Competency-Based Evaluation Methodology Enhances Learning During Internship: A Pilot Study

A Multicenter, Randomized, Single-blind, 2-Arm Intervention Study Evaluating the Adverse Events and Quality of Life After Irreversible Electroporation for the Ablation of Localized Low-Intermediate Risk Prostate Cancer. Letter.

Objective This is a preliminary research of using 3D printing and computer modeling technology in orthopedic clinical teaching to eight-year program medical students. Methods Eighty students from eight-year program medical specialty of Huazhong University of Science and Technology were randomly divided into two groups. 3D printing and computer modeling technology was applied in the observation group. Traditional teaching method was applied in the control group. All students were examined with theory and standardized patients after class, and filled out questionnaires about teaching satisfaction. Results The average examination scores of theory and standardized patients were higher in observation group than in control group. More teaching satisfaction was got in observation group comparing to control group(P<0.05). Conclusions Using 3D printing and computer modeling technology in orthopedic teaching to eight-year program students can improve the teaching effect and satisfaction. It could be a potential choice in orthopedic teaching in future. Key words: 3D printing; Computer modeling; Orthopedics; Eight-year program medical education

Patients with urological tumours may exhibit varying degrees of physiological and psychological distress during the course of treatment. This study aims to explore the influence of psychological nursing model based on the Rosenthal effect on the mental health and quality of life of patients. The clinical data of 120 patients who underwent surgical treatment of urinary system tumours in the department of urology in our hospital from June 2023 to October 2023 were collected retrospectively. The patients were divided into the observation and control groups according to the nursing mode under the Rosenthal effect. Fifty cases were assigned in the observation group, and 70 cases were placed in the control group. The intervention period was 2 weeks and 3 months. The patients were scored and compared according to Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), 36-Item Short-Form (SF-36), and Pittsburgh Sleep Quality Index (PSQI) the day before and after the intervention cycle. After nursing, the scores of SAS, SDS and PSQI in the two groups were lower than those before nursing. Compared with the control group, the observation group had a higher decrease. The SF-36 score in both groups after nursing was higher than that before nursing, and the score in the observation group after nursing was higher than that in the control group (p < 0.05). The psychological care model based on the Rosenthal effect can effectively improve the psychological health and quality of life of urological oncology patients in the postoperative period. This intervention is worth to be promoted and practiced in medical institutions and professional fields.

Objective To analyze the difference and correlation of the evaluation of the medical students' communication ability between the examiners, standardized patients (SP) and medical students themselves in objective structured clinical examination (OSCE), and to provide scientific basis for the appropriate evaluation method of medical students' communication ability. Methods OSCE was used to evaluate the communication ability of 90 medical students in Daping Hospital, Chongqing, and the three parties were evaluated by the examiners, SP and medical students themselves. Excel and SPSS 17.0 statistical analysis software were used, through Friendman M test, t test and correlation analysis to analyze the differences and correlation of the three parties evaluations. Results The different evaluation between the three parties on the communication ability of medical students was as follows. Examiner's evaluation was the lowest (8.39±1.18), SP's evaluation was the highest (9.62±0.73), Medical students themselves' evaluation was higher (9.28±1.09); The examiner's evaluation of Medical students' empathy, verbal communication ability, non-verbal communication ability and etiquette was lower (P=0.00). The correlation analysis of the three parties' evaluation showed that there was a significant correlation between the three parties on the communication ability, empathy and nonverbal communication ability (P<0.05). The evaluation of SP and medical students themselves on medical students' language communication ability and etiquette was significantly correlated (P<0.05). Conclusions Using examiner or SP or medical students themselves only to evaluate the communication ability of medical students is not accurate, The Examiner and SP as the main trial test personnel should collaborate to evaluate medical students' communication ability. The examiner can evaluate three projects such as what is medical ethics and law, empathy, nonverbal communication ability, while the SP can evaluate the two projects: what is language communication ability and etiquette. The collaborative evaluation of the two sides can be more accurate to reflect the doctor-patient communication ability of medical students. Key words: Objective structured clinical examination; Medical students; Communication ability; Evaluation method

We explored the role of hindrance stress appraisal and psychological resilience in the relationship between work stress and work engagement among academic researchers. Data were collected from academic researchers in China (n = 314; female = 48.7%; professor = 10.8%, associate professor = 25.8%, assistant professor = 63.4%). The regression analysis findings indicated high work stress contributed to low work engagement. Hindrance stress appraisal played a partial mediating role between work stress and work engagement, for lower work engagement. Psychological resilience moderated the relationship between work stress and work engagement, for higher work engagement. Psychological resilience moderated the indirect mediating effect of hindrance stress appraisal between work stress and work engagement, for higher work engagement. These findings indicate a need for work resourcing for resilient work engagement of research communities for their healthy work stress and productive work engagement.

Objective To analyze the application value of language communication and psychological support in urodynamic examination of patients with benign prostatic hyperplasia (BPH) . Methods From July 2016 to October 2018, a total of 106 BPH patients who underwent urodynamic examination in the Department of Urology at the First Affiliated Hospital of Kangda College of Nanjing Medical University were enrolled as subjects. They were divided into the observation groups and the control group by random number table method, with 53 cases in each group. The control group was given routine nursing. The observation group was given language communication and psychological support intervention besides routine nursing. The incidence of abnormal abdominal pressure changes, unnatural detrusor contraction, and unnatural external urethral sphincter contraction, examination time, and examination success rate were compared between the two groups. At 20 min before the start of examination (T1) , 10 min after the start of examination (T2) , and 10 min after end of the examination (T3) , changes in hemodynamics indexes [systolic blood pressure (SBP) , diastolic blood pressure (DBP) , heart rate (HR) ]were also analyzed. The pain grading and incidence of complication during examination were compared too. Results The incidence of abnormal abdominal pressure changes, unnatural detrusor contraction, and unnatural external urethral sphincter contraction in the observation group was lower than that in the control group (P<0.05) . The examination time in the observation group was shorter than that in the control group, while the examination success rate was higher than that in the control group (P<0.05) . At T2, SBP, DBP and HR in the observation group were lower than those in the control group. At T3, SBP and DBP in observation group were lower than those in control group (P<0.05) . The pain grade of the observation group was lower than that of the control group (P<0.05) . The incidence of bladder irritation, fever, hematuria and dysuria in the observation group was lower than that in the control group (P<0.05) . Conclusions The application of language communication and psychological support in urodynamic examination for BPH patients can effectively improve examination efficiency, reduce hemodynamic fluctuations and pain, prevent or reduce complications risks so it is worth promoting in clinical practices. Key words: Prostatic hyperplasia; Urodynamic examination; Language communication; Psychological support

BACKGROUNDPostoperative nutritional management of gastric cancer (GC) remains a problem that needs to be solved in clinical treatment.AIMTo develop an early graded nutrition management plan and evaluate its impact on feeding tolerance, nutritional status, and prognosis.METHODSIn total, 142 patients who underwent laparoscopic radical gastrectomy at Jiujiang University Affiliated Hospital between August 2021 and August 2022 were included in this study. Based on postoperative nutritional management and feeding, the patients were divided into observation and control groups. The general information questionnaire, Visual Analog Scale, and Pittsburgh Sleep Quality Index were used to evaluate pain and sleep of patients, respectively. Independent sample t-test and χ2 test were used to analyze differences between groups.RESULTSThe feeding intolerance rates in the control and observation groups were 13.2% and 4.1%, respectively. Hospitalization time and first defecation times in the observation group were shorter than those in the control group. Hemoglobin, prealbumin, transferrin, and immunological indices in the observation group were significantly higher than those in the control group 7 days after surgery, whereas calcitonin levels were significantly lower than those in the control group (P < 0.05). In general, the nutritional status of the observation group was better than that of the control group, and pain and sleep quality scores improved.CONCLUSIONCompared with the conventional postoperative feeding, early stepwise nutritional management can significantly enhance the nutritional status of patients with GC after surgery, improve their feeding tolerance, and reduce postoperative complications.

Objective To explore the application effect of liquid sanyrene on preventing incontinence associated dermatitis for rectal cancer patients indwelling canal postoperation. Methods We systematically reviewed records of patients with rectal cancer whose excrement outflowed outside the canal from November 2015 to November 2016 at National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Patients were divided into liquid sanyrene nursing group (observation group) and skin care powder group (control group). And the incidence ofincontinence associated dermatitis and its severity were compared between the two groups. Results Ninety-six cases were included into our study, including 51 cases in observing group and 45 cases in control group. The incidence of incontinence associated dermatitis in observation group was lower than that in control group (X2=4.145, P=0.042). And the severity of incontinence associated dermatitis in observation group was lighter than that in control group (Z=-2.372, P=0.018). Conclusions The incidence of incontinence associated dermatitis is effectively prevented by using liquid sanyrene for rectal cancer patients indwelling canal post operation. Key words: Rectal neoplasms; Nursing services; Liquid dressing; Incontinent-associated dermatitis; Perianal

BACKGROUNDColon cancer is one of the most common malignancies of the digestive tract, often complicated by intestinal obstruction, which can significantly impact patient outcomes. While traditional laparotomy is the standard treatment, it is associated with large wounds, slower recovery, and higher complication rates. Laparoscopic surgery, a minimally invasive approach, may offer better outcomes for these patients.AIMTo evaluate the clinical effects and prognosis of laparoscopic surgery in patients with colon cancer complicated by intestinal obstruction compared to traditional laparotomy.METHODSA retrospective analysis was conducted on 100 patients diagnosed with colon cancer and intestinal obstruction who underwent surgical treatment between January 2020 and December 2022. Patients were divided into two groups: The control group (CG), treated with traditional laparotomy, and the observation group (OG), treated with laparoscopic surgery. Clinical effects, surgical indicators, postoperative pain, inflammatory response, complication rates, quality of life, and prognosis were assessed and compared between the two groups.RESULTSThe OG showed superior clinical outcomes compared to the CG (P < 0.05). Patients in the OG had shorter operation times, reduced intraoperative blood loss, faster recovery of intestinal function, earlier mobilization, and shorter hospital stays (P < 0.05). Postoperative pain (numerical rating scale scores) and inflammatory markers [tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)] were lower in the OG (P < 0.05). The incidence of complications was significantly reduced in the OG (6.00% vs 22.00%, P < 0.05). Quality of life scores, including physical function, psychological state, social communication, and self-care ability, were significantly higher in the OG (P < 0.05). There were no significant differences between groups in abdominal drainage volume, 1-year tumor recurrence or metastasis rates, or 1- and 3-year survival rates (P > 0.05).CONCLUSIONThe OG showed superior clinical outcomes compared to the CG (P < 0.05). Patients in the OG had shorter operation times, reduced intraoperative blood loss, faster recovery of intestinal function, earlier mobilization, and shorter hospital stays (P < 0.05). Postoperative pain (NRS scores) and inflammatory markers (TNF-α, IL-6, CRP) were lower in the OG (P < 0.05). The incidence of complications was significantly reduced in the OG (6.00% vs 22.00%, P < 0.05). Quality of life scores, including physical function, psychological state, social communication, and self-care ability, were significantly higher in the OG (P < 0.05). There were no significant differences between groups in abdominal drainage volume, 1-year tumor recurrence or metastasis rates, or 1- and 3-year survival rates (P > 0.05).

Objective: To evaluate the effect of multimodal analgesia using periprostatic nerve block anesthesia (PNB) combined with flurbiprofen in patients undergoing transperineal template-guided prostate biopsy (TTPB). Methods: Totally 166 patients (aged (68.2±9.1) years, range: 47 to 81 years) who received TTPB from October 2017 to June 2018 at Department of Urology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University were enrolled prospectively. All the patients were randomly divided into 2 groups. The observation group (n=79) was given flurbiprofen axetil 1 mg/kg intravenously for half an hour before operation and lidocaine was used for PNB before the biopsy. The control group (n=87) was given normal saline combined with PNB. A visual analog scale (VAS) and visual numeric scale (VNS) were used to assess the patients' pain and quantify their satisfaction at two time points: VAS-1 and VNS-1: during biopsy procedure, VAS-2 and VNS-2: 30 min after the procedure. The date were compared by t test, χ(2) test, Fisher exact test and two-way repeated measures anova analysis between the 2 groups. Results: The age, total prostate volume, serum prostate-specific antigen and the number of cores were comparable among the 2 groups (P>0.05). The VAS-1 scores of the control group and the observation group were 2.8±1.7, 1.9±1.2, respectively, and the VNS-1 were 3.1±0.7, 3.4±0.3, respectively. The VAS-1 were significantly lower in observation group than in control group (F=3.904, P=0.000). Conversely, the VNS-1 were higher in observation group (F=3.526, P=0.000). At 30-minute postoperative, the VAS-2 and VNS-2 were 0.7±0.4 and 3.7±0.2 in the control group, respectively. The VAS-2 and VNS-2 were 0.6±0.5 and 3.8±0.1 in the observation group, respectively. There were no significant differences in the pain scores or the satisfaction scores between the 2 groups (F=1.429, 2.825; P=0.136, 0.083). The incidence of overall complications was 26.4% (23/87) in the control group and 25.3% (20/79) in the observation group, with no statistical difference between the 2 groups (χ(2)=0.027, P=0.869). And the complications had no statistically significant difference among the 2 groups including hematuria, urinary retention, infection, hematospermia, vascular and neurological reactions, nausea, vomiting, dizziness, headache, and respiratory depression (P>0.05). Conclusion: The multimodal analgesia induced by PNB and flurbiprofen could effectively relieve the pain for patients who received TTPB.

Objective: To prospectively compare the efficacy and safety of the greenlight laser anatomical vaporization-incision technique (AVIT) and photoselective vaporization of the prostate(PVP)in the treatment of benign prostatic hyperplasia (BPH). Methods: From November 2019 to September 2020, a randomized controlled study was conducted on 136 BPH patients undergoing greenlight laser surgery in the Department of Urology, the Second Affiliated Hospital of Soochow University. The patient's age ranged from 53 to 85 years and the prostatic volume ranged from 30 to 104 ml. They were divided into two groups by random number table method,including 68 cases of AVIT(observation group)and 68 cases of PVP(control group). The clinical data of the two groups before, during and after operation were collected and analyzed. Results: Operations were successfully completed in the two groups. At 6 months after operation, 63 cases in the observation group and 66 cases in the control group completed the follow-up. There was no significant difference in the prevalence of hypertension, diabetes, coronary heart disease, atrial fibrillation and renal insufficiency between the two groups before operation (all P>0.05). The differences of preoperative age [(66.8±6.5) vs (67.3±5.4) years], international prostate symptom score (IPSS) [(24.2±4.7) vs (23.5±4.5) ], quality of life score (QOL) [4.7(4.1, 4.9) vs 4.6(4.2, 5.0)], peak urinary flow rate (Qmax) [(6.9±2.8) vs (6. 8±2.6) ml/s], post-void residual volume (PVR) [(137(52.8, 190.9) vs 119(70.6, 172.1) ml], prostate volume (PV) [70.5(60.6, 80.9) vs 68.2(61.2, 80.5) ml], serum prostate specific antigen (PSA) [4.4(3.5, 5.1) vs 4.4(3.4, 5.0) ng/ml] were not statistically significant between the two groups (all P>0.05). There was no significant difference in the amount of intraoperative blood loss, catheterization time and the postoperative hospitalization time between the two groups (all P>0.05). Compared with the control group, the operation time and lasing time of the observation group were longer[69.0(64.6, 75.0) vs 55.8(49.1, 63.4) min,(36.3±9.9) vs (31.3±9.3) min], and the intraoperaive laser energy consumption and laser energy density were higher[(297±20) vs (240±20) kJ,(4.50±1.35) vs (3.73±1.17) kJ/ml]. The differences were all statistically significant (all P<0.05). At the follow-up of 1, 3 and 6 months after operation, IPSS and QOL in the observation group were lower than those in the control group, and the differences were all statistically significant (all P<0.05). Qmax in the observation group was higher and PVR was lower than those in the control group, with statistically significant differences (P<0.05). Six months after operation, PV and PSA in the observation group decreased more significantly than those in the control group (56% vs 47%, 70% vs 60%, both P<0.05). No urethral stricture and urinary incontinence occurred in two groups after operation. The incidence rate of urinary tract irritation in the observation group was 6.3%(4/63),lower than the 18.2%(12/66)in the control group (P<0.05). There was no significant difference in the incidence rates of urinary retention, bladder neck contracture and secondary bleeding between the two groups (all P>0.05). Conclusions: Greenlight laser anatomical vaporization-incision technique is safe and effective in the treatment of BPH. Compared with PVP, AVIT has more prostate tissue removed and better curative effect, which is worthy of clinical promotion.

Objective To explore the application effect of six-step standard communication process in nursing communication with elderly patients with lung cancer. Methods A six-step standard communication process training was conducted for 38 nurses in the Thoracic Surgery Department of the First Affiliated Hospital of Zhengzhou University from January to June 2017 selected by purposive sampling. Nurses' Clinical Communication Competence Scale (NCCCS) was used to evaluate the changes of nurses' communication ability with patients before and after training. A total of 38 elderly patients with newly diagnosed lung cancer in Thoracic Surgery Department from January to December 2016 were enrolled as the control group, and during their in-hospital period of time, the nurses had not received the training and their communication was in the conventional way; a total of 35 elderly patients with newly diagnosed lung cancer in Thoracic Surgery Department from July 2017 to June 2018 were enrolled as the observation group, and during their in-hospital period of time, the nurses had already completed the training and their communication mode was based on the six-step standard communication process. The two groups were compared in terms of their scores in Profile of Mood States-Short Form (POMS) 24 hours after getting newly diagnosed (before intervention) , 24 hours before operation (after intervention) , and their nursing satisfaction degree upon discharge. Results After training, nurses' communication ability in difficult situations, emotional perception ability, emotional support ability, basic language communication ability and basic non-verbal communication ability were significantly improved with statistical differences (P 0.05) ; after intervention, the observation group had lower scores in dimensions of depression-dejection , tension-anxiety , anger-hostility , confusion-bewilderment , and fatigue-inertia than the control group with statistical differences (P<0.05) . The observation group had higher nursing satisfaction degree upon discharge than the control group with statistical differences (P<0.05) . Conclusions For elderly patients with lung cancer in Thoracic Surgery Department, the application of six-step standard communication process can effectively improve the nursing communication efficacy, improve patient's bad mood and improve nursing satisfaction. Key words: Lung neoplasms; Aged; Six-step standard communication process; Communication ability; Patient satisfaction

Objective To explore the application effect of the dual-mentor system in the standardized training in cardiovascular internal medicine. Methods 40 physicians received from January to December in 2016 and 40 from January to December in 2017 were selected as the control group and the observation group respectively. The control group was administrated with the traditional training mode, while the obser-vation group was administrated with the dual-mentor training model, namely a theoretical mentor and a skill mentor. The training was carried out in accordance with the training plan formulated by the teaching group. The training effect was investigated by questionnaire survey and compared with that of the traditional train-ing mode. Results Under the dual-mentor system, the physicians acquired more theoretical knowledge and clinical skills and their ability of doctor-patient communication was improved significantly. The complete mastery rate of the theoretical knowledge and clinical skills in the observation group was 42.5% and 35.0% respectively, significantly greater than that in the control group (15.0% and 12.5%, respectively, P<0.05). The ability of doctor-patient communication improved more significantly in the observation group than in the control group (92.5% vs. 77.5%, P<0.05), and the satisfaction with the teachers and the training arrangement was higher in the observation group than in the control group (82.5% vs. 60.0%, 82.5% vs. 52.5%, P<0.05). Conclusions The dual-mentor system has a definite effect on the standardized residency training of cardiovascular internal medicine, The dual-mentor system facilitates the mastery of professional knowledge and skills in residents, improves the ability of doctor-patient communication, and increases residents' satisfaction with the mentors and the training program, thereby worthy of widespread promotion and application. Key words: Dual-mentor system; Cardiovascular internal medicine; Standardized residency train-ing

To investigate the effects of integrating standardized patients with the situational simulation teaching method (SSTM) on nursing interns' learning outcomes, work capabilities and engagement in the respiratory department. Traditional simulation methods may lack realism and interactivity. Combining standardized patients with SSTM may provide a more immersive and effective teaching strategy. A randomized controlled trial. This randomized controlled trial compared the outcomes of traditional SSTM versus a combined standardized patient and SSTM approach. From April 2022 to April 2023, 108 nursing interns were randomly assigned to either a control group (traditional SSTM) or a research group (combined SSTM and standardized patients). Outcomes measured included theoretical and practical knowledge, self-directed learning, work engagement, caregiving skills, self-efficacy, stress levels and teaching evaluations. Nursing interns in the research group showed significant improvements in theoretical and practical knowledge, autonomous learning, work engagement, caregiving skills and self-efficacy, with a reduction in stress levels. Teaching evaluations rated the research group higher across multiple aspects. The integration of standardized patients with SSTM is an effective educational strategy that enhances learning outcomes, practical capabilities and motivation among nursing interns, offering a valuable approach for better preparing students for clinical practice.

In this study, we aim to explore the status quo of self-health management of patients with bipolar disorder and influencing factors. A total of 80 patients with bipolar disorder were included and assigned into the observation group and the control group, with 40 cases per group. The patients in the control group were given general health education, and those in the observation group were given personalized education combined with peer support. It was found that there was no significant difference in gender, age, educational degree, marital status, and living state between the observation group and the control group (P&gt;0.05). There are significant differences with regard to self-management between the two groups. The observation group showed stronger self-care ability, health education level, self-protection ability, and emotional control ability than the control group (P&lt;0.05). Before the intervention, no significant difference in Hamilton Depression Rating Scale (HAMD) scores was observed between the observation group and the control group (P&gt;0.05). After the intervention, the HAMD scores were lower in the observation group than in the control group (P&lt;0.05), suggesting an alleviation in manic and depressive episodes in the observation group. It was also revealed that the observation group exhibited lower Functioning Assessment Short Test (FAST) scores in all aspects than the control group, suggesting personalized education combined with peer support could significantly improve the quality of life of patients with bipolar disorder. Self-health management ability of the patients was regarded as the dependent variable and healthy education level, health literacy, and objective support as the independent variables, and the regression model was performed. The results show that information acquisition ability, communication and interaction ability, objective social support, subjective social support, and utilization of social support can all affect the self-health management ability of patients. Personalized education combined with peer support can effectively alleviate the condition of patients with bipolar disorder, improve the degree of overall functional impairment, enhance the patient’s self-management ability, and promote their recovery. It is worthy of promotion and application. In conclusion, information acquisition ability, communication and interaction ability, objective social support, subjective social support, and utilization of social support can all affect the self-health management ability of patients.