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Abstract Background This article presents a history of efforts by the World Health Organization and its most important ally, the World Federation for Medical Education, to strengthen and standardize international medical education. This aspect of WHO activity has been largely ignored in recent historical and sociological work on that organization and on global health generally. Methods Historical textual analysis is applied to the digitalized archives and publications of the World Health Organization and the World Federation for Medical Education, as well as to publications in the periodic literature commenting on the standardization of international medical training and the problems associated with it. Results Efforts to reform medical training occurred during three distinct chronological periods: the 1950s and 1960s characterized by efforts to disseminate western scientific norms; the 1970s and 1980s dominated by efforts to align medical training with the WHO’s Primary Healthcare Policy; and from the late 1980s to the present, the campaign to impose global standards and institutional accreditation on medical schools worldwide. A growing number of publications in the periodic literature comment on the standardization of international medical training and the problems associated with it, notably the difficulty of reconciling global standards with local needs and of demonstrating the effects of curricular change.

Abstract Background Grade inflation which is known as the awarding of higher grades than students deserve in higher education has been observed since the 1960s. There is comprehensive evidence that document the allegations, prevalence, and severity of grade inflation in higher education in universities around the world for the past 10 years. Methods This study analyzes the change in the ratio of graduates with a “very good (>2.99)” degree in medical education in Turkey within a 15-year-long period in terms of the grade inflation (when all other factors are constant), and factors that affect the overall achievement grades. The analyses were carried out using the grade point average (GPA) of 9,618 students who graduated from the medical schools of 25 Turkish universities, and grades of 288,540 students for 7,597 courses. In doing so, the “real” university random effects estimator modelling considering the differences in universities with correlation, ANOVA, t-test and ANCOVA analyses were carried out. Results The results revealed that there was a marginal increase in grades in medical training before graduation. Twenty-nine percent grade inflation was detected in line with the relevant findings in literature and this figure is one of the highest that has been reported so far. It was also detected that the ratio of graduates with a “very good (>2.99)” degree was 17% in 2005 and it increased to 46% in 2020. Additionally, the class size, academic rank of the instructors, grades, course contents, types of the universities (public & non-profit private), accreditation of the program, and the age of the medical schools were considered as important determinants of the difference in course grades. Conclusion These results show that both the uncontrolled expansion of medical schools in Turkey and the decrease in quality cause a significant increase in grades. Moreover, an important finding is that accreditation slows down the grade inflation. Both the course grades following the accreditation process and the inflation in the graduation grades (grade inflation) slowed down significantly in the accredited medical schools. This finding is an important example for the necessity of accreditation for universities, which is referred to as the “gold standard” to improve the quality of medical education.

Abstract Background To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. Methods We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. Results The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. Conclusions While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians.

Many patients experiencing incarceration (PEI) in the United States (U.S.) have significant and complex medical conditions that require offsite consultation and hospitalization. Physicians in our academic medical system report that their education in caring for PEI is limited. We developed an online learning resource for physicians who care for PEI within our institution. Development included project planning, content development, iterative graphical design, feedback incorporation from key constituents, including individuals previously incarcerated, and module launch. The e-module was designed with a graphic user interface including video and case simulations. The curriculum includes background information on the U.S. carceral system, the basics of carceral health care, ethical considerations for community-based health care workers (introducing concepts of “dual loyalty” and examining patient privacy and autonomy for PEI), and policy and procedural considerations specific to our health care system. Future directions include disseminating the module to practicing physicians, advanced practice providers, and other allied health professionals (such as nursing, social work, and skilled therapists) and collecting feedback on user engagement. Institutions and groups wishing to improve care for this vulnerable patient population can implement training to address limitations in knowledge and confidence among staff and providers. [ABSTRACT FROM AUTHOR]

Copyright of Human Review is the property of Eagora Science 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: There are many ways that students and trainees learn to talk about patients. The way trainees and physicians use language during clinical care is important, as labeling patients can have adverse effects on patient safety. Communication is considered a core competency by The Accreditation Council on Graduate Medical Education (ACGME). Past research has shown that participants in narrative medicine curricula report developing stronger communication skills however it is not clear how these workshops motivated trainees to use language differently during patient care. To explore this, we interviewed second-year residents in academic year 19–20 about their experiences both in participating in narrative medicine workshops and giving patient care. Methods: The framing context for this constructivist thematic analysis is a series of narrative medicine workshops facilitated for interns in an internal medicine residency program at a large academic medical center during the 18–19 academic year. We developed a semi-structured interview study that allowed residents to reflect on their experiences in these workshops. Eighteen out of 60 residents (30%) were interviewed. Results: We found that sessions regarding language use in patient care shaped how interns thought about and used language during clinical work, a finding that arose spontaneously during interviews. Conclusions: Our research suggests that workshops aimed specifically at addressing the use of language in healthcare can have meaningful impact on trainees. Our study makes a unique contribution to the scholarship by suggesting that training in narrative medicine can lead to a change in the way that trainees use language during their clinical work. [ABSTRACT FROM AUTHOR]

Background: Medical students are at a significant risk of experiencing psychological issues, such as burnout. Over the past few years, more studies have been conducted on this topic, producing different results. Aims: The purpose of this review was to determine the global pooled prevalence rate and risk factors associated with burnout and its components among undergraduate (pre-intern) medical students. Method: From inception until 30 November 2021, nine electronic databases were used for an electronic search. Using random-effects meta-analysis, we pooled the estimates using the DerSimonian-Laird method. The prevalence of burnout in medical students was the primary outcome of interest. Data were analyzed globally, by country, by research measure. Age and sex were examined as confounders using meta-regression analysis. Results: A random-effects meta-analysis of 42 studies involving 26,824 evaluating the prevalence of burnout in medical students showed an overall prevalence rate 37.23% [32.66%; 42.05%], Q = 2,267.15(41), p < .0001, t2 = .42, t = .65, I2 = 98.2%; H = 7.5. Prevalence of emotional exhaustion, depersonalization, and personal accomplishment were 38.08% [30.67%; 46.10%], 35.07% [26.74%; 44.41%], and 37.23% [32.66%; 42.05%], respectively. Variations were observed between countries and research measures. Age (older) and sex (female) were both significant predictors of burnout. Conclusion: The prevalence of burnout in medical students was estimated to be 37.23%. It is urgent that future studies serve as a basis for the development of prevention and treatment programs to prevent and treat burnout in students. [ABSTRACT FROM AUTHOR]

Aim Of the Study: To determine the effectiveness of a multidimensional neonatal simulation-based medical education training programme on direct and indirect patient outcome parameters.Methods: This was a retrospective analytical study with a historical control group in a level II neonatal care unit (1,700 births per year). A multidimensional interdisciplinary training programme on neonatal resuscitation was implemented in 2015; pre-training (2012-2014) and post-training (2015-2019) eras were compared in terms of mortality (direct outcome) and the received intervention level immediately after birth (indirect outcome). Intervention levels were defined as follows: A) short-term non-invasive ventilation, B) prolonged non-invasive ventilation (>5 inflation breaths), C) chest compressions.Results: Of 13,950 neonates born during the study period, 826 full-term newborns received one of the three intervention levels for adaptation after birth. A total of 284 (34.4%) patients received short-term non-invasive ventilation (A), 477 (57.8%) had prolonged ventilation (B), and 65 (7.9%) chest compressions (C), respectively. Comparing the pre- and post-training eras, there was no significant reduction in mortality, and no significant changes were found in groups A or B. However, the risk for chest compressions (group C) decreased significantly from 0.91% in the pre-training era to 0.20% in the post-training era (p < 0.001).Conclusion: Although there was no significant effect on neonatal mortality, regular interdisciplinary simulation training decreased the number of administered chest compressions immediately after birth. Further studies are needed to test indirect outcome-related parameters, such as frequency of chest compressions as a measure of effectiveness and impact of medical training. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Medicina y Cine / Journal of Medicine & Movies is the property of Ediciones Universidad de Salamanca 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.)

Purpose: Commercial medical ultrasound phantoms are highly specific as they simulate particular clinical scenarios. This makes them expensive to use in multi-target research and training. General approaches to human tissue and organ modeling are described in the manufacturing methodology, access to which is restricted by the manufacturer's trade secret. Our aim is to propose a reproducible methodology to design a head phantom for transcranial ultrasound training and research from widely available materials and to validate its applicability. Methods: To create an anthropomorphic phantom, we used data from real patients obtained by CT and MRI scans. We combined FDM and LCD 3D printing to achieve the desired acoustic performance and ergonomics of the phantom. We fabricated the phantom using polyvinyl chloride plastisol, photopolymer, and PLA to simulate brain tissue, temporal acoustic windows, and acoustically opaque parts of the skull, respectively. Notably, the phantom fabrication method uses only readily available materials and is easy to reproduce. Results: We developed a basic one and anatomical one versions of the head phantom. The basic version contains a simplified brain: tissue-mimicking material is poured into the skull with needles inserted, which specific pattern is easy to recognize in B-mode images. The anatomical version has an anatomically correct brain dummy extracted from MRI data and contains multiple randomly distributed small metal, plastic, and bony objects ranging in size from 1 to 3 mm each. Conclusion: The proposed methodology allows producing head phantoms for transcranial ultrasound training and research. The anatomical accuracy of the model is proved by ultrasonography and CT studies. Both versions of the phantom comprise the skull and the brain and are intended for ultrasound imaging through the temporal bone acoustic window. Needles and small objects serve as navigation targets during the training procedure. The basic version helps learning basic navigation skills, while the anatomical one provides a realistic setting to perform the diagnostic procedure. [ABSTRACT FROM AUTHOR]

The aim of our research was to establish a reproducible curriculum that offers the possibility to gain basic surgical skills (knot tying, suturing, laparoscopy basics) through distance education in emergency situations by using tools available in the household. Forty-six volunteering third- and fourth-year medical students were involved in the study. The distance education system was set up using homemade or easily obtainable tools (an empty can, shoe box, sponge, etc.) to teach surgical knotting, suturing, and basic laparoscopic skills. The reachable learning objectives were contrasted with the original course plan. Feedback from the students has been collected. The students' results were compared to the regular course of the previous years. Seventy-nine percent of the original learning objectives could be reached completely, and 15% partially. The necessary tools were available for 82% of the students. The students evaluated the course for 4.26 in general and 4.86 considering the circumstances (on a 5-level-scale). The homemade trainers were assessed over four as an acceptable substitution. Students' exam results decreased only by 7% compared to the previous two years. Basic surgical skills can be educated with acceptable efficiency and student satisfaction using distance teaching and homemade tools. This is the first study where not only the simulators but the surgical instruments were replaced with household tools and evaluated by a reproducible curriculum. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance is one of the main public health problems worldwide. One key tool to optimize antibiotic prescription is medical training. The aim of this study is to compare the impact of training in infectious diseases on students' knowledge of the antibiotic resistance problem and the rational use of antibiotics. Methods: We performed a cross-sectional study in the medical school of the University of Navarra. We conducted an anonymous in situ survey of students in each year of training. Data were analyzed grouping the students as follows: GROUP 1: first three years of education, no training in Clinical Microbiology (CM) or in Infectious Diseases (ID); GROUP 2: fourth-year students, training in CM but not ID; GROUP 3: Fifth and sixth-year students who have completed the training in CM and ID. Chi-square test (or Fisher's exact test when appropriate) was performed to evaluate potential associations. Wilcoxon's test was used to compare the median correct answers between groups. We used Spearman's test for correlation between year of training and performance in questionnaire. Results: A total of 994 students respond to the survey, 80.4% of the eligible students. Almost all students who had completed infectious diseases training perceive antibiotic resistance as an important problem in comparison with students who had not completed the formation (99.5% in group 3 vs 94.5% in group 1, p = 0.02). Knowledge of antibiotic stewardship underwent a statistically significant change after training in infectious diseases (from 9.2% in group 1 to 52.2% in group 3, p < 0.001). In the training questions block we also found an increase in the average number of correct answers (21.4% in group 1 vs 44.7% in group 3, p < 0.001). When comparing the results of subgroups 3A and 3B we found a significant loss of knowledge as we moved away from training (49% vs 40.9%, p < 0.001). Conclusions: The training of medical students is the key to improving both perception and knowledge of infectious diseases. However, we have an opportunity for educational improvement as far as infectious diseases are concerned, regarding both the acquisition of knowledge and its loss as time lapses after training. [ABSTRACT FROM AUTHOR]

Background: The current global pandemic has caused unprecedented strain on critical care resources, creating an urgency for global critical care education programs. Learning needs assessment is a core element of designing effective, targeted educational interventions. In theory, multimodal methods are preferred to assess both perceived and unperceived learning needs in diverse, interprofessional groups, but a robust design has rarely been reported. Little is known about the best approach to determine the learning needs of international critical care professionals. Method: We conducted multimodal learning needs assessment in a pilot group of critical care professionals in China using combined quantitative and qualitative methods. The assessments consisted of three phases: 1) Twenty statements describing essential entrustable professional activities (EPAs) were generated by a panel of critical care education experts using a Delphi method. 2) Eleven Chinese critical care professionals participating in a planned education program were asked to rank-order the statements according to their perceived learning priority using Q methodology. By-person factor analysis was used to study the typology of the opinions, and post-ranking focus group interviews were employed to qualitatively explore participants' reasoning of their rankings. 3) To identify additional unperceived learning needs, daily practice habits were audited using information from medical and nursing records for 3 months. Results: Factor analysis of the rank-ordered statements revealed three learning need patterns with consensual and divergent opinions. All participants expressed significant interest in further education on organ support and disease management, moderate interest in quality improvement topics, and relatively low interest in communication skills. Interest in learning procedure/resuscitation skills varied. The chart audit revealed suboptimal adherence to several evidence-based practices and under-perceived practice gaps in patient-centered communication, daily assessment of antimicrobial therapy discontinuation, spontaneous breathing trial, and device discontinuation. Conclusions: We described an effective mixed-methods assessment to determine the learning needs of an international, interprofessional critical care team. The Q survey and focus group interviews prioritized and categorized perceived learning needs. The chart audit identified additional practice gaps that were not identified by the learners. Multimodal methods can be employed in cross-cultural scenarios to customize and better target medical education curricula. [ABSTRACT FROM AUTHOR]

Background: Recently, the demand for mechanical ventilation (MV) has increased with the COVID-19 pandemic; however, the conventional approaches to MV training are resource intensive and require on-site training. Consequently, the need for independent learning platforms with remote assistance in institutions without resources has surged. Objective: This study aimed to determine the feasibility and effectiveness of an augmented reality (AR)-based self-learning platform for novices to set up a ventilator without on-site assistance. Methods: This prospective randomized controlled pilot study was conducted at Samsung Medical Center, Korea, from January to February 2022. Nurses with no prior experience of MV or AR were enrolled. We randomized the participants into 2 groups: manual and AR groups. Participants in the manual group used a printed manual and made a phone call for assistance, whereas participants in the AR group were guided by AR-based instructions and requested assistance with the head-mounted display. We compared the overall score of the procedure, required level of assistance, and user experience between the groups. Results: In total, 30 participants completed the entire procedure with or without remote assistance. Fewer participants requested assistance in the AR group compared to the manual group (7/15, 47.7% vs 14/15, 93.3%; P=.02). The number of steps that required assistance was also lower in the AR group compared to the manual group (n=13 vs n=33; P=.004). The AR group had a higher rating in predeveloped questions for confidence (median 3, IQR 2.50-4.00 vs median 2, IQR 2.00-3.00; P=.01), suitability of method (median 4, IQR 4.00-5.00 vs median 3, IQR 3.00-3.50; P=.01), and whether they intended to recommend AR systems to others (median 4, IQR 3.00-5.00 vs median 3, IQR 2.00-3.00; P=.002). Conclusions: AR-based instructions to set up a mechanical ventilator were feasible for novices who had no prior experience with MV or AR. Additionally, participants in the AR group required less assistance compared with those in the manual group, resulting in higher confidence after training. Trial Registration: ClinicalTrials.gov NCT05446896; https://beta.clinicaltrials.gov/study/NCT05446896 [ABSTRACT FROM AUTHOR]

Introduction: The heath care performance of the gastroenterology resident conditions his professional pertinence in the public health as for the diagnosis and treatment of patients with digestive diseases. Objective: To deepen in the training process of the gastroenterology resident. Method: An epistemologic analysis and factic diagnosis of the training process of the gastroenterology resident regarding the care to patients with digestive neoplasm in Juan Bruno Zayas Teaching General Hospital from Santiago de Cuba during the biennium from the observation of the health care performance, the survey to residents and interviews to specialists of this branch in the province. Results: There were inconsistencies in this training as a result of a visible polarization doctor-tools of practice in the care, orientated to the endoscopic and therapeutic digestive endoscopy, contrary to the preventive procedure. Conclusion: It could be confirmed that the care dimension had not been sufficiently systematized while giving care to patients with digestive neoplasm taking into account the training integration of prevention, diagnosis and therapeutics in the endoscopic praxis of this professional. [ABSTRACT FROM AUTHOR]

Current teaching and training methods for surgical techniques in the pediatric population involve artificial models (manikins), animals or adult human cadavers embalmed using various techniques. We found no references in the literature concerning the use of the Thiel method in the pediatric population. The aim of this study, therefore, was to assess the viability of using pediatric human cadavers embalmed through Thiel's technique and to compare them with standard pediatric manikins. After donation of a 24-week stillborn, the Thiel technique was carried out for fixation following the usual protocol. A video recording with eye-tracking glasses was used to perform an examination, and techniques. The same procedures were conducted on a pediatric manikin. Medical students, medical residents and physicians were asked to respond to questions in an online survey after being shown the video. A total of 92 responses were obtained. The Thiel-embalmed stillborn was assessed as superior to the manikin in all items. Our study confirmed that this technique is feasible even with extremely small donors. The value of this form of preservation for medical training is not widely known though it is receiving increasing interest. Our results show that Thiel fixation in pediatrics is clearly more highly valued than a manikin and offers great potential. This innovative application of the Thiel method in the pediatric population is technically possible. It poses no additional difficulties and is very positively assessed for undergraduate and postgraduate teaching. [ABSTRACT FROM AUTHOR]

Copyright of Perspectives of Higher Education Development / Oliy Ta'lim Taraqqiyoti Istiqbollari is the property of NGO NEO Hamkor 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.)

Abstract Background In 2014, Nigeria issued the task-shifting/sharing policy for essential health services, which aimed to fill the human resource gap and improve the delivery of health services across the country. This study focuses on the characteristics, spread, and family planning (FP) stocking practices of medicine vendors in Lagos and Kaduna, assessing the influence of medical training on the provision and stocking of FP services and commodities by vendors. Methods We conducted a census of all Patent Medicines stores (PMS) followed up with a facility assessment among 10% of the mapped shops, utilizing an interviewer-administered questionnaire. Bivariate analysis was conducted using the Chi-square test, and multiple logistic regression was used to estimate the adjusted odds ratio (OR) and confidence intervals (CI) for the test of significance in the study. Results A total of 8318 medicine shops were enumerated (76.2% urban). There were 39 shops per 100,000 population in both states on average. About half (50.9%) were manned by a medicine vendor without assistance, 25.7% claimed to provide FP services to > 2 clients per week, and 11.4% were not registered with the regulatory body or any professional association. Also, 28.2% of vendors reported formal medical training, with 56.3% of these medically trained vendors relatively new in the business, opening within the last 5 years. Vendors utilized open drug markets as the major source of supply for FP products. Medical training significantly increased the stocking of FP products and inhibited utilization of open drug markets. Conclusion Patent and Proprietary Medicines Vendor (PPMVs) have continued to grow progressively in the last 5 years, becoming the most proximal health facility for potential clients for different health services (especially FP services) across both Northern and Southern Nigeria, now comprising a considerable mass of medically trained personnel, able to deliver high-quality health services and complement existing healthcare infrastructure, if trained. However, restrictions on services within the PPMV premise and lack of access to quality drugs and commodities have resulted in poor practices among PPMVs. There is therefore a need to identify, train, and provide innovative means of improving access to quality-assured products for this group of health workers.

Augmented Reality refers to a technology that enables users to superimpose digital material (images and text) on top of a physical environment. The science of human anatomy is the study of the body's structure and the human body's organs functions. The traditional learning method of human anatomy is based on textbooks and plastic models. The student still faces problems with understanding human anatomy based on these methods. This study aims to create an augmented reality application to address the challenge of seeing and imagining complicated human body's anatomy, and also help students to understand the procedure of Total Hip Replacement (THR) surgery and to explore the medical devices used in this surgery. Through the use of an augmented reality-based application, learning human anatomy and the procedure of the surgery will be more enjoyable and interactive. In this AR application, the user performs THR surgery procedures and interactively explores human anatomy. Also, The user may test their knowledge with a quiz about the THR surgery procedure. The Research results show that the AR application received a System Usability Scale score of (82.125), indicating that it is user-friendly, recommended, and good according to the System Usability Scale range.

Abstract Background Pain is a devastating sensation and has to be treated immediately. Therefore, we developed a training program to improve the knowledge of medical students in the field of pain medicine. In the present study, the applicability and efficacy of this training program was tested. Methods Half of the students attended first a training with simulated patients (SP) followed by bedside teaching (Group 1). Group 2 performed the training programs in reverse order. The evaluation based on standardized questionnaires completed by students (self-assessment) and all students took part in two practical examinations after the learning interventions. Results This study included 35 students. The quality of the simulation was evaluated by the students with average grade 1.1 (1 = very good, 6 = very bad). The practical work on the ward with patients was rated with grade 1.4 of 6, the whole course with 1.1. Students of Group A were significantly better in the final examination (grade 1.7 vs. grade 2.2, p

Issue: Harassment is a common experience for medical and healthcare trainees. Experiencing harassment can have significant consequences for trainees in multiple domains, including mental, physical, social, and occupational well-being. Harassment remains entrenched in medical education despite efforts to address it. Evidence: Many articles have documented the prevalence of harassment in medical education. Likewise, articles have provided recommendations for how individuals or hospitals can attempt to reduce harassment. However, despite calls for reform, harassment persists, largely due to the hierarchical, paternalistic, high-pressure, and evaluative nature of medical culture. Most literature has emphasized the need for policies and reporting structures, yet such top-down initiatives have not had a sufficient impact on the attitudes and beliefs that drive culture change. Instead, change requires intervention at every level of an organization. Little, if any, literature has proposed applying a change management model to change the culture of medical training and therefore decrease harassment. Implications: This paper applies principles of organizational change theory, and in particular, the ADKAR model, in conjunction with a summary of the existing harassment literature, to propose a framework for addressing harassment by facilitating organizational culture change. Intervention is needed at all levels of the medical education system (the healthcare system, the supervisor or training program, and the individual), and the ADKAR framework can guide what interventions are offered and when to capitalize on the current level of change readiness. Recommendations go beyond the typical focus on formalized policies and procedures, which are necessary, but not sufficient, components of culture change. Implementation of these practices, as well as ongoing evaluation and refinement through research, should foster cultural change in medical education to address harassment. [ABSTRACT FROM AUTHOR]

Introduction  The coronavirus disease 2019 (COVID-19) pandemic has affected the healthcare system. The residents who are at the frontline of this pandemic have suffered the most. The extent of the training loss due to the COVID-19 pandemic on gastroenterology (GE) training is not studied in India. Methods  We designed a 36-question based google survey and distributed it to the GE residents all across India, via email. All the responses collected were analyzed using appropriate statistical methods. Results  A total of 140 responses were received. No significant decrease in teaching sessions/ classes was reported. Most of the residents (83.5%) reported inability to complete the target thesis enrolment. The number of patients seen by the residents in outpatient department, patients managed in wards and endoscopic procedures done by residents have decreased significantly (p -valve <0.001 for all). An overwhelming 89.9% (n  = 125) of the GE residents were posted for COVID-19 duties. Almost half (50.4%) of them were COVID-19 positive. Conclusion  The COVID-19 pandemic has affected the training of GE residents in India immensely and an extension period of 3 months may be offered to them. [ABSTRACT FROM AUTHOR]

Some restrictionist arguments justifying the duty to stay as a means of addressing medical brain drain have relied on reciprocity as the moral basis for their policy proposals. In this essay, I argue that such reciprocity-based justifications for the duty to stay ignore crucial conditions of fittingness as relates to the funding of medical training. [ABSTRACT FROM AUTHOR]

Training in the subspecialty of spinal tumors is challenging and less researched. The anatomic variations and complex relationship with paraspinal structures tend to be the main obstacle for the trainees in this field. Three-dimensional (3D)-printing technique has the advantage of individual customization and high fidelity, and can produce case-tailored models as auxiliary tools in medical training. The main parts of the study included case-based lectures with tailored 3D-printing models, evaluating their performances in a controlled examination and anonymous questionnaire survey regarding the trainees' opinion towards the tailored models. The examination was designed as case-based clinical analysis. All trainees were randomly allocated to the study group and control group, and the former group was additively provided a case-tailored model. Thirty-six participants were recruited in this study, including 16 residents and 20 fellows. In the section of examination, there was significant difference in the aspects of describing the involvement of paraspinal structures and discriminating the relationship between the tumor and large vessels (P < 0.05), but similar in the aspects of surgical planning and relevant complications (P > 0.05). In the survey, most participants gave favorable responses to 3D-printing models in the aspects of understanding anatomic structures and relationship, inter-trainee communication, surgical planning, and enhancement of interest and confidence (50.0% to 94.4%, respectively). The 3D-printing model is a valuable tool in the training of new residents and fellows in the subspecialty of spinal tumors. It can facilitate the trainees' understanding of tumor anatomy, surgical readiness, and confidence as well. [ABSTRACT FROM AUTHOR]

An acknowledgment of feedback is extremely helpful in medical training, as it may improve student skill development and provide accurate, unbiased feedback. Data are generated by hundreds of complicated and variable processes within healthcare including treatments, lab results, and internal logistics. Additionally, it is crucial to analyze medical training data to improve operational processes and eliminate bottlenecks. Therefore, the use of process mining (PM) along with conformance checking allows healthcare trainees to gain knowledge about instructor training. Researchers find it challenging to analyze the conformance between observations from event logs and predictions from models with artifacts from the training process. To address this conformance check, we modeled student activities and performance patterns in the training of Central Venous Catheter (CVC) installation. This work aims to provide medical trainees with activities with easy and interpretable outcomes. The two independent techniques for mining process models were fuzzy (i.e., for visualizing major activities) and inductive (i.e., for conformance checking at low threshold noise levels). A set of 20 discrete activity traces was used to validate conformance checks. Results show that 97.8% of the fitness of the model and the movement of the model occurred among the nine activities. [ABSTRACT FROM AUTHOR]

Purpose of Review: Type 2 diabetes is frequently accompanied by obesity, nonalcoholic fatty liver disease, chronic kidney disease, and cardiovascular disease, which collectively contribute to the high burden of cardiometabolic disease. This review discusses cardiometabolic disease management, strategies to implement cardiometabolic centers to deliver care, and dedicated programs to train the next generation of cardiometabolic experts. Recent Findings: Sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 receptor agonists, and a nonsteroidal mineralocorticoid receptor antagonist have demonstrated beneficial effects across cardiometabolic conditions. However, utilization of effective pharmacotherapies is low in clinical practice, in part due to clinical inertia and traditional sharp delineation in clinical responsibilities of specialists. Multidisciplinary clinics and population-health models can provide comprehensive care but require investment in physical and information technology infrastructure as well as in training and accreditation. Post-internal medicine residency cardiometabolic health training programs have been proposed. Summary: Implementing cardiometabolic centers in health systems involves reshaping current practices. Training programs focused on cardiometabolic health are needed to address the growing burden of disease and specific training needs in this ever-expanding area. [ABSTRACT FROM AUTHOR]

Background: Augmented Reality (AR) represents an innovative technology to improve data visualization and strengthen the human perception. Among Human–Machine Interaction (HMI), medicine can benefit most from the adoption of these digital technologies. In this perspective, the literature on orthopedic surgery techniques based on AR was evaluated, focusing on identifying the limitations and challenges of AR-based healthcare applications, to support the research and the development of further studies. Methods: Studies published from January 2018 to December 2021 were analyzed after a comprehensive search on PubMed, Google Scholar, Scopus, IEEE Xplore, Science Direct, and Wiley Online Library databases. In order to improve the review reporting, the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used. Results: Authors selected sixty-two articles meeting the inclusion criteria, which were categorized according to the purpose of the study (intraoperative, training, rehabilitation) and according to the surgical procedure used. Conclusions: AR has the potential to improve orthopedic training and practice by providing an increasingly human-centered clinical approach. Further research can be addressed by this review to cover problems related to hardware limitations, lack of accurate registration and tracking systems, and absence of security protocols. [ABSTRACT FROM AUTHOR]

BACKGROUND: Telemedicine involves the use of electronic communication and technology to remotely deliver clinical services to patients. With the increase in the adoption of telemedicine in healthcare delivery, "webside healthcare" is becoming the virtual analog of bedside care. The Ministry of Health in Saudi Arabia has recently established the use of telemedicine, including social media (SM) and medical applications (Apps) to enhance the quality and accessibility of healthcare services to patients and healthcare providers. In the present study, we evaluated medical interns' perception of the use of telemedicine, SM, and medical Apps in patient care, their awareness of related guidelines to find out if targeted training is needed. MATERIALS AND METHODS: A qualitative study recruited and interviewed, through semi-structured key informant (KI) interviews and focus group discussions (FGD), a total of 24 male and female medical interns. The Interns were purposefully sampled from all Saudi Arabia's 5 main geographical regions until data saturation was observed. The transcripts of five KI interviews and 6 FGDs done were thematically analyzed and are presented as themes and subthemes. RESULTS: Medical interns discussed the advantages and disadvantages related to telemedicine, SM, and medical Apps in healthcare services. Overall, interviewees appreciated the role telemedicine, SM, and medical Apps play in the healthcare and for such particular specialties as family medicine and (tele-) psychiatry. However, the interns believed that training on the technical operational aspects of different telemedicine modalities with an emphasis on targeted education for related ethical and legal regulating guidelines was vital. CONCLUSION: Most interviewed medical interns had a positive perception of telemedicine and were willing to use it in their daily clinical practice. However, there were some challenges to its successful implementation such as prompt training on its proper use and clear ethical and legal guidance. [ABSTRACT FROM AUTHOR]

Background: There is numerous empirical evidence supporting that college students studying in fields with rigorous curriculum and high requirements, such as medical training, are characterized by a higher risk of attrition than their peers. Since Hungarian medical training attracts more and more international students every year, the issue of dropout can have a global impact. Our study aimed to examine attrition risks of local and international students in Hungarian medical training. Methods: In our study, we examined the dropout behaviour of all medical students who started their studies in 2010 in Hungary (N = 2391) by analysing longitudinal administrative data of those who studied between 2010 and 2017. Doing this, we conducted descriptive statistics and uncovered the risks of dropout using binary logistic regression. Results: Our results indicate that the danger is primarily increased by factors directly linked to or indicating poor academic performance (slow pace of credit accumulation, tuition-based forms of finance). Individual characteristics, namely gender, and citizenship, also have a moderate but significant effect on the latter. Conclusions: Thus a policy proposal can be formulated consisting of making the training network less rigid, devoting more educational attention to and providing targeted mentoring for students with learning difficulties and academic hardships. Foreign medical students studying in Hungary comprise a large group that has a high attrition rate, making it a prime target for dropout-reducing programs. [ABSTRACT FROM AUTHOR]

Background: Distance learning is an interactive way of education when teachers and students are physically separated. Our purpose was to examine its effectivity in training of basic surgical techniques and to provide an alternative sustainable methodology for the training of medical professionals. Methods: Sixty students were involved in our single blinded randomized controlled study. Six homogenized groups were created then randomized into three groups of distance learning and three groups of in-person teaching. The groups completed the same curriculum using our own "SkillBox". All students took the same pre- and post-course test evaluated blindly. The students filled out an online feedback form after the course. A financial analysis was also made. Results: There was no significant difference in the post-course exam results (distance 28.200 vs. in-person 25.200). We managed to achieve significantly better improvements in the distance learning of suturing (distance 19.967 vs. in-person 15.900, p = 0.043). According to 93% of the study group students, the quality of teaching did not decrease compared to the traditional classes. Conclusion: The results of the students improved similarly in distance learning and in-person education. The online form of teaching was received positively among the students; they found it an effective and good alternative. [ABSTRACT FROM AUTHOR]

Sex and gender are concepts that are often misunderstood and misused, being utilized in a biased, preconceived, interchangeable way. Sex and gender medicine is generally overlooked, despite the profound impact of sex and gender on health outcomes. The aims of the present rapid systematic literature review were (i) to assess the extent to which sex- and gender-sensitive topics are covered in medical courses; (ii) to assess the need for and willingness toward integrating/incorporating sex and gender medicine into health-related education; (iii) to identify barriers and facilitators of the process of implementation of sex and gender medicine in medical teaching, mentoring, and training; and (iv) to evaluate the effectiveness of interventional projects targeting curriculum building and improvement for future gender-sensitive physicians. Seven themes were identified by means of a thematic analysis, namely, (i) how much sex- and gender-based medicine is covered by medical courses and integrated into current medical curricula, (ii) the knowledge of sex and gender medicine among medical and allied health profession students, (iii) the need for and willingness toward acquiring sex- and gender-sensitive skills, (iv) how to integrate sex- and gender-based medicine into medical curricula in terms of barriers and facilitators, (v) existing platforms and tools to share knowledge related to sex and gender medicine, (vi) sex- and gender-based medicine aspects in the post-medical education, and (vii) the impact of sex- and gender-sensitive topics integrated into medical curricula. Based on the identified gaps in knowledge, further high-quality, randomized trials with larger samples are urgently warranted to fill these gaps in the field of implementation of gender medicine in educating and training future gender-sensitive physicians. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. 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 HNO is the property of Springer Nature 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.)

The literature on the health care of migrant patients has often emphasized the importance of cultural skills and cultural humility that caregivers must bring to their care. Recent work has emphasized the importance of adopting a structural reading of this competency. Based on two empirical surveys conducted in France and Germany in facilities providing access to care for migrants with precarious residency status, this article demonstrates the importance of competency linking in terms of what is produced by structures and institutions and what is produced during medical interactions between patients, medical professionals, and volunteers. The complexity of accessing health protection systems for migrants with precarious residency status is often the main structural and institutional barrier to care. To remove this barrier, health professionals can develop legal and administrative competency regarding residency and health rights. They can also develop institutional and practical competency regarding the possibilities of access to health care for people without health coverage in the local geographical context. Structural competency is also effective in deconstructing the stigma and discrimination that minority groups experience in the healthcare system. [ABSTRACT FROM AUTHOR]

Pulse palpation is an important procedure that allows a physician to rapidly assess the status of a patient's cardiovascular system. This paper explores the possibility of using vibrotactile stimuli to render fine temporal profiles of pulse pressure waves. A lightweight wearable vibrotactile glove, called Hap-pulse, is designed to render fine pulse waves through vibrotactile stimuli on users’ fingertips. To preserve the fine features of original pulse waves, models are fitted from real pulse wave data (photoplethysmogram (PPG) pulse waveform database), using fourth-order polynomial functions. A square wave envelope mapping algorithm is proposed to produce vibration amplitudes of Linear Resonance Actuators (LRAs), which aims to render the detailed waveform of systolic and diastolic blood pressure states. Evaluation results suggest that Hap-pulse can render pulse waves with an average correlation coefficient 97.84%. To validate the distinguishability and fidelity of Hap-pulse's palpation rendering, a user study consisting of traditional Chinese medicine doctors and unskilled students is conducted. The correct recognition rate of identifying four typical pulse waves is 87.08% (doctors), 57.50% (untrained students) and 79.59% (trained students). These results indicate a novel application of rendering subtle pulse wave signals with vibrotactile gloves, which illustrates the potential of simulating patient palpation training in virtual or remote medical diagnosis. [ABSTRACT FROM AUTHOR]

Abstract Background Despite being a vital part of medical workforce planning and development, how medical students and graduates choose their career specialty is still not well understood. This study aimed to identify the factors medical graduates consider important influences in their choice of specialty after their first year of practice, and to test the validity of relying on respondent recall to measure changes in specialty choice. Methods The baseline survey was administered online to all final year students in Ireland’s six medical schools. Those who consented to follow-up (n = 483) were surveyed 18 months later (June 2018), during the final month of first year of practice. Results The baseline survey had a 67% (n = 483) response rate. At the follow-up survey, (n = 232, 48% response rate) the top specialty choices were: Medicine, n = 54 (26%); Surgery, n = 34 (16%); General Practice, n = 28 (13%); Anaesthesia, n = 16 (8%) and Paediatrics, n = 14 (7%). Of the 49 respondents (28%) reporting a change of specialty since baseline, 13 (27%) selected the same specialty in both surveys; of the 121 (69%) reporting no change, 22 (18%) selected a different specialty at follow-up. Over 90% of respondents rated as ‘important or ‘very important’: ‘Own aptitude’, ‘Work-life balance’ and ‘What I really want to do’. Over 75% rated as ‘not at all’, or ‘not very important’ ‘Current financial debt’ and ‘Inclinations before medical school’. When adjusted for sex and age, compared with Medicine, General Practice rated as more important: continuity of patient care (RRR 3.20 CI(1.59–6.41), p = 0.001); working hours/conditions (RRR 4.61 CI(1.03–20.60), p = 0.045) and a career that fit their domestic circumstances (RRR 3.19 CI(1.27–8.02), p = 0.014). Those choosing Surgery rated as less important: patient contact (RRR 0.56 CI(0.33–0.95), p = 0.033) and working hours/conditions (RRR 0.55 CI(0.31–0.96), p = 0.035). Conclusions The different demographic and motivational profiles by specialty choice are consistent with other studies suggesting a distinct profile for doctors intending to enter General Practice. In addition, our results suggest longitudinal study designs guard against recall bias and so provide more robust medical workforce models to inform and direct recruitment drives and interventions in future medical workforce planning.

Abstract Background The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019–2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact of the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors. Methods An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. Results Clerks from 10 of the 17 Canadian medical faculties participated in this study (n = 627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25 ± 4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. Conclusion The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.