Trained Males Research Articles

626 Barriers Faced by Female Surgical Trainees – A Qualitative Study

Abstract Aim Today women make up 56% of medical students, yet just 12% of surgical consultants, a number that has remained static since 2013. This qualitative study aimed to explore the barriers to female success in modern surgery. Method Semi-structured qualitative interviews were undertaken primarily with female surgical trainees to determine the barriers they face. Male trainees and Training Programme Directors were also interviewed for triangulation. Results Nineteen interviews were performed (15 female trainees, 3 male trainees and 1 TPD) between October 2019 and March 2020. Family pressures and becoming a mother were significant barriers for women training in surgery, a barrier that did not apply to male trainees who were fathers, often resulting in women choosing to train less than full time (LTFT). Unfortunately, LTFT training presents further obstacles for female trainees. The set-up of the National training programme in surgery provides many non-gender specific barriers, chiefly moving hospital every 6 months resulting in disrupted training and long commutes. Sexism and discrimination are still common, both from colleagues and patients. Many participants perceived inherent differences between genders in communication and methods for coping with stress. Conclusions Greater gender equality in surgery may be achieved by changes in the structure and organisation of training to reduce the tension between the professional role and the predominantly female-led role of raising children. Better equality and diversity training and awareness at all levels in surgery may help to mitigate some of the conscious and unconscious bias that still exists.

Autonomy in the Operating Room: A Multicenter Study of Gender Disparities During Surgical Training.

Gender disparities are prevalent in medicine, but their impact on surgical training is not well studied. To quantify gender disparities in trainee intraoperative experiences and explore the variables associated with ratings of surgical autonomy and performance. From September 2015 to May 2019, attending surgeons and trainees from 71 programs assessed trainee autonomy on a 4-level Zwisch scale and performance on a 5-level modified Dreyfus scale after surgical procedures. Multivariable regression models were used to examine the association of trainee gender with autonomy and performance evaluations. A total of 3255 trainees and attending surgeons completed 94 619 evaluations. Attendings gave lower ratings of operative autonomy to female trainees than male trainees when controlling for training level, attending, and surgical procedure (effect size B = -0.0199, P = .008). There was no difference in ratings of autonomy at the beginning of training (P = .32); the gap emerged as trainees advanced in years (B = -0.0163, P = .020). The gender difference in autonomy was largest for the most complex cases (B = -0.0502, P = .002). However, there was no difference in attending ratings of surgical performance for female trainees compared to male trainees (B = -0.0124, P = .066). Female trainees rated themselves as having less autonomy and worse performance than males when controlling for training level, attending, procedure, case complexity, and attending ratings (autonomy B = -0.0669, P < .001; performance B = -0.0704, P < .001). While there was no significant difference in ratings of operative performance, a small difference between ratings of operative autonomy for female and male surgical trainees was identified.

THE CURRENT LANDSCAPE OF CARDIAC CATHETERIZATION TRAINING IN CANADA: A NATIONWIDE SURVEY OF CORE CARDIOLOGY TRAINEES

<h3>BACKGROUND</h3> The Royal College of Physicians and Surgeons of Canada (RCPSC) provides training objectives for cardiac catheterization and hemodynamics for adult cardiology training in Canada. We evaluated current core cardiology trainee perspectives on cardiac catheterization training across Canada and identified potential barriers to pursuing a career in interventional cardiology (IC). <h3>METHODS AND RESULTS</h3> Residents from all cardiology training programs across Canada (n=15 programs) were provided open and closed ended questions regarding the ability of their programs to address the mandatory components of their core angiography rotations. Programs were divided based on size for analysis. A small program was defined as ≤ 10 total trainees, a medium program as 11-15 trainees and a large program as > 15 trainees. Survey responses were received from 82 residents (82/206, 40% response rate). There was equal representation from all three years of training (post-graduate year (PGY)-4: n=24, 30%, PGY-5: n=28, 35%, PGY-6: n=29, 36%) and 39% of respondents were female (n=32). Overall 91% of trainees (n=70/77) felt that their program met the RCPSC requirements for cardiac catheterization. Of the trainees who felt that their training was inadequate, most common reasons indicated were lack of right heart catheterization exposure and lack of structured teaching specifically related to hemodynamics. When stratified by PGY of training or program size, there were no statistically significant differences in comfort with procedural skills or hemodynamic interpretation. The proportion of teaching by faculty was higher in small programs (p=0.039). There was a higher proportion of trainees who indicated that they had no structured cardiac catheterization teaching in medium sized programs (p=0.041). Only 22% of residents (n=18) identified IC as a career goal. Trainee-identified barriers to a career in IC are outlined in Figure 1 and stratified by gender. Lifestyle and family considerations were the two most common barriers with no statistically significant difference between genders (p=1.000 and p=0.18 respectively). Sexism was identified as a barrier only by female trainees (n=12/32, 38%, p < 0.0001) and length of training was identified more frequently as a barrier by male trainees (n=25/50, 50%, p=0.037). <h3>CONCLUSION</h3> Regardless of program size, the majority of Canadian cardiology trainees feel the RCPSC requirements for cardiac catheterization are met by their programs. Lifestyle and family considerations were the most common barriers to interventional training. Sexism was also identified as a common barrier amongst women. Creating an environment that promotes diversity, equity and inclusivity is crucial for all programs across Canada.

US Army basic combat training alters the relationship between body mass index and per cent body fat

Introduction/backgroundAs a proxy for adiposity, body mass index (BMI) provides a practical public health metric to counter obesity-related disease trends. On an individual basis, BMI cannot distinguish fat and lean...

Prior Physical Activity Influences Changes In Tibial Bone Microarchitecture During U.S. Army Basic Combat Training

Bone stress injuries (BSIs) are common among military personnel due to heightened physical activity. Whereas we have previously shown significant tibial bone adaptation following 8 weeks of Basic Combat Training (BCT), it is not known whether prior exercise habits influence the skeletal response to BCT. PURPOSE: Determine the relationship between exercise history and changes in tibial bone microarchitecture induced by BCT. METHODS: We collected high-resolution peripheral quantitative computed tomography images of the distal tibia, pre- and post-BCT, on U.S. Army trainees. We created low (LOW; 0-2 days/wk, n = 312), moderate (MOD; 3-4 days/wk, n = 597), and high (HIGH; 5+ days/wk, n = 696) exercise groups based on self-reported average days/wk of exercise during the 2 months prior to BCT. Linear mixed models were used to estimate within and between group differences from pre- to post-BCT controlling for sex, race, age, height, and weight. RESULTS: We enrolled 552 female and 1053 male trainees (20.7 ± 3.7 yrs) with normal BMI (24.7 ± 3.5 kg/m2). Trabecular thickness (Tb.Th), cortical thickness (Ct.Th), Ct area (Ct.Ar), total volumetric bone mineral density (Tt.vBMD), Tb.vBMD and Ct.vBMD increased significantly among all exercise groups over the BCT period (0.46-1.9%; all p < 0.0001, Fig 1). However, there was a greater increase in Ct.Th (p < 0.0001), Ct.Ar (p = 0.02), Tb.vBMD (p < 0.0001) and Tt.vBMD (p = 0.001) in LOW vs. HIGH. Similarly, MOD had greater increases in Tb.Th (p = 0.003), Ct.Th (p = 0.004), Ct.Ar (p = 0.001), Tb.vBMD (p = 0.0001), and Tt.vBMD (p < 0.0001) compared to HIGH. There were no differences between LOW and MOD CONCLUSION: All groups saw improved bone microarchitecture in response to BCT. LOW compared to MOD had greater increases than HIGH, perhaps due to a greater relative increase in novel physical activity during BCT experienced by LOW and MOD. Ongoing work will determine whether a more robust skeletal response to BCT reduces BSI incidence.

Attitudes of preservice teachers having pedagogical formation certificate training towards instructional technology and material design course

The purpose of this study was to determine the attitudes of the trainees registered in Pedagogical Formation Certificate Program (PFCP) towards the Instructional Technologies and Material Design (ITMD) course and to analyze whether these attitudes differed according to gender, department and level of grade. The data were obtained from totally 110 trainees including 78 females and 38 males. In addition to the personal information form, the Attitude Scale towards ITMD Course was used as the data collection tool. The scale had three sub-dimensions as effectiveness, admiration and denial, and the internal consistency coefficients calculated for the current implementation were between .99 and .77. It was understood that the trainees regarded the ITMD course effective enough to be considered good, admired the course at a moderate level, and did not neglect the course very much. It was noticed that female trainees found the course more effective and admired it more rather than the male trainees. The trainees in the English group were determined to consider ITMD course more effective than the trainees in the philosophy group. Moreover, it was proved that the students in the English group admired more rather than the trainees in the theology and philosophy groups. The graduate trainees regarded ITMD course more effective than the ones who were still students.&#x0D; &#x0D; Keywords: instructional technologies, information technologies, instructional technologies and material design, attitude towards itmd course;

UNRAVELLING INGRAINED LEADERSHIP BEHAVIOURS AND STYLES IN WESTERN AND CENTRAL REGIONAL COLLEGES OF EDUCATION IN GHANA

This study examined leadership behaviours and leadership styles of students and tutors of colleges of education in Western and Central Regions of Ghana. Four specific leadership behaviours were discussed. These include: Team work, Discipline and Loyalty, Working relationships and Attitudes to welfare issues. Traditionally known leadership styles such as "Democratic"; "Autocratic" and Laissez faire were discussed in relation to both students and tutors. Percentage views of both students and tutors were taken about the leadership behaviours and leadership styles, then an independent sample T-test of male and female teacher trainees" views about the four thematic leadership behaviours were computed and discussed. The study also revealed that there is a correlation between students" participation in decision-making and their levels. There is also a correlation between Principals" leadership styles and the number of years spent in College. Recommendations made include: Measures should be put in place by College authorities to create democratic, open and transparent administration to ensure that both students and tutors operate without fear of being maligned or discriminated against in the performance of their duties.

Gender differences in surgical case volume among ophthalmology trainees.

The number of females in ophthalmology has steadily increased over recent decades. The aim of this study was to evaluate whether there is a difference in procedural volume and cataract surgery between male and female trainees in the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). A longitudinal retrospective review of de-identified surgical RANZCO trainee logbook data from 2008 to 2020 was undertaken. Data from 241 trainee logbooks were analysed for: location of training, gender, date of commencement of training, maternity/paternity leave status, number of surgeries observed, assisted, supervised and unsupervised. Surgical cases were grouped as: (1) all surgical cases; (2) complete cataract cases and (3) partial cataract cases. Among 241 trainees (40.7% females), 197 263 procedures were performed. Total surgical volume was 21.1% lower at 4 years for females (median 665.5 vs. 843.5; p=0.036). Completed cataract surgery was 21.5% lower at 18 months (median 87.5 vs. 111.5; p=0.022) and 41.7% lower at 4 years (median 216 vs. 369; p < 0.001). Interrupted training was significantly more common in females (30.6% vs. 0.7%; p < 0.001). However, linear regression analysis did not identify parental leave or duration as a significant predictor for number of completed cataracts (p=0.206). Complication rate was not different between males and females (p=0.35). Female trainees completed 41.7% fewer cataract operations at the end of their training compared to male counterparts with the gap widening between years 1 and 4 of training. The current data demonstrates that female and male RANZCO trainees are not receiving equivalent operating experiences.

The relationship between total mi score and consecutive interpreting performance in iranian male and female trainee interpreters

This empirical descriptive study aimed at finding a relationship between Iranian trainee interpreters' total MI (Multiple Intelligences) scores and their consecutive interpreting performance. It also tried to determine if there is any relationship between the trainee interpreters' gender and their performance in consecutive interpreting. The researcher has always encountered female trainees' superiority in consecutive interpreting classes and wanted to find out if there is any relationship between the trainees' gender and their consecutive interpreting performance. At first, a standard English proficiency test (IELTS, 2007) was administered to homogenize the trainees. One hundred thirteen participants who were all undergraduate students of English Translation took part in the study. At last, 109 of the participants were chosen for the study. Pearson's Product-moment correlation coefficient showed a significant correlation between total MI score in female interpreter trainees and consecutive interpreting performance.

Trainee Sex and Accreditation Council for Graduate Medical Education Milestone Assessments During General Surgery Residency

In evaluating the effectiveness of general surgery (GS) training, an unbiased assessment of the progression of residents with attention to individual learner factors is imperative. To evaluate the role of trainee sex in milestone achievement over the course of GS residency using national data from the Accreditation Council for Graduate Medical Education (ACGME). This cross-sectional study evaluated female and male GS residents enrolled in ACGME-accredited programs in the US from 2014 to 2018 with reported variation in milestones performance across years in training and representation. Data were analyzed from November 2019 to June 2021. Mean reported milestone score at initial and final assessment, and predicted time-to-attainment of equivalent performance by sex. Among 4476 GS residents from 250 programs who had milestone assessments at any point in their clinical training, 1735 were female (38.8%). Initially, female and male residents received similar mean (SD) milestone scores (1.95 [0.50] vs 1.94 [0.50]; P = .69). At the final assessment, female trainees received overall lower mean milestone scores than male trainees (4.25 vs 4.31; P < .001). Significantly lower mean milestone scores were reported for female residents at the final assessment for several subcompetencies in both univariate and multivariate analyses, with only medical knowledge 1 (pathophysiology, diagnosis, and initial management) common to both. Multilevel mixed-effects linear modeling demonstrated that female trainees had significantly lower rates of monthly milestone attainment in the subcompetency of medical knowledge 1, which was associated with a significant difference in training time of approximately 1.8 months. Both female and male GS trainees achieved the competency scores necessary to transition to independence after residency as measured by the milestones assessment system. Initially, there were no sex differences in milestone score. By graduation, there were differences in the measured assessment of female and male trainees across several subcompetencies. Careful monitoring for sex bias in the evaluation of trainees and scrutiny of the training process is needed to ensure that surgical residency programs support the educational needs of both female and male trainees.

Predictors of ophthalmology career success (POCS) study

ObjectiveOphthalmology is the busiest outpatient specialty with demand predicted to rise over 40% in the next 20 years. A significant increase in the number of trainee ophthalmologists is required to...

Impact of changing medical workforce demographics in renal medicine over 7 years: Analysis of GMC national trainee survey data

Increasing numbers of doctors in training are taking career breaks, with burnout cited as a potential cause. This study analysed General Medical Council (GMC) national training survey data (renal medicine) to understand the impacts of changing workforce demographics on trainee outcomes and wellbeing. Increasing proportions of female, Black, Asian and minority ethnic (BAME), and international medical graduates are entering the workforce. Specialty exam pass rates have fallen and are lower for BAME and international medical graduates in renal medicine. Time to complete higher specialty training has increased for female trainees. Self-reported burnout rates for renal trainees were higher than other medical specialties and highest for male BAME trainees. Burnout was only partially mitigated by less-than-full-time working, but had no impact on progression, sick-leave or time out of training. It is important to recognise changes to the workforce and proactively plan to effectively support a more diverse group of trainees, to enable them to succeed and reduce differential attainment.

A cross-sectional survey study of United States residency program directors' perceptions of parental leave and pregnancy among anesthesiology trainees.

Little is known about program directors' knowledge, attitudes, and beliefs regarding parental leave policies in anesthesiology training. This study sought to understand program director perceptions about the effects of pregnancy and parental leave on resident training, skills, and productivity. An online 43-question survey was developed to evaluate United States anesthesiology program directors' perceptions of parental leave policies. The survey included questions regarding demographics, anesthesiology program characteristics, parental leave policies, call coverage, and the perceived effects of parental leave on resident performance. Data were collected by Qualtrics (Qualtrics, Provo, UT, USA). Fifty-six of 145(39%)anesthesiology program directors completed the survey. Forty-eight of 54 (89%) program directors had a female resident take maternity leave in the past three years. When asked how parental leave affects residents' futures, 24/50 (48%) program directors felt it delayed board certification and 28/50 (56%) thought it affected fellowship opportunities. Program directors were split on their perceived impact of becoming a parent on a trainee's work. Yet, when compared with male trainees, program directors perceived that becoming a parent negatively affected female trainees' timeliness, technical skills, scholarly activities, procedural volume, and standardized test scores and affected training experience of co-residents. Program directors perceived no difference in impact on female trainees' dedication to patients and clinical performance. Program directors perceived that becoming a parent negatively affects the work performance of female but not male trainees. These negative perceptions could impact evaluations and future plans of female residents.

141 The COVID-19 Pandemic: A Disproportionate Impact on Pregnant Surgical Trainees?

IntroductionDespite increases in the female surgical trainee workforce over the last decade male trainees still dominate the surgical specialties. It is well recognised that there is strong gender disparity in surgery. The wider challenges further experienced by pregnant surgical trainees are also well documented.MethodNHS digital data on the surgical workforce and the Royal College of Obstetricians and Gynaecologists COVID-19 guidance for pregnant healthcare workers was reviewed.ResultsWomen account for 27% of the surgical workforce and the average time taken to complete training is longer for female trainees. Current guidelines for pregnant healthcare workers advise strict social distancing measures up to 28 weeks gestation with avoidance of high-risk areas including operating theatres. A non-patient facing role is advised from 28 weeks onward.ConclusionsThe COVID-19 pandemic has created additional barriers for women in surgery. Restrictions for pregnant trainees, whilst vital for their wellbeing, has denied access to some essential training opportunities necessary for progression. It will likely further isolate them from the workforce and hinder their advancement into senior roles where they are already underrepresented. Although it is recognised that surgical training in general has been impacted by COVID-19 there is an argument that this disproportionately affects pregnant trainees.

Abstract No. 581 Gender-based analysis of mentoring in interventional radiology: opportunities to engage the next generation of women in interventional radiology

To assess the experience of male and female trainees in seeking mentorship in interventional radiology and to identify differences in access to mentors and gaps in engaging trainees interested in the field In this IRB-approved prospective survey study, we sent a 27-item survey to all members of the Society of Interventional Radiology Resident, Fellow and Student (SIR-RFS) section and Medical Student Section (SIR-MSC) in the summer of 2020. Items assessed included basic demographic information, whether or not the respondent has a mentor in IR, experience in seeking mentorship in IR and what guidance trainees are hoping to obtain from mentors in IR. Descriptive statistics were computed for all assessed continuous and categorical variables, including student’s t-test and Fischer’s exact analysis. A P < 0.05 was considered to be statistically significant. A total of 151 trainees completed the survey, for a response rate of 21%. Of those, 70% were male and 30% were female. 74% of responding men indicated that they can currently identify a mentor in IR while only 58% of responding women did (P < 0.05). Among the responding men, 88% indicated they received guidance for career advice and 80% had guidance for research from their mentors. Conversely, while 80% of women received career guidance, only 64% of them received guidance related to research from their mentors. Significantly more men indicated that they meet with their mentors weekly or every month (62%) compared to only 41% of responding women (P < 0.05). Interestingly, 78% of responding women indicated that mentorship is absolutely essential to ensure success in IR compared to only 59% of responding men. While more women trainees believe that mentorship is essential to ensure success in IR, fewer women have mentors in the specialty and even a lower percentage receives research mentorship in IR. Greater efforts to develop IR mentorship programs are needed to better engage the next generation of interventional radiologists.

Assessment of the Education Environment of the Saudi Board of Family medicine, KSA. 2020

Background: Competent educational environment for medical postgraduate is crucial to ensure sound clinical outcome. The quality of the educational environment is influenced by many factors, physical, social and intellectual. The current study aimed at assessing the educational environment in a postgraduate Saudi Board for Family Medicine in Jeddah.&#x0D; Methodology: Through cross sectional study design, all residents in the Saudi Board of Family medicine in Jeddah were invited to participate in the study; they were asked to fill a predesigned adopted valid questionnaire based on the Scan of Postgraduate Educational Environment Domain (SPEED) which is used to assess the quality of the Post Graduate Medical Education. Data were collected during gathering of the residents in a usual didactic teaching day. A total of 186 residents responded, making a response rate 93%.&#x0D; Results: Out of all participants (n=186), females formed two thirds of the residents (60.8%), their mean age was 27.6±2.27 years, with an almost equal representation of the four residency levels. The highest scores about the quality of the educational process was observed in the item regarding the supervisors being respectful towards the registrars (mean score 4.1 out of 5), followed by the being approachable and helpful (mean score 4.0). The lowest scores were observed regarding presence of staff in general who have positive impact on the educational environment (mean score 3.2), followed by availability of good clinical supervisors all the time (mean score 3.3). The overall mean score accounted for 3.6± 0.56, although it was higher in females (3.7±0.642) than males (3.5±0.661), and in those in R1 (3.7±0.509) and R4 (3.7±0.605), however, these differences are not statistically significant p&gt;0.05. Also, no statistically significant correlation between and age and overall mean score was observed.&#x0D; Conclusion and recommendations: The Saudi Board residents for Family Medicine considered their educational environment as more positive than negative with potential areas for improvement. Although females perceived the educational environment better than male trainees, no significant changes observed along the different stages of the program. It is recommended to use these findings in reforming the educational environment in the Saudi Board.

Profiling the New Zealand police physical appraisal test

PurposeThe aims of this study were to evaluate fitness levels in a cohort of police trainees and compare these results to other police trainees and the general population.Design/methodology/approachRetrospective data for 274 male and 152 female police trainees were supplied. Measures included height, body mass and physical appraisal test (PAT; 2.4 km run, vertical jump, push-ups and grip strength) results, assessed twice, prior to commencement of training, separated by several months. Wilcoxon signed rank tests were used to analyze non-parametric initial and final PAT scores and Mann–Whiney U tests were used to determine variance between groups.FindingsMale trainees were significantly quicker in the run (−12%, p < 0.001), completed more push-ups (+74%, p < 0.001) with greater grip strength (+52% left and +50% right, p < 0.001) when compared to female trainees. Following the second PAT assessment, the significant differences between male and female trainees remained (p < 0.001). Only female trainee 2.4 km run times improved significantly between initial and final PAT (−4%, p = 0.002).Originality/valueWhen compared to the general population from which they were drawn and to other law enforcement trainees, the police trainees in this study were quicker, more powerful and stronger. While there was no loss of fitness between initial and final PAT performance, a conditioning program, spanning the periods between initial and final PAT may be of benefit to increase fitness prior to training commencement especially for female trainees who were generally less fit than, yet must complete the same training as, male trainees.

Doppelganger-based training: Imitating our virtual self to accelerate interpersonal skills learning.

Interpersonal skills require mastering a wide range of competencies such as communication and adaptation to different situations. Effective training includes the use of videos in which role models perform the desired behaviours such that trainees can learn through behavioural mimicry. However, new technologies allow new ways of designing training. In the present study, given that virtual reality is emerging as a valuable training setting, we compare two different demonstration conditions within virtual reality by investigating the extent to which the use of doppelgangers as role models can boost trainees' interpersonal skills development as compared to a role model that does not resemble the trainees. We also assess trainees' level of self-efficacy and gender as potential moderators in this relationship. Participants delivered a speech in front of a virtual audience twice. Before delivering their second speech, they watched a role model giving a speech in front of the same audience. The role model was either their doppelganger or an avatar of the same gender depending on the condition they were randomly assigned to. Results showed that the doppelganger-based training was the most beneficial for male trainees low in self-efficacy. These findings have important implications for training design, suggesting that doppelganger-based training might be effective only for a specific subset of trainees.

Knowledge, attitude, and practice regarding atrial fibrillation among primary care physicians: the potential role of postgraduate training.

Atrial fibrillation (AF) is known to lead to stroke and thromboembolism, causing a five-fold increase in the risk of stroke and almost doubling the mortality rate. Optimal anticoagulant therapy is effective in reducing AF-related death. However, prescription of anticoagulants in AF in East Asian countries has been low, ranging from 0.5% to 28%. This study aimed to determine whether vocational training in family medicine improves primary care physicians' knowledge, attitude, and practice in the management of AF. This investigation was a cross-sectional study carried out during centralized workshops for two groups of trainees using a validated questionnaire: (i) junior trainees were newly enrolled postgraduate trainees in the Graduate Certificate in Family Medicine (GCFM) program, and (ii) senior trainees were postgraduate trainees in Advance Training in Family Medicine (ATFM) programs of the Academy of Family Physicians of Malaysia (AFPM). A total of 223 trainees (127 junior and 96 senior) participated in this study. Only 55.2% of the trainees passed the knowledge test; senior trainees were more likely to pass the knowledge test compared to junior trainees (69.8% vs. 44.1%, p < 0.001). Female trainees were significantly more likely to pass the knowledge test than male trainees. While the attitude of senior and junior trainees was similar, more of the latter group worked in public clinic that provide better support where there is better support for outpatient anticoagulation treatment (e.g., same-day INR test, direct access echocardiogram, and warfarin in in-house pharmacy). Vocational training in family medicine appears to improve primary care physicians' knowledge regarding the management of AF. Better knowledge will help vocationally trained primary care physicians to provide anticoagulation treatment for AF within primary care clinics. More optimal AF management within primary care can take place if the identified barriers are addressed and a shared care plan can be implemented.

Knowledge Outcome of Essential Care for Every Baby Training in Southern Nations, Nationalities, and People's Region, Ethiopia: A Pre- and Post-Test Study.

This study was aimed to evaluate the knowledge outcome of ECEB training given to reduce neonatal mortality in Ethiopia. The study was conducted by using data from training given for 98 health professionals. Data were entered into Epi info7 and analyzed by SPSS version 21. Accordingly, the paired sample T-test, the independent sample t-test, and one way ANOVA were calculated at P-value <.05. Likewise, the mean knowledge score of the trainees increased from 59.10 (SD ± 13.180) before the training to 73.73 (SD ± 14.173) after the training. The increment was statistically significant (t (97) = 11.684, CI = 12.147-17.118, P < 0.001). The mean knowledge score was significantly varied between female and male trainees at pre-test t (96) = 2.424, P = .017 and post-test t (96) = 2.944, P = .004. Similarly, it was significantly varied between trainees from hospitals and Health centers at post-test t (96) = 2.403, P = .018. To sum up, the overall knowledge outcome of trainees significantly improved after the training. However, regarding knowledge outcome in relation to different variables, there was a significant mean knowledge score difference by sex both at pre- and post-test. Concerning the knowledge outcome in relation to facility type of the trainees, knowledge outcome significantly increased only those who came from hospitals at post-test. Therefore, to further enhance female trainees and those who come from Health Centers, a separate training session with extra support should be arranged by programmers.