Diagnostic Skills Research Articles

Assessment of the Need for Designing an Interactive Educational Tool on Exophytic Lesions of the Oral Mucosa.

Introduction This study sought to evaluate the necessity of creating an interactive educational resource for instructing dental students on oral exophytic lesions. It also aimed to determine the validity and reliability of a questionnaire designed to assess the quality of educational software tailored to these lesions. Materials and methods This descriptive cross-sectional study involved 102 dental students from Mashhad University of Medical Sciences, Iran, who had completed the theoretical course on oral exophytic lesions. A paper questionnaire, including 23 items, assessed their clinical knowledge, the efficacy and limitations of existing educational resources, and the need for interactive electronic courseware (e-courseware). The questionnaire's validity and reliability were evaluated through expert feedback and statistical measures (intraclass correlation coefficient (ICC) and Cronbach's alpha). Results Students' answers to the seven items about evaluating their clinical diagnosis knowledge of oral exophytic lesions were between four and five items correct on average. This finding indicated that students' overall skill in diagnosing exophytic lesions was poor to moderate.The study highlighted a moderate level of self-assessed clinical ability in diagnosing oral exophytic lesions among students (62.7%), with a preference for textbooks and color atlases as primary information sources. The disadvantages of existing electronic resources were noted, alongside a strong student consensus (88.23%) on the need for interactive e-courseware featuring comprehensive, visually engaging content for differential diagnosis education. The reliability and validity analyses of the questionnaire underscored its appropriateness for assessing educational needs. In this regard, ICC for the usability of scientific context, training ability, and interaction was 0.92, 0.73, and 0.82, respectively. Also, Cronbach's alpha score was at 0.90. Conclusion The research underscores a significant gap in dental students' knowledge and diagnostic skills regarding oral exophytic lesions. It emphasizes the critical need for an innovative, interactive educational tool that aligns with contemporary students' digital learning preferences. The envisioned e-courseware would facilitate self-learning and address current resources' limitations, potentially transforming dental education by enhancing clinical diagnostic skills through accessible, effective, and engaging digital content.

Standardized IETA criteria enhance accuracy of junior and intermediate ultrasound radiologists in diagnosing malignant endometrial and intrauterine lesions.

To transform the standardized descriptions of the ultrasound characteristics of endometrial and intrauterine lesions devised by the International Endometrial Tumor Analysis (IETA) group into a practical scoring method and to investigate whether application of this method enhances the diagnostic accuracy of ultrasound radiologists with different levels of experience in detecting malignancy compared with subjective assessment. This was a retrospective study of 855 patients with endometrial and/or intrauterine lesions, who were divided into a training (n = 600) and a validation (n = 255) set. Ultrasound radiologists with varying levels of experience (expert, intermediate and junior) evaluated all lesions by subjective assessment and according to IETA rules. Using IETA rules, the experts identified signs of malignancy in the training set, assigned scores for each indicator and validated the scoring method in the validation set. The intermediate-level and junior ultrasound radiologists reassessed the malignancy of the lesions using the IETA scoring method and compared their classifications with those made previously by subjective assessment. Postsurgical pathological evaluation was used as the reference standard. Using subjective assessment, the experts demonstrated the highest level of diagnostic accuracy, with a sensitivity of 85.0%, specificity of 94.3% and an area under the receiver-operating-characteristics curve (AUC) of 0.897. Applying the IETA scoring method (comprising eight ultrasound characteristics that contributed to the total score) with a threshold of > 25 points for the diagnosis of malignancy achieved a sensitivity of 84.7%, specificity of 94.7% and AUC of 0.9533 in the training set, with similar performance in the validation set, when performed by experts. Using the IETA scoring method, both junior and intermediate ultrasound radiologists showed improvement in sensitivity (from 55.5% to 74.8% and from 70.2% to 77.1%, respectively), specificity (from 88.4% to 91.5% and from 87.4% to 92.2%, respectively) and AUC (from 0.704 to 0.827 and from 0.793 to 0.841, respectively) for diagnosing malignant lesions. The IETA scoring method exhibits high diagnostic efficacy for malignant endometrial and intrauterine lesions. This method compensates for the lack of experience among junior and intermediate-level ultrasound radiologists, enhancing their diagnostic skill to a level nearing that of experienced senior ultrasound radiologists. Further research is essential to validate the practicality of implementing this method and to confirm its clinical value. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Using PACS for teaching radiology to undergraduate medical students

BackgroundTraditional radiology education for medical students predominantly uses textbooks, PowerPoint files, and hard-copy radiographic images, which often lack student interaction. PACS (Picture Archiving and Communication System) is a crucial tool for radiologists in viewing and reporting images, but its use in medical student training remains limited.ObjectiveThis study investigates the effectiveness of using PACS (Picture Archiving and Communication System) for teaching radiology to undergraduate medical students compared to traditional methods.MethodsFifty-three medical students were divided into a control group (25 students) receiving traditional slide-based training and an intervention group (28 students) using PACS software to view complete patient images. Pre- and post-course tests and satisfaction surveys were conducted for both groups, along with self-evaluation by the intervention group. The validity and reliability of the assessment tools were confirmed through expert review and pilot testing.ResultsNo significant difference was found between the control and intervention groups regarding, gender, age, and GPA. Final multiple-choice test scores were similar (intervention: 10.89 ± 2.9; control: 10.76 ± 3.5; p = 0.883). However, the intervention group demonstrated significantly higher improvement in the short answer test for image interpretation (intervention: 8.8 ± 2.28; control: 5.35 ± 2.39; p = 0.001). Satisfaction with the learning method did not significantly differ between groups (intervention: 36.54 ± 5.87; control: 39.44 ± 7.76; p = 0.129). The intervention group reported high familiarity with PACS capabilities (75%), CT principles (71.4%), interpretation (64.3%), appropriate window selection (75%), and anatomical relationships (85.7%).ConclusionPACS-based training enhances medical students’ diagnostic and analytical skills in radiology. Further research with larger sample sizes and robust assessment methods is recommended to confirm and expand upon theses results

Diagnostic and Feedback Behavior of German Pre-Service Teachers Regarding Argumentative Pupils’ Texts in Geography Education

The study sheds light on the importance of diagnostic and feedback skills regarding argumentative pupils’ texts for (prospective) teachers and the current state of research in this area. The importance of argumentation in geography education is undisputed, as geographical problems often require multi-layered solutions that can be analyzed, assessed and reflected upon by teachers and pupils through argumentation skills. Nevertheless, research findings reveal that both teachers and pupils often have limited argumentation skills, which poses a challenge for both. The present study investigates the attitudes and practices of prospective geography teachers regarding the diagnosis of and feedback on pupils’ argumentative texts. Using a qualitative research design, twenty German pre-service teachers of geography were interviewed about their diagnostic and feedback experiences and asked to analyze and provide feedback on an argumentative pupil text. The results were evaluated using qualitative content analysis. In addition, a theoretical model for diagnosis was developed, which was used to analyze the pre-service teachers’ diagnostic behavior. The criteria used by the pre-service teachers to evaluate the argumentative pupils’ text were examined. The results show that the diagnosis often lacks the exploration of causes and the deduction of consequences, and that only a few subject-specific criteria were taken into account in the text assessment. In addition, the feedback was generally more positive than the diagnosis itself. The results offer insights into the design of diagnostic and feedback processes in geography education and provide impulses for (higher) education teaching and future research.

Kampo diagnostic ability is specific in post‐clinical clerkship objective structured clinical examination: An observational study

AbstractBackgroundThe Japanese medical educational model core curriculum requires an understanding of the characteristics of Kampo medicine. However, there are few reports on the methods of evaluating the skill levels of Kampo medicine practitioners.ObjectiveThis study investigated the utility of objective structured clinical examination (OSCE) for evaluating the skills of Kampo medicine practitioners, exploring its relationship with other medical skills.MethodsThe 2022 post‐clinical clerkship OSCE assessed the accuracy of Kampo‐related tasks, specifically abdominal examinations. In addition, correlation coefficients and factor analysis were used to analyze the relationship of Kampo tasks with other tasks (three clinical‐reasoning tasks, electrocardiogram attachment task, joint examination task).ResultsMedical students showed significant variation in their ability to accurately assess different abdominal regions. The epigastric region had the highest accuracy (92.0%), while the para‐umbilical region had the lowest (45.1%). Correlation analysis between Kampo tasks and other clinical tasks (clinical reasoning, electrocardiogram attachment, joint examination) yielded coefficients ranging from 0.10 to 0.19, suggesting a low relationship. Factor analysis confirmed the independence of Kampo skills from other assessed medical skills across four distinct factors.ConclusionsSince Kampo diagnostic skills are highly unique, it is possible that Western medicine OSCE tasks alone may not sufficiently assess competency in Kampo medicine. Therefore, it is necessary to consider incorporating Kampo tasks into the OSCE.

‘Thrown at twins’ - A qualitative study exploring the lived experience of Australian osteopaths who regularly treat paediatric patients

Backgroundand purpose: Little is known about the training and experience of osteopaths who treat paediatric patients, and graduates report feeling unprepared for this aspect of practice. The purpose of this study was to investigate the lived experience of Australian osteopaths who regularly treat these patients, in order to better understand their individual educational pathways and their management of this population. Materials and methodsOsteopaths who reported regularly treating paediatric patients were recruited through the Osteopathy Research and Innovation Network (ORION) national practice-based network. Semi-structured interviews were completed, transcribed and thematically analysed using the principles of Descriptive Phenomenology to compile qualitative data. ResultsTen osteopaths were interviewed, whose age ranged from 33 to 71 years and with 15–46 years of clinical experience. Proportion of paediatric patients ranged from 20 to 90 % of participants’ caseload according to self-report. Seven themes were identified that reflected the lived experience of treating paediatric patients: 1) Variable pathways to practice, 2) Challenges and rewards, 3) Scope of practice, 4) Team-based care, 5) Importance of entry-level skills, 6) Family-centred care, and 7) Success. ConclusionThe study found a diversity of educational pathways, that paediatric practice was highly rewarding, the scope of practice was based on diagnostic skills and experience, the practitioners had extensive team-based professional networks, practice reflected a family-centred care model, and personal measures of success were multifactorial. These results give insight into this area of practice to guide further research.

The effect of promoting factors on learning by four different delivery modes

BackgroundIn the digital era, developing effective teaching methods is crucial due to the challenges of maintaining students’ concentration amidst distractions. This study assessed the effects of learning-promoting factors both across group boundaries and within RCT learning groups examined in our previous study on the effectiveness of online versus live teaching.MethodsThe participants’ experiences in the domains of Concentration, Anticipation, Liking and Desire to reuse were evaluated online immediately after a lesson on diagnosing pediatric respiratory issues implemented either in a Live, Live-stream, Vodcast or Podcast setting. The students rated their experiences on a scale of 1–10 with scores above a median of 8 indicating high experience levels in each factor. Learning was evaluated using a Webropol e-Test immediately and five weeks after the teaching session. The 15-minute test, comprised of 10 multiple-choice questions and real-life video scenarios, measured both theoretical and diagnostic skills. The test score scale ranged from − 26 to 28 points.ResultsHigh concentration was experienced by 70/72 (97.2%) students in the Live, 41/75 (54.7%) students in the Live-stream, 53/72 (73.6%) students in the Vodcast and 36/79 (45.6%) students in the Podcast teaching groups (P < 0.01). High concentration promoted learning the most, resulting in a 1.93 score improvement in the short-term test and a 1.65 score improvement in the long-term test. Among those with high concentration, the average test scores ranged from 21.9 to 23.4, while the range for low concentration was 18.3–20.0.ConclusionIn our study, good concentration promoted higher test scores in comparison with low concentration across all the learning modalities, both in digital and live settings. However, the live teaching modality resulted in the highest levels of concentration. Our results suggest that teachers should use various teaching modalities and utilize related special features to engage learners and maintain their concentration.

Role of Neurologists in Stroke Treatment

Determination of indications for acute reperfusion therapy (intravenous recombinant tissue plasminogen activator administration and mechanical thrombectomy) and identification of stroke mimics and chameleons are essential components of effective stroke treatment. Moreover, neurologists select the appropriate medications and manage the patient's general condition. Therefore, a neurologist's solid diagnostic skills based on neurological symptomatology and an internist's broad knowledge and insight play key roles clinically.

Emergency Care for High-Altitude Trekking and Climbing.

Introduction: High altitude regions are characterized by harsh conditions (environmental, rough terrain, natural hazards, and limited hygiene and health care), which all may contribute to the risk of accidents/emergencies when trekking or climbing. Exposure to hypoxia, cold, wind, and solar radiation are typical features of the high altitude environment. Emergencies in these remote areas place high demands on the diagnostic and treatment skills of doctors and first-aiders. The aim of this review is to give insights on providing the best possible care for victims of emergencies at high altitude. Methods: Authors provide clinical recommendations based on their real-world experience, complemented by appropriate recent studies and internationally reputable guidelines. Results and Discussion: This review covers most of the emergencies/health issues that can occur when trekking or during high altitude climbing, that is, high altitude illnesses and hypothermia, freezing cold injuries, accidents, for example, with severe injuries due to falling, cardiovascular and respiratory illnesses, abdominal, musculoskeletal, eye, dental, and skin issues. We give a summary of current recommendations for emergency care and pain relief in case of these various incidents.

HEREDITARY CONGENITAL NEPHROTIC SYNDROME IN CHILDREN: FEATURES OF THE COURSE, MODERN PROSPECTS FOR LIFE AND HEALTH

Every pediatrician-nephrologist repeatedly have to deal with cases of the birth of childrenwith early onset of nephrotic syndrome, which is characterized by a severe course, persistent progression ofsymptoms, resistance to standard immunosuppressive therapy, questionable and, often, unfavorable prognosesfor life and health, which requires constant improvement of existing professional knowledge, diagnostic andtherapeutic skills. The article presents a review of the scientific literature of domestic and foreign authors,which allows changing the perception of the disease, improving outcomes, giving chances to the patient andhis family in conditions of modern and timely diagnosis and the correct choice of patient management strategy.

Interdisciplinary Applications of AI: Dermatology and Psychology

Artificial Intelligence (AI) is profoundly transforming interdisciplinary domains like dermatology and psychology, providing revolutionary possibilities in the areas of diagnosis, treatment, and patient care. AI-driven solutions in dermatology are improving diagnostic accuracy by analyzing medical photos to identify skin disorders such as melanoma with a level of precision comparable to that of professional dermatologists. These technologies utilize machine learning algorithms that have been trained on extensive datasets to detect minor patterns and anomalies in skin lesions. This enables the early detection of skin conditions and the creation of personalized treatment strategies. Moreover, artificial intelligence (AI) assists in optimizing the efficiency of workflows, minimizing diagnostic inaccuracies, and enhancing the availability of dermatological treatment, particularly in places with limited access to healthcare services. Within the field of psychology, artificial intelligence (AI) has a significant influence. It is utilized to assess individuals' mental well-being by analyzing their text and speech patterns, employing techniques such as natural language processing and sentiment analysis. Artificial intelligence algorithms have the capability to observe and analyze patient interactions, offering immediate and accurate observations regarding emotional states and possible psychological illnesses. The incorporation of AI enables more precise evaluations and prompt actions, enhancing conventional therapeutic methods. In addition, chatbots and virtual therapists that utilise artificial intelligence provide instant assistance and ongoing supervision, thereby extending the accessibility of mental health care. The integration of AI with dermatology and psychology not only improves diagnostic skills and treatment results but also highlights the significance of interdisciplinary collaboration in advancing healthcare. By using artificial intelligence (AI), these industries can utilize data-driven analysis to provide more accurate, tailored, and easily accessible healthcare, thereby enhancing patient results and quality of life.

Brief Teaching Intervention Improves Medical Students' Dermatology Diagnostic Skills and Comfort in Performing Dermatology Exams.

Skin disease is a significant contributor to the global disease burden, with dermatologic health disparities adding to this burden. Internists, general practitioners, and other medical professionals often manage skin disease with limited exposure to dermatologic education in medical school. This study evaluated a brief educational intervention for medical students to improve dermatologic knowledge, diagnostic and communication skills, and comfort in performing dermatology-focused physical exams. A secondary focus of the intervention was to promote awareness of skin disease, detection, and prevention for patients with a variety of skin tones. Sixty-five first through fourth-year students at Rutgers RWJMS participated in a pre-test-post-test within-subject study. Students described images using open-ended responses followed by multiple-choice identification questions. Students watched a one-hour self-paced module created by a licensed dermatologist and completed a follow-up assessment. At pre-test, descriptions were brief and often inaccurate but significantly improved post-intervention to include descriptors such as primary morphology and demarcation. Accuracy on diagnostic and management questions significantly improved and comfort in advising patients and performing dermatologic exams significantly increased. A low-cost, brief, self-paced module can augment dermatologic education for medical students while increasing exposure to multiple skin tone presentations of lesions.

The role of community health workers in the management of hypertension in Nigeria

BackgroundHypertension is the number one risk factor for cardiovascular death worldwide and its prevalence has been on the increase in LMICs including Nigeria. There is an increasing awareness and recognition of the contributions of the community health workers (CHWs) in the healthcare system. This study assessed their current role in the management of hypertension and patient satisfaction with the care received.MethodsA mixed method study (cross-sectional study of 381 CHWs and key informant interview of 14 patients with hypertension selected using multi-stage and purposive sampling respectively) was conducted across five states in different geopolitical zones of Nigeria to assess the role of CHWs in hypertension management and the patients’ level of satisfaction with services of CHWs. Chi-square test was used to assess relationship between categorical variables. A p-value ≤ 0.05 was considered statistically significant. Thematic analysis of the text data from the KII was done using Nvivo® version 12 pro.ResultsA total of 381 CHWs completed the study. They were predominantly males (63%) with mean age of 40.96 ± 12.51 years. Only about one-third of the CHWs (31%) could correctly diagnose hypertension while only 15% knew the base-line investigations to be requested. Being female (FE = 9.205, p = 0.008) and resident in northwest geopolitical region (χ2 = 20.920, p < 0.001) had statistically significant associations with appropriate diagnostic skills for hypertension. Being supervised by doctors was associated with appropriate knowledge of baseline investigations for hypertension (χ2 = 5.534, p = 0.019). Mostly, hypertensive patients reported positive experiences and satisfaction with the services provided by the CHWs.ConclusionsCommunity health workers currently have critical contributions in the management of hypertension in Nigeria. Hypertensive patients generally reported satisfactory experience with CHWs managing them. The services rendered by CHWs can be improved upon by adequate supervision and training.

Diagnostic Errors in Obstetric Morbidity and Mortality: Methods for and Challenges in Seeking Diagnostic Excellence.

Pregnancy-related morbidity and mortality remain high across the United States, with the majority of deaths being deemed preventable. Misdiagnosis and delay in diagnosis are thought to be significant contributors to preventable harm. These diagnostic errors in obstetrics are understudied. Presented here are five selected research methods to ascertain the rates of and harm associated with diagnostic errors and the pros and cons of each. These methodologies include clinicopathologic autopsy studies, retrospective chart reviews based on clinical criteria, obstetric simulations, pregnancy-related harm case reviews, and malpractice and administrative claim database research. We then present a framework for a future study of diagnostic errors and the pursuit of diagnostic excellence in obstetrics: (1) defining and capturing diagnostic errors, (2) targeting bias in diagnostic processes, (3) implementing and monitoring safety bundles, (4) leveraging electronic health record triggers for case reviews, (5) improving diagnostic skills via simulation training, and (6) publishing error rates and reduction strategies. Evaluation of the effectiveness of this framework to ascertain diagnostic error rates, as well as its impact on patient outcomes, is required.

Harnessing Fusion Modeling for Enhanced Breast Cancer Classification through Interpretable Artificial Intelligence and In-Depth Explanations

Integrating Artificial Intelligence (AI) into healthcare has shown tremendous promise in several domains, such as prediction, decision-making, and diagnosis. Nevertheless, the widespread belief that AI is incomprehensible and mysterious has restricted its practical use, particularly in medicine. This skepticism highlights the need for methods that provide precise predictions and clear explanations for these projections. The present study presents a hybrid method “BC2” (Breast Cancer Classification) that combines deep learning techniques to accurately detect breast cancer and provide detailed explanations for its predictions. “BC2” exploits the collaborative effects of Convolutional Neural Networks (CNN) and the Light Gradient Boosting Model (LGBM). The automated feature learning process of the model is integrated into many convolutional layers, and LGBM then follows it to provide predictions for class labels. To evaluate the effectiveness of the proposed approach, the authors performed experiments with real-world Breast Cancer Data. The results demonstrate substantial enhancements compared to the current methods in key metrics such as accuracy, precision, recall, and F1 score. The proposed technique obtains an accuracy of 0.982906, a precision of 0.987179, a recall of 0.987179, and an F1-score of 0.987179, demonstrating its exceptional performance. After generating exact forecasts, authors use the “SHAP” (SHapley Additive exPlanation) approach at local and global levels to explain the reasoning behind each projection. This guarantees clarity and improves the comprehensibility of the predictions made by the proposed model. The proposed hybrid model consists of three main components: a feature learning module, a diagnostic module, and an explanation-generating module. The proposed model can improve medical professionals’ diagnostic skills in managing breast cancer patients by clearly explaining its forecasts.

The relation between learners’ experience in simulations and diagnostic accuracy: Generalizability across medical and teacher education

Simulation-based learning is being increasingly implemented across different domains of higher education to facilitate essential skills and competences (e.g. diagnostic skills, problem-solving, etc.). However, the lack of research that assesses and compares simulations used in different contexts (e.g., from design perspective) makes it challenging to effectively transfer good practices or establish guidelines for effective simulations across different domains. This study suggests some initial steps to address this issue by investigating the relations between learners' experience in simulation-based learning environments and learners' diagnostic accuracy across several different domains and types of simulations, with the goal of facilitating cross-domain research and generalizability. The findings demonstrate that used learners' experience ratings are correlated with objective performance measures, and can be used for meaningful comparisons across different domains. Measures of perceived extraneous cognitive load were found to be specific to the simulation and situation, while perceived involvement and authenticity were not. Further, the negative correlation between perceived extraneous cognitive load and perceived authenticity was more pronounced in interaction-based simulations. These results provide supporting evidence for theoretical models that highlight the connection between learners' experience in simulated learning environments and their performance. Overall, this research contributes to the understanding of the relationship between learners’ experience in simulation-based learning environments and their diagnostic accuracy, paving the way for the dissemination of best practices across different domains within higher education.

Video Otoscopy as a Novel Teaching and Remote Otolaryngology Consultation Tool at an Academic Medical Center.

Assess the use of video otoscopy (VO) as a tool for teaching Emergency Department (ED) residents and remote Otolaryngology consultation. Survey and retrospective chart review. Tertiary care center. Emergency Medicine resident physicians completed an otologic skill self-assessment and pathology followed by an interactive training on VO and postintervention assessment after 9 months of use. Outcomes compared change in pre- to posttraining scores. ED consultations using VO during this time period were reviewed to detect differences between the presumed diagnosis/treatment based only on phone consultation and VO image compared to the final diagnosis/treatment after in-person Otolaryngology consultation. Forty-six (63.1%) ED residents participated. Diagnostic accuracy improved by 20.7% overall. The most improved diagnoses were of a normal ear canal (+75%), tympanosclerosis (+58.4%), and ear canal foreign body (+57.1%); most challenging were external auditory canal cyst (-13.6%), hemotympanum (-11.3%), and cerumen (-1.9%). Cholesteatoma did not improve because all responses were incorrect; neither did tympanic membrane perforation because all were correct. Confidence in the otologic exam and anatomy also increased (P < .01). Thirteen consults used VO and 3 (23.1%) had a change in diagnosis/treatment after in-person Otolaryngology evaluation. Training on the use of VO significantly improves the confidence and diagnostic skills of ED providers for many pathologies. This application suggests the efficacy of an otologic e-consultation model.

Lung ultrasound in respiratory therapy: a global reflective survey.

Lung ultrasound (LUS) is a non-invasive point of care diagnostic tool used to assess the presence and severity of various lung disorders for more than two decades. Within the healthcare professionals are the respiratory therapists (RTs) who play a vital role in managing ventilated and other patients requiring respiratory support, but the incorporation of LUS into their scope of practice has not been well highlighted. This international cross-sectional survey was specifically designed to evaluate the knowledge, attitude, and practice of RTs with respect to LUS. This observational cross-sectional study was conducted among RTs from different parts of the world using a questionnaire-based study tool. 514 RTs responded to all the questions and were considered for statistical analysis. Descriptive statistics, Analysis of variance, Fisher's exact, Chi-square, Bonferroni post-hoc analysis, and Binomial logistic regression analyses were performed to identify the significance of the data. From 22 countries, 514 RTs responded to the survey, with the major share from the middle eastern countries. Out of the 514 responders, 44.9% of the responders were in the age group of 23-30 years; 67.1% were bachelor's degree holders; and 40.9% of participants had more than 10 years of experience. The knowledge-based questions revealed that RTs with higher experience and academic qualification provided more positive responses. While in the attitude-related domain it is observed that standardized training in LUS helps them to enhance the current practice and to add LUS to the academic curriculum of respiratory therapy schools; however there remains barriers to practice LUS based on their responses. The practice-based questions revealed that RTs expect some additional seminars/workshops/webinars to be done on LUS frequently. More than half of the participants are found to be knowledgeable with a positive attitude and working towards the inclusion of LUS in respiratory therapy profession. It is concluded that respiratory therapists have a positive attribute towards the inclusion of lung ultrasound in their clinical practice. Providing more structured training for professional respiratory therapists and including lung ultrasound modules in the respiratory therapy school curriculum may facilitate mastering their diagnostic skills, thereby expanding the scope of practice.

Dermoscopy Education for Plastic Surgery Residents: How a Brief Theoretical Course and Practical Training Have an Impact.

Currently, the evaluation of pigmented skin lesions relies on dermoscopy, which has become the standard of care. As melanoma is one of the principal areas of expertise in plastic surgery, it is essential that diagnostic skills be acquired during the course of specialization. This study aimed to assess the impact and effectiveness of a brief and intensive dermoscopy training program for plastic surgery residents. This study was carried out on a group of 41 doctors, who were divided into three categories based on their experience in dermoscopy (none, intermediate, and advanced). A preliminary assessment of each participant's baseline knowledge was conducted by using a 15-query test. Subsequently, the participants attended a 90-minute lecture on diagnostic techniques and the process of differentiating between various skin lesions. To determine the effectiveness of the lecture in improving diagnostic skills, the participants were tested immediately after the lecture and again after a 3-month period. At the conclusion of the final examination, all three groups achieved an accuracy rate of at least 80% for dermatoscopic diagnosis. However, none of the groups was completely successful. The variations in diagnostic accuracy among the three groups are presented, and P values were calculated for each group. The short, intensive course of dermoscopy has proven to have a significant positive impact on plastic surgeons in their postdegree training program.

Clinicopathological discrepancies in the diagnoses of childhood causes of death in the CHAMPS network: An analysis of antemortem diagnostic inaccuracies

IntroductionDetermining aetiology of severe illness can be difficult, especially in settings with limited diagnostic resources, yet critical for providing life-saving care. Our objective was to describe the accuracy of antemortem...