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Background: Delirium is a common condition in hospitals, particularly among older people. This refers to a dramatic decline in mental capabilities, which is marked by diminished concentration and consciousness. Aim: The purpose of this study was to assess the views, knowledge, and behavior of non-consultant hospital doctors in managing delirium in a large Irish hospital. Methods: Questionnaires were administered to 28 healthcare professionals from various departments according to Davis and MacLullich (Age Ageing 38(5):559–563, 2009). It was conducted between July and September 2023, with an emphasis on determining the prevalence rate, diagnostic criteria, and management strategies for delirium. Results: The study established that the majority of respondents recognized the importance of delirium, but there appears to be a gap in the practical management of this clinical syndrome. Although many doctors agreed that delirium was significant, most lacked confidence in its diagnosis and management. The use of standardized assessment tools, such as the 4AT, was limited. Conclusions: This study highlights the disparity between what is known and practiced by hospital doctors regarding delirium care. This implies increased training for delirium management with frequent use of assessment tools and ongoing education aimed at enhancing patient outcomes in cases of delirium. [ABSTRACT FROM AUTHOR]

Background: Medical Foundation Year (FY) doctors demonstrate greater psychological distress compared with the general population and other student groups. This feasibility study investigated FY doctors' perceptions of mindfulness and the impact of a mindful resilience and effectiveness training (MRET) programme on stress, wellbeing, and performance. Methods: Mixed-methods study utilising a questionnaire (study 1, N = 144) and a pre-post analysis design of MRET programme (study 2, N = 13), along with focus groups (N = 7). Results: In study 1 28.5% of FY's reported using mindfulness. All five mindfulness facets were significantly, and positively, associated with mental wellbeing (p < 0.05). Acting with awareness (AA) and non-reactivity (NR) were significantly, positively associated with a challenge responses to stress (p < 0.05). Threat and loss appraisals were negatively associated with AA, NR, and non-judging (p < 0.01). Perceived productivity was positively associated with mindfulness facets: describing, AA, and NR (p < 0.001). In study 2, there were significant increases in wellbeing and mindfulness facets observing, describing, AA, and NR, and threat appraisals decreased (p < 0.05). The main themes identified across the focus group included Reframed Mindset, Values-Based Action, Embodied Leadership and Pedagogy. Conclusions: There exists a relationship between mindfulness, psychological wellbeing, and performance in FYs. The MRET prorgamme improved psychological wellbeing and reduced threat appraisals. Future work could focus resources on enhancing the skills of AA and NR, as this may be sufficient to bring about meaningful improvements in wellbeing, percieved productivity and cognitive reappraisal of stressful life events. [ABSTRACT FROM AUTHOR]

Introduction: Radiological imaging has played an important role in diagnostic medicine for over a century, though it is known to contribute to dermatological conditions, cataracts, and cancer. The associated risk of harm has led to the introduction of protective regulations around the world. Present-day NHS clinicians are increasingly requesting and relying on diagnostic imaging. Knowledge surrounding the radiation doses of common radiological investigations and the associated risks is imperative, and on a global level has been found to be inadequate. Consequently, there is a need for the formal inclusion of teaching within training programmes. Aims/objectives: This prospective audit aims to establish the knowledge of radiation doses and risks of common radiological investigations of both medical students and referrers within four NHS Health Boards based in the North of Scotland. It also seeks to establish prior teaching and the preference for further educational interventions. Audit standard: Referrers should have adequate knowledge of radiation doses and the risks associated with common radiological investigations. Audit target: The standard should be achieved by 90% of referrers. Methods: A 19-question online survey was devised to include subjective and objective questions on ionising radiation awareness, education preference, and respondent demographics, based on RCR (Royal College of Radiologists) audit criteria and previous studies. Data collection was conducted between the 22/02/23 to the 22/03/2023 and the questionnaire was distributed to senior medical students and radiological referrers of different grades within NHS Grampian, NHS Highland, NHS Shetland, and NHS Orkney. A descriptive analysis of the data was undertaken using Microsoft Excel Version 16.71. Results: Two hundred eight questionnaires were completed. 22.11% (n = 46) of the sample population had received no prior teaching on the topic of ionising radiation. Over half of the respondents (51.92%, n = 108) rated the importance of radiation risks as either important or extremely important, with 69.71% (n = 145) of participants rating their perceived knowledge as limited or average. Most correctly identified that a CT scan (n = 203), PET-CT scan (n = 199) and a chest x-ray (n = 196) exposed patients to ionising radiation. A small proportion of the participants incorrectly thought that an MRI scan (n = 21) and an ultrasound scan (n = 2) involved ionising radiation. The results obtained failed to meet the RCR audit target, which states that 90% of doctors should be aware of common radiological doses. It was observed that only 17.79% (n = 37) of survey respondents scored over 50% in the knowledge assessment, with the median knowledge score of the whole cohort being 2.5 out of 9 (27.78%). Respondents who had prior teaching on the topic performed better those who had no prior teaching, with average scores of 3.19 (35.44%) and 2.04 (22.67%) respectively. Senior clinicians performed better when compared to junior clinicians and medical students. Conclusion & future recommendations: This audit found that the knowledge of radiation risks within the North of Scotland in the selected sample population was insufficient across all levels of the clinical team. Further, continuous education around the topic and future audit opportunities may help to optimise knowledge and training. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate e-portfolios for undergraduate medical students in the subject of Pediatrics. Methods: A descriptive study was conducted among the second year medical undergraduate students. A core committee validated the e-portfolio created on the Google platform. The students were sensitized, trained on the platform, and encouraged to innovate by designing the e-portfolios themselves, and record their clinical experiences under the mentorship of faculty. The feedback was collected using a validated student and faculty questionnaire with closed and open ended questions. Satisfaction index was calculated based on the responses to closed ended questions using Likert scale. Open ended questions were analyzed using thematic approach. Results: The study enrolled 34 students and 12 faculty members. Students recorded a high satisfaction index on their experience to be interesting (97%), well structured (85%), user-friendly (82%), and on being able to archive their clinical experiences (100%). Faculty members recorded a high satisfaction index (100%) in students' ability to record their clinical knowledge and reflect on their learning and innovation; all were motivated to use e-portfolios in their specialty. The thematic analysis highlighted student satisfaction with accessibility and organized record-keeping, while faculty praised e-portfolios for nurturing creativity and aiding memory retention. Concerns included resource intensiveness, design prioritization, and privacy issues. Conclusion: E-portfolios are rated as promising tools to record comprehensive clinical experience in pediatric by undergraduate students and faculty. Addressing identified challenges will further optimize their adoption in medical curricula, facilitating informed integration decisions. [ABSTRACT FROM AUTHOR]

Background: In medical education, new technologies like Virtual Reality (VR) are increasingly integrated to enhance digital learning. Originally used to train surgical procedures, now use cases also cover emergency scenarios and non-technical skills like clinical decision-making. This scoping review aims to provide an overview of VR in medical education, including requirements, advantages, disadvantages, as well as evaluation methods and respective study results to establish a foundation for future VR integration into medical curricula. Methods: This review follows the updated JBI methodology for scoping reviews and adheres to the respective PRISMA extension. We included reviews in English or German language from 2012 to March 2022 that examine the use of VR in education for medical and nursing students, registered nurses, and qualified physicians. Data extraction focused on medical specialties, subjects, curricula, technical/didactic requirements, evaluation methods and study outcomes as well as advantages and disadvantages of VR. Results: A total of 763 records were identified. After eligibility assessment, 69 studies were included. Nearly half of them were published between 2021 and 2022, predominantly from high-income countries. Most reviews focused on surgical training in laparoscopic and minimally invasive procedures (43.5%) and included studies with qualified physicians as participants (43.5%). Technical, didactic and organisational requirements were highlighted and evaluations covering performance time and quality, skills acquisition and validity, often showed positive outcomes. Accessibility, repeatability, cost-effectiveness, and improved skill development were reported as advantages, while financial challenges, technical limitations, lack of scientific evidence, and potential user discomfort were cited as disadvantages. Discussion: Despite a high potential of VR in medical education, there are mandatory requirements for its integration into medical curricula addressing challenges related to finances, technical limitations, and didactic aspects. The reported lack of standardised and validated guidelines for evaluating VR training must be overcome to enable high-quality evidence for VR usage in medical education. Interdisciplinary teams of software developers, AI experts, designers, medical didactics experts and end users are required to design useful VR courses. Technical issues and compromised realism can be mitigated by further technological advancements. [ABSTRACT FROM AUTHOR]

As technological advancements continue to redefine the landscape of adult education and training, virtual reality (VR) has emerged as a potent tool for enhancing skill acquisition. This literature review synthesizes existing research on the utilization of immersive and discrete VR in training adults in the medical domain. The primary focus was on understanding the effectiveness, challenges, and potential applications of VR-based training programs. Specifically, we reviewed studies related to practical skills critical to safety that target a non-surgical, discrete medical procedure (e.g., diabetes care procedures, how to correctly set a G-tube, CPR, correct personal protective equipment [PPE] usage) using an immersive VR technology as a training modality. Further, the studies reviewed had to include a comparison of immersive VR training to that of a business-as-usual (BAU) method. We conducted a review of the six studies that met the criteria and coded variables related to what technology was used, targeted skills being trained, social validity, effectiveness of the intervention, and whether generalization occurred. Key themes explored in the literature include the role of immersive experiences in enhancing learning outcomes when comparing VR training to BAU and the adaptability of VR platforms to different skill sets. Special attention was given to identifying factors that contribute to the success or limitation of VR-based training initiatives, including individual differences, technology acceptance, and effectiveness. [ABSTRACT FROM AUTHOR]

Medical careers increase infertility risks and pregnancy complications. Residents often postpone pregnancy, contributing to these risks. Limited data exist regarding residents' family planning concerns. This study aims to evaluate fertility concerns and family planning during residency via a survey of residents and attending physicians. Anonymous online surveys were distributed to all residents (n = 1030) and attending physicians (n = 1111) at a large, urban, single-campus academic hospital center. Data analysis was performed using chi-square analysis with significance at P < 0.05. Two hundred nine residents and 111 attendings submitted responses. Most respondents were female (74.7%). Slightly more than one-quarter of respondents were from a surgical specialty (26.6%). Residents compared to attending physicians indicated a higher concern for infertility during (57.4% versus 38.3%, P = 0.006) and after residency (68.9% versus 51.9%, P = 0.011) and a greater concern about pregnancy complications (67.8% versus 38.0%, P < 0.001). Most respondents felt pregnancy could negatively affect their training (67.3%). Surgical respondents were more concerned about the negative effects on colleagues (68.8% versus 51.1%, P = 0.045). Residents considered oocyte preservation more (57.9% versus 20.3%, P < 0.001). Respondents in surgical specialties had more concerns for fertility after residency (72.6% versus 57.9%, P = 0.033). Those in surgical fields trended for consideration of oocyte preservation (53.4% versus 39.7%, P = 0.084). Most respondents reported a need for education on oocyte preservation during residency (94.5%). Residents have increasing concerns about fertility and family planning related to their training. In addition to more institutional and residency program support, residents desire dedicated fertility and family planning education, such as oocyte preservation, as part of their curriculum. • There are increasing fertility and family planning concerns among medical trainees. • Residents think that fertility preservation education should be included in their curriculum. • Residents want residency programs to provide information on their fertility and family planning benefits. [ABSTRACT FROM AUTHOR]

Our aim is to relate the linguistic features, the linguistic-discursive quality, the disciplinary evaluation and the perception of self-efficacy in writing of the genre Clinical History. In this correlational study, a corpus of 52 Clinical produced by medical students from a Chilean university. The participants answered a self-efficacy perception questionnaire. For disciplinary evaluation, the grades given to the text given by doctors-teachers was considered. For the analysis of linguistic-discursive quality, a specific instrument was designed and validated (Rubric for Evaluating the Linguistic-Discursive Quality of Disciplinary Texts in Medicine). The results show statistically significant correlations between the evaluation carried out by the doctors and the linguistic-discursive quality. The perception of self-efficacy is not correlated with any of these variables. The research represents an important advance in the description of the Medical History as a genre from a multidimensional and a interdisciplinary perspective. [ABSTRACT FROM AUTHOR]

Purpose: Maintaining a robust healthcare workforce in underserved rural communities continues to be a challenge. To better meet healthcare needs in rural areas, training programs must develop innovative ways to foster transition to, and integration into, these communities. Mountain Area Health Education Center designed and implemented a 12-month post-residency Rural Fellowship program to enhance placement, transition, and retention in rural North Carolina. Utilizing a '6 Ps' framework, the program targeted physicians and pharmacists completing residency with the purpose of recruiting and supporting their transition into the first year of rural practice. Method: To better understand Rural Fellows' experiences and the immediate impact of their Fellowship year, we conducted a semi-structured interview using a narrative technique and evaluated retention rates over time. Interviews with the eight participants, which included Fellowship alumni and current Fellows, demonstrated the impact and influence of the key curricular '6 Ps' framework. Results: An early retention rate of 100% and a long-term retention rate of 87%, combined with expressed clarity of curricular knowledge, skills, and attitudes related to the '6 Ps', demonstrate the potential and effectiveness of this Rural Fellowship model. Participants indicated the Rural Fellowship experience supports the transition to rural practice communities and expands their clinical skills. Conclusion: The Rural Fellowship program demonstrates an effective model to support early career healthcare providers as they begin practice in rural communities in western North Carolina through academic opportunities, personal growth, and professional development. Implementation of this model has demonstrated the success of a rural retention model over a 6-year period. This model has the potential to target an array of clinical providers and disciplines. We started with family medicine and have expanded to psychiatry, obstetrics, pharmacy, and nursing. This study demonstrated that this model supports clinical providers during the critical transition period from residency to practice. Targeting the most important stage of one's medical training, the commencement of professional practice, this is a scalable model for other rural-based health professions education sites where rural recruitment and retention remain a problem.

Dima Tareq Al Absi,1 Khadija Yousuf,2 Kholoud Aljaberi,2 Rahma AlBreiki,2 Mecit Can Emre Simsekler,1 Mohammed Atif Omar,1 Sanjay Ayathan,2 Tahir Mehmood,2 Siddiq Anwar,2,3 Deanne T Kashiwagi2 1Department of Management Science and Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates; 2Department of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates; 3College of Medicine and Health Science of Medicine, Khalifa University of Science and Technology, Abu Dhabi, United Arab EmiratesCorrespondence: Siddiq Anwar, Department of Medicine, Sheikh Shakhbout Medical City, P.O. Box 11001, Abu Dhabi, United Arab Emirates, Tel +971 2 314 2760, Fax +971 2 314 4446, Email sanwar@ssmc.aeBackground: Research has increasingly become important to career progression and a compulsory component in most medical programs. While medical trainees are consistently urged to undertake research endeavors, they frequently encounter obstacles at both personal and organizational levels that impede the pursuit of high-quality research. This study aims to identify the barriers and recommend successful interventions to increase research productivity amongst medical trainees.Methods: A descriptive cross-sectional survey was carried out among interns, residents, and fellows within a single hospital located in the emirate of Abu Dhabi, UAE. The survey included inquiries regarding perceived obstacles hindering engagement in research activities, factors driving motivation for research involvement, and the assessment of how research participation relates to their job in terms of relevance.Results: Fifty-seven medical trainees participated in the survey, reflecting a response rate of 53%. The survey highlighted common obstacles, notably including time constraints, insufficient statistical and methodology training, the weight of other educational commitments, as well as inadequate incentives and rewards. While a majority of participants expressed interest in engaging in research activities, the consensus was that more incentives and increased funding opportunities would significantly encourage their involvement.Conclusion: Implementing successful interventions such as allocating dedicated time for research, facilitating access to research mentors, and organizing training sessions have the potential to be effective strategies in fostering a thriving research culture and subsequently elevating research productivity of medical trainees.Keywords: medical research, residents, medical trainees, medical training, future of work, medical education

The transition between medical students and junior doctors is known to be a notoriously challenging period of time, contributed by heavy clinical responsibilities, steep learning curves, poor working conditions and various psychological stressors. In addition, there is often a significant lack of support at the organisational or health systems level for fledgling junior physicians in their transition to work life. In this article, I hope to offer several important guiding principles from the perspectives of a medical resident-in-training that I hope will be useful for graduating medical students to ease their transition into the foundational year of practice, such that they can optimise their training and work experience within what is in their control and maintain a sense of purpose even in difficult times. [ABSTRACT FROM AUTHOR]

Copyright of RED - Revista de Educación a Distancia is the property of Universidad de Murcia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Virtual reality (VR) has revolutionized the healthcare sector by introducing new methods of diagnosis, treatment, and medical training. This article presents a comprehensive analysis of VR applications in healthcare, exploring its advantages, challenges, and impacts. The review includes case studies and relevant literature, highlighting areas such as rehabilitation, surgical training, and exposure therapies. The results indicate that VR can enhance the effectiveness of treatments and the quality of medical training, offering immersive experiences that benefit both patients and healthcare professionals. Despite the promising advantages, challenges such as cost and specialized training remain. Future research should focus on developing more accessible solutions and expanding VR applications in medicine to ensure broader patient access to this revolutionary technology. [ABSTRACT FROM AUTHOR]

Pulsed-wave Doppler ultrasound is a widely used technique for monitoring pregnancies. As ultrasound equipment becomes more advanced, it becomes harder to train practitioners to be proficient in the procedure as it requires the presence of an expert, access to high-tech equipment as well as several volunteering patients. Immersive environments such as mixed reality can help trainees in this regard due to their capabilities to simulate real environments and objects. In this article, we propose a mixed reality application to facilitate training in performing pulsed-wave Doppler ultrasound when acquiring a spectrogram to measure blood velocity in the umbilical cord. The application simulates Doppler spectrograms while the trainee has the possibility of adjusting parameters such as pulse repetition frequency, sampling depth, and beam-to-flow angle. This is done using a combination of an optimized user interface, 3D-printed objects tracked using image recognition and data acquisition from a gyroscope. The application was developed for Microsoft HoloLens as the archetype of mixed reality, while a 3D-printed abdomen was used to simulate a patient. The application aims to aid in both simulated and real-life ultrasound procedures. Expert feedback and user-testing results were collected to validate the purpose and use of the designed application. Design science research was followed to propose the intended application while contributing to the literature on leveraging immersive environments for medical training and practice. Based on the results of the study, it was concluded that mixed reality can be efficiently used in ultrasound training. [ABSTRACT FROM AUTHOR]

Ultrasound is widely employed in medical examinations due to its noninvasive, radiation‐free, and convenient features. However, the quality of acquired ultrasound images is highly dependent on the skill of the operator and experience, which significantly limits the use of ultrasound. In this study, we propose a new user interface (UI) designed to assist novices in independently acquiring accurate ultrasound images. The operator can complete image acquisition by adjusting the position and angle of the actual probe to align the projected probe on the UI screen to a specific position, while simultaneously observing the breath state of the subject to capture ultrasound images at the appropriate position and moment. We compare our UI with a previous UI in an experiment. The results demonstrate that novice operators can acquire more accurate ultrasound images using our UI compared to the previous UI, indicating that our UI offers improved guidance. Regarding breath state observation, the experiment reveals a strong association between changes in lung air volume of a subject and respiratory level changes measured by our system. © 2024 Institute of Electrical Engineers of Japan. Published by Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Enhancing healthcare professionals' education and training to effectively manage the healthcare needs of People Identifying as Lesbian, Gay, Bisexual, Transgender, Queer, and other Sexual and Gender Minorities (LGBTQ+) is imperative. Recognizing the importance of mitigating LGBTQ+ health disparities, healthcare associations have affirmed their commitment to providing inclusive and culturally competent healthcare. However, despite these efforts, there is still a gap in LGBTQ+-specific teaching within nursing and other healthcare professionals' schools, resulting in healthcare professionals being ill-equipped to meet the unique needs of LGBTQ+. To address this gap, we suggest integrating LGBTQ+ health content into healthcare training programs, focusing on the Philippine nursing curriculum. Drawing from various reports, including insights from discussions with the local LGBTQ+, the suggested topics include LGBTQ+ identities, sexual health, trans health, mental health, and social determinants of LGBTQ+ health. By fostering understanding and competence through education, equitable and inclusive healthcare practices for LGBTQ+ can be better cultivated, helping to ensure that the unique healthcare needs of LGBTQ+ are met effectively. Furthermore, it is necessary to share best practices for providing health services to LGBTQ+ people. Additionally, future studies can explore the median time allocated to LGBTQ+ teaching, the optimal number of teaching hours for LGBTQ+ content, and the specific contents of local nursing curricula that can better address their needs. By undertaking these steps, we can move toward effectively addressing the unique healthcare needs of LGBTQ+. [ABSTRACT FROM AUTHOR]

Copyright of Cuadernos Médico Sociales is the property of Colegio Medico de Chile (A.G.) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cuadernos Médico Sociales is the property of Colegio Medico de Chile (A.G.) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Lege Artis Medicine (LAM) is the property of LifeTime Media Kft. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Research has increasingly become important to career progression and a compulsory component in most medical programs. While medical trainees are consistently urged to undertake research endeavors, they frequently encounter obstacles at both personal and organizational levels that impede the pursuit of high-quality research. This study aims to identify the barriers and recommend successful interventions to increase research productivity amongst medical trainees. Methods: A descriptive cross-sectional survey was carried out among interns, residents, and fellows within a single hospital located in the emirate of Abu Dhabi, UAE. The survey included inquiries regarding perceived obstacles hindering engagement in research activities, factors driving motivation for research involvement, and the assessment of how research participation relates to their job in terms of relevance. Results: Fifty-seven medical trainees participated in the survey, reflecting a response rate of 53%. The survey highlighted common obstacles, notably including time constraints, insufficient statistical and methodology training, the weight of other educational commitments, as well as inadequate incentives and rewards. While a majority of participants expressed interest in engaging in research activities, the consensus was that more incentives and increased funding opportunities would significantly encourage their involvement. Conclusion: Implementing successful interventions such as allocating dedicated time for research, facilitating access to research mentors, and organizing training sessions have the potential to be effective strategies in fostering a thriving research culture and subsequently elevating research productivity of medical trainees. [ABSTRACT FROM AUTHOR]

ObjectivesA cumulative imbalance between rheumatologic need and an inadequate number of young colleagues entering the field leads to a dearth of rheumatologists in the near future. The Austrian Society for Rheumatology and Rehabilitation (ÖGR) has been organizing an annual Rheumatology Summer School (RSS) for medical students since 2017. The aim of this study was to analyze the annual RSS evaluations, the RSS’ overall effects on attracting new talent into the field and the lasting promotion of rheumatology.MethodsA questionnaire was distributed immediately after each RSS meeting. Additionally, we conducted an electronic survey among RSS participants (2017–2022) to assess their career development trajectories.ResultsFrom 2017–2023, a total of 220 students attended the RSS. They all completed the annual evaluation. Accordingly, students’ expectations were met in 80% (2017) to 97% (2023) of cases. The electronic survey was completed by 64/133 (48%) students; 49 (77%) indicated that the RSS had markedly increased their desire to specialize in rheumatology. Among the 36 graduates, 10 (28%) had already been working in the field of rheumatology and 6 (17%) were considering this specialty but had not decided yet. RSS attendees in their 6th study year were influenced to a greater extent by the RSS to choose rheumatology as their primary specialty than 4th or 5th year students. The participants indicated that they benefited most from the RSS in terms of knowledge gain, personal awareness of rheumatology, networking among fellow students as well as gaining access to RSS faculty.ConclusionThe RSS enhanced students’ intention to choose rheumatology, particularly in those close to graduation, and led to increased awareness and deeper knowledge about rheumatology.

Note from the Editors: This article by Drs. Borroto Cruz and Salas Perea was published in the Fall 2008 edition of MEDICC Review. We will be publishing a Spanish translation this month in Medicina Social. We present here the abstract of the article. We encourage readers to read the English original which is available at: www.medicc.org/mediccreview/. The issue is entitled: Teaching for Health Equity: Changing Paradigms of Medical Education. National Training Program for Comprehensive Community Physicians, Venezuela Introduction: Through the 1990s, wide disparities in health status were recorded in Venezuela, a mirror of poor social conditions, decreasing investment in the public health sector and a health workforce distribution unable to meet population health needs or to staff effective, accessible public health services. Venezuelans’ health status deteriorated as a result. In 2003-2004, the Venezuelan government launched Barrio Adentro, a new national public health model aimed at assuring primary health care coverage for the entire population of an estimated 26 million. Cuban physicians staff Barrio Adentro clinics, mainly in poor neighborhoods, until enough Venezuelan physicians can be trained to fill the posts. Intervention: Cuban experience with community-oriented medical education and global health cooperation was drawn upon to develop curriculum and provide faculty for the new National Training Program for Comprehensive Community Physicians, begun in 2005 in cooperation with six Venezuelan universities. The program differs from previous Venezuelan medical education models by adopting a stated goal of training physicians for public service, recruiting students who had no previous opportunity for university-level education, and concentrating the weight of their training on a service- and community-based model of education, relying on practicing physician-tutors. Results: Over 20,000 students have been enrolled in three years. The six-year program has been extended to all 24 Venezuelan states, relying mainly on Cuban faculty who are practicing Barrio Adentro doctors and who receive postgraduate training in medical education. This “university without walls” has accredited 5,131 Barrio Adentro clinics as teaching institutions; its infrastructure includes other health care delivery facilities plus 855 multipurpose classrooms throughout the country. For the 2006-2007 academic year, the pass rate was 82% for first-year students and 94% for second-year students. Some difficulties persist in student selection, pre-medical preparation, and achieving optimum use of existing resources. Academic, institutional, and external evaluations are ongoing. Conclusion: This is the most ambitious example of scaling up of physician training in a single country. The program has been made possible by considerable political will from the Venezuelan and Cuban governments; by the experience acquired through development of the Cuban health system and medical education programs; by the individual commitment of Cuban curriculum developers and physician-tutors; and by ever-more-organized Venezuelan communities. The size of the undertaking, coupled with significant innovations in curriculum, present challenges. The Venezuelan experience — emphasis on training physicians for a revitalized public health sector, accompanied by a paradigm shift in primary care — warrants attention from the international community in the context of the global shortage of health workers and efforts to achieve a more equitable distribution of health services worldwide. Keywords: medical education, human resources for health, community-based medical education, primary care, health equity, Venezuela

Planetary health is being or should be added to medical training curricula in accordance with association consensus. Several articles published in recent years have addressed concern on the implementation, and the challenges that can occur if not addressed properly. This scoping narrative literature review focuses on planetary health as a concept, as well as challenges and suggested solutions to address these challenges. Planetary health is an important concept and needs to be addressed in all medical training. We found that one main challenge is implementation without ensuring the right competences and resources. Medically trained teachers set out to understand and teach complex natural and social systems. At some institutions the time allocated to teach planetary health is limited or non-existent. Case studies and student led teaching are solutions suggested, while other argue that true interdisciplinarity by inviting experts are more in line with what we expect from other subjects. In conclusion, the roots of planetary health, the enormous health risks at stake and nature of the subject requires medical training to adopt a true inter/trans-disciplinary approach to succeed. It might not be expected for all students to become planetary health experts, but all need a general understanding of the most important aspects and values.

Objective: Non-neurosurgeons in regional and rural hospitals may be required to operate on patients presenting with a traumatic brain injury where timely transfer to a tertiary hospital is not possible. Confidence and experience can vary significantly due to limited access to hands-on training. Increasing availability to advanced 3D printed models opens new opportunities to provide accurate head models suitable for this purpose. This study evaluated the experience of regional clinicians and nurses following a neurotrauma workshop where 3D printed head models were used to provide training in burr hole and craniotomy procedures. Methods: A neurotrauma seminar and workshop was hosted at the Sunshine Coast Health Institute, in the state of Queensland, Australia. The workshop component allowed 26 local clinicians and nurses to gain hands-on experience with a 3D printed head model, guided by neurosurgeons from the closest tertiary hospital. Following training, participants completed a short survey. Results: Prior to this workshop, most participants had never performed a burr hole (58 %, n=15) or interacted with a 3D printed model (69 %, n=18). Overall, most participants indicated that the 3D printed model performed better (58 %, n=15) and much better (15 %, n=4) than their expectations. 81 % (n=21) left the workshop with improved confidence in performing burr hole and craniotomy procedures. Despite some melting of the plastic, 96 % (n=25) of participants would recommend this model to their colleagues.

As technological advancements continue to redefine the landscape of adult education and training, virtual reality (VR) has emerged as a potent tool for enhancing skill acquisition. This literature review synthesizes existing research on the utilization of immersive and discrete VR in training adults in the medical domain. The primary focus was on understanding the effectiveness, challenges, and potential applications of VR-based training programs. Specifically, we reviewed studies related to practical skills critical to safety that target a non-surgical, discrete medical procedure (e.g., diabetes care procedures, how to correctly set a G-tube, CPR, correct personal protective equipment [PPE] usage) using an immersive VR technology as a training modality. Further, the studies reviewed had to include a comparison of immersive VR training to that of a business-as-usual (BAU) method. We conducted a review of the six studies that met the criteria and coded variables related to what technology was used, targeted skills being trained, social validity, effectiveness of the intervention, and whether generalization occurred. Key themes explored in the literature include the role of immersive experiences in enhancing learning outcomes when comparing VR training to BAU and the adaptability of VR platforms to different skill sets. Special attention was given to identifying factors that contribute to the success or limitation of VR-based training initiatives, including individual differences, technology acceptance, and effectiveness.

IntroductionThe use of robotic systems in the surgical domain has become groundbreaking for patients and surgeons in the last decades. While the annual number of robotic surgical procedures continues to increase rapidly, it is essential to provide the surgeon with innovative training courses along with the standard specialization path. To this end, simulators play a fundamental role. Currently, the high cost of the leading VR simulators limits their accessibility to educational institutions. The challenge lies in balancing high-fidelity simulation with cost-effectiveness; however, few cost-effective options exist for robotic surgery training.MethodsThis paper proposes the design, development and user-centered usability study of an affordable user interface to control a surgical robot simulator. It consists of a cart equipped with two haptic interfaces, a VR visor and two pedals. The simulations were created using Unity, which offers versatility for expanding the simulator to more complex scenes. An intuitive teleoperation control of the simulated robotic instruments is achieved through a high-level control strategy.Results and DiscussionIts affordability and resemblance to real surgeon consoles make it ideal for implementing robotic surgery training programs in medical schools, enhancing accessibility to a broader audience. This is demonstrated by the results of an usability study involving expert surgeons who use surgical robots regularly, expert surgeons without robotic surgery experience, and a control group. The results of the study, which was based on a traditional Peg-board exercise and Camera Control task, demonstrate the simulator’s high usability and intuitive control across diverse user groups, including those with limited experience. This offers evidence that this affordable system is a promising solution for expanding robotic surgery training.

Abstract Background Medical internship is a key transition point in medical training from student to independent (junior) doctor. The national Regional Training Hubs (RTH) policy began across Australia in late 2017, which aims to build medical training pathways for junior doctors within a rural region and guide students, interns and trainees towards these. This study aims to explore preferencing and acceptance trends for rural medical internship positions in Queensland. Moreover, it focuses on internship preference and acceptance outcomes prior to and following the establishment of RTHs, and their association with key covariates such as rural training immersions offered by medical schools. Methods Data from all applicants to Queensland Health intern positions between 2014–2021 were available, notably their preference order and location of accepted internship position, classified as rural or metropolitan. Matched data from Queensland’s medical schools were added for rural training time and other key demographics. Analyses explored the statistical associations between these factors and preferencing or accepting rural internships, comparing pre-RTH and post-RTH cohorts. Results Domestic Queensland-trained graduates first preferencing rural intern positions increased significantly (pre-RTH 21.1% vs post-RTH 24.0%, p = 0.017), reinforced by a non-significant increase in rural acceptances (27.3% vs 29.7%, p = 0.070). Rural interns were more likely to have previously spent ≥ 11-weeks training in rural locations within medical school, be rurally based in the year applying for internship, or enrolled in the rural generalist pathway. Conclusions The introduction of the RTH was associated with a moderate increase of graduates both preferencing and accepting a rural internship, though a richer understanding of the dominant reasons for and against this remain less clear. An expansion of graduates who undertook longer periods of undergraduate rural training in the same period did not diminish the proportion choosing a rural internship, suggesting there remains an appetite for these opportunities. Overall, domestic graduates are identified as a reliable source of intern recruitment and retention to rural hospitals across Queensland, with entry to the rural generalist pathway and extended rural placement experiences enhancing uptake of rural practice.

BackgroundFirearm injury and death are significant public health problems in the U.S. and physicians are uniquely situated to help prevent them. However, there is little formal training in medical education on identifying risk for firearm injury and discussing safe firearm practices with patients. This study assesses prior education, barriers to counseling, and needs for improved training on firearm safety counseling in medical education to inform the development of future education on clinical strategies for firearm injury prevention.MethodA 2018 survey administered to 218 residents and fellows at a large, academic medical center asked about medical training on firearm injury prevention, frequency of asking patients about firearm access, and perceived barriers.ResultsThe most common barriers cited were not knowing what to do with patients' answers about access to firearms (72.1%), not having enough time (66.2%), not feeling comfortable identifying patients at-risk for firearm injury (49.2%), and not knowing how to ask patients about firearm access (48.6%). Prior education on firearm injury prevention was more strongly associated with asking than was personal exposure to firearms: 51.5% of respondents who had prior medical education reported asking compared with who had not received such education (31.8%, p=0.004). More than 90% of respondents were interested in further education about interventions, what questions to ask, and legal mechanisms to separate dangerous people from their firearms.ConclusionsEducation on assessing risk for firearm-related harm and, when indicated, counseling on safe firearm practices may increase the likelihood clinicians practice this behavior, though additional barriers exist.

Abstract Background and Aim Gastointestinal endoscopy is a complex practical skill, and training and experience are required to ensure the accuracy and safety of the procedures. Therefore, proper endoscopy training is needed to provide highly skilled endoscopists. This study explores the learning experience and assesses the need for endoscopy training in Indonesia from an endoscopy trainee's point of view. Limitations from the current training model and the trainees' suggestions hopefully will become a foundation for the future endoscopy training model in Indonesia. Methods A total of 132 current endoscopy trainees and graduates of endoscopy training from various centers in Indonesia completed an online qualitative survey regarding their endoscopy training experience, their satisfaction with the current training method, barriers to achieving competency, and their suggestions for future training. Data were subjected to descriptive and qualitative analysis using content analysis. Results We found variations in the trainee's learning experience regarding the training supervision, feedback, and assessment methods. The most common endoscopy training methods were observation and direct practice with supervision. There was only a low proportion of simulator use (25%). The most found concept in barriers to achieving competency was “insufficient number of patients.” Meanwhile, the most found concept in suggestions for future training methods was “increasing the variety of cases and procedures.” Conclusion Our findings suggest that there are still variations in endoscopy training methods in Indonesia. Therefore, we propose to design a standardized endoscopy training program to ensure the competence of endoscopy trainees and better care for endoscopic patients. Simulators might be used to increase the trainees' competence in settings with low numbers of patients or cases.

Abstract Medical AI has transformed modern medicine and created a new environment for future doctors. However, medical education has failed to keep pace with these advances, and it is essential to provide systematic education on medical AI to current medical undergraduate and postgraduate students. To address this issue, our study utilized the Unified Theory of Acceptance and Use of Technology model to identify key factors that influence the acceptance and intention to use medical AI. We collected data from 1,243 undergraduate and postgraduate students from 13 universities and 33 hospitals, and 54.3% reported prior experience using medical AI. Our findings indicated that medical postgraduate students have a higher level of awareness in using medical AI than undergraduate students. The intention to use medical AI is positively associated with factors such as performance expectancy, habit, hedonic motivation, and trust. Therefore, future medical education should prioritize promoting students’ performance in training, and courses should be designed to be both easy to learn and engaging, ensuring that students are equipped with the necessary skills to succeed in their future medical careers.

Abstract Engaging family members in care improves person- and family-centered outcomes. Many healthcare professionals have limited awareness of the role and potential benefit of family engagement in care. This review describes the rationale for engaging families in care, and opportunities to engage family in various clinical care settings during training and early career practice.

Abstract Background Virtual consultation is a synchronous mode of telemedicine provided remotely via information and communication technology. The projected growth of digitalization in healthcare delivery, however, necessitates medical student training in virtual consultation (VC) to ensure safe and effective patient care. This study describes the implementation and preliminary evaluation of a competency-based VC training module for undergraduate medical students. Methods A newly developed six-week VC module was implemented online through asynchronous microlearning and synchronous simulation-based experiential learning modalities. Clinical students in years 4 and 5 and fresh graduates, who had not started pre-registration house officer or residency programmes, were invited to participate. Training outcomes using checklist-based video-recorded assessments of VC encounters between medical students and simulated patients were compared. Each video was independently assessed by two facilitators trained in VC teaching and assessment, using a direct observed virtual consultation skills checklist derived from established VC competencies. The participants completed course evaluations electronically as additional outcome measures. Results Fifty-two clinical phase medical students and alumni completed both the instructional and practical phases of this module. Altogether, 45 (95.7%) students found the module beneficial, and 46 (95.9%) reported increased self-efficacy for conducting VC. In total, 46 (95.9%) students would recommend the course to others. Post-test results showed a significant increase in the students’ abilities to conduct a VC (t-test = 16.33, p

Introduction: The Northern Ontario School of Medicine University seeks to address rural physician shortages in Northern Ontario. One key strategy the school employs is the use of experiential learning placements embedded throughout its undergraduate curriculum. In second year, students embark on two 4-week placements in rural and remote communities. This study sought to explore the factors that contribute to a positive learning experience from the preceptor's perspective. Methods: Semi-structured interviews were conducted with five community preceptors who have participated in these placements. Using the information from these interviews a survey was created and sent to another 15 preceptors. Data were analyzed using qualitative methods and frequencies. Results: Three key themes were identified from both the interviews and survey data: the role of early rural and remote placements; the risks of these placements; and the need for a reciprocal relationship between institutions, preceptors, and students to create a positive learning environment. Conclusion: Preceptors value the opportunity to teach students, but the aims of these placements are not clear and preceptors and local hospitals need more workforce resources to make these experiences positive.

Longitudinal integrated clerkships (LICs) are effective in promoting careers in rural primary health care environments. This model of training medical professionals involves longer clinical placements of medical students and a different approach to learning which better prepares them for primary health care practice. Stellenbosch University created a LIC in 2011 for this purpose and has trained almost 100 doctors in their yearlong LIC since then. The past 12 years have brought about a lot of learning as this model of training was implemented, developed, and refined to suit the needs of students and the clinical environments. Contribution: Countries across the globe face challenges in recruiting and retaining doctors in rural primary health care environments. Longitudinal integrated clerkships have several educational benefits in addition to increase recruitment and retention of rural doctors, and 12 years of experience have led to a greater understanding regarding implementation and outcomes of an LIC in the South African context.

Background: Patients with high body weight are persistently stigmatized in medical settings, with studies demonstrating that providers endorse negative stereotypes of, and have lower regard for, higher-weight patients. Very little is known about how this weight bias varies across specialties. Objective: The purpose of this study is to examine how explicit weight bias varies between resident providers among sixteen of the largest residency specialties in the USA. The identification of these differences will guide the prioritization and targeting of interventions. Design: The current study utilized cross-sectional, observational data. Participants: Forty-nine allopathic medical schools were recruited to participate in this national, longitudinal study. The current study utilized data from 3267 trainees in Year 2 of Residency among those who specialized in one of the most common sixteen residency programs in 2016. Main Measures: Participants reported demographic information and residency specialties and completed three sets of measures pertaining to explicit weight bias. Key Results: A significant minority (13–48%) of residents reported slight-to-strong agreement with each anti-fat statement. There was a significant relationship between residency specialty and anti-fat blame (F(15, 3189 = 12.87, p <.001), η2 =.06), anti-fat dislike (F(15, 3189 = 7.01, p <.001), η2 =.03), and attitudes towards obese patients (F(15, 3208 = 17.78, p <.001), η2 =.08). Primary care residents (e.g., family medicine, pediatrics) consistently reported lower levels of weight bias than those in specialty programs (e.g., orthopedic surgery, anesthesiology). Conclusions: This study is the first to report on weight bias in a large, heterogeneous sample of US resident physicians. Problematic levels of weight bias were found in all specialties, with residents in specialty programs generally reporting more bias than those in primary care residencies. Future research should examine which factors contribute to these differences to guide intervention. [ABSTRACT FROM AUTHOR]

Against the backdrop of poor discharge communication in hospitals, this study explores the purpose of discharge interviews from the physicians' perspective and the challenges they are confronted with. Discharge interviews are legally required in Germany as part of the discharge management. Led by the ward physician, the discharge interview should summarize relevant information about the hospital stay, medication, lifestyle interventions and follow-up treatment. Semi-structured interviews with n = 12 physicians were conducted at Heidelberg University Hospital between February and April 2020. Qualitative content analysis was carried out using MAXQDA. Physicians reported gaining information, providing information, and answering open-ended questions as the purpose of the discharge interview. Challenges in conducting discharge interviews were related to finding a common language, patient-related challenges, conditions of everyday ward life, and lack of training. Physicians reported receiving no explicit training on discharge interviews. While professional experience seems to mitigate the lack of training, some physicians expressed a prevailing sense of insecurity. The lack of preparation for discharge interviews in medical school makes it particularly challenging for physicians to translate their theoretical knowledge into patient-centered discharge communication. Medical training on discharge interviews should be expanded in terms of theoretical input on the ideal content, its purpose and potential (e.g. in reducing readmissions), as well as practical exercises. [ABSTRACT FROM AUTHOR]

To obtain 3D printed bone models with a haptic sensation similar to that of the real bone, which will help the surgeon to learn and improve based on practice. From computed tomography, 3 digital anatomical models of the human proximal femur were created and, by modifying the printing parameters, both cortical and trabecular tissues were simulated, which were combined in a different cortico-cancellous interface depending on the bone segment. The 3 equivalent models obtained were compared with a commercial Sawbone synthetic model and subjected to a series of blind surgical practice trials performed by 5 TOC specialists from a hospital, each of them with different degrees of expertise. A statistical analysis of the qualitative data collected based on the Wilcoxon test, the Spearman correlation matrix, and the Validity Ratio Coefficient was performed. The deviations observed in the dimensional study are less than 0.2 millimeter, which confirms the validity of the 3DP-FFF technology to geometrically recreate personalized biomodels with high anatomical precision. The reproductions obtained have given rise to a reliable method that professionals can refine to plan operations with the consequent reduction of time and risks for the patient, as well as for medical training. [ABSTRACT FROM AUTHOR]