work or low back pain (PR: 2.15, 95% CI: 1.51, 3.06) interfering with work, whereas no statistically significant association was observed in the analysis of lower limb pain. Conclusions: This study suggests that extremely long working hours are associated with upper limb and low back pain interfering with their work among Korean medical residents. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the opinions of Brazilian medical residents in Obstetrics and Gynaecology on abortion legislation according to their personal beliefs.Material and methods: A multicentre cross-sectional study. Residents at 21 university teaching hospitals completed a self-report questionnaire on their opinions in abstract terms, and about punishing women who abort in general and women they know.Results: In abstract terms, 8% favoured allowing abortion under any circumstances (fully liberal); 36% under socioeconomic or psychological constraints (broadly liberal); 75.3% opposed punishing a woman who has aborted (liberal in general practice); and 90.2% opposed punishing women they knew personally (liberal in personal practice). Not having a stable partner and not being influenced by religion were factors associated with liberal opinions. In personal practice, however, 80% of those who are influenced by religion were liberal. The percentage of respondents whose opinions were liberal was significantly greater among those who believed that abortion rates would remain the same or decrease following liberalisation.Conclusions: Judgements regarding the penalisation of women who abort are strongly influenced by how close the respondent is to the problem. Accurate information on abortion needs to be provided. Although about one third of the respondents were broadly liberal, the majority oppose punishment. [ABSTRACT FROM AUTHOR]

This study aimed to validate a Simplified Chinese version of the 14-item Perceived Stress Scale (CPSS-14) for use with Chinese population and clarify its reliability and validity. A sample of 835 Chinese medical residents were asked to complete the CPSS-14, Zung Self-rating Depression Scale (SDS), and Zung Self-rating Anxiety Scale (SAS). The results showed that the two-factor model for CPSS-14 was a better fit than the one-factor model. The composite reliability of the two factors were higher than.80 and all standardized factor loadings were statistically significant, ranging from.514 to.806. Significant correlations were also found between the CPSS-14, SDS and SAS. The CPSS-14 is best conceptualized as being driven by two underlying dimensions of perceived stress and possessed satisfactory internal consistency, acceptable construct validity and good concurrent validity. [ABSTRACT FROM AUTHOR]

Introduction. Medical residents (MR) are an important pillar for a future effective health system. As such, it is important to study all the factors throughout their training that may influence their professional development, like gender-based violence (GV). Objetive. To design and evaluate the psychometric proprieties of subtle GV among medical residents' assessment scale (SGEVRA). Method. The design was carried out in two phases: (1) in the qualitative phase, three focus groups were interviewed to obtain information about GV during medical training; and (2) in the quantitative phase, the information was incorporated into the instrument and the psychometric properties were tested. Results. A total of 1,645 medical residents (MRs) completed the instrument. Exploratory factor analysis led to a final two factor model comprised of 31 items that explained 74.9% of the variance. The factors were labelled as gender discrimination (factor 1) and sexual violence (factor 2); both demonstrated high internal consistency using Cronbach's alpha (factor 1: .987; factor 2: .935). Discussion and conclusion. The SGEVRA is a brief, valid, and reliable instrument for assessing subtle GV among MR. [ABSTRACT FROM AUTHOR]

Background: Several studies correlate medical residency with the occurrence of mental health disorders, Burnout Syndrome and quality of life impairment. It has been demonstrated that mental health disorders increase medical errors and lead to less effective patient care. Considering such context, this study aimed to evaluate the prevalence of anxiety, depression, stress and to identify its correlates with Burnout Syndrome and quality of life in a sample of medical residents and fellow physicians of the largest Brazilian academic health system. Methods: In 2017, 1648 participants were voluntarily and anonymously surveyed online about demographic characteristics, Burnout Syndrome, mental symptoms, and quality of life measured by validated questionnaires. Responses were captured through REDCap platform and multivariate statistical analyses were performed with STATA 15. Results: A total of 606 (36.8%) residents/fellows physicians completed the survey. Depression symptoms were present in 19%, anxiety symptoms in 16% and stress symptoms in 17.7% of the sample. Burnout Syndrome was present in 63% of the sample. Multivariate analysis showed a statistical significant positive correlation between Burnout Syndrome and depression, anxiety and stress symptoms and a negative correlation between mental symptoms and quality of life scores. Conclusions: Mental health symptoms prevalence in this study is similar to other studies and their occurrence is positively correlated with Burnout Syndrome among medical residents/fellow physicians of the largest Brazilian academic health system. These results are relevant and must be confirmed by multicentric longitudinal studies. This study reinforces the importance of debating interventions to improve mental health among doctors in training. [ABSTRACT FROM AUTHOR]

Objectives: The Dubai Residency Training Program (DRTP) commenced in the year 1993; then, a "Residency Research Program (RRP)" has implemented from 2011 to promote research among young physicians. This study was conducted by the Dubai Health Authority to review the RRP to assess its effectiveness in meeting original objectives and generating desired outcomes. Methods: Source documents such as the chronicles of the DRTP, communication between the stakeholders, resident feedback, research director, and program director reports were accessed and retrospectively reviewed. Results: Seven research workshops and ten advanced statistics courses were held. Ten scholarships were provided to the residents for "Introduction to Clinical Research Training" held by Harvard Medical School. Of 370 residents, a total of 156 residents submitted their research proposal, of which 128 residents presented their thesis. Nineteen residents presented their research on international conferences, 12 published their study, and 9 got award locally. Conclusions: Efforts are focused on improving the quality of the research projects, as well as getting residents involved in research that leads eventually to publication. Research is a major component of DRTP; nevertheless, it is challenging for residents to conduct research successfully because of some barriers inherent in residency training. This experience was the first in the United Arab Emirates, and we believe that this paper will contribute to the integrating research in residency programs by the educators and academics in across countries within the region. [ABSTRACT FROM AUTHOR]

Team-based learning (TBL) is a well-established instructional strategy that provides students with the chance to apply conceptual knowledge through a series of actions, including pre-class, individual, team class activity, and immediate feedback. The purpose of the present study was to introduce a course of teaching the evidence-based medicine (EBM) to all first-year medical residents in different disciplines at Shiraz Medical School in Iran country using the TBL instructional strategy. The sample included 86 medical residents at Shiraz Medical School. This study had a quasi-experimental design and was conducted in 12 sessions of evidence-based medicine (EBM) based on team-based learning (TBL) strategy. The obtained data were analyzed using SPSS software. In all sections, the results of Individual Readiness Assurance Tests (IRATs) and Group Readiness Assurance Tests (GRATs) were added and calculated. Cronbach's alpha test was implemented to evaluate the reliability of the questionnaires. For the descriptive analysis of data, descriptive statistics were used. ANOVA and T-test were used for analytic analysis. There was a significant difference in answering the questions between individual (3.73 ± 2.33) and group (4.71 ± 2.29) stages. Residents gained higher average grades on working in the team (P-value < 0.02). Results of residents' response about satisfaction questionnaire are shown that the best scores belong to group activities in TBL. The results of this study showed that TBL could be used as an effective method for residents' education in different disciplines. [ABSTRACT FROM AUTHOR]

Background: Burnout may be defined as physical and emotional exhaustion due to stress from work under demanding conditions. It is a grave problem in physicians; its significance can be estimated by the fact that around 25% to 60% practicing physicians are affected by burnout worldwide. Objective: The objective of this study is to determine the frequency of burnout in medical residents of a tertiary care hospital in Karachi and its relationship with income and family type. Methodology: This was a descriptive, cross-sectional study in which questionnaires were distributed to 425residents in Medicine and Surgery wards of tertiary care hospitals of Karachi. The Maslach Burnout Inventory (MBI), a series of demographic questions, salary and family type were asked in the questionnaire. Results: Total 77.6% residents were found to be burnout. High and moderate level burnout was more common in female residents (33.4% and 18.5%) than males (28.7% and 15.6%) with odd ratio 0.7 in both groups. The majority of residents with monthly income less than fifty-five thousand reported of high burnout levels. Burnout in residents living alone (86.3%) was more frequent than residents living with joint family (67.2%). Conclusion: There was an inverse relationship between amount of monthly income and degree of burnout. Residents living with nuclear background were found to be more depressed than residents living in joint families. [ABSTRACT FROM AUTHOR]

Previous empirical studies examining the impact medical residents have on hospital productivity have made a priori assumptions about whether medical residents are inputs (labour providing patient care) or outputs (students receiving mandatory training under the supervision of an attending physician) when specifying their estimating equations. We shed light on the role medical residents play in hospital production by using a data-driven parametric approach based on the directional technology distance function. Our primary goal is to assess the extent to which one of the two roles of medical residents empirically dominates the other and to see whether the role varies across different types of hospital. Using the American Hospital Association data from 1994 to 2010, we find that residents are inputs in all rural and public non-teaching hospitals, but they are outputs in urban-area not-for-profit teaching hospitals. We also demonstrate that the status of residents is related to the case-mix index and can vary with hospital size. [ABSTRACT FROM AUTHOR]

Radiation Oncology Milestones 1.0 was developed in 2011 using the Accreditation Council of Graduate Medical Education's (ACGME) 6 core competencies to standardize the competency-based assessment of radiation oncology medical residents conducted by Clinical Competency Committees biannually. Critiques of Milestones 1.0 included the lack of clear progression between levels of the subcompetencies, and the complex language made it difficult to interpret by residents and faculty. The development of Milestones 2.0 aimed to simplify the language, clarify the expected progression of residents' competence, and provide supplemental resources for implementation. The ACGME assembled a 9-member working group (academic radiation oncologists, residents, community members) to compose Milestones 2.0 for Radiation Oncology using a modified Delphi method consisting of multiple asynchronous small-group meetings interspersed with four web-based whole-group meetings until consensus was reached for each competency. Milestones 2.0 replaced disease-specific Patient Care subcompetencies (e.g., Lymphoma, Genitourinary) with those that emphasize the care delivery pathway (e.g., Consult, Simulation, Contouring and Target Delineation, Treatment Planning and Plan Evaluation, Treatment Delivery, Follow-up), restructured the Medical Knowledge competency, revised all subcompetency descriptions to chart a clear progression between levels, removed research from level 5 criteria, and provided a supplemental guide to aid implementation. Patient Care subcompetencies in Milestones 1.0 limited direct assessment of residents to specific rotations while revised subcompetencies in Milestones 2.0 can be assessed on every rotation. Level 5 in each subcompetency now reflects skills exhibited by the top 10% of residents and includes items such as "leads the multidisciplinary care team" under Consult. Previously, Medical Knowledge was an assessment of Medical Physics and Radiation/Cancer Biology. This has been modified to include Applied Sciences and Evidence-Based Foundations of Radiation Oncology with specific constructs to guide assessment. The supplemental guide gives real-life examples for each level within the subcompetencies to promote consistency in the implementation of Milestones 2.0 across residencies. The guide is designed as a living document to be tailored by programs to align with individual practices and allow for a shared mental model for faculty expectations. Milestones 2.0 builds on the foundation laid by Milestones 1.0 by aligning subcompetencies with clinical practice and represents a comprehensive approach to assessing core competencies necessary to succeed as a competent clinical radiation oncologist. The new framework will be put into practice in July 2022. Real-time feedback and additions to the supplemental guide will continue to refine and improve assessment of radiation oncology residents' clinical competence. [ABSTRACT FROM AUTHOR]

Οι ειδικευόμενοι ιατροί βιώνουν υψηλότερα ποσοστά κατάθλιψης από τον γενικό πληθυσμό. Σκοπός του παρόντος άρθρου ήταν η μελέτη του επιπολασμού καταθλιπτικών συμπτωμάτων σε ειδικευόμενους εν μέσω της οικονομικής ύφεσης, η οποία διεξήχθη κατά το χρονικό διάστημα Μαΐου-Ιουλίου του 2016 σε ειδικευόμενους 3 τριτοβάθμιων νο- σοκομείων της Αθήνας. Καταγράφηκαν δημογραφικά στοιχεία και δεδομένα σχετικά με τον δείκτη μάζας σώματος, το κάπνισμα, την κατανάλωση οινοπνεύματος, τον ύπνο, την ειδικότητα και την ικανοποίηση από την εκπαίδευση, την κατάσταση υγείας, τα χρόνια προβλήματα υγείας, τον πόνο και τη χρήση φαρμάκων. Τα καταθλιπτικά συμπτώ- ματα αξιολογήθηκαν χρησιμοποιώντας το ερωτηματολόγιο υγείας ασθενούς (PHQ-9). Από τους 135 ειδικευόμενους που προσεγγίστηκαν, 128 συμμετείχαν στην έρευνα. Η μέση ηλικία ήταν 32,5±4,5 έτη, 61 ήταν άνδρες και 67 γυναί- κες. Σε ποσοστό 59,2% αναφέρθηκαν καταθλιπτικά συμπτώματα. Όταν χρησιμοποιήθηκε το όριο ≥10, που έχει υψη- λή ευαισθησία και ειδικότητα για τη διάγνωση μείζονος καταθλιπτικής διαταραχής, τότε ο επιπολασμός ήταν 29,5%. Η χειρότερη κατάσταση υγείας, η παρουσία χρόνιων προβλημάτων υγείας, ο σωματικός πόνος κατά τη διάρκεια των τελευταίων 4 εβδομάδων και η χαμηλότερη σωματική δραστηριότητα ήταν πιο συχνά σε ειδικευόμενους με κατά- θλιψη. Συμπερασματικά, ο επιπολασμός κατάθλιψης σε ένα δείγμα Ελλήνων ειδικευόμενων ήταν εξαιρετικά υψηλός (29,5%). Η ελληνική ιατρική κοινότητα πρέπει να εφαρμόσει παρεμβάσεις που θα συνδράμουν στη μείωση της κατά- θλιψης μεταξύ των ειδικευόμενων ιατρών. [ABSTRACT FROM AUTHOR]

Burnout is highly prevalent in medical residents. In order to prevent or reduce burnout in medical residents, we should gain a better understanding of contributing and protective factors of burnout. Therefore we examined the associations of job demands and resources, home demands and resources, and work-home interferences with burnout in male and female medical residents. This study was conducted on a nation-wide sample of medical residents. In 2005, all Dutch medical residents (n = 5245) received a self-report questionnaire on burnout, job and home demands and resources and work-home interference. Path analysis was used to examine the associations between job and home characteristics and work-home interference and burnout in both males and females. In total, 2115 (41.1 %) residents completed the questionnaire. In both sexes emotional demands at work and the interference between work and home were important contributors to burnout, especially when work interferes with home life. Opportunities for job development appeared to be an important protective factor. Other contributing and protective factors were different for male and female residents. In females, social support from family or partner seemed protective against burnout. In males, social support from colleagues and participation in decision-making at work seemed important. Effectively handling emotional demands at work, dealing with the interference between work and home, and having opportunities for job development are the most essential factors which should be addressed. However it is important to take gender differences into consideration when implementing preventive or therapeutic interventions for burnout in medical residents. [ABSTRACT FROM AUTHOR]

Introduction: Work engagement is important for medical residents and the healthcare organizations they work for. However, relatively little is known about the specific predictors of work engagement in medical residents. Therefore, we examined the associations of work and home characteristics, and work-home interference with work engagement in male and female residents. Methods: This study was conducted on a nationwide sample of medical residents. In 2005, all Dutch medical residents ( n = 5245) received a self-report questionnaire. Path analysis was used to examine the associations between the potential predictors and work engagement. Results: In total, 2115 (41.1%) residents completed the questionnaire. Job characteristics, home characteristics and work-home interference were associated with work engagement. Important positive contributing factors of work engagement were opportunities for job development, mental demands at work, positive work-home interference and positive home-work interference. Important negative contributing factors were emotional demands at work and negative home-work interference. The influence of these factors on work engagement was similar in male and female residents. Discussion: Opportunities for job development and having challenging work are of high relevance in enhancing work engagement. Furthermore, interventions that teach how to deal skilfully with emotional demands at work and home-work interference are expected to be the most effective interventions to enhance work engagement in medical residents. [ABSTRACT FROM AUTHOR]

Objectives: The adequacy of laboratory test orders by medical residents is a longstanding issue. The aim of this study is to analyze the number, types, and pattern of repetition of tests ordered by medical residents.Methods: We studied all tests ordered over a 1-year period for inpatients of an internal medicine ward in a university hospital. Types, results, and repetition pattern of tests were analyzed in relation to patients' diagnoses.Results: We evaluated 117,666 tests, requested for 1,024 inpatients. The mean number of tests was 9.5 per day. The test repetition pattern was similar, regardless of patients' diagnoses, previous test results, or duration of stay. The probability of an abnormal result after a sequence of three normal tests was lower than 25%, regardless of the diagnosis.Conclusions: Number of tests and repetition were both high, imposing costs, discomfort, and risks to patients, thus warranting further investigation. [ABSTRACT FROM AUTHOR]