Years Of Training Research Articles

Effects of Successive Annual Training on Young Swimmers’ Strength Asymmetries and Performance

This study aimed to compare changes in swimmers’ performance, biomechanical variables, and strength asymmetries within two successive training years. Eight competitive age-group swimmers (four males and four females; age: 14.8 ± 1.3 years) were tested before and after the same 12-week mesocycle period within two successive years (Year-1, Year-2). The swimmers were timed in 50, 200, and 400 m, and the stroke rate (SR), stroke length (SL), and stroke index (SI) were calculated. SI was calculated by the product of SL with swimming speed. Dryland shoulder isometric strength (ISO), hand grip isometric strength test (HG), and in-water maximum 30 s tethered swimming force (TF) were evaluated. The asymmetry index was calculated using ISO, HG, and TF tests as [(Fd − Fnd)/0.5 × (Fd + Fnd)] × 100, where Fd is strength in the dominant hand and Fnd is strength in the non-dominant hand. Performance time improved in 200 and 400 m, while the asymmetry indices calculated by the ISO, HG, and TF tests were similar after 12 weeks of training in both Year-1 and Year-2 (p = 0.01). Changes (Δ) in HG strength asymmetries correlated with Δ in 200 and 400 m in Year-2 (r = 0.78–0.87, p = 0.01). The asymmetry index does not change after two successive years of training but may be connected to performance changes in 200 and 400 m front crawl.

Impact of advanced endoscopy training on colonoscopy quality and efficiency.

Few reports have detailed improvements in the quality of colonoscopies with continuous training post-fellowship completion. We examined the changes in colonoscopy performance among trainees during our advanced endoscopy training program. Screening or surveillance colonoscopies performed by 11 trainees who participated in our 3-year advanced endoscopy training program between April 2015 and March 2020 were retrospectively analyzed. Quality and efficiency metrics of colonoscopies were evaluated annually. Altogether, 297, 385, and 438 colonoscopies were enrolled in the first, second, and third training years, respectively. The mean insertion times were 8.6, 7.6, and 6.9 min in the first, second, and third training years, respectively, with significant improvement from the first to second year (p = 0.03) and from the first to third year (p < 0.01). The adenoma detection rate, proximal adenoma detection rate, and mean number of adenomas per patient exhibited a tendency to improve annually; however, the difference was not significant. Polypectomy efficiency was 10.5%, 11.2%, and 13.0%, with significant improvements from the first to third year (p < 0.01) and from the second to third year (p = 0.02). Insertion time and polypectomy efficiency showed significant improvements, especially among trainees experienced with <500 colonoscopies. Through our advanced endoscopy training program, there has been an improvement in the quality and efficiency of colonoscopy for trainees who have completed their fellowships, particularly those with <500 colonoscopies.

Building the clinical workforce of pediatric infectious diseases in Bolivia for better care of children with cancer

Abstract Background Infections in children with cancer can be fatal if not appropriately managed. Access to trained and competent professionals in infection care and prevention (IC&amp;P) improve care outcomes. Bolivia expects about 1700 new pediatric cancer cases annually. In 2023, 2371 hematological neoplasms were reported in children, cared mainly at 4 public hospitals where, until 2016, 5 pediatric infectious disease (PID) specialists were working in 2 of these 4 hospitals. For better PID clinical workforce for critically ill children, we built a PID medical residency training. In 2017, the training accepted its first trainees at Hospital del Niño “Dr. Ovidio Aliaga Uría” (Hospital del Niño), a public hospital in La Paz. Here, we describe the program, how we built it, and its outcomes. Methods The PID training goal is to train leaders in PID for clinical observations, PID literature interpretation, and to transform them into concepts that can be applied to ID pathogenesis or treatment. At the end of the 2-year PID training program, we expect trainees will gain expertise in PID clinical practice and clinical or translational science research. Our PID program was based on other PID specialty training programs from Mexico, Spain, and the USA of which, we adapted standard topics and formats of training. The content has routine and prevalent PIDs of Bolivia and the region, including on immunocompromised patients. We expected that the trainee dedicate full time to the PID training program plus caring for assigned patients and those requested consultations in the wards and clinics of Hospital del Niño; review articles; participate in clinical discussions; attend the Infection Control Course of St. Jude Children’s Research Hospital; attend and / or present in the PID case-based learning international sessions; visit the virology, bacteriology, parasitology and immunology laboratories of the national reference laboratory; and attend international rotations at participating hospitals. Results Since 2017, 5 new PID pediatricians graduated from our program, 3 work in public hospitals that care for children with cancer and 2 work in government insurance hospitals. They are working in hospitals in La Paz (n=2), Cochabamba (n=1), Santa Cruz (n=1), and Tarija (n=1). These graduates are leaders in ICP, antimicrobial stewardships, and education of hospital staffs. As per December 2023, they produced 5 articles for local journals, 2 for international journals, 7 abstracts for scientific meetings. Currently, 2 pediatricians participate in the PID training program, and post-graduation, they plan to work in departments of Potosí and Sucre where there are no PID specialists. Challenges to establish PID specialists in Bolivia are lack of value attributed to PID and its role in care quality. Conclusion Creating local expertise in PID are essential to improve and sustain the optimum care for children with cancer in Bolivia especially in places where these personnel did not exist before. However, for best investment return of PID trained professionals, having PID job descriptions and paid positions in hospitals will absorb PID specialists to benefit the largest population of children with cancer in Bolivia.

Annual Training Program in Radiological Protection in a Radiotherapy Service – A Case Study

The safety and radiological protection in radiotherapy services are essential to ensure the safe use of ionizing radiation for the benefit of patients and involved professionals. Evaluative research on multidisciplinary teams regarding annual training in radiological protection in radiotherapy is scarce. It is crucial to understand how professionals from each area assess the acquired knowledge and apply theoretical precepts in the radiotherapy service. This study aimed to analyze the annual radiological protection training offered in a radiotherapy service, and as specific objectives, to map the knowledge of professionals from each area regarding radiological protection applied during training. This is a qualitative research of the case study type. Data collection occurred through semi-structured interviews, simple observation, and documentary analysis, organized in the ATLAS.ti software version 24. The results indicate significant challenges, including the lack of understanding of basic principles by professionals, the absence of integration between the team and supervisors, and the lack of clear definition of the training format in current regulations. The results were categorized into: professionals' knowledge of radiological protection; training weaknesses; training strengths; suggestions for training delivery methods and topics in radiological protection. More effective educational strategies, along with precise guidance on the training format, emerge as promising solutions to overcome these challenges.

Scotland's internal medicine simulation strategy: A 5-year journey

In 2019, the internal medicine (IM) stage 1 curriculum was implemented in the UK. This introduced a revised 3-year training programme for physicians in training. The new IM stage 1 curriculum emphasised simulation-based education, triggering the integration of simulation training on a national scale in Scotland. Bespoke training courses were developed for IM trainees in Scotland, spanning all 3 years of their training programme. Each course was meticulously designed with input from key stakeholders and trainees, aligning learning objectives with curriculum outcomes. The Scottish IM simulation strategy encompasses a 3-day bootcamp in IM year 1, a 1-day skills day in IM year 2, and a 2-day ‘registrar ready’ course in IM year 3. These courses, delivered at central locations, focus on immersive simulation, communication workshops, and simulation-based mastery learning of procedural skills. Evaluation of the programme includes pre- and post-course questionnaires, data tracking over the training programme, interviews with trainees and faculty, and annual review days to gather feedback and make necessary adaptations. The impact of the programme for trainees includes transfer to clinical practice of communication skills, improved non-technical skills, and increased confidence in procedural skills. Alignment with the IM stage 1 curriculum supports trainees’ annual reviews of competence progression. The IM simulation training also offers valuable social benefits and remains crucial, especially with increased pressure in the NHS. It is our belief that ongoing delivery of this training is invaluable to the IM stage 1 programme in Scotland.

The Leaders in Informatics, Quality, and Systems (LInQS) Fellowship.

Leaders in Informatics, Quality, and Systems (LInQS) is a non-ACGME (Accreditation Council for Graduate Medical Education)-accredited 2-year training program developed to enhance training in the fields of health care delivery, quality improvement (QI), clinical informatics, and leadership. This single-institution 2-year longitudinal training program grounded in QI and informed by leadership and clinical informatics includes didactics, coaching, and mentorship, all centered around individualized QI projects. The program has been available to sub-specialty fellows, advanced practice providers, and physicians. From 2019 to 2023, 32 fellows have been accepted into the program with 13 graduates and 16 currently enrolled. Fellows have been predominately female, physicians, and from multiple specialties but predominantly hospital medicine. Fellows' evaluations of the fellowship are highly positive, rating the didactics and mentorship aspects of the curriculum most favorably. Most fellows' projects utilized informatics solutions including clinical decision support tools to increase quality of care, improve patient outcomes, and reduce costs of care resulting in manuscript publications, national presentations, and a national specialty society award. Since matriculation, 50% of fellows received certification as Epic Physician Builders and 34% received leadership positions in clinical informatics, quality, and education. Our experience supports the need to provide health care providers more expansive training in the areas of QI, clinical informatics, and leadership for improving health care delivery. Additional in-depth knowledge and experience in these fields may produce and benefit leaders in these fields.

A community health worker–led intervention to improve patient knowledge and receipt of precision medicine: Updated ALCANCE randomized clinical trial findings.

181 Background: Inequitable access to precision medicine limits its impact. To address disparities, we co-developed the Addressing Latinx Cancer Care Equity Study (NCT04843332), a multi-level intervention with community stakeholders. ALCANCE was designed for low-income and Latinx adults with cancer in rural Monterey County, California. We provided annual training for clinicians about testing guidelines and precision medicine disparities. Trained CHWs educated patients about precision medicine and encouraged them to raise the topic with their oncologist. We tested whether the intervention improved patient knowledge and receipt of precision medicine. Methods: Patients with newly diagnosed or recurrent cancer, age ≥ 18 years, able to consent in English or Spanish, and who self-identified as a racial and ethnic minority OR low-income status OR were insured by public or agricultural company insurance OR uninsured and receiving cancer care at Pacific Cancer Care, a rural community oncology practice in Monterey County, were randomized 1:1 to usual care (control group) or usual care augmented with the multi-level intervention for 12 months (intervention group). The primary outcome was whether the multilevel intervention could increase patient knowledge of precision medicine using a validated 6 question survey from time of enrollment (baseline) to 6-months post-enrollment between groups. A secondary outcome was receipt of precision medicine. CHWs and clinicians completed semi-structured interviews. Results: 110 participants were randomized; 70% (n = 67) reported Spanish as their primary language; 81% (n = 89) identified as Hispanic. Median age was 55 years (55.4 ± 14.3, mean± SD); majority had annual household incomes (USD) ≤ $34,999 (59.0%, n = 46); majority obtained a high school diploma/GED or less (67.3%, n = 74). Most had gastrointestinal (35.5%, n = 39) and breast (24.5%, n = 27) cancers and were diagnosed with stage 3 or 4 (64.5%, n = 71) disease. Precision medicine knowledge was low at baseline across both the control and intervention groups (23.5 ± 19.3 versus 23.0 ± 17.7, respectively). Intervention group participants had greater precision medicine knowledge at 6-months (39.2 ± 23.0) than control group participants (24.2 ± 20.0) with greater increase in knowledge overtime than control group participants (p &lt; 0.001). More intervention group participants (n=46, 79.3%) received precision medicine testing than control (n=34, 60.7%). Across both groups, 26 of those tested had an actionable mutation. Of those 26, 66.7% (n=6 of 9) in the control group and 94.1% (n=16 of 17) in the intervention group received targeted therapy (p=0.065). Interviews with the care team indicated the model was acceptable and has been sustained as part of usual care. Conclusions: CHW-facilitated interventions may reduce disparities in precision medicine cancer care. Clinical trial information: NCT04843332

Vaccination should be everyone's business: Challenges in vaccinating pregnant women against influenza in the Republic of Moldova

SynopsisObstetricians/gynecologists are not included in annual influenza training and have contraindicated influenza vaccines to pregnant individuals, representing a missed opportunity for a provider recommendation.

Breaking chains of tobacco: empowering African American churches in West Virginia for a healthier future.

Across West Virginia, tobacco use continues to be a significant public health challenge. Specifically, tobacco use is linked to high poverty across the state and disproportionately affects African Americans. A faith-based tobacco prevention network was formed to address these concerns and increase education and cessation. The West Virginia African American Tobacco Prevention Network (WVAATPN) was formed in 2021 and since then has expanded its reach across the state, involving 22 congregations. The Network's model includes annual training for lay leaders on various tobacco-related topics, tailored educational curriculum for congregations, and collaboration with national experts to enhance program efficacy. The Network has run educational and cessation workshops and promoted events such as No Menthol Sunday. Workshops have yielded positive outcomes among participants, including increased awareness of tobacco marketing tactics, higher cessation rates, and improved understanding of the health impacts of tobacco. The WVAATPN continues to expand its reach and effectiveness by advocating for policy change, enhancing community engagement, and fostering partnerships to combat tobacco-related disparities in West Virginia's African American communities.

Evaluation of the Annual Physical Training Examination and Possible Suggestions for Change in the Endurance Discipline of Running

The annual examination is an integral part of the physical training system of a soldier of the Army of the Czech Republic, which assesses his physical fitness. This assessment provides dual feedback - it informs examinees of how they are performing against normative tables and each other, and at the same time, gives commanders an idea of the current physical fitness of their subordinates. This thesis focuses on the endurance event of the 12-minute run (also known as the Cooper test). Based on data from 2011 to 2021 and nearly 50,000 evaluated tests, the potential effects of age on soldiers' physical performance and appropriate adjustments to individual age limits were examined. The analysis showed that the difficulty setting for achieving the same rating differs for both genders and that there is a different decline in physical performance with increasing age than reflected in current norms. Based on these analyses, a proposal for modifications to the annual physical training test was developed and is appended to this paper.

Effect of Annual Yoga Training Programme on Physical Fitness Breathe Holding Time and BMI of Boarding Male Students

Effect of Annual Yoga Training Programme on Physical Fitness Breathe Holding Time and BMI of Boarding Male Students

Damage Control Training: A Cross-sectional Survey of Health care Personnel of French Emergency Medicine Structures.

Terrorist threats are a worldwide phenomenon. The injuries caused with military weapons or explosives are multiple and unusual for civilian care services. Damage control (DC) training has then become a critical need. In response to the November 2015 attacks, the French authorities launched a national DC training campaign for emergency care personnel. The aim was to describe the implementation of DC training campaign and its perception according to the respondent's profession, DC teaching levels, and the history of terrorist attacks in the last decade of the hospital center's activities. A survey was distributed to all Casualty Department staff in France. The answers were collected between June 9, 2020 and July 22, 2020. The project was qualified as not involving humans and participation was on voluntary basis. The study is out of the French Jardé law. Two-thirds of the 1,525 respondents considered themselves trained in DC (emergency physicians [76.8%], nurse anesthetists [68.1%], and ambulance drivers [65.3%]). Less than half considered their theoretical (41.1%) and practical (44.7%) knowledge excellent or good. More than 95% of the untrained personnel wanted to receive this type of training. Trained personnel were in favor of annual refresher training (95.7%) and training for practical applications (95.1%). Personnel at teaching centers were more frequently trained than personnel at nonteaching centers (respectively 75.3% and 64.3%, P < .0001) and had applied their knowledge significantly more often (50.1% vs. 43.4%, P = .038). They often considered their knowledge to be excellent (respectively 50.8% vs. 42.4%, P = .064). The training of emergency personnel in DC is far from being generalized in France. Among the trained personnel, it was often deemed insufficient, in theory and in practice. There was an inequity of training in favor of those in teaching centers. It is therefore essential that training in DC techniques in France be continued, generalized, improved, and standardized throughout the country in order to guarantee an optimal response from the health care systems in the event of new terrorist attacks.

The tasks of the stages of the annual cycle, the solution of which is the basis for improving physical qualities, which ensures the effectiveness of middle-distance running of athletes at the stage of specialized basic training

The current training method focuses on the athlete at the stage of specialized basic training to further achieve a consistent level of development of special strength, as well as basic strength and strength abilities, It is fundamentally necessary to thoroughly understand the technical and tactical abilities of a mid-distance runner in the minds of a high level for The highest level of basic tasks is to achieve a high level of diversity and the interconnection of all types of preparation - physical, technical, tactical, psychological, moral-volitional, etc. Based on periodization systems, we improved the annual training macrocycle for middle-distance runners in the third year of specialized basic training, which includes: 2 autumn-winter and spring-summer macrocycles, 6 main periods and 16 training stages, which include 18 mesocycles and 52 microcycles. Considering the stages of preparation of the annual training cycle as the basis of the training process of middle-distance runners at the stage of specialized basic training, we developed groups of exercises with different predominant orientation, and on this basis, model microcycles of each stage were built depending on the tasks. On the basis of the annual training macrocycle of qualified middle-distance runners in the third year of training at the stage of specialized basic training, the main tasks of the stages of the annual training cycle of different predominant orientations were developed, which are the basis for improving the components of physical qualities. The developed tasks of the stages of the annual training cycle are aimed at increasing the capabilities of the aerobic system, the aerobic-anaerobic system, as well as the anaerobic energy supply system, which will make it possible to lay an aerobic-anaerobic base on which middle-distance runners will successfully perform large volumes of special work, carry loads more easily, and recover faster after them at the stage of specialized basic training.

Considerations to Optimize Structurally Responsive Work Environments for U.S. Military Specialty Physicians.

Recruitment, training, and retention of wartime critical specialty physicians may be stymied by discrimination and abuse. It is unclear to what extent the US combat specialty physicians witness or experience discrimination and abuse, whether they or others intervene, and if they would subsequently discourage people from entering their field. The present study surveyed US active duty anesthesiologists, emergency medicine physicians, and orthopedic surgeons (N = 243; 21% response rate). A generalized linear model evaluated the extent to which gender, specialty, service, and number of witnessed/experienced negative/stigmatizing comment/event types were associated with burnout. A bootstrapped mediation analysis evaluated whether gender and burnout were mediated by the number of comment/event types. The sample was majority non-Latine White (87%) and men (66%) with tri-service and specialty representation. The most commonly reported negative/stigmatizing comment/event types were related to pregnancy (62%) and parental leave (61%), followed by gender and assigned sex (42%), lactation (37%), and sexual harassment (35%). Of the respondents who witnessed/experienced such comments/events, self-intervention was reported after comments regarding lactation (43%), assigned sex and gender (42%), race and ethnicity (41%), pregnancy (41%), parental leave (37%), and sexual harassment (24%). Witnessing another person intervene was reported after sexual harassment (25%) and comments/events regarding race and ethnicity (24%), pregnancy (20%), assigned sex and gender (19%), lactation (19%), and parental leave (18%). Nonintervention was reported after comments/events related to parental leave (42%), pregnancy (38%), sexual harassment (26%), lactation (26%), assigned sex and gender (26%), and race and ethnicity (22%). Respondents reported moderate-to-high intervening likelihood, importance, and confidence. Respondents reporting neutral to extremely agree on prompts indicating that pregnant active duty physicians are trying to avoid deployment (P = .002) and expect special treatment that burdens the department (P = .007) were disproportionately men (36% and 38%, respectively) compared to women (14% and 18%, respectively). The highest proportion of neutral to extremely agree responses regarding discouraging specialty selection were reported in relation to transgender and gender diverse students (21%), followed by cisgender female students (18%); gay, lesbian, or bisexual+ students (17%); cisgender male students (13%); and racial and ethnic minoritized students (12%). In the primary model, the number of witnessed/experienced comment/event types was associated with greater burnout (0.13, 95% CI 0.06-0.20, P = .001), but women did not report significantly different levels of burnout than men (0.20, 95% CI -0.10 to 0.51, P = 0.20). The number of comment/event types mediated the relationship between gender and burnout (0.18, 95% CI 0.06, 0.34; P < .001). Although reported intervening confidence, likelihood, and importance were high, it is unclear whether perceptions correspond to awareness of intervention need and behaviors. Bivariate differences in burnout levels between men and women were fully explained by the number of comment types in the mediation model. Annual trainings may not effectively address workplace climate optimization; institutions should consider targeted policy and programmatic efforts to ensure effective, structurally responsive approaches.

Jump Squat Vs. Resisted Sprint Training Programs Applied to Elite Youth Soccer Players: Effects on Sprint and Power-Related Performance.

Loturco, I, Pereira, LA, Mercer, VP, Oliveira, LP, Zanetti, V, Lima, L, Bastos, T, Moura, TBMA, and McGuigan, MR. Jump squat vs. resisted sprint training programs applied to elite youth soccer players: effects on sprint and power-related performance. J Strength Cond Res XX(X): 000-000, 2024-This study examined the effectiveness of 2 different and widely used training programs on the sprint and power-related performance of youth soccer players. Two distinct training strategies-vertically oriented jump squats (JSs) or horizontally oriented resisted sprints (RSs)-were executed under the same absolute loading conditions (i.e., 30% of the athletes' body mass [BM]) during a 4-week preseason period. Training schemes, loading intensities (based on %BM), and the number of experimental sessions were designed in conjunction with the soccer club's coaching staff, considering the calendar, available resources, and regular training programs. Twenty-five under-17 soccer players performed a series of speed, power, and jump tests before and after 10 resisted training sessions, consisting solely of loaded JS or RS. Overall, neither group (i.e., JS or RS training groups) exhibited any improvement in linear sprint and change-of-direction (COD) speed. Conversely, vertical jumping ability and peak velocity in the loaded JS increased significantly only in the JS group, which may positively affect players' performance and training prescription during short soccer preseasons. Given the challenges in enhancing sprint speed among soccer players during preseasons (and even over the competitive season), coupled with the limited effectiveness of RS in improving sprinting, COD, and jumping capabilities within congested and short training phases (i.e., ≤4 weeks), the regular use of RS training methods during these phases may be highly questionable. Coaches should carefully consider these critical limitations and potential disadvantages when designing neuromuscular training programs for soccer players during the preparatory phases of the annual training season.

Annual board orientation training helps new and old board members alike

Annual board orientation training helps new and old board members alike

Rheumatological care in Germany : Memorandum of the German Society for Rheumatology and Clinical Immunology 2024

Rheumatology in Germany is facing major challenges. The need for rheumatological care is increasing and can no longer be met in some regions for capacity reasons. Too many people with an inflammatory rheumatic disease (IRD) have to forego appropriate care or receive it too late. The 4thnew edition of the memorandum of the German Society for Rheumatology and Clinical Immunology (DGRh) provides information on rheumatological care in Germany. It was produced under the leadership of the DGRh together with the Professional Association of German Rheumatologists (BDRh), the Association of Acute Rheumatology Clinics (VRA), the German Rheumatism League (DRL) and the German Rheumatism Research Center (DRFZ). The memorandum describes the current state and development of the following areas: number of people with IRD, outpatient, inpatient and rehabilitative care structures, number of specialists in rheumatology, education and training, quality of care, health economic aspects and digital care concepts. Proposals for health policy measures to safeguard rheumatological care are presented. Prevalence: approximately 1.8million adults in Germany have an IRD. The prevalence is increasing, due to changes in the demographic structure of the population, improved diagnostics, treatment and longer survival. Care structures: outpatient specialist care (ASV) for rheumatic diseases is developing as across-sectoral care model for hospital outpatient clinics and rheumatology practices. Hospitals have been able to be certified as rheumatology centers since 2020, which enables structural developments. Specialists in rheumatology: as of 31December 2023, there were 1164 specialists in rheumatology working in Germany. This included 715 physicians accredited to work in practices for national health assurance patients, 39% of whom were employees. In hospitals, 39% of doctors worked part-time. At least 2rheumatology specialists per 100,000 adults are needed, i.e. around 1400, in order to provide adequate care. This means that there is ashortage of around 700 rheumatology specialists in the outpatient sector alone. Of all working specialists, 30% are currently aged60 years old and over. Medical training: only 10 out of38 (26%) state universities have an independent chair in rheumatology. In addition, 11rheumatology departments are subordinate to anonrheumatology chair. In the rheumatology-integration into student training (RISA)III study, only 16 out of 36faculties fulfilled the recommended minimum number of compulsory hours of student rheumatology teaching. Continuing education in rheumatology: the annual postgraduate training qualificationsdo not cover the demand for rheumatology specialists, which isadditionally increasing due to intensified workload, reduced capacities through retirement, and part-time work. Quality of care: since the introduction of highly effective medication patients with IRD have amuch better chance of achieving remission of their disease. With early initiation of targeted therapy, the lives of many patients are hardly restricted at all: however, waiting times for afirst rheumatological visit often last more than 3 months. Quality target is afirst consultation within the first 6 weeks after the onset of symptoms. Models for early consultation, delegation of medical services, structured patient training and digital care concepts have been positively evaluated but are not covered financially. the total annual costs for inflammatory joint diseases alone amount to around 3billion euros. The direct costs have significantly risen since the introduction of biologics, while the indirect costs for sick leave, disability and hospitalization have fallen. The core demands of this memorandum are asignificant and sustainable increase in the number of further training positions in the outpatient and inpatient sector, the creation of chairs or at least independent departments for rheumatology at all universities and the further implementation of new and cross-sectoral forms of care. This will ensure modern needs-based rheumatological care for all patients in the future.

Comparing virtual reality and simulation to teach the assessment and management of acute surgical scenarios: A pilot study.

Traditional apprenticeship-based surgical training presents with challenges, especially in acute scenarios. Simulation provides the current standard of facilitating surgical training in a low-risk environment but is restricted by limited accessibility and high costs. Virtual reality (VR) offers immersive three-dimensional computer-generated training scenarios and can connect users from various locations. We aimed to compare the performance of junior doctors to manage an acute surgical scenario using VR and mannequin-based simulation. We hypothesised that VR would be as effective as mannequin-based simulation in performance outcomes. This multicentre, randomised controlled pilot study was conducted with eighteen junior doctor volunteers (Foundation and Core Trainee Year 1). Ten were randomly allocated to VR and eight to mannequin-based simulation. Participants completed questionnaires and a 15-min pneumothorax scenario. Quantitative metrics included overall score, time-to-critical decisions, and academic buoyancy scores (ABS). Qualitative metrics included participants' likes and dislikes of their allocated simulation modality. VR participants scored significantly higher than mannequin-based simulation participants in overall scores (74.30% (SD ± 5.08%) vs. 59.75% (SD ± 10.14) (p = 0.04)), and technical skills aspects (77.20% (SD ± 8.01%) vs. 65.00% (SD ± 8.21%) (p = 0.01)). Mannequin-based simulation participants initiated critical decisions faster and demonstrated a trend towards a faster mean time-to-completion (p = 0.06). ABS scores increased for both study groups, though was only significant for VR participants (p ≤ 0.01). VR participants liked how VR fostered independent learning but disliked the formulaic content and impaired communication-learning compared to mannequin-based simulation. Both VR and mannequin-based simulation training are effective in training junior doctors in acute surgical scenarios but present different educational benefits. Future research should recruit a larger sample size for a full comparative randomised controlled trial.

Improving OBGYN resident CREOG scores

Background: OBGYN residents take an annual in-service training exam from the Council on Resident Education in Obstetrics and Gynecology (CREOG). The CREOG exam is used within the residency program to identify areas of improvement in education and to help residents prepare for passing the written boards. Introduction: This study’s aim was to improve knowledge and preparation for the CREOG exam through an improved didactic schedule and more focused test preparation strategy. This included incorporating a question bank and CREOG preparation throughout the year. Methods: The average standardized scores per resident class year for Corewell Health East- Dearborn were reviewed from 2019 to 2024. Study Design: The didactic schedule emphasized areas of weakness identified in the prior year, a question bank gamified, and CREOG preparation was initiated at the beginning of the academic year. Residents were also given a personal analysis with areas of improvement from prior years and a faculty liaison. Results: From 2019 to 2024, scores of each class year increased. In the PGY1 class year, the score increased from 54% in 2019 to 60% in 2024. In the PGY2 class year, the score increased from 57% in 2019 to 69% in 2024. In the PGY3 class year, the score increased from 55% in 2019 to 70% in 2024. In the PGY4 class year, the score increased from 58% in 2019 to 71% in 2024. The overall score has increased from 56% in 2019 to 67% in 2024. Discussion: Over six years, our residency didactic schedule and learning environment was revamped by our residents and faculty which resulted in improved scores in the CREOG exam. Conclusion: The improvement in CREOG scores will continue to guide future changes in our didactic schedule.

Addressing the Issue of Potential Workplace Violence Events for Sonographers and Vascular Technologists

Workplace violence is considered the act or threat of violence, exemplified by verbal threats and or physical threats perpetrated to an employee in the workplace. As part of the ongoing survey research being conducted, workplace violence events (WVEs), specific to sonographers and vascular technologists, were explored. These threats were further categorized based on the four types of WVE proposed by the Injury Prevention Research Center in 2001. Qualitative analysis of this survey data and voluntary comments, provided by study participants, were identified as condescending behavior, and being bullied as major workplace concerns. Further qualitative assessment of the comments resulted in identifying the added risk of Customer/client (Type 2) and Worker-on-worker (Type 3) WVEs, which are considered forms of verbal abuse. This information needs to be considered by each sonographer and vascular technologist and whether it is an issue in their workplace. In addition, a comprehensive workplace violence prevention program is advocated to address workplace incivility and promote worker health, safety, and well-being. Providing annual training is not enough, as workers need to have policies and resources readily available to address WVEs when they occur. These policies and resources should specifically address WVEs perpetrated by patients and co-workers.