Medical Residents Research Articles

Navigating Cultural Challenges in Transplant Surgery: Insights from Turkish Surgeons.

To achieve expertise, transplant surgeons in Turkiye undergo rigorous training, including medical school, residency, compulsory service, and extensive training in transplant surgery. Despite their high academic and clinical knowledge level, success in transplant surgery heavily depends on cultural competency. Through semi-structured interviews with 21 transplant surgeons specializing in kidney and liver transplants in Ankara, this study reveals how health illiteracy, culture, and folklore create significant barriers. Surgeons navigate these challenges while enduring harsh working conditions. This research highlights the critical role of cultural competency in transplant surgery, emphasizing the necessity for surgeons to understand and address the diverse cultural needs of their patients. Key findings indicate that surgeons must balance medical expertise with cultural sensitivity to deliver effective care. This study identifies four main cultural barriers: spiritual trust, family politics, health illiteracy, and subcultural incompetency. Effective transplant surgery requires a combination of theoretical proficiency and cultural awareness to meet a patient's needs and improve surgical outcomes.

Perfil dos acidentes com exposição a material biológicoentre residentes e estudantes de medicina

Introduction: Resident physicians and medical students who suffered occupational accidents involving biological risks can present serious health problems. Objective: To describe occupational accidents involving exposure to biological material among medical undergraduates and residents at the State University of Campinas from 2011 to 2020. Method: This was a retrospective case series study conducted from the records of work accidents involving exposure to biological material that occurred among medical undergraduates and residents. Data were analyzed using the Statistical Analysis System (SAS) software, version 9.4. To check the association between the use of personal protective equipment and exposure route, the method Generalized Estimating Equations was used. Results: A total of 1,121 notifications were analyzed, of which 78.5% involved medical residents and 21.5% involved medical undergraduates. Most exposures were due to percutaneous injury (80.1%), the needle with lumen was the main causative agent (37.6%), and 49.0% accidents occurred during surgical procedures or sutures. The operating room and emergency unit had the highest number of accidents. It was evidenced association between accidents that occurred with exposure to the mucous membranes of eyes and non-adherence to eye protection (p<0, 0001). Residents suffered more accidents in the first two years of residency (66.3%), whereas in medical undergraduate students, the prevalence was between the fifth and sixth year of the program (81.9%). Conclusions: Awareness and early education regarding the issue of safety in the work environment should be a priority in medical education, because they provide students with the necessary knowledge to protect themselves from occupational biological hazards.

Duration of New-Onset Depressive Symptoms During Medical Residency

The implications of new-onset depressive symptoms during residency, particularly for first-year physicians (ie, interns), on the long-term mental health of physicians are unknown. To examine the association between and persistence of new-onset and long-term depressive symptoms among interns. The ongoing Intern Health Study (IHS) is a prospective annual cohort study that assesses the mental health of incoming US-based resident physicians. The IHS began in 2007, and a total of 105 residency programs have been represented in this national study. Interns enrolled sequentially in annual cohorts and completed follow-up surveys to screen for depression using the 9-item Patient Health Questionnaire-9 (PHQ-9) throughout and after medical training. The data were analyzed from May 2023 to March 2024. A positive screening result for depression, defined as an elevated PHQ-9 score of 10 or greater (indicating moderate to severe depression) at 1 or more time points during the first postgraduate year of medical training (ie, the intern year). The main outcomes assessed were mean PHQ-9 scores (continuous) and proportions of physicians with an elevated PHQ-9 score (≥10; categorical or binary) at the time of the annual follow-up survey. To account for repeated measures over time, a linear mixed model was used to analyze mean PHQ-9 scores and a generalized estimating equation (GEE) was used to analyze the binary indicator for a PHQ-9 score of 10 or greater. This study included 858 physicians with a PHQ-9 score of less than 10 before the start of their internship. Their mean (SD) age was 27.4 (9.0) years, and more than half (53.0% [95% CI, 48.5%-57.5%]) were women. Over the follow-up period, mean PHQ-9 scores did not return to the baseline level assessed before the start of the internship in either group (those with a positive depression screen as interns and those without). Among interns who screened positive for depression (PHQ-9 score ≥10) during their internship, mean PHQ-9 scores were significantly higher at both 5 years (4.7 [95% CI, 4.4-5.0] vs 2.8 [95% CI, 2.5-3.0]; P < .001) and 10 years (5.1 [95% CI, 4.5-5.7] vs 3.5 [95% CI, 3.0-4.0]; P < .001) of follow-up. Furthermore, interns with an elevated PHQ-9 score (≥10) demonstrated a higher likelihood of meeting this threshold during each year of follow-up. In this cohort study of IHS participants, a positive depression screening result during the intern year had long-term implications for physicians, including having persistently higher mean PHQ-9 scores and a higher likelihood of meeting this threshold again. These findings underscore the pressing need to address the mental health of physicians who experience depressive symptoms during their training and to emphasize the importance of interventions to sustain the health of physicians throughout their careers.

Mixed-methods study of medical students’ attitudes toward peer physical examinations in Japan

BackgroundMost Japanese medical schools likely continue to rely on peer physical examination (PPE) as a tool to for teaching physical examination skills to students. However, the attitudes of medical students in Japan toward PPEs have not be identified. Therefore, we evaluated students’ attitudes toward PPE in a Japanese medical school as a preparation for developing a PPE policy tailored to the context of Japanese culture.MethodsWe conducted a mixed-methods study with an explanatory sequential approach, in which qualitative data were used to interpret the quantitative findings. Surveys and interviews were conducted with medical students and junior residents at a Japanese university. A total of 63 medical students and 50 junior residents responded to the questionnaire. We interviewed 16 participants to reach theoretical saturation and investigated the attitudes of medical students toward PPE and the themes emerging from the interview data, providing detailed descriptions of the quantitative findings.ResultsFemale participants were significantly more likely than male participants to report varying degrees of resistance to being a model patient during PPE (male: 59.7%, female: 87%, p < 0.001). Most of the participants who took on the role of patients that involved undressing were males. The participants expected improvements in issues related to the guarantee of freedom to refuse to be a model patient and measures to protect confidentiality. Approximately 22% of the participants reported that they witnessed incidental findings (including variations within the normal range) in front of other students during PPE.ConclusionsThe findings imply that medical students expect high levels of autonomy and confidentiality when volunteering as model patients during PPE. Thus, developing a PPE policy suitable for Japanese culture may be effective in establishing a student-centered PPE environment.

Experiences of racism of Black medical students and residents in Montréal: "I wear my stethoscope around my neck at all times".

Black students and residents experience racism in medical school. This qualitative study documents Black students' and residents' experiences of racism using Critical Race Theory (CRT) and explores their coping mechanisms using the theatrical metaphor. We conducted semi-structured interviews with four Black medical students and residents (two medical students and two residents) studying in Montréal and analyzed their experiences through counter-stories. We identified themes related to their experiences of racism during medical training and their coping mechanisms. Our analysis reveals these experiences of racism occur in academic and clinical settings (classes, internships, social interactions with peers, faculty, and patients, and through the curriculum), in the form of microaggressions. The analysis also indicates that Black students and residents try to cope with racism using a hyper-ritualization strategy to better fit in (e.g., clothing, behaviours). Considering that Black students and residents experience various forms of racism (subtle or explicit) during their medical training, these findings urge us to increase awareness about racism of students, residents, teachers and health care workers in universities and teaching hospitals. Pathways to increase the representation of Black students and residents seem to be part of the solution, but improving the learning environment must be a priority to achieve racial justice in medical training in Québec.

Identifying the Factors Affecting e -learning by Synthesis of Research from Databases of (1389 to 1402 SH) and (2010 to 2023 AD)

Introduction: Given the importance of empathy in caring for patients, this study investigated the level of empathy and its associated factors among medical residents at Ahvaz Jundishapur University of Medical Sciences (AJUMS). Electronic education is a type of educational program that stems from the impact of technology, utilized to facilitate the learning process. Its purpose is to use this educational technology and its effects on the learning process, and the present research seeks the main factors affecting electronic education. Method: The method of this research is qualitative and synthesis research, the statistical population, numerous types of research that have been conducted in domestic and foreign articles in the period(1389-1402 SH) and (2010-2023 AD), and analyzed the 6-step model of Roberts' research synthesis was used and in the data reliability check from the provided framework, four criteria; believability, transferability, reliability, and confirmability were used. Results: The findings in this research showed that the effective dimensions in electronic education include technology-oriented, need-oriented, learning-oriented, communication-oriented, program-oriented, obstacle-oriented, motivation-oriented, and development-oriented dimensions, respectively. Conclusion: In this study, we found that given that e-education is used in all sciences, this research is a suitable model for learners.

(071) IMPROVING TRAINEE COMFORT IN ASSESSMENT AND MANAGEMENT OF FEMALE SEXUAL HEALTH AND MENOPAUSE THROUGH AN INTERACTIVE WORKSHOP

Abstract Introduction Concerns related to female sexual health and menopause are common in clinical practice, but these topics are often inadequately covered during training. Many medical schools and residency programs lack a formal curriculum, and trainees in internal medicine, family medicine, and obstetrics and gynecology often graduate feeling uncertain in their management of these conditions. Objective Improve resident comfort with assessment and management of female sexual health and menopause through an interactive workshop. Methods We created a 90-minute, interactive workshop focused on female sexual health and menopause. Residents in internal medicine at a large academic medical center were invited to participate. A multidisciplinary group including physicians, advanced practice providers, registered nurses and a certified sex therapist were recruited to lead the workshop. Results Participants rotate through three 30-minute sessions targeted to learning objectives. One session focuses on conducting a symptom-based pelvic exam. A 3-dimensional model is used to review the anatomy of the female pelvic floor and demonstrate physical exam techniques to evaluate vaginal and vulvar symptoms, pelvic pain, and dyspareunia. Diagnostic skills include vulvar inspection to assess for skin and mucosal changes, cotton swab test of the vestibule, and assessment of pelvic floor musculature. A second session focuses on the genitourinary syndrome of menopause (GSM). The pathophysiology, presentation and treatment of GSM is introduced. Next, registered nurses with expertise in female sexual health and menopause lead an interactive demonstration of vaginal moisturizers and lubricants. Advice for counseling patients on the proper use and application of vaginal estrogens is also reviewed. The final session focuses on sexual health counseling, including sexual history-taking skills. Participants are taught about the domains of sexual function, female sexual response cycle, types of desire, patient resources, and sexual aids. Feedback following the initial iteration of this workshop was very positive. All participants felt that the experience was an effective use of time, would recommend it to others, and were confident in their ability to apply skills to their clinical practice. Conclusions This interactive workshop led by a multidisciplinary group of providers aims to improve trainee comfort in evaluation and management of female sexual health and menopause. Given the commonplace nature of these topics in primary care and paucity of existing curricula, consideration could be given to the inclusion of a similar educational experience into internal medicine, family medicine and/or obstetrics and gynecology residency programs. Disclosure No.

Inter- and Intrarater Reliability of the Gap-Kalamazoo Communication Skills Assessment Form Among Occupational Therapy Interns.

Effective communication skills (CS) are essential for occupational therapists. The Gap-Kalamazoo Communication Skills Assessment Form (GKCSAF) is a standard tool for assessing the CS of medical residents. However, the interrater reliability for the nine CS domain scores ranges from poor to good. The intrarater reliability remains unclear. To examine the inter- and intrarater reliability of the GKCSAF's nine domain scores and total score among occupational therapy interns. Repeated assessments with the GKCSAF. Medical center psychiatry department. Twenty-five interns and 49 clients with mental illness, recruited from August 2020 to December 2021. The transcripts of 50 evaluation interviews between clients and interns were used. Three independent raters assessed each transcript twice, at least 3 mo apart. The GKCSAF demonstrated poor interrater reliability for the nine domain scores (weighted κ = .08-.30) and the total score (intraclass correlation coefficient [ICC] = .22, 95% confidence interval [CI] [.10, .35]). The GKCSAF showed poor to intermediate intrarater reliability for the nine domain scores (weighted κ = .27-.73) and fair reliability for the total score (ICC = .69, 95% CI [.60, .77]). The GKCSAF demonstrates poor interrater reliability and poor to intermediate intrarater reliability for the nine domain scores. However, it demonstrates fair intrarater reliability in assessing the overall CS performance of occupational therapy interns. Significant variations were observed when different raters assessed the same interns' CS, indicating inconsistencies in ratings. Consequently, it is advisable to conservatively interpret the CS ratings obtained with the GKCSAF. Plain-Language Summary: It is essential for occupational therapists to effectively communicate with clients. The Gap-Kalamazoo Communication Skills Assessment Form (GKCSAF) is a standard tool that is used to assess the communication skills of medical residents. The study authors used the GKCSAF with occupational therapy interns in a medical center psychiatry department to assess how effectively they interviewed clients with mental illness. This study aids occupational therapy personnel in the interpretation of GKCSAF results. The study findings also highlight the importance of developing reliable and standardized measures to assess communications skills in the field of occupational therapy.

How Effective Are In-Hospital Training Workshops on Infection Control for Physicians? First Report in Iran

Background: The treatment staff should properly understand infection prevention and control (IPC) methods. Adherence to IPC has significant implications and outcomes for maintaining treatment staff safety, patient protection, and environmental care. Objectives: This study was conducted to examine infection control training in doctors. Methods: This study was conducted in Imam Khomeini Hospital in Tehran, Iran, and practitioners in internal and surgical departments participated. The research focused on infection prevention and control (IPC) through specialized workshops and questionnaires using a pre-and post-test design. The sessions included topics such as infection control, transmission, hospital-acquired infections, and components of the IPC program. Questionnaires based on the KAP method evaluated participants' knowledge, attitude, and performance. This study was approved by the university's research vice department and the research ethics committee. Data were analyzed using SPSS software, and the significance of P &lt; 0.05 was emphasized. Results: Of the 251 medical residents, 189 completed the study, 122 of whom were in internal medicine and 67 in surgery. Among the 158 faculty members, 60 completed the study, 39 were in internal medicine, and 21 were in surgery. The mean pre-test scores for internal medicine residents were 15.63 (out of 30) and 13.11 for surgical residents, respectively, which increased to 22.41 and 18.09 in the post-test. Conclusions: The results showed that regular and standard periodic training can improve doctors' knowledge and performance in implementing infection prevention and control programs.

Model for an Academic Medicine Interest Group: A student-led initiative

Academic physicians are responsible for the education of medical students, residents, and other practicing physicians through clinical rotations lectures, seminars, research, and conferences. Therefore, the increasing need to recruit academic physicians holds immense value within the healthcare system. Academic Medicine Interest Group (AMIG) is a collective made up of students who share an interest in the growth and advancement of academic medicine. We present a guide and model on establishing an AMIG. We found that AMIG fostered professional growth by providing leadership, research, and teaching opportunities. Strategic planning, effective leadership, and group organization were all necessary for the success of the group.

Medical residents’ perceptions of group biases in medical decision making: a qualitative study

BackgroundSystematic biases in group decision making (i.e., group biases) may result in suboptimal decisions and potentially harm patients. It is not well known how impaired group decision making in patient care may affect medical training. This study aimed to explore medical residents’ experiences and perspectives regarding impaired group decision making and the role of group biases in medical decision making.MethodsThis study used a qualitative approach with thematic analysis underpinned by a social constructionist epistemology. Semi-structured interviews of medical residents were conducted at a single internal medicine residency program. Residents were initially asked about their experiences with suboptimal medical decision making as a group or team. Then, questions were targeted to several group biases (groupthink, social loafing, escalation of commitment). Interviews were transcribed and transferred to a qualitative data analysis software. Thematic analysis was conducted to generate major themes within the dataset.ResultsSixteen interviews with residents revealed five major themes: (1) hierarchical influence on group decision making; (2) group decision making under pressure; (3) post-call challenges in decision making; (4) interactions between teamwork and decision making; and (5) personal and cultural influences in group decision making. Subthemes were also identified for each major theme. Most residents were able to recognize groupthink in their past experiences working with medical teams. Residents perceived social loafing or escalation of commitment as less relevant for medical team decision making.ConclusionsOur findings provide unique insights into the complexities of group decision making processes in teaching hospitals. Team hierarchy significantly influenced residents’ experiences with group decision making—most group decisions were attributed to consultants or senior team members, while lower ranking team members contributed less and perceived fewer opportunities to engage in group decisions. Other factors such as time constraints on decision making, perceived pressures from other staff members, and challenges associated with post-call days were identified as important barriers to optimal group decision making in patient care. Future studies may build upon these findings to enhance our understanding of medical team decision making and develop strategies to improve group decisions, ultimately leading to higher quality patient care and training.

How (Cautious) Social Media Use May Improve Education and Pipeline Efforts of a Growing Postpandemic Forensic Pathologist Workforce Shortage.

Many subspecialties of pathology have initiated novel methods and strategies to connect with medical students and residents, stimulate interest, and offer mentorship. Emerging concern about the future of forensic pathology has been highlighted in contemporary literature as recruitment of new fellows has stagnated and workforce shortage concerns have blossomed. Amidst these challenges, the potential role of social networking platforms like social media (SoMe) in enhancing autopsy pathology/forensics education has garnered attention, yet literature focusing specifically on its application in autopsy and forensic pathology remains limited. This review aims to provide a comprehensive narrative overview of the current literature on the established uses of SoMe in forensic pathology. It seeks to build upon existing recommendations, introducing a contemporary compilation of online resources designed to facilitate virtual engagement among pathologists, learners, patients, and families. The review supports the idea that strategic, ethical, and conscientious use of SoMe has a place in addressing the growing workforce shortages and closing educational gaps in forensic pathology by enhancing exposure to the field and dispelling antiquated stereotypes.

Transforming the delivery of care from “I” to “We” by developing the crisis resource management skills in pediatric interprofessional teams to handle common emergencies through simulation

BackgroundThe healthcare system is highly complex, and adverse events often result from a combination of human factors and system failures, especially in crisis situations. Crisis resource management skills are crucial to optimize team performance and patient outcomes in such situations. Simulation-based training offers a promising approach to developing such skills in a controlled and realistic environment.MethodsThis study employed a mixed-methods (quantitative-qualitative) design and aimed to assess the effectiveness of a simulation-based training workshop in developing crisis resource management skills in pediatric interprofessional teams at a tertiary care hospital. The effectiveness of the intervention was evaluated using Kirkpatrick’s Model, focusing on reaction and learning levels, employing the Collaboration and Satisfaction about Care Decisions scale, Clinical Teamwork Scale, and Ottawa Global Rating Scale for pre- and post-intervention assessments. Focused group discussions were conducted with the participants to explore their experiences and perceptions of the training.ResultsThirty-nine participants, including medical students, nurses, and residents, participated in the study. Compared to the participants’ pre-workshop performance, significant improvements were observed across all measured teamwork and performance components after the workshop, including improvement in scores in team communication (3.16 ± 1.20 to 7.61 ± 1.0, p < 0.001), decision-making (3.50 ± 1.54 to 7.16 ± 1.42, p < 0.001), leadership skills (2.50 ± 1.04 to 5.44 ± 0.6, p < 0.001), and situation awareness (2.61 ± 1.13 to 5.22 ± 0.80, p < 0.001). No significant variations were observed post-intervention among the different teams. Additionally, participants reported high levels of satisfaction, perceived the training to be highly valuable in improving their crisis resource management skills, and emphasized the importance of role allocation and debriefing.ConclusionsThe study underscores the effectiveness of simulation-based training in developing crisis resource management skills in pediatric interprofessional teams. The findings suggest that such training can impact learning transfer to the workplace and ultimately improve patient outcomes. The insights from our study offer additional valuable considerations for the ongoing refinement of simulation-based training programs. There is a need to develop more comprehensive clinical skills evaluation methods to better assess the transferability of these skills in real-world settings. The potential challenges unveiled in our study, such as physical exhaustion during training, must be considered when refining and designing such interventions.

RISE-EM: Resident Instruction in Social Emergency Medicine, a Cohort Study of a Novel Curriculum.

There is recognition in the field of emergency medicine (EM) that social determinants of health (SDoH) are key drivers of patient care outcomes. Leaders in EM are calling for curricula integrating SDoH assessment and intervention, public health, and multidisciplinary approaches to EM care throughout medical school and residency. This intersection of SDoH and the emergency care system is known as social emergency medicine (SEM). Currently, there are few resources available for EM training programs to integrate this content; as a result, few EM trainees receive adequate education in SEM. To address this gap, we developed a four-part training in SEM tailored to EM residency programs and medical schools. This curriculum, known as RISE-EM (Resident Instruction in Social Emergency Medicine), uses video lectures, case examples, and group discussions to engage trainees and develop competency in providing sound care that is grounded in evidence-based principles of SEM. In the current study, we tested RISE-EM by delivering the video lectures to residents and medical students in two training programs. We administered pre- and post-course knowledge tests and a post-course participant attitudes survey to assess the acceptability and potential efficacy of the program for improving SEM knowledge and attitudes among EM learners. We found it to be both feasible and acceptable to introduce SEM content in residency conferences, with preliminary data showing statistically significant improvement in knowledge of the content and self-efficacy to apply it to their clinical practice. In summary, RISE-EM has been highly valued by EM learners and viewed as a strong supplement to their existing training, and it has been shown to successfully improve SEM knowledge and attitudes.

Ethics training as a crucial scope in the various specialties of the medical residency

Ethics training as a crucial scope in the various specialties of the medical residency

Variegated racism: exploring experiences of anti-Black racism and their progression in medical education.

Addressing anti-Black racism in medical education in Canada has become increasingly urgent as more Black learners enter medical institutions and bring attention to the racist harms they face. We sought to gather evidence of experiences of racism among Black medical learners and to explore the contexts within which racism is experienced by learners. Drawing on critical race and structural violence theories, we conducted interviews with Black medical faculty, students, residents, and staff at the University of Saskatchewan College of Medicine between May and July 2022. We thematically analyzed interviews using instrumental case study methodology. Thematic analyses from 13 interviews revealed 5 central themes describing experiences of racism and the compounding nature of racist exposures as learners progressed in medicine. Medical learners experienced racism through uncomfortable encounters and microaggressions. Blatant acts of racism were instances where patients and superiors harmed students in various ways, including through use of the N-word by a superior in 1 instance. Learners also experienced curricular racism through the absence of the Black body in the curriculum and the undue pathologizing of Blackness. Medical hierarchies reinforced anti-Black racism by undermining accountability and protecting powerful perpetrators. Finally, Black women medical learners identified intersecting oppressions and misogynoir that compounded their experience of racism. We propose that experiences of racism may worsen as learners progress in medicine in part because of increases in the sources of and exposure to racism. Anti-Black racism in medical education in Canada is experienced subtly through microaggressions or blatantly from different sources including medical faculty. As Black learners progress in medicine, anti-Black racism may become worse because of the compounding effects of exposures to a wider range of sources of racist behaviour.

Translation, cultural adaptation and linguistic validation of the postgraduate hospital educational environment measure into Arabic

BackgroundAssessment of the clinical learning environment (CLE) is an essential step that teaching hospitals routinely undertake to ensure the environment is conducive, learning-oriented and supportive of junior doctors’ education. The Postgraduate Hospital Educational Environment Measure (PHEEM) is an internationally recognized tool for assessing the CLE with evidence of high reliability and validity. Translation of PHEEM into other languages such as Spanish, Japanese and Persian enabled wider adoption of the instrument in the world. However, in Syria and other Arabic countries, a validated Arabic translation of PHEEM is still not available, making it difficult to adopt it and use it in Arabic contexts. This study aims to translate and culturally adapt the PHEEM from English into Arabic.MethodsThis study followed the structured translation and validation process guideline proposed by Sousa & Rojjanasrirat 2010. First, the PHEEM went through forward translation by three translators, then reconciled with the aid of a fourth translator. Afterwards, two professional bicultural and bilingual translators conducted back translation into English and compared it with the original version. This formed the Pre-final Version (PFV) which was then pretested for clarity on a sample of medical residents in Damascus, Syria. Following appropriate modifications, the PFV was sent to a panel of experts for a comprehensive review of language clarity and to assess content validity.ResultsA total of thirty-five medical residents were recruited. Ten items with language clarity issues were identified and modified according to the elicited suggestions. Thereafter, the modified PFV was presented to ten subject experts who identified three items in need of revision. The item-content Validity Index (CVI) was over 0.78 for all of the 40 items; the calculated scale-CVI was 0.945.DiscussionThis study provided the first linguistically valid Arabic translation of the widely used PHEEM inventory. The next step is to conduct a full psychometric analysis of the Arabic PHEEM to provide further evidence of validity and reliability.

Validation of entrustable professional activities for use in neonatal care residency programs

ObjectiveDefine and develop a set of entrustable professional activities (EPAs) to link clinical training and assessment of the hospital components of neonatal care in neonatology medical residency programs. MethodsAn exploratory study was conducted in two phases using a modified Delphi approach. In the first phase, a committee of five neonatology residency program coordinators drafted an initial set of EPAs based on the national matrix of competencies and on EPAs defined by international organizations. In the second phase, a group of neonatal care physicians and medical residents rated the indispensability and clarity of the EPAs and provided comments and suggestions. ResultsSeven EPAs were drafted by the coordinators´ committee (n = 5) and used in the content validation process with a group (n = 37) of neonatal care physicians and medical residents. In the first Delphi round, all EPAs reached a content validity index (CVI) above 0.8. The coordinators´ committee analyzed comments and suggestions and revised the EPAs. A second Delphi round with the revised EPAs was conducted to validate and all items maintained a CVI above 0.8 for indispensability and clarity. ConclusionSeven entrustable professional activities were developed to assess residents in the hospital components of neonatal care medicine. These EPAs might contribute to implementing competency-based neonatology medical residency programs grounded in core professional activities.

Demographic trends and outcome measures found in randomized controlled trials of wellness interventions among medical trainees: A systematic review.

9014 Background: To our knowledge, there is no systematic review that identifies and characterizes the wellness interventions with high-quality evidence in the form of randomized controlled trials (RCTs) among medical education trainees (medical students, residents, and fellows). Methods: A medical librarian (YL) searched Embase, MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), APA PsycINFO, and Clinicaltrials.gov from the earliest timepoint to March 2022. We included full text/ published studies that were prospective RCTs that included quantifiable measures related to mental health, wellness, or other measures of wellbeing. Medical students, residents, and/or fellows must be included in the intervention that is intended to improve wellbeing. We excluded studies that included only qualitative outcome measures, had no control group, or took place outside the USA. Results: Our search strategy resulted in 3,806 unique articles. 161 articles passed initial screening of titles and abstracts, and 46 studies met eligibility criteria with dates ranging from 1980 to 2022. A total of 8,016 participants were studied with the majority of studies (26) focusing on medical students, a minority of studies (20) focusing on residents, and no studies that included fellows. A minority (10) of studies were multi-institutional with the vast majority (36) being single-institutional. Outcome measures shared among two or more studies include variants of the Maslach Burnout Inventory (MBI) (5), Perceived Stress Scale (PSS) (5), PHQ-9 (5), Five-Facet Mindfulness Questionnaire (FFMQ) (5), State Trait Anxiety Inventory (STAI) (3), step count (3), Epworth Sleepiness Scale (ESS) (2), General Anxiety Disorder-7 (GAD-7) (2), Global Severity Index (GSI) (2), and Brief Symptom Index (BSI) (2). Interventions included in two or more studies center around mindfulness and/or meditation practices (15), cognitive behavioral therapy (CTB) (3), hypnosis (3), activity trackers (2), flexible work hours (2), and massage and/or manipulation (2). Conclusions: We conducted a systematic review to identify evidence-based wellness interventions and in the process potentially inform future research in regards to standardized outcome measures and highlighting the need for interventions targeting fellows, particularly in fields with a majority of physicians reporting burnout such as hematology/oncology.1 1. McKenna J. Medscape Physician Burnout &amp; Depression Report 2024: “We Have Much Work to Do". Medscape. Published 2024. https://www.medscape.com/slideshow/2024-lifestyle-burnout-6016865.

Implementation of a "Best Self" Exercise to Decrease Imposter Phenomenon in Residents.

Background Imposter phenomenon (IP) is common in medicine. An intervention from the business world, the Reflected Best Self Exercise (RBSE), in which an individual elicits stories of themselves at their best, has not been studied in medical residents. Objective To determine the feasibility of implementing the RBSE and its potential for reducing IP in residents. Methods All incoming internal medicine and medicine-pediatrics interns in the 2022-2023 academic year at a single institution were invited to complete the RBSE. Participants elicited stories from contacts prior to beginning residency and received their stories during intern orientation in a 1-hour session led by one author with no prior training. Cost and time requirements were assessed. IP was measured via the Clance Impostor Phenomenon Scale (CIPS) at baseline, 1 month, and 6 months following the RBSE. Informal feedback on the RBSE was collected via surveys at 1 month and 6 months. Results Nineteen of 35 interns (54.3%) completed the RBSE. It cost $75 per participant, for a total cost of $1,425. Twenty-eight of 35 (80%) completed the baseline CIPS, with scores similar between participants and nonparticipants (64.9 vs 68.9). CIPS scores were lower in participants at 1 month (57.6 vs 69.6) and 6 months (55.6 vs 64.5) but did not meet statistical significance. Survey feedback from participants suggested the intervention was beneficial. Conclusions Implementing the RBSE in residents was feasible with reasonable cost and time commitment. It appeared highly acceptable to residents, with some promise of effects on an IP scale.