Clinical Rotations Research Articles

Addressing the Decline in Clinical Skills: A Call for Comprehensive Educational Reform

Despite technological advances, clinical skills are the foundation of medical practice. Taking a comprehensive clinical history, performing physical examinations, and communicating effectively are crucial for high-quality patient care. Medical students need to focus on developing strong clinical skills to ensure they are well-prepared for their careers and adapt to the evolving field of medicine through continual practice and refinement.1 The medical community is worried about declining essential clinical skills among undergraduate medical students.2,3 This editorial aims to analyze the reasons for the decline and suggest evidence-based methods to address the situation. 05885.0258063. The declining standards of clinical skills among medical students can be attributed to the widespread adoption of technology-based learning, which has the potential to diminish the importance of traditional hands-on bedside teaching.4 Technology should enhance, not replace, practical clinical experiences. Practical training improves the clinical abilities, expertise, and self-assurance of medical students.5 Moreover, the growing magnitude and expansion of medical curricula provide difficulties in the development of educational programs without ample time for bedside practical teaching.6,7 There is frequently an excessive focus on remembering facts rather than on cultivating clinical reasoning abilities.8 The reduced patient interaction during medical school, due to increased reliance on simulations and less time in clinical rotations and bedside teaching, hampers the development of clinical skills.9 External factors such as limited time and extensive paperwork may affect the quality of patient encounters. Efficient communication is crucial for building good relationships with patients, obtaining accurate medical histories, and ensuring patient understanding and adherence to treatment.9 Insufficient training in communication skills can result in less-than-ideal interactions between patients and healthcare providers and can also contribute to errors in diagnosis and medical treatment.10 The provision of trained faculty for teaching medical students is an issue worldwide. Insufficient supervision and feedback during clinical rotations hinder the development of essential clinical skills.11 Larger student cohorts reduce the opportunities for individual students to practice and receive personalized instruction in clinical skills.12 Medical education often prioritizes theoretical testing over practical examinations and undervalues communication skills training. Variability in clinical experiences at different medical schools can lead to inconsistencies in skill acquisition. The scarcity of skilled clinicians as role models impacts students’ learning. Economic constraints and modern healthcare pressures limit opportunities for thorough patient interactions and clinical training.13 THE WAY FORWARD Educational institutions should prioritize hands-on clinical experiences throughout the curriculum to improve students’ diagnostic and communication abilities. These experiences should include simulation-based learning, standardized patients, and longitudinal clerkships. Faculty members need support and resources for effective clinical mentorship and development. Reflective practice should be integrated into the curriculum to enhance self-awareness and critical thinking. Open communication and mentorship programs between students and faculty can strengthen medical training and promote continual learning. To address declining clinical proficiency among medical students, institutions can adopt evidence-based approaches including curriculum changes, faculty training, promoting reflective thinking, collaboration among healthcare professionals, and fostering a culture of ongoing learning. Regulatory bodies should ensure adequate time for bedside teaching and appropriate assessment weightage.

Design, Implementation, and Evaluation of a Logbook for Clinical Education of Undergraduate Physiotherapy Students

Introduction: Clinical performance without documentation, assessment, and feedback may lead to an inefficient internship in the field. Logbooks are recommended to assess physiotherapy (PT) students’ clinical practice in the curriculum, therefore, this study aims to design, implement, and evaluate a logbook for undergraduate PT students. Materials and Methods: The present study includes three phases. In the first phase, a logbook was designed based on the existing evidence, undergraduate PT program curriculum, and opinions of clinical instructors of the relevant internships. After that, it was adjusted based on the topics of clinical rotations. In the implementation phase, students completed these logbooks during neurology, musculoskeletal inpatient, outpatient, and cardiovascular inpatient rotations. In the third phase, a 29-item questionnaire was used to assess the students’ and instructors’ perspectives on the logbook. Results: The designed logbook for undergraduate PT students consisted of two major sections, assessment of students’ clinical competencies and documentation of clinical experience. Sixtynine students and 12 clinical instructors completed the questionnaires. Approximately 49% of the students and 87% of the instructors felt that the logbook’s quality was satisfactory. Nearly 53% of the students and over 90% of the instructors consider the use of the logbook and its content essential. Conclusion: A logbook was developed as a workplace-based assessment (WBA) method. It was designed to cover different internships, including PT in musculoskeletal, cardiovascular, and neurological conditions in outpatient or inpatient settings. Both students and instructors agreed on using the designed logbook to assess the student’s clinical performance.

Fostering Clinical Judgment and Promoting Transition Into First Clinical Rotation Through Active Learning.

Undergraduate nursing education builds on knowledge obtained from previous semesters to grow critical thinking skills and promote clinical judgment attainment. Transitioning knowledge from the classroom to the clinical setting is often difficult. Students finishing their first semester of courses in a BSN program participated in a novel, interactive classroom activity to help them practice critical thinking, transfer their learning, and develop clinical judgment by applying concepts to patient scenarios. Using an engaging student experience promotes long-term deep learning in hopes that students will remain successful in their progression through the curriculum.

Facilitating interprofessional learning: experiences of using a digital activity for training handover of critically ill patients between a primary health care centre and ambulance services – a qualitative study

ObjectiveTo explore students’ and facilitators’ experiences of using a developed digital activity for interprofessional learning (IPL) focusing on critically ill patient handovers from a primary healthcare (PHC) centre to the...

LMIC-26. DEVELOPMENT OF THE ST. JUDE GLOBAL VIRTUAL PEDIATRIC NEURO-ONCOLOGY FELLOWSHIP (VPNOF): INCREASING PEDIATRIC NEURO-ONCOLOGY CAPACITY IN LOW- AND MIDDLE- INCOME COUNTRIES (LMIC)

Abstract BACKGROUND Most children with central nervous system (CNS) tumors reside in LMICs, yet their complex management is limited by the availability of trained pediatric neuro-oncologists (PNO). The St. Jude Global VPNOF was designed to train pediatric oncologists (PO) in LMICs as CNS tumor experts while remaining in their home countries. METHODS The VPNOF structure was initially developed through semi-structured interviews of physicians who had served as global mentors or mentees in pediatric oncology. Employing a modified Delphi method, we identified the key components necessary to virtually train POs in LMICs to become PNOs. RESULTS A two-year fellowship program was designed with a curriculum tailored for POs in LMICs. Two main components were identified as critical to the objective of building PNO capacity: mentorship and clinical training. Mentorship involves a triad with one global and one loco-regional mentor per fellow, aiding in the fellow’s career and institutional goal setting to advance PNO care. Clinical training includes regularly scheduled virtual tumor boards and didactics, and ad-hoc case discussions with mentors while managing patients at their home institution. Additionally, fellows travel to their mentors’ institution twice for a four-week clinical rotation. In 2022, five fellows from Armenia, China, Indonesia, Mexico, and Pakistan were selected. In 2023, an additional six fellows were selected from China, Costa Rica, India, Romania, South Africa, and Sri Lanka. To date, 18 months of the two-year fellowship have resulted in the establishment of multi-disciplinary approaches, increased patient volume, increased evidence-based practices, and publication by the first cohort of 21 abstracts and two journal publications to date. CONCLUSIONS The VPNOF is an innovative approach to leveraging global mentorship to train PO in resource-limited settings to become PNOs. Virtual mentorship and training have led to implementation of new practices aimed at improving quality of care for children with CNS tumors in LMICs.

Effectiveness of spaced repetition for clinical problem solving amongst undergraduate medical students studying paediatrics in Pakistan

BackgroundStudies using spaced repetition for teaching and learning in undergraduate clinical rotations such as paediatrics are limited, even more so in the South Asian region. Therefore, this study aimed to identify the effectiveness of utilizing spaced repetition compared to traditional learning methods among undergraduate medical students during their paediatric rotation at a medical university in Pakistan.MethodsBahria University Medical and Dental College (BUMDC) conducted quasii-experimental research in Karachi. Four topics were identified from the Year 5 Pediatrics curriculum to be used in the study, using which the study content was developed along with 50 multiple choice questions (MCQs) for assessment. All BUMDC Year 5 medical students rotating in Pediatrics were included and randomly allocated to the control or intervention group. In the control group, they provided the students with traditional study methods consisting of books and lectures to learn topics. In the intervention group, we created an Anki flashcard deck of the same topics to enable learning via spaced repetition. The researchers conducted a pretest and post test assessment of the 50 MCQs in both groups at the beginning and after the four-week study interval. The data were analysed using SPSS 19.ResultsA total of 115 BUMDC medical students agreed to participate in the study; 70 (59.1%) were in the intervention group, and 45 (41.7%) were in the control group. The pretest mean score of the control group was 27.96 ± 3.70, and the posttest mean score was 27.22 ± 5.02, with no statistically significant difference at the 95% confidence level. The mean score of the pretest for the intervention group was 27.93 ± 4.53, and that of the posttest was 30.8 ± 4.56, with a statistically significant difference at the 95% confidence level. The intervention showed a significant effect size of 0.8.ConclusionThe use of spaced repetitions resulted in significantly greater scores for medical students studying paediatrics than for those using more traditional methods of learning, compromising medical books and lectures. Considering that medical students need to retain a vast amount of information, using spaced repetition through flashcards can be a more effective learning tool that is more cost-efficient and time-efficient than traditional learning methods.

(073) WOMEN'S SEXUAL DYSFUNCTION TRAINING MODULE INCREASES SCREENING COMFORT

Abstract Introduction Sexual dysfunction in women affects approximately 40% of patients, however, many providers fail to screen for it. The continual lack of screening presents limited opportunities for healthcare trainees to observe, learn and master this skill. Approximately half of medical students feel inadequately prepared to discuss these diagnoses with patients. For this reason, experts advocated a multidisciplinary, longitudinal sexual health education approach to address the exposure of women’s sexual health in the clinical setting. In order to address this issue, our institution created a module focusing on sexual dysfunction in women to educate healthcare students on screening, assessment and baseline treatment for the most common dysfunction, hypoactive sexual desire disorder or decreased libido. This module was created by a gynecologist and reviewed by professors in the psychology department and graduate nursing school. Additionally, it was approved by the medical school for use. It simulates a clinical rotation to emphasize screening for sexual dysfunction in women and baseline evaluation of decreased libido using a biopsychosocial model. Objective The primary aim of this study is to evaluate changes in students’ comfort level who screen for women’s sexual dysfunctions after completion of the Female Sexual Dysfunction Module. Additionally, we aim to assess the over baseline level of comfort in screening and determine if knowledge about when to screen is gained through the module. Methods This study was IRB approved. US medical students and graduate nursing students were approached via email to complete demographic information, a pre-survey, module, and post-survey. In the redcap survey, participants were asked to identify scenarios appropriate to broach the subject of a patient's sexual functioning. Additionally, they were asked to rate their comfort level asking patients about sexual desire, dyspareunia, and anorgasmia as well as general knowledge-based questions about sexual dysfunction in women. Results This study surveyed 425 medical students and nursing students from over 70 institutions across the US. Compared to their pre-module response, more respondents felt it was appropriate to query patients about their sexual functioning following the module (all p < .05). Respondents were also far more comfortable asking patients about their sexual health after the module compared to pre-module responses (all p < .05). Compared to their pre-module response, more respondents correctly identified the components of the linear female sexual response cycle created by Masters and Johnson (24.8% versus 61.6%; p < .001), and more respondents identified the components of the Plisst screening model (6.3% versus 53.7%; p < .001). Conclusions This nationwide study demonstrates our module provides statistical improvement in students’ comfort level when screening for female sexual dysfunction. It agrees with previous studies in terms of healthcare trainees’ overall lower baseline aptitude with this diagnosis and shows that this module statistically increases knowledge These results support using interactive modules in healthcare training curricula in order to standardize training. It can be especially helpful for schools where clinical exposure to this diagnosis is sparse. To further elucidate the most efficacious method of teaching, this study recommends future directions to assess the various models of sexual medicine education. Disclosure No.

Model for an Academic Medicine Interest Group: A student-led initiative

Academic physicians are responsible for the education of medical students, residents, and other practicing physicians through clinical rotations lectures, seminars, research, and conferences. Therefore, the increasing need to recruit academic physicians holds immense value within the healthcare system. Academic Medicine Interest Group (AMIG) is a collective made up of students who share an interest in the growth and advancement of academic medicine. We present a guide and model on establishing an AMIG. We found that AMIG fostered professional growth by providing leadership, research, and teaching opportunities. Strategic planning, effective leadership, and group organization were all necessary for the success of the group.

Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis

BackgroundThe number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence.MethodsA descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs.ResultsPC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs.ConclusionsPC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs’ curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC.Trial registrationNot applicable.

Learning Clinical Ethics for Medical Students in Clinical Phase

Background: Clinical ethics is a method of clinical decision making ethically. The implementation of clinical ethics learning to clinical rotation students is one way to help students learn to make decisions about ethical dilemmas according to the learning outcomes in clinical rotations. There is no evaluation of the implementation of clinical ethics in clinical rotation learning in our institution, so a study is needed.Methods: This research is a descriptive study with a cross-sectional design using primary data through filling out online questionnaires (g-form) adopted from four box quadrant of clinical ethics by Johnsen, Siegler and Winslade. The respondent was clinical rotation students who underwent inpatient treatment from 10 clinical rotation stages at Zainoel Abidin Hospital. This research has been done from November until December 2022 by using consecutive sampling techniques with 75 respondent as minimum sampling. Results: A total of 87 respondents were involved in this study. This study shows that clinical ethics has been implemented in clinical rotation at Zainoel Abidin Hospital Banda Aceh. The most frequent implementation of clinical ethics is Obstetrics and Gynecology, and the least common is the Psychiatric. The implementation of clinical ethics learning in clinical rotation is already good, as seen from the majority of respondents who often get learning related to the medical indications quadrant (52.9%-58.6%), patient preference quadrant (44.8%-64.4%), the quality of life quadrant (57.5%-63.2%), and the contextual features quadrant (40.2%-59.8%).Conclusion: The implementation of clinical ethics learning in clinical rotation at Zainoel Abidin Hospital Banda Aceh is already good, although not optimal. Continuous learning of clinical ethics is necessary so that clinical rotation students are accustomed to solving ethical dilemmas in clinical situations.

Exploring Unprofessional Behaviors and Biased Perceptions in the Clinical Environment: Students’ Perspectives

Professionalism stands as a fundamental cornerstone within the realm of physician training, representing a core competency that holds significant importance. It entails creating workplaces that are physically and psychologically safe within the health care system. Positive role modeling from health professionals is important in creating a learning environment that fosters diversity, equity, and inclusion for all. Using the mixed-methods sequential design, this study investigated unprofessional behaviors and biased perceptions demonstrated by health professionals as perceived and experienced by medical students during their clinical rotations at one medical school. Seventy-three M3 students and 37 M4 students responded to the survey, followed by three focus groups (n = 11) to further examine unprofessionalism and biases as well as impacts on performance, learning opportunities, and well-being. The results from both the quantitative and qualitative data demonstrate the presence of unprofessionalism and biases within the current medical education environment. These issues include a lack of respect and compassion, a lack of commitment to professional duties, malfunctioning teamwork, and a lack of sensitivity towards individuals regardless of their group affiliations. The unprofessional behaviors and biased perceptions have detrimental impacts on students’ performance, learning, and well-being. The reasons behind unprofessionalism and bias are multifaceted, influenced by societal and local environmental factors that extend beyond individual beliefs and values. By collecting empirical data on students’ experiences and perceptions, the study sheds light on the areas that need improvement and offers insights into adopting strategies to decrease unprofessional conducts and foster a respectful and inclusive learning environment.

The growth and development of a novel distance accelerated bachelor of science in nursing program

Severe nursing shortages threaten the sustainability of US health systems. Rural and underserved communities are disproportionately affected by staffing crises and associated facility closures, as well as health disparities. A major factor contributing to geographic gaps in care is the absence of nursing schools, nursing faculty, and locations for clinical rotations in many rural and underserved areas. Emory School of Nursing is helping to solve for these issues through the Distance Accelerated Bachelor of Science in Nursing (DABSN) program. The DABSN is establishing accelerated pipelines of nursing students into practice in locations where nursing education has historically been difficult or impossible to access. This innovative nursing education model allows students to enroll in a top-ranked nursing school while remaining in their home communities. Students complete synchronous didactic coursework with peers in every US time zone while performing clinical rotations in local healthcare facilities. This paper details the growth and development of the DABSN. It describes the challenges and opportunities we have navigated in implementing the program, along with information about its pedagogy, clinical placement practices, and student/faculty characteristics. We share program outcomes and conclude with recommendations for the future.

Sustainable Academic-Clinical Alliance: A Model to Improve Academic-Practice Partnerships.

Background: National nurse shortages, ongoing nurse faculty retirements, and a dearth of clinical sites make it challenging to prepare advanced practice registered nurses (APRNs) who are ready to transition into independent provider roles, especially in acute care settings. One of the most effective ways to address these experiential learning challenges is for academic institutions and healthcare systems to form collaborative academic-practice partnerships. However, many partnerships between schools of nursing and healthcare institutions have found numerous challenges, including time to devote to the partnership, funding of ideas, competing initiatives and needs, and sustainability. Objective: The University of Maryland School of Nursing (UMSON) set out to expand the traditional academic-clinical partnership approach with a new collaborative model. Methods: Rather than both parties coming to the table with their own goals, the partnership focused on intentional relationship building, transparency, measurable outcomes, and sustainability. This model, further called the Sustainable Academic-Clinical Alliance (SACA), assures that both sides of the partnership benefit. The SACA model was used to create an academic-practice partnership with the University of Maryland Upper Chesapeake Health System in order to increase APRN clinical practice sites and readiness of APRN students to provide care across the continuum in the state of Maryland. Results: Since July 2016, the SACA model has enabled over 40 clinical providers in over 20 different clinical areas to offer 329 different clinical and nonclinical experiences to APRN students from UMSON. At the end of the 5-year alliance, 150 unique UMSON APRN students completed 257 different clinical rotations. Conclusion: The SACA model effectively promotes the development and achievement of sustainable academic-practice partnerships by focusing on (a) intentional relationship building, (b) transparency in goal setting and alliance maintenance, (c) development of outcome measures, and (d) sustainability. Implications for Nursing: The components of the SACA model made sustainability more achievable, which has eluded previous academic-clinical partnerships. This model can serve as a blueprint for other academic and healthcare institutions to establish sustainable academic-practice partnerships.

Relationship of Physical Activity with Sleep Disturbance and Anxiety in Medical Students of Sahiwal

Background: Physical activity has been shown to have anxiolytic effects, improve sleep quality, and enhance overall student mental health. Despite these benefits, medical students often have limited time for physical activity due to demanding academic schedules and clinical rotations. Objective: To examine the relationship between physical activity, sleep disturbance, and anxiety among medical students in Sahiwal. Methods: This observational study was conducted over six months among medical students in Sahiwal. A simple random sample of 280 university students, aged 19-25 years and from the 3rd to 5th years of study, was selected. Participants completed three standardized questionnaires: the International Physical Activity Questionnaire (IPAQ) to assess physical activity, the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, and the Generalized Anxiety Disorder-7 (GAD-7) to measure anxiety levels. Data were analyzed using SPSS version 25, with descriptive statistics summarizing demographic data and key variables. The Chi-square test of association was used to determine the relationships between physical activity levels (IPAQ scores), sleep quality (PSQI scores), and anxiety levels (GAD-7 scores), with a significance level set at p < 0.05. Results: The mean age of the participants was 22.24 ± 1.285 years. Among the 280 students, 207 (73.9%) were females and 73 (26.1%) were males. Anxiety levels were as follows: 39 (13.9%) had mild anxiety, 124 (44.3%) had moderate anxiety, 76 (27.1%) had moderately severe anxiety, and 41 (14.6%) had severe anxiety. Physical activity levels were: 144 (51.4%) had low physical activity, 79 (28.2%) had moderate physical activity, and 57 (20.4%) had high physical activity. A significant association was found between GAD-7 and IPAQ levels (Chi-square value = 60.691, p = 0.031). No significant association was found between PSQI and IPAQ levels (Chi-square value = 22.162, p = 0.680). Conclusion: This study highlights the significant relationship between physical activity and anxiety among medical students, suggesting that regular physical activity is associated with reduced anxiety symptoms. However, no significant relationship was observed between physical activity and sleep quality.

Measuring Sleep Quality Among Medical Students Using the Epworth Sleepiness Scale.

Introduction While existing literature establishes the positive impact of sleep on test performance among medical students and its correlation with better outcomes among physicians, there is a notable gap in the quantitative understanding of how the transition from preclinical to clinical training affects sleep quality. Methods Our survey was sent to all medical students attending the California University of Science and Medicine between April 2023 and January 2024. The relative risks for having an Epworth sleepiness scale (ESS) greater than 10 were calculated and compared for various subgroups in our sample. Univariate logistic regression analysis was also carried out to assess the effect of covariates on our primary outcome. Results In total, our sample consisted of 124 medical students. Only 11.3% (n=14) were somewhat dissatisfied or very dissatisfied with their medical school experience. The relative risk of having an ESS > 10 when on clinical rotations was 2.06 (95% CI: 1.22-3.49). Conclusion This study demonstrates that the risk of medical students experiencing excessive sleepiness, defined by an ESS > 10, doubles when students are on clinical rotations. Despite being limited by information bias and a smaller sample size, this study provides interesting pilot data on the quantitative examination of sleepiness among medical students and may be used to guide areas for future work.

Adapting and applying student-centered learning in a perfusion clinical rotation.

While the process of teaching student perfusionists has been in development since the 1950s, the publication of the processes to improve perfusion clinical education has been largely lacking. Publications regarding education from other allied health and medical fields have shown the value of student-centered learning. The use of reflective practice to move perfusion students from thinking about actions after cardiopulmonary bypass (CPB) to reflecting and reacting on actions during CPB is better encouraged by moving from a teacher-centered to a student-centered clinical model. Our institution's teaching process has developed into a multi-point procedure to make our students into reflective practicing clinicians. Student preceptor evaluations were reversed to allow the students to evaluate themselves first, with feedback from the preceptor given subsequently. Additionally, a biweekly student educational session, where the student chooses a topic and reviews current evidence-based practice, was instituted. The clinical program director serves as the moderator and clinical expert to facilitate problem-based learning during the sessions. Students were also given three skill/experience levels with goals to reach and move through during the rotation. These student levels were also helpful to our preceptors in knowing what each student's skill level was throughout their rotation. Overall, moving from a teacher-centered to a student-centered clinical rotation has helped make students familiar with reflective practice, self-evaluation, evidence-based practice, and problem-based learning. The incorporation of these processes will hopefully lead students to become lifelong reflective perfusionists.

Pathway to cardiothoracic surgery: A primer for aspiring students

ObjectiveThe pathway to cardiothoracic surgery is often obscure for premedical students and aspiring applicants and requires navigating various known and unknown obstacles. Recognizing the challenges encountered on the path to a career in cardiothoracic surgery in the United States, we present this guide for students interested in the field to maximize success in their premedical, preclinical, and preresidency years. MethodsThis is a joint collaboration between the Thoracic Surgery Residents Association and the Thoracic Surgery Medical Student Association. Drawing from firsthand experiences and insights gathered from numerous student applicants and current surgical residents, a comprehensive guide was constructed for students from the point of undergraduate school to advanced training options, including super-fellowship training. ResultsSeveral intricacies to cardiothoracic surgery career planning were discussed, including differences between traditional and integrated/fast-track pathways, college and medical school selection, networking, performing during clinical rotations, extracurricular and research activities, building mentorship relationships, and pursuing alternate career and advanced training opportunities. ConclusionsFor premedical students and aspiring applicants, the road to cardiothoracic surgery requires meticulous planning, grit, and thoughtful dedication. This document consolidates firsthand insights and advice from numerous aspiring and matched applicants to serve as a comprehensive guide for students seeking a career in cardiovascular and thoracic surgery.

Creation of a resident-led medical student education committee.

The Resident-Student Education Committee (RSEC) is a novel approach to integrate and expand medical student education within an emergency medicine (EM) residency at a large academic center. There is a paucity of literature on such programs and there is no documentation of longitudinal initiatives with residents serving as specialty-specific advisors to students throughout medical school. The goals of creating the RSEC were to expand and improve the student educational experiences in EM, strengthen the connection between students and EM residents, and foster resident career development through sustainable leadership and teaching opportunities. The RSEC was composed of three divisions: the Preclinical Division aimed to increase student exposure to EM through didactics, skill sessions, simulation, and shadowing; the Clinical Division intended to enhance the student experience during clinical EM rotations through simulation and skill sessions and resident-student socials; and the Mentoring Division focused on advising students applying into EM through informational panels and one-on-one resident mentorship. Outcome measures include students applying into EM residency, which saw an increase from 8.9% prior to the RSEC's creation in 2020 to 12.9% in 2023, despite a national decline in EM applicants. Survey data also indicates favorable student preclinical experiences and improved confidence in clinical skills. The RSEC model, with its structured approach, resident leadership, and clear objectives, presents a sustainable and replicable framework for other residency programs seeking to enhance medical student education and promote resident engagement in teaching. Future directions include expanding shadowing opportunities and procedural skills teaching, introducing career mentorship earlier in the medical education timeline, and tracking outcomes data for continuous assessment and improvement.

Fortifying the workforce: A national survey of hematology/oncology fellowship program directors and training fellows for community-based careers.

9028 Background: Most hematology/oncology (HO) care occurs in community settings. In a recent national survey of currently practicing community oncologists, we highlighted areas of unmet need regarding preparation for community-based (CB) careers during fellowship [Agrawal et al, JCO OP 2024]. Our study aims to explore attitudes of HO fellowship program directors (PDs) relating to CB HO training. Methods: We conducted a cross-sectional email survey of 185 HO fellowship PDs in the United States. The primary outcome was assessing PDs’ attitudes regarding inclusion of CB HO training during fellowship. Secondary outcomes included assessing whether programs currently have clinical and/or non-clinical training experiences specifically addressing skills relevant to community practice. Participants were also surveyed to assess PDs’ attitudes regarding what motivates fellows to choose careers in community practice. Demographics pertaining to program leadership and fellows were also obtained. Results: We received a total of 53 responses (29% response rate). The majority of respondents’ programs were in academic tertiary care hospitals (76%) with a plurality in the Northeast (32%), had a median of 5 trainees per class, and had roughly equal Male and Female (including transgender men and women) trainees (70%). The majority of PDs had been in clinical practice for ≥10 years (68%) and in their program leadership position for ≤10 years (83%). Almost all PDs (96%) reported having graduates who pursue careers in CB settings, with financial compensation cited most frequently in making this decision (98%). The majority of PDs (83%) agreed that training experiences in CB HO should be available for their trainees during fellowship. A multivariate regression analysis demonstrated that there were no significant factors associated with this outcome (p>.05). Training experiences relevant to community practice were not uniformly available amongst programs, with 74% of programs offering clinical experiences, but only 32% offering non-clinical experiences. The most cited clinical experience was the option to rotate in a CB setting (80%), and the most common non-clinical experience was exposure to training in quality improvement/patient safety (88%). Conclusions: While most HO training programs in the U.S. are embedded within academic centers, nearly all PDs indicated their programs train fellows who pursue careers in the community. PDs believe that experiences tailored to CB HO practice should be available to their fellows. Although many respondents’ programs offer CB clinical rotations, relevant extra-clinical skill development opportunities are lacking. Goal-concordant pathways for career development during HO fellowship can be optimized, particularly as they relate to training individuals for practice in CB settings, a growing need within the HO workforce.

Veterinary students’ attitudes toward anesthesiology as a specialty

ObjectiveTo identify the perceptions of veterinary students interested in specialization regarding veterinary anesthesiology. Study designCross-sectional, multi-institutional, voluntary, anonymous, nonrandomized survey. PopulationVeterinary students (303 of 557 total respondents) from 10 veterinary schools. MethodsQuantitative data were obtained via 5-point Likert scale questions about anesthesia-related topics. Open-ended questions were used to obtain qualitative data. A multivariate logistic regression model assessed the likelihood of choosing a career as an anesthesiologist. Spearman’s rank correlation coefficient was used to assess the relationship between ‘anesthesia is interesting’ and other variables. ResultsOf the respondents, 14 (6%) indicated veterinary anesthesia as their chosen specialty. There was a significant positive relationship between ‘anesthesia is interesting’ and the following variables: age, enjoyment in anesthesia class, belief in the importance of anesthesia for their career, belief in the importance of analgesia for their career, belief that anesthesia and analgesia have a large impact on patient care, interest in pharmacology, interest in physiology, interest in learning technical skills, belief that anesthesiologists are respected by their colleagues and belief that anesthesiologists are an important part of the health care team. More weeks on the anesthesia clinical rotation was positively and significantly associated with increased rotation enjoyment. Enjoyment in the anesthesia class [p = 0.001, Exp(β) = 2.1, 95% confidence interval (CI): 1.3–3.4] and belief that anesthesia is interesting [p = 0.013, Exp(β) = 2.6, 95% CI: 1.2–5.4] were predictors that respondents would be more likely to consider a career as a veterinary anesthesiologist. ConclusionsThose veterinary students with an interest in pharmacology and who enjoyed their anesthesia course were more likely to consider a career as a veterinary anesthesiologist. If students indicated no interest in specializing in veterinary anesthesia, they appreciated the value the specialty brings to animal care and believed that veterinary anesthesiologists are respected by their peers.