Clinical Rotations Research Articles

Challenges and opportunities in pediatric surgery training in Germany: a view from the trenches

IntroductionPediatric surgery training in Germany faces significant challenges related to structural issues and resource limitations, including variability in training sites and a lack of standardized oversight. This study aims to assess the current state of pediatric surgery training including its structure, quality, and resident satisfaction and identify areas for improvement.Materials and methodsWe conducted an online survey between May 2022 and November 2023 using single-choice, multiple-choice and open-ended questions. Additionally, information was gathered via analysis of available statistics and through direct contact with the State Chambers of Physicians.Results75 pediatric surgery residents and 15 young specialists participated in the survey. 12 of 17 state medical chambers responded to our inquiry, but only 4 maintain detailed statistics. Training often extends beyond the planned six years, mainly (75%) due to insufficient surgical exposure. Residents reported a predominant role of attendings in surgical training and other residents in clinical training. They desired more involvement from chiefs in their education. A significant proportion (58.9%) noted a lack of dedicated scientific education. Nearly half (44.4%) of the respondents had changed training sites, primarily due to clinical rotations (26,7%) and dissatisfaction with training conditions (30,0%).ConclusionPediatric surgery residents in Germany face inconsistent training quality and extended training periods, mainly due to insufficient surgical exposure. They report that some chiefs do not meet their obligations as trainers adequately. To address these issues, there is a need for enhanced oversight, standardized curricula, more surgical exposure and improved collaboration among training institutions.

Reflections on Life, Loss, and the Importance of Empathy During Clinical Rotations

Reflections on Life, Loss, and the Importance of Empathy During Clinical Rotations

P-968. Academic - Practice Partnership to Advance Infection Prevention Education and Practice

Abstract Background Nurses entering the workforce must have the requisite knowledge, skills, and abilities to recognize, prevent, and manage infection in individuals and populations, and be prepared to respond collaboratively to local, regional, and global infection prevention and control (IPC) challenges. Studies indicate that IPC content is lacking in US baccalaureate nursing (BSN) programs and graduates feel ill-prepared to implement infection risk mitigation strategies to protect patients and health care workers. Establishing academic- practice partnerships between colleges of nursing and health system IPC programs could close this gap. Methods Our urban college of nursing, enrolling over 600 BSN students annually, convened a one-day invitational workshop focused on establishing an academic- practice partnership with our 18-hospital University-Health System IPC program. The workshop included presentations and small group work among expert inter-professional participants from IPC, nursing faculty and students, health system nursing, public health, and research. Results A strategy and research agenda was developed to advance BSN student IPC education and practice, including opportunities for infection preventionists to inform academic content and provide IPC student clinical practice experiences. As an immediate outcome, we conducted a survey of our graduating BSN seniors (n=345) to gauge perceived value of a clinical IPC rotation, and a survey of student’s clinical preceptors (n=345) to elicit perceived ability of students to transfer their classroom knowledge into clinical practice. A quarter of the 86 student respondents (25%) expressed value in doing a clinical rotation in the IPC department. Almost 100% of the 160 preceptor respondents (46%) indicated that students successfully adapt classroom knowledge to various clinical practice situations. Conclusion The workshop provided a forum to explore and begin to establish an academic- practice partnership between our college of nursing and the University-Health System IPC program. The survey results provide informative stakeholder data. The aim of this abstract is to report on the workshop proceedings, including short and long-term strategies, results of student and clinical preceptor surveys and next steps. Disclosures All Authors: No reported disclosures

Improving Medical Education in Oncology: Enhancing Students' Understanding of Cancer Treatments Through Multidisciplinary Clinical Rotations.

Cancer remains a leading cause of mortality worldwide, requiring physicians to understand multidisciplinary treatments. This study assessed the impact of a clinical rotation in a cancer center on medical students' knowledge of cancer treatments from a multidisciplinary perspective. A traditional single-department rotation was compared to a multidisciplinary rotation to determine whether broader exposure enhances knowledge and prepares students for multidisciplinary care. This prospective, comparative study was conducted between April and September 2024 at Institut Godinot, a regional cancer center. Medical students were divided into two groups: Group A (traditional model), where students remained in a single department, and Group B (multidisciplinary model), where students rotated through pharmacy, medical oncology, nuclear medicine, radiology, radiotherapy, and surgery. Knowledge acquisition was assessed using a 20-item multiple-choice questionnaire before and after the rotation, with scores out of 20 representing oncology knowledge. Among the 40 students rotating during the inclusion period, 28 (70%) completed both pre- and post-rotation assessments and were included in the analysis. A total of 13 students were in Group A and 15 in Group B. Students in Group B showed greater improvement in post-rotation scores (14.4 ± 1.7 vs. 11.4 ± 4.2, p = 0.06). Group B also had a larger increase in their score (1.9 ± 1.9 points vs. - 0.9 ± 5.3 points, p = 0.07). Multidisciplinary rotations improved students' understanding of oncology, suggesting this model should be expanded and further evaluated for its long-term impact on clinical competency.

Shaping future pharmacists: Transformative effects of clinical rotations on attitudes toward depression and diabetes care

Background: Clinical rotations play a vital role in preparing future pharmacists for the responsibility of providing care for patients with chronic diseases. This study aimed to evaluate the impact of clinical rotations on the attitudes of final-year pharmacy students at a Nigerian University toward providing Pharmaceutical Care (PC) for patients with depression and diabetes. Methods: This was a pre-post interventional study design among randomly selected final-year pharmacy students of a Nigerian public University. All participants took part in a nine-week clinical rotation. Two validated self-administered questionnaires were used for data collection before and after the clinical rotation. Descriptive statistics and paired sample t-tests were used for data analysis. Results: A total of 301 pharmacy final-year students participated in this study. The findings showed that clinical rotation improved students’ attitudes toward providing PC for patients with depression (29.90 ± 10.35 vs 32.00 ± 8.10, p = 0.006) but had no significant effect on diabetes care (32.47 ± 9.58 vs 33.60 ± 8.23, p = 0.120). However, pharmacy students had more positive attitudes toward providing PC for people living with diabetes than those with depression (30.95 ± 9.35 vs 33.03 ± 8.94, p < 0.001). Conclusion: Although clinical rotation improved students’ attitudes toward providing care for people with depression, the study findings underscore the need for the inclusion of more mental health training to ensure that future pharmacists are equally prepared to care for patients with both mental and physical illnesses.

Developing active learning activities for didactic perfusion courses.

In the world of academia, traditional lecturing has been the most common pedagogical approach for centuries. However, it can create an environment for students to be passive learners in the classroom. Alternatively, active learning is a pedagogical approach intended to encourage students to engage with content in manners which have been associated with improved exam performance, final course grades, clinical reasoning skills, and critical thinking skills. Given that perfusion is inherently a profession where didactic information must be applied in practice, the implementation of active learning in didactic courses is worth considering. Although active learning is practiced in perfusion education through participation in simulations and clinical rotations, there are no easily identifiable active learning resources available to supplement didactic perfusion courses. In response, written active learning activities were specifically designed for didactic perfusion courses. The activities were designed based on the format for guided inquiry worksheets, the incorporation of the learning cycle, and the implementation of process oriented guided inquiry learning (POGIL) strategies. Key concepts were identified, learning objectives were specified, and models (figures or tables of data) were created as targets of engagement and analysis. Following each model, questions and prompts are given to guide students through identifying, understanding, and exploring the concepts incorporated in the activity as well as opportunities to apply the newly gained knowledge and understanding. Ten active learning activities have been developed based on the methods summarized above. While the purposes of this paper are to inform the perfusion community of active learning and to share guidelines on how to create active learning activities for didactic perfusion courses, the goals of the activities are to provide examples to perfusion educators and to guide students in understanding basic perfusion concepts in a clinically relevant manner. It is recommended that perfusion students complete these activities alongside their didactic perfusion courses.

Medical Students' Observations of High Value and Potentially Wasteful Care Behaviors Modeled During Clinical Rotations.

Medical student exposure to role-modeling of high-value care (HVC) behaviors may shape professional identity formation and future HVC practices. To investigate the frequency and characteristics of HVC role-modeling witnessed by medical students during core clinical rotations. Cross-sectional survey study. Medical students on clinical rotations at 11 US medical schools. A validated 13-item survey was used to assess medical student perception of cost-conscious role-modeling behaviors or potentially wasteful role-modeling behaviors and modified to include whom demonstrated the behavior (attending vs resident/fellow) and during which clinical rotation the modeling occurred. Cost-conscious role-modeling behaviors were observed by medical students sometimes/often 52.9-70.5% (353/667-452/641) of the time across all clinical rotations, except for praising a student for ordering a cost-effective diagnostic work-up which was seen only 25.7% (143/556) of the time. Potentially wasteful role-modeling behaviors were observed sometimes/often 5-14.3% (26/537-87/609) of the time, except simultaneously ordering numerous tests before seeing results of initial screening tests 45.1% (273/605) and repeating tests rather than attempting to obtain recently performed test results 32.2% (194/602). HVC modeling was most often demonstrated by internal medicine attendings 67.7% (65/96) and least frequently by general surgery attendings 47.3% (17/36). Attendings were overall more likely to model HVC compared to residents/fellows. HVC role-modeling, as observed by medical students, is not consistently demonstrated across clinical rotations. Attendings generally model more HVC than residents and general surgery models less HVC compared to other specialties. Future studies should strive to identify factors which promote or inhibit HVC modeling.

Specialty choice among final-year medical students and house officers in Nigeria: implications for anaesthesia practice – a cross-sectional study

ObjectivesNigeria’s doctor shortage is worsening with mass exodus and imbalanced specialty distribution. Anaesthesia faces particularly critical shortages. Medical graduate specialty choices have a vital impact on the workforce and are...

Remediation in Pediatric Residency Training: A National Survey of Pediatric Program Directors.

The goal of graduate medical education is for residents to achieve the skills and knowledge to practice medicine independently. While remediation is not uncommon in residency training, evidence is lacking to guide best practices. We conducted a national survey of pediatric residency programs regarding their remediation experiences identifying struggling residents, documentating the process, and monitoring progress during remediation. A total of 50.8% (99/195) programs responded. Approximately 4.7% of residents underwent remediation, and 91% (262/288) of residents successfully completed remediation. Programs used data from the Clinical Competency Committee (CCC; 100%), rotation evaluations (98.9%) and direct observation (96.6%) to identify residents who need remediation. Most programs used an improvement plan to document resident progress (88.8%) and assigned a mentor or coach to support the resident (88.8%). Nearly all programs used rotation evaluations (93.3%) to monitor progress towards achieving the goals of remediation. Two-thirds (66.3%) felt their remediation process was either very effective or effective, and about half (56.2%) were very satisfied or satisfied with their remediation process. Programs with more residents who successfully completed remediation were more likely to feel satisfied with their program's remediation processess and effectiveness. Nearly 5% of pediatrics residents undergo remediation, with 91% successfully remediating. Two-thirds of program leaders feel their remediation practices are effective, and only half are satisfied with remediation processes in their program. Opportunities exist to improve remediation processes for pediatric residents and for programs to ensure graduation of competent pediatricians.

From shadowing to active learning: exploring the impact of supervised teaching clinics on gynecology education.

Supervised Teaching Clinics (STCs) have emerged as an innovative approach to medical education, particularly in specialties like gynecology, where hands-on experience is crucial. Traditional clinical rotations often leave students in passive roles, limiting their active participation and the development of essential clinical skills. This study aimed to evaluate the impact of STCs on the clinical competencies and professional development of medical students within a gynecological clinic, comparing the outcomes with those of traditional clinic shadowing. A total of 144 fifth-year medical students were randomly assigned to either a control group, which participated in traditional clinic shadowing, or an STC group, which engaged in both shadowing and supervised teaching activities. The study utilized the Generalized Self-Efficacy Scale (GSES) and the mini-Clinical Evaluation Exercise (mini-CEX) to assess clinical performance. Feedback was also collected from students, tutors, and patients to gage satisfaction and perceived effectiveness. Students in the STC group demonstrated significantly higher improvements in clinical skills, particularly in medical interviewing, counseling, and overall clinical competence, compared to the control group. The STC group also reported greater satisfaction with their learning experience, citing enhanced confidence and a deeper understanding of gynecological practice. Tutors and patients provided positive feedback, noting the STC's role in fostering effective student-patient interactions and comprehensive learning. The structured design of the STC, with a focus on goal direction, relationships, and supporting services, significantly improved educational outcomes in gynecology. By fostering active learning and delivering constructive feedback, STCs effectively enhance students' clinical competencies and professional development. The study suggests that integrating STCs into traditional clinical education models could substantially optimize medical training.

Integrating High-Value Cost-Conscious Care into an Existing Medical School Curriculum.

High-value cost-conscious care (HVCCC) education has been shown to reduce wasteful health care spending. Incorporating HVCCC into a medical school curriculum can be challenging due to limited curricular time. We explored the feasibility of medical students creating HVCCC peer education within existing platforms at a single urban academic medical school. We reasoned that curricular changes could improve student knowledge, attitudes, and competency with HVCCC within 2 hours and 25 minutes of curricular time. First-year medical student attitudes and understanding regarding HVCCC were evaluated via a survey before and after the delivery of a mixed asynchronous and in-person HVCCC curriculum created by two medical student peers. The curricula comprised three spaced asynchronous online sessions targeting HVCCC skill development followed by a gamified 90-minute clinical skills lab where students competed to determine the correct diagnosis at the lowest cost. One hundred and twenty-three medical students (out of 145 first-year medical students) completed the presurvey and indicated willingness to participate in the educational innovation, and 54 completed both surveys. Forty-two percent of students agreed/strongly agreed that the curriculum was effective/strongly effective at promoting cost-effective care. Sixty-five percent of students agreed they would likely use these resources during their clinical rotations. Comfort accessing HVCCC resources improved from 4% precurriculum to 41% postcurriculum. There was no significant difference in HVCCC knowledge pre- and postsurvey. This educational innovation demonstrated the feasibility of a peer-developed HVCCC curriculum in preclinical education that minimally impacted curricular time and improved student comfort in accessing cost-effective resources.

Perceived Preparedness for the Clinical Practice Among Medical Interns: A Cross-Sectional Study.

Measurement of medical graduates' perception of their internship program can help to improve the program to guarantee the general satisfaction of medical interns and enhance their clinical training. To evaluate the medical interns' perceived preparedness for clinical practice and investigate the contributing elements. The study was carried out to include 109 medical interns. Assessment preparedness for hospital practice questionnaire in Hospitals was used. For clinical practice, the vast majority of participants (81.7%) were either fully or very well prepared. However, no statistically significant relationship was observed between the intern characteristics and preparedness level. It was found that the interns were not well prepared regarding handling emergencies, dealing with dying patients (44%), inserting an intravenous line (35.8%), conducting a digital-rectal examination (31.2%), as well as speaking with the social worker about the patient (29%). Males scored significantly higher than females regarding the interpersonal domain. The results revealed that most interns were adequately trained for their clinical experiences. More emphasis on training in emergencies, catheterization, insertion of intravenous lines, and dealing with dying patients is required, in addition to continuous assessment of the interns after each clinical rotation to discover the areas of weakness.

Cardiac Ultrasound Training for Medical Students Utilizing Drawing and Ward-Based Instruction.

In this report, we present a cardiac ultrasound training module for medical student learners. The module assists medical students in developing foundational skills in image acquisition, identification of normal cardiac ultrasound anatomy, and demonstration of professionalism when performing the associated OSCE exam. We delivered the module across a 2-week cardiology rotation. On the first day, participants completed a pretest, a 1-hour introductory tutorial including a drawing exercise, and 1-hour of supervised practice with ward patients. Following supervised practice, participants were provided with an ultrasound machine for self-directed practice over the remainder of the clinical rotation. On the final day, participants completed a posttest and module evaluation. Pre- and posttest OSCE scores were compared to assess participants' cardiac ultrasound skills. A total of 121 students completed the module, of whom 116 completed the pre- and posttest. Median OSCE scores improved from 6 to 24 out of 39 (p < .001). Before the module, 9% of participants agreed or strongly agreed they were able to identify cardiac anatomy on an ultrasound of the heart, which increased to 98% after the module. Following the module, 92% of participants agreed or strongly agreed that ultrasound training helped with other learning on the cardiology rotation. We demonstrated that a brief training session followed by self-directed ward-based practice improved cardiac ultrasound skills in undergraduate medical students. Participants felt more confident identifying cardiac anatomy, and a large proportion felt the ultrasound training helped with other learning objectives on the cardiology rotation.

Accelerated competency-based education in primary care (ACE-PC): a 3-year UC Davis and Kaiser permanente partnership to meet California’s primary care physician workforce needs

ABSTRACT Problem Our nation faces an urgent need for more primary care (PC) physicians, yet interest in PC careers is dwindling. Students from underrepresented in medicine (UIM) backgrounds are more likely to choose PC and practice in underserved areas yet their representation has declined. Accelerated PC programs have the potential to address workforce needs, lower educational debt, and diversify the physician workforce to advance health equity. Approach With support from Kaiser Permanente Northern California (KPNC) and the American Medical Association’s Accelerating Change in Medical Education initiative, University of California School of Medicine (UC Davis) implemented the Accelerated Competency-based Education in Primary Care (ACE-PC) program – a six-year pathway from medical school to residency for students committed to health equity and careers in family medicine or PC-internal medicine. ACE-PC accepts 6–10 students per year using the same holistic admissions process as the 4-year MD program with an additional panel interview that includes affiliated residency program faculty from UC Davis and KPNC. The undergraduate curriculum features: PC continuity clinic with a single preceptor throughout medical school; a 9-month longitudinal integrated clerkship; supportive PC faculty and culture; markedly reduced student debt with full-tuition scholarships; weekly PC didactics; and clinical rotations in affiliated residency programs with the opportunity to match into specific ACE-PC residency tracks. Outcomes Since 2014, 70 students have matriculated to ACE-PC, 71% from UIM groups, 64% are first-generation college students. Of the graduates, 48% have entered residency in family medicine and 52% in PC-internal medicine. In 2020, the first graduates entered the PC workforce; all are practicing in California, including 66% at federally qualified health centers, key providers of underserved care.

The Impact of Clinical Rotation in Addiction Treatment Centers (AMATEM) on Attitudes and Behaviors of Psychiatry Residents Toward Individuals with Addiction

Aim: Psychiatry residents often feel unprepared and may exhibit negative attitudes toward individuals with substance use disorders, which can undermine treatment access and outcomes. This study examined the impact of a three-month Alcohol and Drug Treatment Center (AMATEM) rotation on residents’ attitudes and explored factors influencing these attitudes. Material and Method: Ninety-one psychiatry residents who applied for a three-month rotation training on addictions at Ankara Training and Research Hospital AMATEM Clinic completed a personal information form and the Attitudes and Behaviors Toward Substance Users Scale at the start and end of the rotation. Results: Residents’ stigmatizing attitudes significantly decreased post-rotation. Those who felt unsafe before the rotation reported higher stigma scores, and residents who believed they needed more education had fewer negative attitudes initially. Paradoxically, participants who anticipated referring patients to AMATEM due to insufficient training showed increased stigma after completion of the rotation. Conclusion: Overall, structured, practical, and case-based training—delivered under experienced supervision—can reduce negative attitudes and help residents feel safer. Further research should clarify how specific training processes influence the knowledge, attitudes, and beliefs of future psychiatrists regarding substance use disorders.

Nursing students and role modeled behavior while caring for LGBTQ + people: a cross-sectional, descriptive study

BackgroundWhile efforts to improve the educational preparedness of nurses to care for lesbian, gay, bisexual, transgender, and queer (LGBTQ +) people have increased, the influence of role-modeled behaviors by healthcare professionals working with nursing students and recent graduates is not well understood. The purpose of this study is to describe the role-modeled behaviors of healthcare professionals observed by nursing students and recent graduates caring for LGBTQ + patients in clinical settings.MethodsA cross-sectional, online survey was conducted. Recruitment of nursing students who had completed one or more clinical rotations or were recent graduates (≤ 2 years) was performed through university emails and social media. Items included measurement of stigmatizing attitudes, observed stigmatizing behaviors, and ability to provide inclusive/affirming care for LGBTQ + patients. Open-text items prompted participants to describe observed behaviors. Data were analyzed using descriptive statistics and Wilcoxon signed rank sum tests to evaluate differences between LGB (lesbian, gay, bisexual) and T + (transgender and gender diverse) subscales. Open-text responses were analyzed using thematic analysis to identify relevant themes.ResultsParticipants (N = 73) had a low level of stigmatizing attitudes toward LGBTQ + people (M = 1.8, SD = 0.4), although higher stigmatizing attitudes toward T + people were reported (M = 3.0, SD = 0.2; Z = -7.254, p < .001). Half of the participants reported that they observed LGBTQ + stigmatizing behaviors role-modeled by two + healthcare professional roles; approximately one-third of participants personally engaged in one + LGBTQ + stigmatizing behaviors, most commonly toward T + people. Themes from participants’ examples of observed stigmatizing behaviors included: cis-heteronormative bias, non-affirmation of chosen name/pronouns, outing patients, and rejected competency.ConclusionsThe majority of participants described observing stigmatizing behaviors toward LGBTQ + people in clinical settings. Poorer attitudes and a higher frequency of stigmatizing behaviors observed towards T + people point to deficits in healthcare provided to T + people in particular. Efforts to address LGBTQ + stigma in healthcare should be expanded to include clinical settings to address role-modeled behaviors and socialization of nurses.

Third-year medical students’ perceptions of confidence and readiness to perform EFAST after training

BackgroundAs Point-of-Care Ultrasound (POCUS) education is increasingly incorporated in undergraduate medical education (UME), evaluation of the effectiveness of various ultrasound-related curricula is a developing field. The Extended Focused Assessment with Sonography (EFAST) is a POCUS exam widely used in emergency medicine. This project examines third-year osteopathic medical (OMS III) students’ perceptions of the impact of a focused introduction to EFAST training curriculum on their performance ability and utilization of EFAST during third-year clinical rotations. Furthermore, we assessed student perceptions of barriers to the use of POCUS during third-year clinical rotations.MethodsThe introduction to EFAST curriculum was developed using competency-based backward design and was delivered in July 2022 to incoming OMS III students. The curriculum involved didactics, hands-on ultrasound practice with standardized patients, and a comprehensive OSCE assessment, where students performed the EFAST exam. In July/August 2023, curriculum participants were anonymously surveyed regarding the effectiveness of the EFAST curriculum and perceived barriers to EFAST and POCUS utilization during their third-year clerkships. Descriptive and thematic analyses were performed on quantitative and qualitative data.ResultsTwenty-one of 69 (30.4%) participants responded to the survey, with 17 (24.6%) participants completing the entire survey. Respondents reported increased knowledge and confidence in performing and interpreting EFAST, with 82.4% indicating increased likelihood of performing EFAST and POCUS in general. 76.4% performed EFAST at least once during third-year clerkships, with 11.8% performing it 15 times or more. Students reported valuing the safe simulated learning environment of the EFAST training, and identified lack of patients with indications for EFAST, time constraints, lack of ultrasound machine availability and clinician comfort level as barriers to EFAST utilization.ConclusionsThis study presents the implementation of a focused EFAST curriculum developed through competency-based deliberate backward design based on professional guidelines and the anticipated educational needs of our institution and community. Student perceptions provided valuable insight into access and barriers to EFAST and POCUS use in subsequent clinical clerkships, indicating student perception of POCUS curriculum effectiveness may provide insight to continual curriculum improvement.

Comparison of clinical independence level scores among predoctoral dental students between dental school clinic and community clinic rotation.

The aim of this study was to compare the difference in the level of clinical independence among predoctoral dental students during their community clinic rotation with their dental school clinic rotations. Descriptive statistics, assessment of sample normality, and T-tests were performed to present the difference in average independence scale scores for the participants in each of the clinical disciplines at dental school clinical rotations and community rotations. The relative impact of each community clinical site was assessed to compare scores assigned at varying locations by different faculty. This study analyzed 222 dental students, including 29 from International Dental Program (IDP) and 193 traditional Doctor of Dental Surgery (DDS) students. Community clinic scores showed greater variability, with significantly higher scores in diagnostics and operative dentistry compared to school clinics, where higher scores were noted in endodontics and oral surgery. IDP students scored lower than traditional DDS students in school clinics but outperformed them in community settings. Community clinic scores showed greater variation between 2023 and 2024 compared to the smaller changes observed in dental school clinic scores. This study highlights the impact of clinical setting, and duration on student procedural experience and performance, suggesting that varied clinical settings can enhance students' skills and readiness for practice. It reveals differences in DDS and IDP students' experiences due to prior training and potential evaluation biases. Study findings suggested lack of significant variance in the overall scores across different evaluators in community rotations. Future research should focus on refining evaluation metrics and better prepare students for practice.

Ultrasound education, competencies and expected future use among medical interns in Denmark: a national cross-sectional study

BackgroundPoint-of-care ultrasound is increasingly used across medical specialties, calling for timely and relevant ultrasound education in specialty training. To enable customizing such education, we aimed to explore medical interns’ received ultrasound education during medical school and internship, perceived scanning competencies, evaluation of received education, future expectations for using ultrasound, and tendencies for perceiving ultrasound competence.MethodsThis was a national cross-sectional study. We developed a questionnaire based on a theoretical conceptual model, individual interviews with medical interns and focus groups with medical students, followed by pilot testing. The questionnaire was distributed to all medical interns in Denmark (N = 1231). Data were summarized with descriptive statistics. Differences between universities and tendencies for perceiving ultrasound competence were analyzed with Fisher’s exact tests and modified Poisson regression, respectively.ResultsResponses from 420 (34.1%) interns were included. Although varying across medical schools, 95.7% received formal ultrasound training and 86.0% encountered ultrasound examinations through clinical rotation. During internship, 44.2% received formal training, while 68.5% had to pursue it independently. Ultrasound examinations during clinical work were observed by 73.2% and performed by 47.6%. Common ultrasound usage barriers were insufficient scanning routine, supervision, knowledge, confidence and mental surplus. Ultrasound competence gain from medical school and internship was reported by 75.2% and 55.3%, respectively, but mainly to lesser/some extent. Most desired more training, expected to use ultrasound in the future (71.0%) and considered it a core competence (73.0%). Perceived ultrasound competence was significantly associated with receiving practical (RR: 4.08) or both practical and theoretical education (RR: 4.34) in medical school, and practical training on patients (RR: 1.09), required number of performed scans (RR: 1.06), competence test(s) (RR: 1.07), and/or consulting books/encyclopedia (RR:1.07) during internship.ConclusionsUltrasound training is part of medical school curricula but varies in type and extent. While most encounter and many use ultrasound during internships, formal training is less integrated. Most desire more training and attitudes towards future ultrasound usage are positive. Filled curricula pose dilemmas for prioritization and several barriers prevail for using ultrasound, representing missed opportunities for competence development and maintenance. Training governance and scaffolding continuous learning may be needed.Trial registrationNone.

Exploring the perception of nursing students facing burnout in clinical settings during COVID pandemic

Abstract Aim. The purpose of this study was to learn about the experience of the group of students who are at high risk for experiencing burnout and nursing shortage. This study seeks to reveal students’ perception of nursing burnout and nursing shortage observed during a clinical course. Material and methods. This study was conducted with a qualitative method using conventional content analysis approach. Data were collected by conducting in-depth semi-structured interviews. Results. Thematic analysis of the interview transcripts identified four core themes, with corresponding sub-themes: Sources of burnout, Uncertainty, Coping Strategies, Varying faculty support during clinical rotation. This study proves that nursing students experienced similar feelings of burnout and emotional strain during their clinical rotation during COVID. Evidence highlights the impact of psychological stress on nursing students in pandemic circumstances and additionally the stress of completing all required competencies to complete their degree. Conclusions. The findings of this study include sources of burnout such as working conditions, workload, dealing with suffering, death, and dying, and uncertainty in the present and future such as the evolving and changing understanding of COVID. Coping mechanisms involve staying positive and talking to family and friends. Finally, the varied opinions of the students regarding emotions and feelings of support from faculty.