Clinical Training Programs Research Articles

Decision-making tree to support sustainable waste management in optometric clinical practice and healthcare training programmes

ABSTRACT Clinical relevance Waste management strategies are well documented for employee safety, legal compliance and infection control measures; however, appropriate waste disposal is equally important to minimise adverse environmental impacts. Knowledge on best practices related to the disposal of healthcare-generated waste is crucial for environmental sustainability. Background Global healthcare contributes significantly to greenhouse gas emissions, thereby extending the pervasiveness of climate change. Urgent action is required by the healthcare sector to minimise these impacts. Proper waste management is an alleviation measure that can be easily implemented in healthcare practice. The aim of this study was to calculate the approximate mass of plastic waste generated through lens wear and develop an easy-to-use decision-making tree to support optometrists with sustainable waste management. Methods Data were analysed, from an online survey directed to ophthalmic lens wearers, to determine the mass of annual plastic waste associated with lens wear. Information collated from published studies and clinical experience of the researchers, supplemented by a literature search from online databases, EBSCOhost, Google Scholar, ScienceDirect and PubMed, were used to develop the waste decision-making tree. Results Approximately 48 kg of plastic waste was generated from annual lens wear, of which approximately 83% of recyclable materials were landfilled. The waste management decision-making tree was created to guide optometrists regarding sustainable waste management practices. Conclusion Although this study focused on Optometry, its findings and recommendations have applicability across the healthcare field. Environmental stewardship is a joint responsibility of all healthcare professionals. This study highlighted the importance of incorporating and promoting sustainable clinical measures as well as the embedding and regular updating of clinical evidence on waste management best practices into healthcare training programmes. In doing so, the broader healthcare sector can contribute significantly towards reducing healthcare waste and associated emissions and improving health outcomes, thereby safeguarding the planet and its inhabitants.

Analysis of Core Competencies for the Clinical Data Management Profession in Japan

Introduction: Job-specific and competency-based educational programsconstitute essential tools for any professional involved in clinical trials. Inline with this, recently, the Multi-Regional Clinical Trials Centers of Harvardand industry–academia stakeholders issued the Joint Task Force for ClinicalTrial Core Competency (JTF competency), demonstrating that core competencyconsists of eight domains and 47 subdomains. Society for Clinical DataManagement (SCDM) also outlined the essential competencies and tasks for eachcareer level (early-to-mid vs mid-to-late) for clinical data management (CDM)personnel by conducting a questionnaire survey at the 2015 and 2018 SCDM annualconferences. However, to the best of our knowledge, no existing research hasadequately surveyed the competencies required of CDM personnel in Japan.Furthermore, educational programs based on these competencies have not beensufficiently developed.Objective: This study aims to clarify the competencies of CDMpersonnel in Japan, using a nationwide questionnaire.Methods: We developed a questionnaire combining SCDM (fourdomains and 122 items) and JTF (eight domains and 47 items) competencies andconducted a government-funded national web-based survey from November toDecember 2019. The survey was conducted to evaluate the functions of academicresearch organizations in collaboration with the SCDM Japan Steering Committee.Results: In total, 124 individuals from the CDM personnel (50AROs, 38 pharmaceuticals, and 36 CROs) responded to the survey. They were categorizedinto two groups based on their self-evaluated career levels: 70 participantsfor the mid-to-late career CDM personnel and 54 subjects for the early-to-midcareer CDM personnel. Among the seven tasks of SCDM competencies (67 subtasks),results from thirty-eight tasks (56.7%) showed a statistically significantdifference in the design, training project management, and review tasks betweenboth groups. On the other hand, among the eight domains of JTF competencies (47subdomains), results from twenty-seven subdomains (57.4%) showed statisticallysignificant differences, especially in domain 1 “Scientific concepts and researchdesign”, domain 6 “Data management and informatics, and domain 7 “Leadershipand professionalism”) between respondent groups.  Conclusion: We clarified the competency-based tasks for CDMpersonnel in Japan. Our findings will contribute to the development of competency-basededucational programs required for each CDM’s career level.Keywords: clinical data management, job-specific competency,education and training program, Joint Task Force for clinical trial competency,Society for Clinical Data Management.

Islamic Psychology and Herbert George Wells (1866-1946)

Health has five dimensions, namely physical, social, mental, spiritual, and religious health. “Religious health” is the state of physical, mental, social, and spiritual well-being that occurs by complying with the orders, prohibitions and rules of the true religion that is Islam mentioned by Allah. In conclusion, we would like to emphasize that the most important dimension of health is “religious health” since religion has a substantial role in improving physical, mental, social and spiritual health. Wells summarized Islam 100 years ago as follows: modern religion (Islam) appeals to no revelation, no authoritative teaching, no mystery. The statement it makes is, it declares, a mere statement of what we may all perceive and experience. To this, all true religion, casting aside its hulls of misconception must ultimately come. To it indeed much religion is already coming. Lastly, Islamic psychology is rapidly growing and developing with more academic and clinical training programs around the world; therefore, we strongly believe that Islamic psychology should be integrated with mainstream psychology.

Insights From ISASS Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery | Part 3: A Polytomous Rasch Analysis on Surgeons' Endorsement of Multiportal Access, Treatment of Lumbar Facet Cyst, Grade I Spondylolisthesis, and Interbody Fusion.

The International Society for the Advancement of Spine Surgery hosted the third in a series of webinars focused on innovative endoscopic spine surgery techniques. This session aimed to discuss and evaluate advanced treatments for lumbar spinal stenosis and related conditions utilizing multiportal endoscopic approaches; articulating instruments; unilateral biportal endoscopy; transforaminal techniques for facet cysts, herniated disc, and spinal stenosis; as well as percutaneous endoscopic lumbar interbody fusion (PELIF). To analyze the level of surgeon endorsement for the presented endoscopic spine surgery techniques before and after the webinar, utilizing polytomous Rasch analysis, and to evaluate the potential for these insights to inform clinical guideline recommendations. An online survey was administered to 868 surgeons during a sponsored webinar hosted by the International Society for the Advancement of Spine Surgery. The survey used Likert-scale ratings to evaluate 5 main topics and additional surgical experiences and was distributed before and after the webinar. Survey responses were analyzed using descriptive statistics and Polytomous Rasch analysis to evaluate shifts in acceptance and perception. Of the 793 surgeons who attended the webinar, 229 accessed the prewebinar survey, 154 began it, and 119 completed it, yielding a completion rate of 77.3%. The respondents included 52.9% orthopedic surgeons, 37.0% neurosurgeons, 1.7% fellows, 0.8% residents, and 0.8% medical students. In the postwebinar phase, engagement remained high, with 298 accessing the survey, 169 starting it, and 128 completing it, resulting in a 75.7% completion rate. The postwebinar participant demographics closely resembled the initial distribution, consisting of 53.1% orthopedic surgeons, 35.9% neurosurgeons, 6.2% residents, 3.1% fellows, and 1.6% medical students. The confidence in various endoscopic techniques saw notable changes, particularly for procedures involving transforaminal lateral canal decompression for stenosis, herniated disc, and low-grade spondylolisthesis. Unilateral biportal endoscopy facet joint decompression and PELIF saw an increase in high-level endorsements after the webinar. Polytomous Rasch analysis provided insights into procedural techniques. The study showed consensus on the effectiveness of percutaneous endoscopic decompression of low-grade spondylolisthesis, reflecting evolving surgeon preferences and consensus on best practices. Infit and outfit statistics from the Rasch analysis suggested a good fit between the survey responses and the Rasch model both before and after the webinar, indicating minimal data distortion due to bias except for transforaminal decompression for posterolateral and central herniated nucleus pulposus. Differential item functioning analysis showed no significant bias in item responses between orthopedic surgeons and neurosurgeons in the prewebinar survey but identified potential bias for 1 item postwebinar in PELIF and articulating instruments. The webinar influenced surgeon perceptions and endorsements of advanced endoscopic techniques, substantially impacting professional practice. Continued use of Rasch analysis in evaluating educational interventions offered a nuanced understanding of changes in surgical practice toward more complex and controversial issues such as central and migrated herniated nucleus pulposus, facet cyst, low-grade spondylolisthesis, and fusion while potentially guiding future clinical guidelines and training programs to align with evolving endoscopic techniques. Assessing surgeon confidence and acceptance of endoscopic spinal surgeries using polytomous Rasch analysis. Level 2 (inferential) and 3 (observational) evidence because Rasch analysis provides statistical validation of instruments rather than direct clinical outcomes.

Cultural Adaptation and Psychometric Properties of the Spanish Version of the Gay Affirmative Practice Scale (GAP-ES).

Lesbian, gay, bisexual, and transgender (LGBT) individuals often face discrimination in healthcare settings, resulting in health disparities. Evaluating healthcare professionals' affirmative practices is essential for promoting inclusive care and addressing these disparities. The aim of this study was to assess the psychometric properties of the Spanish version of the Gay Affirmative Practice Scale (GAP-ES), which measures healthcare professionals' affirmative practices towards gay individuals. Before assessing its psychometric properties, the original Gay Affirmative Practice Scale (GAP) was translated and culturally adapted from English to Spanish. Following the translation, the psychometric properties were tested on a sample of 236 healthcare professionals. The internal consistency of the questionnaire was measured using Cronbach's alpha and the discriminatory power index. Factor structure was evaluated with Confirmatory Factor Analysis (CFA) using the Diagonally Weighted Least Squares method. The sample consisted of 152 female (64.41%) and 84 male (35.59%) participants, with 58.05% identifying as heterosexual, 28.81% as homosexual, and 13.14% as bisexual. The internal consistency of the GAP-ES was strong, with Cronbach's alpha values of 0.915 for the Beliefs subscale and 0.902 for the Behaviors subscale. The McDonald's Omega coefficient was 0.942, indicating high reliability. CFA confirmed a two-factor structure with satisfactory fit indices (CFI = 0.999, RMSEA = 0.071). The GAP-ES demonstrates strong internal consistency and a stable factor structure. It is a reliable tool for evaluating affirmative practices toward LGBT patients in Spanish-speaking healthcare contexts, supporting improved care for this population. The integration of the GAP-ES into clinical practice and training programs may support the enhancement of cultural competence among healthcare professionals, contributing to the reduction of health disparities for LGBT patients in Spanish-speaking settings.

Bringing Psychoanalytic Thinking to a Contemporary Clinical Psychology Training Programme: A Personal Perspective on a Dynamic Process

Bringing Psychoanalytic Thinking to a Contemporary Clinical Psychology Training Programme: A Personal Perspective on a Dynamic Process

Digital technology implementation in prosthodontics postgraduate programs in Saudi Arabia: a multi-institutional survey of program directors

ObjectiveTo assess the current status of digital technology (DT) implementation in prosthodontics post-graduate (PG) programs in Saudi Arabian dental institutions.MethodologyA 19-item survey was created using Google forms and the link was emailed to the 29 prosthodontics PG program directors (advanced clinical training and joint program) in Saudi Arabia. The questionnaire contained five Sect. 1) didactic training and DT usage in PG preclinical, clinical and laboratory training, 2) incorporation of DT in PG program, 3) utilization of DT and the types of cases treated by PG students during their course, 4) information on the faculties involved in prosthodontics PG education, and 5) potential challenges encountered and program directors’ satisfaction of the PG program. Descriptive statistics was used to present the frequencies and proportions, and Chi square inferential test was used to compare the participants’ response based on the type of PG programs (α = 0.05).ResultsOnly 28 program directors responded to the survey, yielding a 95.5% response rate. Among the program directors, 24 (85.7%) and 4 (14.3%) directors supervised the advanced clinical training and joint programs, respectively. Among the DT, CAD/CAM was the most used technology (50–80%), followed by intra-oral scanning (28–96%). Digital technology implementation was largely limited by lack of resources or equipment (67%), cost (53%) and scarcity of PG teaching staff (46%). A significant difference was observed between the programs regarding the mandatory use of DT for their cases (p = 0.03).ConclusionsThis multi-institutional survey of program directors revealed that DT is continuously implemented in the last few years. Saudi dental institutions must prioritize implementing and utilizing DT in PG training to graduate competent prosthodontists in this fast-paced digital era. While DT is pivotal in dental education, its implementation is limited in many institutions due to resources or equipment, cost, and lack of trained faculty.

Investigating Students' Clinical Experiences of Learning the Nursing Process Using an Integrated Teaching-Learning Method at Shahid Qazi Tabatabaei Hospital: A Qualitative Content Analysis

Introduction: Integrated teaching-learning methods have demonstrated potential in enhancing students' cognitive skills and, subsequently, the quality of patient care. This qualitative study aimed to explore the learning experiences of nursing students engaged in an integrated teaching-learning method during their clinical education in oncology nursing. Method: : Semi-structured interviews were conducted with 19 nursing students who had completed a clinical training program in oncology nursing using an integrated teaching-learning method. Conventional qualitative content analysis was employed to analyze the data, identifying sub-categories and categories related to students' experiences. Results: The analysis revealed four main categories: (1) sustained cognitive learning, (2) non-cognitive learning, (3) application of learned concepts in real-world situations, and (4) students' suggestions for improving the learning of the nursing process. Conclusion: The findings suggest that an integrated teaching-learning method, implemented as a creative and student-centered approach at the bedside, effectively enhances both cognitive and non-cognitive skills, facilitating the practical application of learned concepts. To fully leverage the benefits of this method, its implementation should be expanded across clinical education units, starting in lower semesters. Simultaneously, optimizing real-world clinical education environments will further accelerate positive educational outcomes, enhancing students' cognitive and non-cognitive skills and creating a foundation for applying learned concepts in clinical practice.

A surge of interest: Analysing the increased public interest in lipedema using google trends.

This study aimed to monitor public interest in information related to Lipedema and examine potential temporal, seasonal, and income-related trends that may impact public interest. A dataset was created using the Google Trends tool by inputting the keyword "Lipedema" to obtain the relative search volume (RSV) from 2004 to the present in the United States (US). To examine potential income-related disparities in public interest in Lipedema across the US, RSV values were recorded in the five states with the highest and the lowest median income (Maryland, New Hampshire, New Jersey, Utah, and Washington and Mississippi, West Virginia, Arkansas, New Mexico, Kentucky, respectively). Public interest in Lipedema increased significantly over time (R2 = 0.693, p < .001 for the linear trend; R2 = 0.880, p < .001 for the quadratic trend). There were no significant differences between the RSV values between the month of the year and the season of the year (p = 1.000 and p = .859, respectively). RSV values of the five highest-income and low-income states showed significant increases (R2 = 0.333, p < .001, and R2 = 0.195, p < .001, respectively) More rapid growth in interest in Lipedema in states with high income compared to the states with low income (p < .001). Public interest in Lipedema is increasing in both high-income and low-income states. States with higher incomes are more interested. Searches for lipedema are expected to become more frequent, leading to a rising demand for comprehensive education in medical schools and clinician training programs. In addition, there will also be a need for easily accessible, high-quality information resources.

Exploring considerations of equality, diversity and inclusion in selection for a doctorate in clinical psychology programme: A qualitative study

Diverse and inclusive healthcare workforces are important to optimise patient access and outcomes. Various attempts have been made to promote equality, diversity and inclusion (EDI) in clinical psychology; however, clinical psychology doctoral training programmes (DClinPsy) frequently fail to reflect the population demographics of the communities that they serve within the make-up of their trainees. Some research indicates that the lack of diversity might be linked to potential biases within the selection process.This study seeks to qualitatively explore how application screeners and interview panellists for a DClinPsy programme consider EDI in the selection process. Content analysis of seven semi-structured interviews suggests that participants think broadly about EDI, considering differences between marginalised groups and the provision of equal access for members of these groups. Content analysis of discussions of protected characteristics suggests that, when considering EDI, race, sex, disability, sexual orientation, and socio-economic status prove more salient than other factors such as age, and religion or belief.Barriers and facilitators to accessing the DClinPsy are discussed. Participants discuss the perceived inadequacy of EDI training for their roles in selection, and conflicts related to different EDI measures such as positive action and standardisation. The findings are discussed with reference to existing literature. Future research should seek to examine the EDI training needs of those involved in the selection process and examine the efficacy of EDI initiatives to improve equity and inclusion for underrepresented groups.

Feasibility study of a telehealth school-based behavioral parent training group program for attention-deficit/hyperactivity disorder.

To evaluate the feasibility and preliminary efficacy of Telehealth Behavioral Parent Training (T-BPT), a school telehealth group intervention for attention-deficit/hyperactivity disorder (ADHD) with a companion training program for school clinicians. T-BPT was developed in an iterative three-phase design in partnership with community stakeholders during the COVID-19 pandemic. School clinicians (N = 4) delivered T-BPT over 8 weeks to parents (N = 21, groups of 5-6 per school) of children (Grades 2-5) with ADHD while simultaneously receiving training and consultation from PhD-level study trainers. A single-arm open trial was used to assess feasibility, engagement, and preliminary efficacy. Parents and school clinicians endorsed high feasibility, acceptability, and usability of T-BPT. Parent attendance was high (M = 94.6%) and a majority of parents (66.7%) attended all eight sessions. Preliminary outcomes indicate moderate to large reductions in parent-reported ADHD symptoms (ω2 = .36), functional and clinical global impairment (ω2s= .21 and .19, respectively), and distance learning challenges (ω2 = .22). Results were in line with in-person delivery, indicating promising feasibility of school telehealth BPT groups. This study also provided further support for the feasibility of the remote training model for school clinicians. Implications of the commonly endorsed barriers and benefits beyond COVID-19 and relevance to under resourced communities are also discussed.

12 A home-grown clinical oncology training program to address the shortage of oncologists in Malaysia.

12 A home-grown clinical oncology training program to address the shortage of oncologists in Malaysia.

Impact of a Regional Pediatric Hematology/Oncology Fellowship Program in Guatemala.

This study aimed to describe and assess the regional experience of a pediatric hematology/oncology fellowship program based in Guatemala. The Unidad Nacional de Oncología Pediátrica (UNOP) in Guatemala City, Guatemala, is the only hospital in Central America dedicated exclusively to childhood and adolescent cancer. To address the regional need for specialists, a fellowship program in pediatric hematology/oncology was launched in 2003. The UNOP fellowship program comprises 3 years of training. Although the program is based at UNOP, it also includes rotations locally and internationally to enhance clinical exposure. The curriculum is based on international standards to cover clinical expertise, research, professionalism, communication, and health advocacy. Trainees are selected according to country or facility-level need for pediatric hematologists/oncologists, with a plan for them to be hired immediately after completing their training. Forty physicians from 10 countries in Latin America have completed training. In addition, there are currently 13 fellows from five countries in training. Of the graduates, 39 (98%) are now practicing in pediatric hematology/oncology in Latin America. Moreover, many of them have leadership positions within their institutions and participate in research, advocacy, and policy making. Graduates from the UNOP program contribute to institutions by providing care for an increasing number of patients with pediatric cancer. The UNOP program is the first pediatric hematology/oncology fellowship program in the world to be accredited by Accreditation Council for Graduate Medical Education-International, an international body accrediting clinical training programs. The UNOP program has trained specialists to increase the available care for children with cancer in Latin America. This regional approach to specialist training can maximize resources and serve as a model for other programs and regions.

Analysis of the effect and influencing factors of a clinical competency-oriented prospective pre-job training programme on the comprehensive ability of new employees in the department of transfusion medicine.

The subject of pre-job training for transfusion service laboratory technicians is very important. The key is how to make a reasonable systematic training programme to improve the effectiveness of training. A prospective training programme was conducted and an assessment was performed at enrollment (baseline) and reassessment after 3-months training, using the same tools with a validated questionnaire. Clinical competency-oriented prospective pre-job training significantly improves the clinical transfusion-related comprehensive skills of new employees. The post-training assessment score was significantly affected by undergraduate major. This study provided a clinical competency-oriented training programme for new employees in the department of transfusion medicine that could effectively enhance their comprehensive abilities.

Development of advanced practice nursing core competencies in Saudi Arabia: A modified Delphi study

BackgroundAdvanced practice nursing requires a diverse set of competencies that define what advanced practice nurses need to know and be able to do to deliver safe, effective, and high-quality healthcare. Given the lack of evidence regarding core competencies and the evolution of advanced practice nursing roles in Saudi Arabia, it is becoming increasingly important to develop core competencies to standardize educational and clinical training programs. ObjectiveTo define the core competencies of advanced practice nursing in Saudi Arabia. DesignUtilizing a modified Delphi design and snowball sampling technique, data were collected between April and July 2023 using an online questionnaire consisting of 28 core competencies that was developed based on an in-depth literature review and a critical analysis of advanced practice nursing core competencies published by leading professional organizations. Two rounds of Delphi surveys were conducted. SettingsThe study was set in clinical and academic settings in Saudi Arabia. ParticipantsNursing experts with graduate degrees as advanced practice nurses. ResultsIn Round 1, 34 advanced practice nursing experts reached full consensus on 24 of the 28 core competencies, and four core competencies reached partial consensus. Based on suggestions and feedback from the experts, the investigators revised ten core competencies to reflect the improvement suggestions and created three new core competencies. A total of 26 core competencies were used in Round 2, which achieved a full consensus among the 34 advanced practice nursing experts, under the following six core competency domains: knowledge of advanced practice nursing, person-centered care, professional improvement, professionalism, communication and interprofessional partnership, and leadership and system-based practice. ConclusionsGiven the need for a standardized competency framework, the 26 core competencies proposed in our study have the potential to guide education and training in academic programs and facilitate the implementation of advanced practice nursing in clinical settings.

Daniel H. Wolf: Understanding motivation impairment from clinical, behavioral, and neurobiological perspectives to pave the way for better treatments

Dr. Daniel Wolf grew up in Los Angeles, completed his BA at Harvard College, MD-PhD at Yale University, psychiatry residency at MGH-McLean, and neuropsychiatry fellowship at UPenn. He is an Associate Professor of Psychiatry at UPenn's Perelman School of Medicine. As head of the Laboratory for Motivation in Psychiatry, Dr. Wolf uses functional neuroimaging to study the neural mechanisms of amotivation and other symptom dimensions in psychosis and at-risk states, aiming to develop novel assessment biomarkers for early-stage drug development. Dr. Wolf also provides outpatient care to individuals with psychosis while supervising clinical trainees. As Director of the Clinical Neurosciences Training Program and Co-Director of the Psychosis T32, he provides seminars and mentoring to medical and graduate students and postdoctoral fellows; he earned the School of Medicine's teaching awards in both Basic Science and Translational Science. He is also an ACNP Fellow and member of the Neuropsychopharmacology editorial board. Dr. Wolf answered the Genomic Press Interview, providing our readers with reflections on his life and career.

A surge in queries: Analyzing the increased public interest in dry needling using Google trends – A cross-sectional observational study

BackgroundTo monitor public interest (PI) in information related to Dry needling (DN) therapy and examine potential temporal, seasonal, and income-related trends that may impact PI by using the relative search volume (RSV) from the Google Trends tool for the keyword "Dry Needling." MethodsFor this cross-sectional observational study, a dataset was created using the Google Trends tool from 2004 to the present in the United States (US). To examine potential income-related disparities in PI in DN across the US, RSV values were recorded in the five states with the highest and the lowest median income (Maryland, New Hampshire, New Jersey, Utah, and Washington and Mississippi, West Virginia, Arkansas, New Mexico, Kentucky, respectively). ResultsA linear regression model showed that the PI in DN increased significantly (R2 = 0,902, p < 0.001). There were no significant differences between the RSV values between the month of the year and the season of the year (p = 1.000 and p = 0.997, respectively). RSV values of the five highest-income and low-income states showed significant increases (R2 = 0,624, p < 0.001, and R2 = 0,477, p < 0.001, respectively). More rapid growth in interest in DN in states with high income compared to those with low income (p < 0.001). ConclusionsPI in DN treatment is increasing in both high and low-income states. States with higher incomes are more interested. DN treatment is expected to become more popular, which will lead to a rising demand for comprehensive education in medical schools and clinician training programs. In addition, there will also be a need for easily accessible, high-quality information resources.

The Impact of High-Fidelity Simulator System on Bronchoscopy Operation Skills of Trainees Who Receive Refresher Training: A Teaching Study.

This study aimed to explore the impact of high-fidelity simulator (HFS) training on the bronchoscopy operation skills, confidence, stress, and learning satisfaction of trainees who further their training at endoscopy center in our hospital. The study also investigated the practical application effects of HFS training and provided a reference for the development of clinical teaching and training programs in hospitals. The 18 trainees who furthered their training at the endoscopy center were evaluated for their bronchoscopy operation skills, confidence, and stress levels before and after HFS training. A survey on learning satisfaction was conducted after the completion of HFS training. The scores of all evaluations were collected for comparison of differences before and after HFS training. HFS training improved the clinical operation skill levels and confidence of trainees who further their training at the endoscopy center, reduced their stress, and achieved 100% satisfaction from this training. Education level and department had no significant impact on trainees' operational skills and confidence improvement, and stress reduction (p > 0.05). The results of this study supported the influence of the history of endoscopy operations on the improvement of trainees' improved operational skills after HFS training, but it had no relation to the improvement of confidence and stress reduction. Trainees with a history of endoscopy operations had higher operation skill scores before and after HFS training (n = 5, 94.80 ± 2.95 and 97.60 ± 1.82, respectively) than those without a history of endoscopy operations (n = 13, 80.62 ± 2.53 and 86.38 ± 2.82, respectively), and the difference was significant (p < 0.05). HFS training is an effective clinical teaching method that can significantly improve trainees' bronchoscopy operation skills and confidence, reduce stress, and achieve high levels of satisfaction.

Standardizing clinician training and patient care in the neonatal neurocritical care: A step-by-step guide

Neonatal neurocritical care (NNCC) has emerged as an important specialty to address neurological conditions affecting newborns including a wide spectrum of brain injuries and developmental impairment. Despite the discipline's growth, variability in NNCC service delivery, patient care, and clinical training poses significant challenges and potentially adversely impacts patient outcomes. Variations in neuroprotective strategies, postnatal care, and training methodologies highlight the urgent need for a unified approach to optimize both short- and long-term neurodevelopmental outcomes for these vulnerable population. This paper presents strategic blueprints for establishing standardized NNCC clinical care and training programs focusing on collaborative effort across medical and allied health professions. By addressing these inconsistencies, the paper proposes that standardizing NNCC practices can significantly enhance the quality of care, streamline healthcare resource utilization, and improve neurodevelopmental outcome, thus paving the way for a new era of neonatal neurological care.

Redesigning a faculty development program for clinical teachers in Indonesia: a before-and-after study.

Faculty development (FD) is important to support teaching, including for clinical teachers. Faculty of Medicine Universitas Indonesia (FMUI) has conducted a clinical teacher training program developed by the medical education department since 2008, both for FMUI teachers and for those at other centers in Indonesia. However, participation is often challenging due to clinical, administrative, and research obligations. The COVID-19 pandemic amplified the urge to transform this program. This study aimed to redesign and evaluate an FD program for clinical teachers that focuses on their needs and current situation. A five-step design thinking framework (empathizing, defining, ideating, prototyping, and testing) was used with a pre/post-test design. Design thinking made it possible to develop a participant-focused program, while the pre/post-test design enabled an assessment of the program's effectiveness. Seven medical educationalists and four senior and four junior clinical teachers participated in a group discussion in the empathize phase of design thinking. The research team formed a prototype of a 3-day blended learning course, with an asynchronous component using the Moodle learning management system and a synchronous component using the Zoom platform. Pre-post-testing was done in two rounds, with 107 and 330 participants, respectively. Evaluations of the first round provided feedback for improving the prototype for the second round. Design thinking enabled an innovative-creative process of redesigning FD that emphasized participants' needs. The pre/post-testing showed that the program was effective. Combining asynchronous and synchronous learning expands access and increases flexibility. This approach could also apply to other FD programs.