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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]

Materials and methods: An observational prospective and transverse study was performed in residents of the internal medicine program at the INCMNSZ. The questionnaire included 21 items that allowed the evaluation and categorization of the following aspects related to the delivery of bad news: previous information, first experience, emotional impact, accordance with basic concepts, communication with the patient, self-critical evaluation, personal experience, and willingness to receive training. Results: Fifty-six percent of the surveyed residents had never received information or training in bad news delivery; and only 8.0% communicated that they had received in their judgment an adequate or complete training, for the most part during medical school. Of the surveyed residents 96% considered that patients should know their diagnosis and prognosis; however, only 38.0% of residents referred having queried patients the extent to which they wished to know their prognosis. The majority reported disclosing the diagnosis directly to the patient; only 8% considered it correct to solely inform the responsible family member. Fifty-six percent of surveyed residents consider their capacity to deliver bad news as poor to regular. Of the surveyed residents 100% reported that they would like to be informed in case of terminal disease. Only 58.0% of surveyed residents have had an experience in receiving bad news and it had a positive impact on the majority of them. Eighty-percent of surveyed residents admitted that they needed training in this topic. Conclusions: As in other countries, this survey shows how training in bad news disclosure in Mexico is scarce among specialists. [ABSTRACT FROM AUTHOR]

Background: The evaluation of clinical competence in medical residents is a complex procedure. Teachers need reliable and valid instruments to evaluate objectively the, clinical competence. The aim of this study was to determine the reliability and validity of an instrument designed to evaluate the clinical competence of medical residents., Methods: We designed an instrument taking into consideration every part of the clinical method, and three different levels of competence were determined for each one. The instrument was examined with regards to the clarity, pertinence and sufficiency of each clinical indicator by five expert pediatricians. The instrument was finally constituted by 11 indicators. Each resident was evaluated independently by three pediatricians., Results: A total of 651 measurements were done in 234 residents. The instrument distinguished between extreme groups, had a value of Cronbach's alpha of 0.778 and the factorial analysis set apart two factors: clinical competence and complementary competences. No statistical differences were found between evaluators neither in global evaluation or in each indicator., Conclusions: The instrument here proposed is valid and reliable. It may be used in formative evaluation of medical residents in clinical specialization programs.