Mean Comfort Level Research Articles

Effectiveness of Delayed First Baths on Transepidermal Water Loss in Late Preterm Infants: A Randomized Controlled Trial.

This study evaluates whether delaying the first bath affects late preterm infants' skin barriers, body temperatures, and comfort. Late preterm infants' skin is drier and has a limited water retention capacity compared to term infants and adults. It is important to determine timing of care for this population with limited competencies. A two-arm, three-center, and single- and evaluator-blind randomized controlled trial was conducted. The study is based on the CONSORT guidelines. The participants were recruited from September 2020 to September 2021. The first baths of participants in the intervention group were postponed until 48hours after birth. Outcomes were measured before bathing and 1, 10, and 30minutes after bathing. There was a statistically significant interaction between the groups and times for transepidermal water loss, body temperature, and comfort. The intervention group had a lower transepidermal water loss value at follow-up than the control group in the forearm and sternum. The control group had lower mean body temperatures and comfort levels. When the first bathing of a late preterm infant is postponed by a minimum of 48hours, it reduces damage to the skin barrier, body temperature is maintained, and the experience is more comfortable. Therefore, the first bath should be delayed for at least 48hours after birth. The study can guide nurses to eliminate the uncertainty of the first bath applied for late preterm infants with a fragile structure in the neonatal intensive care setting and to eliminate the differences between clinics.

Multi-objective ergonomics design model optimization for micro electric cars via response surface methodology

Despite advancements in ergonomic comfort assessments in automotive design, optimizing seat dimensions within the constrained spaces of micro-electric cars presents a substantial challenge. In this study, response surface methodology (RSM) is utilized for the ergonomics design of a micro electric car in the conceptual design phase. Specifically, five critical seat dimensions are analyzed: Seatback Angle, Seat Base Angle, Steering Wheel Height from Car Base, Distance from Seat Base to Pedals, and Distance from Seat Base to Steering Wheel. The analysis took place using a 2-level full factorial design L32 orthogonal array. The optimal dimensions are determined using RSM, such as the mean comfort level and signal-to-noise ratio are maximized, and the standard deviation for multiple drivers is minimized. Three regression models are formulated for the three responses, and their adequacy is checked using different methods. The optimal dimensions are obtained and verified through digital human modeling simulation. This research offers practical guidelines for the ergonomic seating design in micro-electric vehicles, enhancing comfort without compromising space efficiency.

Exploration of digital health literacy in the deep south.

385 Background: As technological advances are implemented in healthcare, cancer patients with low digital health literacy are at risk for inequities. Understanding the community’s comfort with using and teaching technology skills can be foundational for the application of digital healthcare tools. Methods: A cross-sectional survey was administered prior to community conversations about digital health literacy to understand community comfort with technology. Surveys measured self-reported personal comfort performing, personal comfort teaching, and perceived county-comfort completing technology-based tasks. Participants rated their comfort level on a 5-point Likert scale (1= not at all, 2 = slightly, 3 = somewhat, 4 = moderately, 5 = completely). Mean scores were calculated and mean comfort levels were compared across healthcare providers, lay navigators, community health advisors (CHAs), and community members using one-way ANOVA tests. Tukey's HSD post-hoc tests were used to explore group differences. Results: Between 8/2023-4/2024, 164 participants across Alabama and Mississippi completed the pre-survey, including 32 healthcare providers, 17 lay navigators, 31 community health advisors (CHAs), and 84 community members. The sample was primarily female (90%), Black (74%), and from Alabama (84%). ANOVA tests revealed significant group differences between personal comfort levels (p<0.001) comfort teaching (p<0.001), and perception of county-level comfort in technology-based tasks (p=0.043) with lay navigators and healthcare providers reporting higher personal comfort and comfort teaching others technology-based tasks compared to community members (post-hoc Tukey’s HSD). Conclusions: Digital health literacy gaps remain, with lay and clinical providers potentially overestimating comfort with technology. Baseline technology skills must be addressed as healthcare increases reliance on technology. Personal Comfort p-value Comfort Teaching Others p-value Perception of County Comfort p-value Using Search Engines 3.61 4.72 4.76 4.23 <.0001 2.95 4.19 4.88 3.48 <.0001 2.52 3.16 3.82 3.13 0.043 Searching Online for Health-Related Information 3.49 4.66 4.71 4.06 2.90 4.03 4.71 3.35 2.46 2.69 3.29 2.97 Scanning QR codes 2.80 4.47 4.65 3.77 2.55 3.84 4.76 3.13 2.38 2.44 2.71 2.81 Logging into their Patient Portal 3.27 4.44 4.59 3.87 2.75 3.94 4.76 3.03 2.44 2.59 3.00 2.65 Sending their Care-Team a Message 3.05 4.38 4.65 3.74 2.63 3.91 4.82 3.03 2.37 2.44 2.71 2.58 Personal comfort, comfort teaching, perception of community comfort with technology; 7/17 tasks shown; C = community, H = hospital, L = lay navigator, CHAs = community health advisors.

The starting temperature of high-flow nasal cannula and perceived comfort in critically ill patients: A pragmatic randomized controlled trial.

High-flow nasal cannula (HFNC) therapy is a non-invasive respiratory treatment characterized by high tolerability, which largely derives from the patient's comfort. The primary aim of this study was to explore whether the patient's perceived comfort was the same regardless of different approaches used to reach the target humidification temperature. The secondary aim was to assess the patient's perceived nasal dryness and humidity. This single-centre, pragmatic, randomized trial was registered at clinicaltrials.gov (NCT05688189). Patients in the intensive care unit (ICU) in need of HFNC therapy were randomly assigned to one of three study arms: a two-step increase (31 to 34 to 37°C), a one-step increase in temperature (34-37°C) or no temperature increase (started and remained at 37°C). The patients were asked to rate their perceived comfort, as well as their perceived nasal dryness and humidity on a scale from 1 (lowest value) to 5 (highest value). We enrolled 21 patients, aged 34-85 years. The mean (±1 standard deviation) comfort level was 3.3 (1.3) for patients who received a one-step increase, 3.1 (1.3) for those who received no increase and 2.7 (1.7) for those who received a two-step increase (p = .714). There was also no difference in nasal dryness (p = .05) or humidity (p = .612) across the study arms. Greater comfort was fairly correlated with less nasal humidity (ρ = -0.34, 95% confidence interval -0.68 to 0.07) but not with nasal dryness (ρ = 0.01, p = .94). After 30 min of HFNC therapy at a target temperature of 37°C, overall comfort was rated similarly in the three study arms. Additional studies are needed to accumulate evidence corroborating the findings of this study. The temperature of the mixture of air and oxygen is a fundamental component of HFNC therapy. A pragmatic approach irrespective of the initial temperature setting seems to yield a similar comfort score in hospitalized patients with mild respiratory failure because of extrapulmonary causes.

Comparing cadaveric and 3D-printed laryngeal models in transcutaneous injection laryngoplasty.

There is increasing focus on the development of high-quality simulation models for medical education. Cadaveric models, although considered more realistic, may be difficult to obtain and costly. The advent of three-dimensional (3D) printing has offered a low-cost, reliable, and reproducible alternative. This study sought to compare the utility of 3D-printed to cadaveric models for training in transcutaneous injection laryngoplasty (TIL). A simulation course with a cross-over design was employed. Video laryngoscopes were utilized for both the 3D and cadaveric models to assess the accuracy of injection into the vocal fold. Pre-procedure and post-procedure surveys were administered to evaluate understanding and comfort level on a Likert scale of 1-10. Each model was also rated on a 1-5 Likert scale for self-efficacy, fidelity, and educational value. Pre- and post-survey data were completed by 15 otolaryngology residents and medical students. Mean pre-seminar understanding and comfort level were 3.7 and 2.2, respectively, compared to 6.9 and 5.9 (p < .05) following use of the 3D model and 6.4 and 4.7 (p < .05) following use of the cadaver model. When comparing 3D and cadaveric models, no significant differences were observed regarding self-efficacy, fidelity, and educational value. There was a similar mean increase in understanding and comfort following use of the 3D and cadaveric models. 3D-printing can provide an excellent adjunct to, and eventually a potential replacement for hands-on cadaveric training in medical education, particularly for TIL. Level III.

Robotically assisted outflow graft anastomosis in minimally invasive left-ventricular assist device implantation: feasibility, surgeon comfort, and operative times in an anatomical study.

Upper hemi-sternotomy is a common approach for outflow graft anastomosis to the ascending aorta in minimally invasive left-ventricular assist device implantation. Right mini-thoracotomy may also be used, but use of robotic assistance has been reported only anecdotally. The aim of our study was to confirm the feasibility of robotically assisted suturing of the outflow graft anastomosis and to assess performance metrics for the robotic suturing part of the procedure. The procedure was carried out in eight cadaver studies by two surgeons. The assist device pump head was inserted through a left-sided mini-thoracotomy and the outflow graft was passed toward a right-sided second interspace mini-thoracotomy through the pericardium. After placement of a partial occlusion clamp on the ascending aorta, a longitudinal aortotomy was performed and the outflow graft to ascending aorta anastomosis was carried out robotically. The procedure was feasible in all eight attempts. The mean outflow graft anastomotic time was 20.1 (SD 6.8) min and the mean surgeon confidence and comfort levels to complete the anastomoses were 8.3 (SD 2.4) and 6.9 (SD2.2), respectively, on a ten-grade Likert scale. On open inspection of the anastomoses, there was good suture alignment in all cases. We conclude that suturing of a left-ventricular assist device outflow graft to the human ascending aorta is very feasible with good surgeon comfort. Anastomotic times are acceptable and suture placement can be performed with appropriate alignment.

Determining the relationship between gastrointestinal symptoms and comfort in inflammatory bowel patients

Aim: This study aimed to reveal the effect of gastrointestinal symptoms on comfort levels in patients diagnosed with inflammatory bowel disease. Methods: A cross-sectional study design was used. 115 patients diagnosed with inflammatory bowel disease between January 15, 2023, and May 15, 2023, were included in this study. Comfort level was evaluated using the General Comfort Scale Short Form. The data were analyzed using descriptive statistics, and regression analyses. Results: The mean age in the study was The mean age in the study was 41.29 (standard deviation (SD)= 12.81) year. The mean comfort level was 98.93 (SD=19.06). There was a difference between gastrointestinal symptom burden scores according to gender (t = 3.048, p = 0.003), marital status There was a difference between gastrointestinal symptom burden scores according to gender (independent sample t-test (t) = 3.048, p = 0.003), and the presence of chronic disease (t = -4.115, p &lt; 0.001). There is a weak negative relationship between age and comfort level There is a weak negative relationship between age and comfort level (pearson correlation (r) = -0.191, p = 0.041). Conclusion: This study emphasized that gastrointestinal symptom burden is an important determinant of comfort level in patients diagnosed with inflammatory bowel disease and comfort decreases as gastrointestinal symptom load increases.

Evaluation of Complications Associated with Fixed Partial Denture: A Prospective Study.

To assess complications, survival rates, and patient-reported outcomes associated with fixed partial dentures (FPDs). A cohort of 146 subjects, aged 18 and above, requiring FPD were recruited. Following comprehensive dental examinations, FPDs were fabricated. Complications, survival rates, and patient-reported outcomes were evaluated at 3, 6, 12, and 24 months. Complications such as marginal discrepancies and framework fractures showed low frequencies over short-, mid-, and long-term intervals. Survival rates were high at 98.6%, 96.2%, 93.7%, and 91.1% at all intervals, respectively. Patient-reported outcomes indicated a mean comfort level of 8.2 with speech difficulties (8.2%) and hygiene challenges (4.8%). Overall satisfaction was high, with a mean score of 9.0. This study provided evidence of favorable outcomes with low complication rates, high survival rates, and positive patient-reported experiences associated with FPDs.

Sports participation after craniosynostosis repair: the critical role of post-operative guidance in parental decision-making.

Despite previous research supporting patient safety in sports after craniosynostosis surgery, parental anxiety remains high. This study sought to evaluate the role of healthcare providers in guiding patients and families through the decision-making process. Parents of children with repaired craniosynostosis were asked to assess sports involvement and parental decision-making in children ages 6 and older. Questions were framed primarily on 5-point Likert scales. Sport categorizations were made in accordance with the American Academy of Pediatrics. Chi-squared, linear regression, and Pearson correlation tests were used to analyze associations between the questions. Forty-three complete parental responses were recorded. Mean ages at surgery and time of sports entry were 7.93 ± 4.73months and 4.76 ± 2.14years, respectively. Eighty-two percent of patients participated in a contact sport. Discussions with the primary surgeon were more impactful on parental decisions about sports participation than those with other healthcare providers (4.04 ± 1.20 vs. 2.69 ± 1.32). Furthermore, children whose parents consulted with the primary surgeon began participating in sports at a younger age (4.0 ± 1.0 vs. 5.8 ± 2.7years, p = 0.034). The mean comfort level with contact sports (2.8 ± 1.4) was lower than that with limited-contact (3.8 ± 1.1, p = 0.0001) or non-contact (4.4 ± 1.3, p < 0.0001) sports. This study underscores the critical role that healthcare professionals, primarily surgeons, have in guiding families through the decision-making process regarding their children's participation in contact sports.

Percepción del confort en el paciente crítico desde el modelo teórico de Kolcaba

BackgroundThe stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ). ObjectivesTo determine the comfort level of patients admitted to the CCU using the GCQ of Kolcaba and to identify the discomfort factors. MethodsCross-sectional descriptive observational prospective study. Population: 580 patients admitted to adult CCU of two high complexity hospitals from June 2015 to March 2020 with stay ≥24h were interviewed. Descriptive analysis, Student's t-test and ANOVA and multivariate analysis were performed using SPSS v26 and STATA v16. ResultsThe mean age was 52.62 (16.21), 357 (61.6%) were male and 434 (74.8%) were believers. The type of admission was planned in 322 (55.5%) and the most prevalent reason for admission was surgical 486 (83.8%). The median pain score (NRS) was 3.00 [0-4] and severity score (APACHE II) was 13.26 (5.89), the median length of stay was 4.00 [2-7] days. The mean comfort level was 3.02 (0.31) showing the highest value for the Reanimation Unit 3.02 (0.30) and the lowest fort the Emergency and Trauma Unit 2.95 (0.38). Statistically significant differences were found between the units in the comfort level of patients >65 years of age (P=.029). The Relief comfort type obtained the lowest mean 2.81 (0.33) and the physical context 2.75 (0.41) in the three units. In the multivariate analysis, statistically significant differences were found between the comfort level and the pain level: no pain (P=.000) OR: 4.361; IC: 2.184-8.707, mild pain (P=.000) OR: 4.007; IC: 2.068-7.763, moderate pain (P=.007) OR: 2.803; IC: 1.328-5.913, and the APACHE II score equal to or greater than 10 (P=.000) OR: 0.472; IC: 0.316-0.705. ConclusionsThe comfort level showed high scores in all three units. The physical and environmental contexts and the relief comfort type negatively affected the perception of comfort. The variables that explained comfort were pain and severity of illness. The evaluation of comfort from the patient's perspective through the GCQ could be considered an indicator of quality of nursing interventions.

The Effect of Preoperative Pain Fear on Postoperative Pain, Analgesic Use, and Comfort Level

BackgroundPreoperative assessment of pain fear could provide essential information for improving perioperative care and could be the first step toward targeted pain management. AimsThe aim of this study is to determine the effect of preoperative pain fear on postoperative pain, analgesic use, and comfort level. MethodThis cross-sectional study was conducted with 201 patients in the general surgery service between January 2022 and March 2022. A sociodemographic questionnaire, Visual Analog Scale (VAS), pain fear, and general comfort scales were used for data collection. Correlation analysis was performed to examine the relationship between scales, and p < .05 was considered statistically significant. ResultsThe mean age of the individuals participating in the study was 51.22±15.89 and 69.2% of them were women. The average score of pain fear was 63.77±21.47, and the average score of the VAS was 7.63±1.82 after the surgery before analgesics and 5.06±1.58 six hours after surgery. The mean comfort level was 132.88±9.26. A significant and positive correlation was detected between the total pain fear and the VAS score, analgesic use, and comfort level (p < .05). ConclusionsIn this research, findings demonstrated that as the patients’ pain fear increased, postoperative pain severity and amount of analgesia increased. Providing pain management with analgesics increases comfort in patients, but it may cause secondary problems in patients who use high-dose analgesics. Therefore, reducing pain fear, which is one of the main factors in pain, is essential in pain management.

Teaching how to navigate difficult conversations: A combined palliative care–oncology didactic simulation intervention for hematology/oncology fellows.

11028 Background: ASCO strongly endorses the integration of palliative care to improve patient outcomes and support patients in their cancer trajectories. Developing core palliative care skills for trainees is therefore essential, with few ACGME approved pilot programs offering combined fellowship training. Our institution’s Heme/Onc fellows reported a need for additional education in leading difficult conversations. Methods: We piloted a didactic simulation (sim) session for each fellowship class, led by a faculty member who is dual board-certified in Medical Oncology and Hospice/Palliative Medicine. Trainees received a lecture on validated communication tools and oncology-specific language to help navigate difficult conversations. Trainees then role-played in small groups using sample cases, with Heme/Onc faculty supervision and real-time feedback, followed by class reflection. Pre- and post-sim surveys were electronically administered to assess knowledge of communication tools and comfort in discussing difficult topics. Comfort questions were scored on a 5-point Likert Scale, using student t-tests to detect differences pre- and post-sim, and ANOVA to compare responses among classes. Results: A total of 16/21 (76.2%) fellows completed both pre- and post-sim surveys. Knowledge of communication tools increased from 21.9% pre-sim to 79.7% post-sim. Comfort significantly increased for explaining palliative-intent chemotherapy, hospice, and discussing an uncertain prognosis (Table). There was a significant difference among classes pre-sim for addressing negative emotions (mean comfort level: 1st years 2.8, 2nd years 3.4, 3rd years 3.83; p=0.046) and for discussing an uncertain prognosis (mean comfort level: 1st years 2.6, 2nd years 3.6, 3rd years 3.83; p=0.043); however, these interclass discrepancies were eliminated post-sim. Overall, fellows reported that the sim sessions were effective for developing their knowledge and comfort in having difficult conversations. Conclusions: A novel sim intervention led by a physician who is dual board-certified in palliative care and medical oncology improves trainee competency with navigating difficult conversations. Analysis of the intervention’s durability of response and iterative refinement of its curriculum are ongoing. [Table: see text]

Efficacy of a hematology/oncology podcast curriculum at a community-based internal medicine program.

11036 Background: Medical podcasts have gained increasing popularity; however, there is limited evidence regarding their utility as an effective learning resource in Graduate Medical Education. Community-based internal medicine (IM) residents often have less exposure and education in hematology and oncology. To address this barrier, we developed a novel trainee-level hematology/oncology podcast curriculum to improve foundational knowledge for IM residents. Methods: A hematology/oncology podcast curriculum was implemented for IM residents at a community-based residency program in the 2022-2023 academic year. We developed ten episodes regarding workup and management of cytopenias, oncologic emergencies, and hematologic emergencies. We distributed anonymous pre- and post-intervention surveys to understand the impact of the podcast curriculum on a 5-point Likert scale on residents’ self-perception of their knowledge. Two sample paired t-test was used to compare mean differences in surveys. Results: A total of 17/27 residents (63%) completed the pre-intervention survey, and 9/27 residents (33%) completed the post survey. The pre-survey was more heavily weighted towards residents earlier in their training with 53% PGY1s, 29% PGY2s, and 18% PGY3s. With 5 being entirely comfortable, there was a statistically significant increase in mean comfort level in the workup and management of various cytopenias (2.65 to 4.0, p &lt; 0.01) and the management of oncologic emergencies (2.29 to 4.2, p &lt; 0.01). Comfort level in the management of hematologic emergencies numerically improved from 3.35 to 3.57 but was not statistically significant. Most residents (90%) agreed or strongly agreed that the fundamentals of hematology/oncology were amenable to a podcast platform. Many residents found this modality convenient and performed other activities while listening to the podcast including driving (82%) and exercising (55%). The majority of residents who completed the post-survey (64%) reported that they will continue to use podcasts to supplement their medical education. Conclusions: Community based IM residents’ comfort with the field of hematology/oncology improved following the medical podcast educational intervention. Residents found the learning platform amenable to the fundamentals of hematology/oncology and will continue to utilize medical podcasts to supplement their education. Our successfully piloted podcast curriculum can be adapted to other IM programs to improve foundational knowledge in hematology/oncology.

An Interactive Approach to Teaching Neurology Residents about Intellectual and Developmental Disabilities (IDD): Effects of In-Person Versus Virtual Noon Conferences (P1-2.006)

<h3>Objective:</h3> To compare the efficacy of in-person versus virtual interactive noon conferences on resident physicians’ comfort levels in caring for adults with intellectual and developmental disabilities (IDD). <h3>Background:</h3> Many neurologists feel uncomfortable treating adults with IDD, partly due to a lack of training. Prior findings suggest that having more experience with people with IDD is associated with more comfort in caring for this population. Comfort Theory explains that increasing meaningful interactions between dissimilar groups increases comfort levels between them. <h3>Design/Methods:</h3> Interactive noon conference sessions were conducted annually with seven adult and pediatric residency programs for three academic years between September 2019 and March 2022. During the conference, artists with IDD shared their work with residents and engaged in conversations following a brief lecture about IDD. Due to the COVID-19 pandemic, sessions after March 2020 were virtual with pre-recorded interviews with an artist with IDD. Residents completed surveys before and after each session. Participants rated their comfort level in interacting with and treating people with IDD using a 6-point Likert scale. Results were analyzed with longitudinal regression models for in-person and virtual participants. <h3>Results:</h3> 68 unique in-person participants and 89 unique virtual participants completed pre- and post-session surveys. In the in-person versus virtual group, mean comfort levels interacting with people with IDD increased from 3.7 to 4.4 (95% CI 0.34–0.96, p&lt;.0001) versus from 4.0 to 4.4 (0.15–0.57, p&lt;.0001) and mean comfort levels treating people with IDD increased from 3.7 to 4.2 (0.14–0.77, p &lt; .0001) versus from 3.9 to 4.2 (0.06–0.5, p&lt;.0001). There was no significant difference between the two groups (difference 0.17; −0.56–0.21, p = 0.38). <h3>Conclusions:</h3> Neurology resident participation in interactive noon conferences with people with IDD increased resident comfort caring for this population. Our findings suggest that virtual sessions also improved physician comfort, offering a valid alternative when in-person sessions are not possible. <b>Disclosure:</b> Dr. Frueh has received research support from ACGME Back to Bedside. The institution of Stefan Sillau has received research support from Alzheimer’s Association. The institution of Stefan Sillau has received research support from Hewitt Family Foundation; State of Colorado. The institution of Stefan Sillau has received research support from PCORI. The institution of Stefan Sillau has received research support from NINR. The institution of Stefan Sillau has received research support from Michael J. Fox Foundation. The institution of Stefan Sillau has received research support from Department of Defense. The institution of Stefan Sillau has received research support from Colorado Department of Public Health and Environment. The institution of Stefan Sillau has received research support from Benign Essential Blepharospasm Research Foundation. Stefan Sillau has a non-compensated relationship as a Statistician with Novartis that is relevant to AAN interests or activities. Stefan Sillau has a non-compensated relationship as a Statistician with Biogen that is relevant to AAN interests or activities. Dr. Elias has nothing to disclose. Dr. Santana Almansa has nothing to disclose. Dr. MacRae has nothing to disclose. Dr. Shapiro has nothing to disclose. Madeline Chiujdea has nothing to disclose. The institution of Dr. Sanders has received research support from Autism Intervention Research Network on Physical Health. The institution of Dr. Sanders has received research support from Accreditation Council for Graduate Medical Education.

Education Research: Predictors of Resident Physician Comfort With Individuals With Intellectual and Developmental Disabilities: A Cross-sectional Study.

Individuals with intellectual and/or developmental disabilities (IDD) experience worse health outcomes compared with peers without a disability partly due to difficulties accessing age-appropriate health care. Provider discomfort with interacting and caring for individuals with IDD is a primary barrier to accessing care. The objectives of this study were to describe resident physicians' education, experiences, and comfort levels regarding individuals with IDD and to identify predictors of higher comfort levels with this patient population. In this cross-sectional study, we surveyed medical trainees in 7 residency programs in Boston, Massachusetts on their education, experiences, and comfort levels regarding individuals with IDD. The comfort level was assessed directly on a 6-point Likert scale. The relationship between comfort regarding people with IDD and several candidate explanatory variables was explored with Spearman and partial Spearman correlations (r s). The estimated survey response rate was 49%. Of 423 resident physicians included in the study, 96% reported they had treated a patient with IDD, while only 25% reported having formal education on caring for this population. On a scale of 1-6, with higher numbers corresponding to greater comfort, the mean comfort level treating individuals with IDD was 3.73 (CI 3.61-3.85). In bivariant analyses, the amount of prior experience with people with IDD had a moderate, positive correlation with increased comfort levels treating individuals with IDD (r s = 0.42, p < 0.01). The following characteristics had a weak, positive correlation with increased comfort levels: training in a pediatric-focused residency specialty (r s = 0.18, p < 0.01), number of hours of formal education on caring for people with IDD (r s = 0.15, p < 0.01), and age (r s = 0.12, p = 0.03). Only the amount of prior experience with this patient population remained positively correlated with higher comfort levels when the other variables were controlled for (r s = 0.38, p < 0.01). Prior experience with individuals with IDD predicted higher comfort levels with this population. This study supports the need for increased opportunities for medical trainees to engage with people with IDD to improve resident physicians' comfort caring for this patient population.

Evaluation of Comfort Levels of Patient and Ergonomics of the Dental Surgeon during Manual Scaling under Both Proprioceptive Derivative Concept and Conventional Approach: A Cross-sectional Study

Introduction: The important components that contribute to successful dental care are maximum accessibility, visibility, comfort, and control over clinical processes. Dental practitioners are more prone to developing musculoskeletal disorders due to awkward working postures. To minimise all these risk factors, a new concept called Proprioceptive Derivative (PD) has come into existence. Aim: The main aim of this study was to evaluate the comfort levels of the patient and ergonomics of the dental professional in the PD approach and conventional approach. Materials and Methods: A cross-sectional study was conducted in which manual scaling was performed by 20 dentists on 120 patients using the PD concept and conventional concept. A 13-item questionnaire was distributed among the patients and clinicians to record their perceptions of comfort levels, clinicians’ treatment satisfaction levels, and the time needed to complete the procedure after mastering the PD concept. In indepedent sample t-test was use to compare the responses among the two groups. p≤0.05 was considered statistically significant. Results: The comfort levels of the clinician (q1) during treatment in the conventional approach, with a mean value of 2.96±0.69, were significantly lower than in the PD approach, with a mean value of 3.46±0.85 (p&lt;0.001). However, from the perspective of the patients, the mean comfort levels using the conventional strategy were 2.61±1.03, while using the PD approach, it was 2.85±1.11, which was not statistically significant (p&gt;0.05). Conclusion: The clinicians had more ergonomic benefits and improved time factors under the PD concept. By following the work postures according to the PD concept, clinicians can avoid musculoskeletal discomfort, which is beneficial to all clinicians and can increase the longevity of their clinical practice.

Examining the utility of a photorealistic virtual ear in otologic education

BackgroundOtolaryngology–head and neck surgical (OHNS) trainees’ operating exposure is supplemented by a combination of didactic teaching, textbook reading, and cadaveric dissections. Conventional teaching, however, may not adequately equip trainees with an understanding of complex visuospatial relationships of the middle ear. Both face and content validation were assessed of a novel three-dimensional (3D) photorealistic virtual ear simulation tool underwent face and content validation as an educational tool for OHNS trainees.MethodsA three-dimensional mesh reconstruction of open access imaging was generated using geometric modeling, which underwent global illumination, subsurface scattering, and texturing to create photorealistic virtual reality (VR) ear models were created from open access imaging and comiled into a educational platform. This was compiled into an educational VR platform which was explored to validate the face and content validity questionnaires in a prospective manner. OHNS post-graduate trainees were recruited from University of Toronto and University of Calgary OHNS programs. Participation was on a voluntary basis.ResultsTotal of 23 OHNS post-graduate trainees from the two universities were included in this study. The mean comfort level of otologic anatomy was rated 4.8 (± 2.2) out of 10. Senior residents possessed more otologic surgical experience (P < 0.001) and higher average comfort when compared to junior residents [6.7 (± 0.7) vs. 3.6 (± 1.9); P = 0.001]. Face and content validities were achieved in all respective domains with no significant difference between the two groups. Overall, respondents believed OtoVIS was a useful tool to learn otologic anatomy with a median score of 10.0 (8.3–10.0) and strongly agreed that OtoVIS should be added to OHNS training with a score of 10.0 (9.3–10.0).ConclusionsOtoVIS achieved both face and content validity as a photorealistic VR otologic simulator for teaching otologic anatomy in the postgraduate setting. As an immersive learning tool, it may supplement trainees’ understanding and residents endorsed its use.Graphical

32840 Utilization of a cutaneous lymphoma primer to improve resident education

Background: Cutaneous lymphoma (CL) is a somewhat esoteric subject from the vantage point of the general dermatologist, however, rarity of a diagnosis is not an adequate reason to discount the benefit in learning more about this subject, particularly in residency. There is a lack of access to concise, relevantly organized educational materials pertaining to CL at the resident level. Furthermore, no data has been published regarding dermatology resident comfort level with diagnosis and treatment of CL. This study aims to improve resident understanding through the creation of a CL primer. Methods: A pre-test evaluated resident comfort level in understanding normal lymph node (LN) architecture and staining and recognizing clinical and histologic features of CL using a 10-point Likert scale (1 being not at all comfortable, 10 being very comfortable). The pre-test was administered to eleven Saint Louis University dermatology residents, followed by dissemination of an online CL primer. After reviewing the primer, a post-test assessing the same parameters was distributed, and post-test results were compared with pre-test scores. Results: Residents showed a significant improvement in their comfort level in understanding normal LN structure and CL, clinically and histologically after reviewing the CL primer. The mean comfort level score improved from 4.66 (95% Cl [3.88-5.44]) to 7.69 (95% Cl [7.43-7.95]), with a mean difference of 3.03 (95% Cl [2.24 – 3.81]) (P < .0001). Conclusion: Use of a CL primer improved resident understanding of normal LN architecture and staining patterns, and with recognition of clinical and histologic features of CL.

Pediatric Web-based Video Capsule Endoscopy Curriculum: A Pilot Study to Determine the Ability to Implement a Standardized Educational Curriculum.

A pilot web-based VCE curriculum was created using REDCap database. An email invitation asking for participation was sent to a pediatric gastroenterology Listserv. Baseline comfort and knowledge regarding VCE skills were measured. Educational links and materials were provided following which participants completed VCE cases with immediate feedback. Finally, participants completed a posttest and a survey to complete the curriculum. Fifty-two participants began the curriculum of which 37 (71%) partially completed, 12 (23%) completed, and 3 (6%) withdrew. Significant improvement was noted regarding self-reported mean comfort level in explaining indications (P = 0.0097), contraindications (P = 0.0036), managing complications (P = 0.0048), using VCE software (P = 0.00035), and interpreting VCE findings (P = 0.00015). Participants showed significant improvement in knowledge (P = 0.041) and photo recognition posttests (P = 0.015). All participants who completed the curriculum found it helpful and reported that they would recommend it to their colleagues. This pilot curriculum demonstrated an improvement in participant self-reported comfort and an increase in VCE knowledge. Further resources would make a web-based curriculum easier to navigate and complete. Providing Continuation of Medical Education and Maintenance of Certification credits for future curricular iterations would provide an opportunity for training with recognition for pediatric gastroenterologists.

Fear Not: Utilizing Simulation for Medical Malpractice Education.

INTRODUCTIONMedical malpractice payouts across specialties totaled over $4.03 billion USD in 2019. It is estimated that over 72% of Emergency Medicine (EM) physicians will be involved in a medical malpractice lawsuit by age 55. The majority of EM residencies do not include adequate education on medicolegal risk mitigation and litigation. The purpose of the study is implementation of an innovative interprofessional simulation to target this education gap.METHODSAn anonymous pre- and post-survey was distributed to participating EM providers electronically. The surveys evaluated baseline medicolegal knowledge, self-rated deposition comfort and concern regarding malpractice litigation. The simulation event involved an interactive lecture on basic tenets of medical malpractice and state legal statutes from medicolegal experts. Resident physician volunteers acted as defendant physicians during simulated depositions using a redacted, closed malpractice case.RESULTSEighty EM providers attended the event over two days. All attendees completed the pre-survey (80/80), and 66.3% (53/80) completed the post-survey. The majority incorrectly answered 4 of 5 medicolegal questions. The mean comfort level regarding being deposed is 1.53 ± 0.94 on a 1-5 Likert scale (extremely uncomfortable to extremely comfortable); the mean level of concern/fear of malpractice litigation is 3.38 ± 0.95 on a 1-5 Likert scale (not at all to extremely concerned). There was a statistically significant increase in deposition comfort level post-event (1.83, P < .01).CONCLUSIONThe majority of EM physicians are inexperienced and concerned regarding litigation. After participating in an educational event and observing a simulated deposition, physicians reported an increased comfort level regarding being deposed in the future.