Didactic Sessions Research Articles

Return on Investment of Incorporating Simulation into a New Graduate Nurse Emergency Department Residency Program.

Ensuring a smooth transition from education to practice for new nurses is essential in helping stem the flow of nurses out of the profession. However, traditional nurse residency education has only included didactic education sessions. In a novel new graduate emergency Nurse Residency Program, simulation-based education was ranked as the best part of the new graduate Nurse Residency Program. The result of incorporating simulation experiences was increased satisfaction by program participants and a decrease in turnover.

Reducing Unnecessary Laboratory Testing: A Quality Improvement Initiative at Wellstar Spalding Medical Center.

The healthcare industry is grappling with escalating expenses, partially attributed to the inefficient use of medical resources, particularly by ordering unnecessary laboratory tests. Such practices not only increase costs but also result in extended hospital stays, patient discomfort, and potential clinical complications such as iatrogenic anemia. Blood tests, although essential for guiding medical decisions, are associated with significant clinical and financial costs. This quality improvement project aimed to decrease unnecessary laboratory testing at Wellstar Spalding Medical Center, a community hospital with a newly established residency program. Our study team played a pivotal role in formulating an algorithm that outlined the indications for a complete blood count and basic or comprehensive metabolic profile. We then conducted standardized didactic sessions for resident physicians and faculty, educating them on the use of "add-on" laboratory values, providing electronic medical records training, and highlighting the compounding costs of these simple laboratory tests. We analyzed data during a 3-month period, both before and in the intervention phase, adjusting for the number of physician-patient interaction days to account for potential variations in patient census in the hospital. The number of complete blood count orders and basic/comprehensive metabolic profile orders underwent an absolute decrease in the postintervention period. When adjusted for the number of physician-patient interaction days, this decrease remained consistent, although not statistically significant. Our project has yielded clinically and administratively meaningful results. We have seen a measurable decrease in costs and the prevention of unnecessary laboratory testing. If it also can be shown that we have prevented iatrogenic anemia, our project could be seen as enhancing the patient experience and reducing hospital length of stay. We also have raised awareness about high-value care and instilled clinical awareness among residents regarding ordering daily blood tests contributing to an improvement in patient care.

Teacher–Child Interaction Training—Group Coaching (TCIT-GC): removing barriers to advancing classroom behavioral health

PurposeThe Teacher–Child Interaction Training program (TCIT) is an evidence-based intervention that coaches effective strategies for managing disruptive classroom behavior (Garbacz et al., 2014). However, its widespread implementation is limited due to its costly and time-consuming model of delivery. This pilot study investigated whether the Teacher–Child Interaction Training- Group Coaching (TCIT-GC), a briefer, cost-effective adaptation of TCIT, would be effective in improving classroom climate, student behavior and professional quality of life among educators.Design/methodology/approachTCIT-GC is a remote, manualized, 8-week adaptation of TCIT. Participants included 41 educators representing both public and private K-12 schools from 11 public school districts. TCIT-GC comprised eight synchronous group sessions via Zoom, four Didactic sessions and four Consultation/Coaching sessions for trainer feedback, paired with asynchronous skill practice. This contrasted with the fully synchronous, one-on-one, in vivo coaching format of traditional TCIT. Participants practiced applying skills with students between Zoom sessions and documented the effectiveness of their acquired skills across various measures.FindingsResults of pre- and post-training comparisons showed significant improvements in reported classroom functioning, positive student behaviors, perceived effectiveness of TCIT-GC skills and significant reductions in problematic student behaviors and discipline use. Findings showed significant improvement in compassion satisfaction. No significant changes in levels of other ProQOL scales were observed.Originality/valueDisruptive student behavior takes a toll on the educational experience of misbehaving students, their classmates and educators. Results of this pilot study supported TCIT-GC as a feasible and promising behavioral health model that warrants further study.

Novel indigenous low cost (NICA) model for hands on training of surgical interns in incision and drainage procedure for superficial skin abscess

BackgroundSurgical education necessitates hands-on training, which poses ethical challenges when practicing on real patients. Simulation training emerges as a pivotal solution, offering a safe and effective environment for skill acquisition. However, existing simulation models often overlook common surgical conditions like superficial skin abscesses. The National Medical Commission advocates for simulation-based training in basic surgical skills, highlighting the need for accessible and cost-effective models. Thus, this study aimed to develop and evaluate a novel Indigenous Cost-effective model for Incision & Drainage (NICA) of subcutaneous abscesses, addressing the gap in surgical education.MethodologyFollowing institutional ethics clearance, the study employed Kern’s Six-step approach for curriculum development. The NICA model was conceptualized and crafted using locally available, low-cost materials, validated by expert opinion, and implemented in a simulation lab setting. A total of 155 surgical interns underwent training, consisting of didactic video sessions, hands-on practice with the NICA model, and structured assessments. Pre- and post-training evaluations were conducted to measure interns’ performance and feedback.ResultsExpert validation confirmed NICA model’s fidelity and usefulness. Training 155 surgical interns resulted in significant skill improvements. Pre-training, 33% correctly performed pre-procedural requisites, 46% executed procedural techniques, and 48% performed post-procedural steps accurately. Post-training, these percentages surged to 95%, 97%, and 98%, respectively. Post test score showed significant skill enhancements across all domains (p < 0.05). Intern feedback highlighted increased confidence, satisfaction, and interest in learning, affirming NICA model’s effectiveness.ConclusionThe development and implementation of the NICA model offer a scalable and cost-effective solution for surgical training in resource-limited settings. The model’s effectiveness in enhancing interns’ skills and confidence underscores its potential to address training needs effectively. The study highlights the significance of simulation-based training in surgical education and advocates for the widespread adoption of indigenous low-cost models to improve surgical skills acquisition.

The Resident Scholars Program for Workforce Diversity: A Qualitative Study About Supporting Family Medicine Abortion Providers

Background and Objectives: While workforce diversity helps mitigate health inequities, few initiatives support prospective abortion providers who are underrepresented in medicine (URiM). To address this issue, Reproductive Health Education in Family Medicine established the Resident Scholars Program for Workforce Diversity (RSPWD), a year-long program for URiM and other Black, Indigenous, People of Color (BIPOC) residents committed to sexual and reproductive health (SRH) provision. Program elements include: (a) mentorship by BIPOC family physicians; (b) virtual didactic sessions about SRH integration into primary care, advocacy, leadership, reproductive justice, and patient-centered care; (3) conference sponsorship; and (4) community-building among residents and mentors. Methods: We conducted a qualitative study with the program’s first cohort of residents and mentors to examine perspectives about program successes and needed improvements. We used a semistructured interview guide along with a direct contact analysis approach. Results: We interviewed eight scholars and four mentors. From the interviews, we gleaned data on three main themes: (a) value of mentorship, (b) importance of community, and (c) program improvement suggestions. Scholars expressed appreciation for SRH mentorship from BIPOC mentors who had lived experiences similar to their own, noted the mentorship’s importance for career-building, and spoke positively of their sense of safe community among all program participants. Respondents shared suggestions for improved scheduling and requested better guidance for navigating the mentee–mentor relationship. Conclusions: The RSPWD success is reflected in the enthusiasm and gratitude for the program and the resulting mentorship and community that fostered supportive personal and professional relationships, including career opportunities. When considering the importance yet dearth of workforce diversification in family medicine, this program offers a promising model for supporting a more diverse and representative future SRH workforce that may apply to other family medicine clinical niches.

Fundamentals of leadership development: a randomized pilot study to evaluate implementation of a leadership curriculum for diversity, equity, and inclusion.

The Fundamentals of Leadership Development (FLD) Curriculum was created to increase integration of diversity, equity, and inclusion (DEI) in leadership skills. The pilot FLD course was utilized 1) evaluate short-term impact of the curriculum, and 2) evaluate optimal delivery methods of curricular interventions on diversity in a leadership context in a randomized fashion. After IRB approval, the pilot FLD course was opened to all SAGES Committee members for enrollment. All participants had access to the same online modules and discussion forum, but were randomized either to a 4-week longitudinal or 2-day intensive didactic session. Participants were asked to assess the curricular content after each online module and provide overall course feedback on all sessions. This data was collected along with leadership experience, course participation, and course completion data. A total of 79 participants registered for the FLD course, with 55 (69.7%) of participants completing the course. Of those that registered, 46 (58.2%) self-identified as underrepresented in medicine, 32 (40.5%) self-identified with she/her/hers pronouns, and 45 (57.0%) held an institutional leadership position. Fifty-nine (74.6%) participants were willing to be randomized. Course engagement was higher in the intensive course with 64.1% and 48.7% participation over days 1 and 2, respectively. In the longitudinal course, participation dropped off every week from 70%, 47.5%, 35%, and 27.5%, throughout the 4-week course. Participants who accessed the online modules spent a median time of 3h and 34min.User confidence after completion of each individual module were "somewhat confident" and "completely confident" for almost all survey respondents on a 5-tier Likert scale. The pilot FLD course appealed to SAGES members in leadership roles and who identified as. URiM. Course engagement was higher in the intensive course. Long-term behavior changes after course completion will need to be assessed with additional qualitative interviews. (300/300 words).

Implementation and outcomes of a dementia-friendly training program in five hospitals

Background: Hospitalized patients living with dementia (PLWD) age 65+ generally experience poor outcomes. This study's purpose was to implement dementia-friendly training with staff, track patient outcomes, and implement sustainable system changes.Methods: We conducted a prospective study in five hospitals. The hospitals adopted HealthCare Interactive's CARES® Dementia 5-Step Method for Hospitals Online Training and Certification Program . After on-line modules completion, a didactic session was offered, and a retrospective pre/post survey was completed. Patient falls, length of stay, and readmission rates were collected.Results: 1,836 (41 %) staff completed the training. Positive changes in staff ratings from pre- to post- intervention were observed. Number of falls and readmissions did not change. The average number of stays per patient decreased by .24 (p=0.01). Hospitals made system changes including innovative identification for PLWD.Conclusions: Dementia-friendly hospital training is effective in improving staff recognition of the symptoms and needs of PLWD, and responding appropriately.

Advancing excellence: a national peer-coaching program for advanced laparoscopic HPB techniques

BackgroundSurgical coaching is valuable for disseminating knowledge, refining skills, and fostering continuous professional development for surgeons in practice. This work aims to implement a national coaching program for Canadian HPB surgeons, emphasizing advanced laparoscopic techniques, and to assess subsequent adoption. Secondary objectives include evaluating surgeon perceptions, barriers, and experiences. MethodsMid-to-late career HPB surgeons across Canada joined a peer surgical coaching program for advanced laparoscopic skills. The program included didactic sessions followed by practical coaching with case observation, simulation labs, and real-time coaching in the operating room. One lead surgeon from each center was invited to participate in the exit interview. ResultsEight centers across four provinces completed the program, and one lead surgeon from each site was interviewed. Surgeons reported a 34.9 % increase in self-perceived comfort levels in laparoscopic HPB surgeries, with a 24.2 % and 56.7 % increase in laparoscopic liver and pancreas resections, respectively. Participants acknowledged challenges in implementing surgical coaching, citing barriers related to surgeon and societal factors. Overcoming these challenges required mutual respect, openness to learning, and building sustained change through team collaboration and long-term coach relationships. DiscussionThis work demonstrated the practicality of a nationwide coaching program and its capacity to effect substantial, long-term change in clinical practice.

Effectiveness of a multidimensional collaborative approach versus usual care in the treatment of adult depression in primary care in Chile: study protocol for a single blinded cluster randomized controlled trial.

Major depression (MD) is a prevalent and disabling condition in Chile, with most cases being treated at the primary care level. In Chilean primary care, the authors have identified key factors associated with more complex presentations of MD and a poorer prognosis, such as a history of childhood trauma, suicidality, and comorbidities. These findings underscore the need for a multidimensional, trauma-informed, and interprofessional approach to the treatment of depression. This protocol is a two-arm, single-blinded, cluster RCT to compare the effectiveness of a collaborative multidimensional approach for depression (CMAD) versus usual care to treat MD in primary care clinics in Chile. In total, 394 depressed adults from 18 to 65 years of age in twelve clinics located in Chile's Maule Region will be consented to participate in the study. Patients and care teams from each clinic will be randomized to the intervention or to the control arm.Interprofessional teams in the intervention arm will attend 27 hours of didactic and active learning sessions focused on clinical competences to effectively engage, treat and follow up patients with the factors associated to the complex presentation of MD. Team in the control arm will receive 27 didactic sessions on current clinical guidelines for MD.Patients of both arms will be blindly assessed at baseline, three months, and six months. The primary outcome will be the reduction in depressive symptoms, with secondary outcomes including improvements in anxiety symptoms, interpersonal and social functioning, and treatment adherence. This protocol proposes the evaluation of an intervention designed to improve depression symptoms by enhancing the clinical competencies of primary care teams. These competencies are structured around collaborative care and trauma-informed practices. NCT05016388, registered on 16 August 2021 at ClinicalTrials.gov.

Implementing a new multidisciplinary, remote, dementia staff training program for Veterans affairs nursing homes

BackgroundPreventing Loss of Independence through Exercise (PLIÉ) is a group program for people living with dementia that combines movements to support daily function with present moment body awareness and social engagement that has been found to have physical, emotional, social, and cognitive benefits. The goal of this study was to develop and refine a PLIÉ remote training program for interdisciplinary Veterans Affairs (VA) nursing home staff members also known as community living center (CLC) staff.MethodsThis pre-implementation study used iterative Plan-Do-Study-Act (PDSA) cycles. The 10-week PDSA cycles occurred from June to September 2021 at 2 VA nursing home sites. Remote training was delivered via Microsoft Teams and included 1-hour live-streamed weekly didactic sessions (nursing staff with PLIÉ instructor) focused on PLIÉ principles and 1-hour weekly live-streamed experiential sessions for staff to apply PLIÉ principles with residents. We administered weekly feedback surveys to iteratively refine the training process.Results14 staff members participated (5 recreation therapists, 3 social workers, 2 registered nurses, 2 chaplains, 1 psychologist, and 1 speech pathologist). The experiential sessions were rated as most helpful overall. Key PDSA refinements included: (1) creating 10-minute video recording summaries to support learning, particularly for those unable to attend live training sessions due to clinical schedules; and (2) incorporating self-reflection and goal setting to support staff incorporation of PLIÉ principles into routine care and personal life. These refinements resulted in increased use of PLIÉ principles with the residents from 67 to 89% of the staff participants. 100% of regular attendees (11/11) rated their overall satisfaction with remote training as “very good” or “excellent.”ConclusionsIt was feasible to train interdisciplinary CLC staff participants to deliver an integrative group movement program for residents with dementia remotely. PDSA cycles supported refinement of the training process and improved uptake. A larger study of PLIÉ remote CLC staff training is needed to assess outcomes on residents and quality of care.

An Innovative Integrated Geospatial Information Systems &amp; Quality Improvement Residency Research Training Program

Introduction Participation in scholarly activity during residency has posed barriers to departments that include: research mentorship, an active and supportive research community, formal research infrastructure and programming, and diverse and accessible opportunities for scholarly activity with faculty, staff and communities in our service region. In response to these barriers our team has created a formal QI research training program for psychiatry residents.2 Our solutions include: assembling a dedicated team, which contains both department leadership and a GIS faculty expert, an expanded interdisciplinary team which includes research librarians and grant support, GIS as a tool and science to best orient residents to the regional landscape and needs of our service populations, formal research training covering GIS, Cultural Psychiatry, and Psychometrics in Psychiatry as curricular themes, and a Chief Resident for Research role to facilitate bridges between residents and faculty and to promote a continuous research community. Methods An inquiry-based approach is applied to our formal research curriculum. Year 1 is an inquiry theme focused on basing resident QI research on the needs of our service region. Year 2 is themed research wherein literature reviews, dashboards and Storymaps are the emphasized outputs. Year 3 is themed implementation and residents are supported to use their dashboards with community to aid community organizations in making decisions for and with populations they serve. Lastly, year 4 is themed construct wherein residents are supported to complete and submit manuscripts and grants. Results Our pre-pilot phase was underway as of July 1st, 2023. To begin integrating within the Psychiatry &amp; Neuroscience department as a formal program our team targeted core departmental programming; Grand Rounds, Journal Club, and didactics. We presented our curriculum to department staff, faculty, leadership and some residents during Grand Rounds in a detailed PowerPoint presentation. We worked with the faculty and staff directors of Journal Club to have our 2nd year deliverable of a StoryMap or Dashboard become the presentation for each PGY2. We presented it to all residents at a didactic session. As a follow-up to the didactic presentation we sent residents a QI attitudes and interest survey, which was an adaptation from the BASiC-QI. An estimated 20% of residents responded to the survey. From the residents who responded to the survey, the majority have followed-up with starting regular research mentor meetings with the Vice Chair for Research and advancing their projects. Findings/Conclusions Our pre-pilot year is nearing an end. Our full pilot year will begin on July 1st 2024. Thus far we have accomplished increasing buy-in for the program, and selecting a Chief Resident for Research and Wellness. We have also invited our new cohort of residents to our first annual QI/GIS conference showcase enabling a group of interns to begin a new year within our formal curriculum. We will also formalize the tracking of our increases in scholarly activities and our effectiveness with promoting and supporting scholarly activities within our department. Results from the integration of this program into the department and residency training program will be more evident in phases to come.

292 Designing Didactic and Simulation Sessions for Online Medical Control Training for Emergency Medicine Residents

292 Designing Didactic and Simulation Sessions for Online Medical Control Training for Emergency Medicine Residents

A Qualitative Study on the Impact and Feasibility of a Simulation-Based Program for Shared Decision-Making in Non-Small Cell Lung Cancer Care.

In the pursuit of improved clinical outcomes and patient experience in health care, shared decision-making (SDM) stands as a pivotal concept garnering increasing attention, but SDM utilization varies widely, often leading to confusion regarding team members' roles. This study explores knowledge, skills, and attitudes of oncology clinicians engaged in a pioneering educational initiative at a comprehensive cancer care center, aimed at enhancing frontline SDM capabilities. Utilizing a prospective cohort qualitative approach, the team conducted interviews with 6 clinicians in a multidisciplinary oncology program who were engaged in an SDM continuing education program. In the program, participants were immersed in experiential learning activities including standardized didactic sessions and simulation-based SDM case role-play activities. Thematic analysis of interview data revealed 5 major categories: 1) perceptions of SDM; 2) training; 3) patient-centered care; 4) challenges and constraints; and 5) leadership buy-in. Participants perceived benefits, including adopting a better approach to integrate SDM into their practice, heightened engagement, emphasizing team collaboration, and embracing a patient-centric care model. This study underscores the transformative impact of education and training on enhancing SDM capabilities among oncology clinicians and is not intended for generalizability. By promoting a basic understanding and application of SDM principles, practicing clinicians can be better empowered to improve health care outcomes and experience. Our findings contribute to the broader endeavor of embedding practical SDM principles within clinical practice, thereby fostering a more patient-centered and effective health care environment.

The Thuss Lectureship Series at Vanderbilt University.

The Thuss lectureship began in 1978 and is carried at both Vanderbilt University Medical Center and Stanford Medical Center. The 2-day event consists of a resident and fellow workshop and dinner with an invited keynote speaker, followed by a didactic session and research presentation the following morning. This lecture honors the career of Dr Charles J. Thuss, Sr, and acts as a memorial for Dr Thuss, Jr, and his son, Carter. Trainee presentations have been catalogued since 2019, and we sought to identify the presentations that resulted in publications. Internal records from 2019 to 2022 were referenced to catalogue presenters and project titles. PubMed searches were conducted to identify projects from these presenters with direct links to their presentations at the lectureship series. The event has been held consecutively from 1978 to 2023 with 44 keynote lecturers. Between 2019 and 2023, 17 residents, fellows, and medical students from Vanderbilt University Medical Center or/and the Tennessee Society of Plastic Surgery gave 19 research presentations for the Thuss lectureship at Vanderbilt. Due to the pandemic, no resident or trainee presentations were given in 2020. Nine of 11 project presentations resulted in publications, with presenters being the resultant first author of 6 of these articles. The Thuss lectureship at Vanderbilt serves as an academic conduit to share research and build camaraderie among plastic surgeons across Tennessee. Additionally, it fosters a platform for trainees to contribute to the academic literature and see projects from inception to publication.

Curriculum Innovations: Enhancing Skills in Serious Illness Communication in Neurology Residents Using Simulation: A Pilot Study.

Patients with acute ischemic stroke are faced with prognostic uncertainty, progressive decline, and early mortality. Many neurologists report a lack of education and experience in providing palliative care. We developed a simulation-based curriculum to improve residents' confidence and comfort with conducting late-stage goals of care (GOC) conversations. To assess and improve neurology residents' self-reported confidence and comfort around GOC discussions, prognostication, and hospice; encourage neurology residents to conduct GOC conversations early in the illness; introduce neurology residents to a structured framework for conducting GOC conversations; facilitate the residents to build rapport and convey a mindful presence during GOC conversations; provide direct, real-time feedback and an opportunity for redo and practice; and identify gaps for education. The 3-hour experience included a didactic session followed by an interactive simulation and debriefing. The residents' objectives were to deliver difficult news, discuss prognosis, explore goals, navigate treatment options, and discuss end-of-life care including hospice. The faculty observed each interaction and called time-outs to allow the residents to self-assess and obtain feedback. Residents and faculty debriefed to identify take-home points and to reflect on their emotions, self-care, and sense of purpose in medicine. Twenty-six neurology residents filled out an anonymous presurvey to self-assess their confidence and comfort surrounding GOC conversations. More than 50% of residents reported being confident in conducting GOC discussions, whereas only 42% reported adequate prior training. Postsession, more than 90% of residents reported that training was relevant, helpful, organized, and clear. Faculty identified that residents had difficulty addressing prognosis, assessing goals, planning treatment, and using silence, responding to emotion, and displaying empathy. Fifteen residents filled out a postsurvey that revealed improved comfort with delivering prognosis, discussing hospice, and initiating early GOC discussions. Our project uniquely focuses on late-stage GOC conversations and builds on existing literature that supports a structured program with both didactic and simulation components to improve residents' abilities to effectively navigate GOC conversations with patients and families. Future work will focus on reinforcement and reassessment of communication skills.

The Brussels Breast Surgery Fellowship | A Three-Month Experience in Advancing Skills in Breast Surgery.

The Brussels Breast Surgery Fellowship at Brussels University Hospital offers a unique 3-month clinical immersion in reconstructive and aesthetic breast surgery. Under the guidance of fellowship director Prof. Moustapha Hamdi and his esteemed colleagues, the fellow is exposed to a high volume and wide breadth of cases spanning autologous and implant-based breast reconstruction, oncoplastic surgery, breast reduction and mastopexy, implant augmentation, revision breast surgery, and fat grafting. The multidisciplinary team approach, involving close collaboration with breast surgeons, provides valuable experience in oncoplastic planning and execution. In addition to time in the operating theater, the fellow gains knowledge through outpatient clinics, didactic teaching sessions, and clinical research opportunities leveraging the department's extensive prospective database. As the 2023 fellowship awardee, I had the privilege of learning directly from Prof. Dr. Moustapha Hamdi and participating in over 130 cases across the reconstructive and aesthetic spectrum. Unique features of the fellowship included exposure to lymphedema surgery utilizing the Symani robotic system, advanced techniques like the internal bra, volume distribution mastopexies, observation of private aesthetic clinic cases, and optional participation in academic workshops. This fellowship represents an outstanding opportunity to refine one's skills in breast surgery and microsurgery while experiencing the rich culture of Belgium.

Ultrasound-Guided Peripheral Intravenous Access Training: A Prospective Observational Study of Emergency Nurses.

Background Ultrasound-guided peripheral intravenous (USGPIV) placement is more successful, comfortable, and longer lasting than traditional landmark-based IVs. While many hospitals have protocols for becoming credentialed in this skill, there is little information available about the USGPIV success rate during and after training. Objectives This pilot study aimed to quantify USGPIV attempts by emergency nurses undergoing USGPIV training and to determine if 10 successful USGPIVs predicted success in the next USGPIV. The secondary aims were to determine failure points for unsuccessful USGPIVs and the time to complete training. Methods Sixteen emergency nurses with no prior USGPIV experience were enrolled. Participants completed a one-hour didactic session and one hour of hands-on training with vein simulators. Participants had direct observation of all USGPIV attempts up until 10 successful cannulations. Each attempt was recorded along with reasons for USGPIV attempt failure and the time required to become credentialed. Results Participants attempted 200 USGPIVs with a success rate of 80% (160/200). Fourteen participants completed 10 successful USGPIVs, requiring a median of 11 attempts (IQR 10-13) and a success rate of 92.9% (13/14) on subsequent USGPIV attempts. Participants required a median observation time of 4.13 hours (IQR: 3.94-4.75). The most common point of failure was using dynamic ultrasound guidance to maintain needle tip visualization. Conclusions USGPIVs are a valuable skill that requires time and practice. Emergency nurses with no prior USGPIV experience can achieve the requirements for hospital credentialing and success on subsequent USGPIV insertion by completing 10 successful USGPIVs after a two-hour training session and four hours of direct observation.

Improving Clinician Awareness of and Screening for Chagas Disease with an Educational Intervention.

Chagas disease is an underrecognized, chronic, and potentially life-threatening disease caused by the parasite Trypanosoma cruzi. We aimed to improve awareness and screening for Chagas disease among patients from endemic areas using a large safety-net academic hospital system in the United States. We developed an educational intervention consisting of a case-based didactic session presented to physicians, trainees, and other healthcare providers at conferences across different departments. Performance on a knowledge assessment administered before and after the presentation was analyzed with paired Student's t-test for within-subject difference testing. Institutional testing rates for T. cruzi were evaluated for an equal time period (29 months) before and after the start of the intervention. Testing rates were compared by a Welch's unequal variances t-test and by interrupted time series based on multivariate linear regression. Eleven educational sessions were held over the intervention period, and 103 participants completed the pre- and post-presentation surveys. The mean survey scores were 59.2% before the presentation and 96.6% after presentation (P <0.001). Trypanosoma cruzi testing during the postintervention period was significantly higher than testing during the pre-intervention period (171 patients pre-intervention versus 378 patients postintervention [P = 0.015]). Notable increases in testing from the pre-intervention to postintervention periods occurred among midwives (1-68 patients tested) and trainees (57-133 patients tested). Overall, 56/537 (10.4%) nonduplicate T. cruzi commercial screening tests were positive. Testing increased over time, both at an institutional level and within targeted departments. In addition to the educational program, other factors likely influenced expanded testing.

Introduction and Effectiveness of Early Clinical Exposure Among Dental Students in Pre-clinical Prosthodontics.

Lack of patient contact in the pre-clinical prosthodontics curriculum makes it difficult for the students to comprehend and correlate the series of complex steps involved in complete denture fabrication. Early clinical exposure in the second year of the undergraduate program will facilitate a smooth transition of dental students from pre-clinics to clinics, thereby helping to mitigate the lacunae existing in the present curriculum. A non-randomized prospective educational interventional study was conducted among 50 second-year dental students. Early clinical exposure in the form of clinical demonstration for complete denture steps of border molding and jaw relation was given subsequent to the completion of didactic and laboratory sessions. Pre- and post-multiple-choice question tests were conducted to explore students' knowledge. Student perception towards early clinical exposure was assessed using a self-administered anonymous questionnaire, while faculty perception was gauged with the help of in-depth interviews. A statistically significant difference was observed when pre- and post-multiple-choice question test mean scores were compared, showing an overall improvement in students' knowledge following early clinical exposure. Students and faculty held a positive perception towards the program and found it to be useful in enhancing the overall learning experience of the students.Faculty expressed their concern regarding limited manpower, paucity of time, and difficulty in integrating early clinical exposure into the present timetable. Early clinical exposure can be integrated into the traditional pre-clinical prosthodontics curriculum with appropriate time and manpower allocation. Faculty sensitization and training workshops need to be conducted before implementing this program.

A review of local global health education in post-graduate medical education

Background Global health (GH) education is offered in post-graduate medical education (PGME) programs and local experiences are desired by trainees and educators. This scoping review aimed to map the literature on local GH education in PGME, to describe curricular components, factors facilitating successes, and challenges to implementation using a validated education intervention checklist and inclusion of seven components of local GH programming. Methods A decolonization conceptual framework informed a 5-step scoping review. In May 2022, eight databases and MedEdPORTAL were searched using key words describing local GH education curricula. Results Sixty-eight full-text articles described local GH education programs in residencies (n = 52; 76.4%) and fellowships (n = 10; 14.7%) spanning multiple specialties, predominantly in North America (90%). Successful programs included faculty mentoring, community-based partnerships, and a multidisciplinary component. Scheduling challenges, cultural and linguistic differences, and trainee workload contributed to implementation difficulties. Only four programs included all seven local GH health equity/decolonization components. Conclusions Local GH curricula vary widely in clinical experiences, didactic sessions, and inclusion of mentorship and partnerships. Local populations within the communities of these training programs could benefit from standardized inclusion of components for local global health education with careful consideration of health equity.