Medical Skills Research Articles

What competences do medical students acquire in asurgical internship?-Curriculum mapping with the National Competence-based Catalogue of Learning Objectives in Medicine (NKLM)1.0

Curriculum mapping describes the process indexing acurriculum to identify academic gaps. The first version of the National Competence-based Catalogue of Learning Objectives in Medicine (NKLM1.0) was created to catalogue the content of medical studies and to promote the implementation of competence-oriented learning objectives. It is unclear and not transparent to what extent learning objectives are achieved in existing courses, particularly in clinical internships that cannot be standardized. The aim of the work was to map the achieved learning objectives of the NKLM1.0. within asurgical internship from the students' perspectives. Medical students mapped their achieved learning objectives after a2-week internship with an online questionnaire. In addition, sociodemographic data, the type of teaching hospital and the surgical specialty were recorded. A total of 81 students participated in the mapping. After the internship 8.78 ± 5.10% (min. = 1.01%; max. = 29.84%) of all learning objectives were achieved by the students. Most of the learning objectives come from section1 "medical roles" with 29.92 ± 15.22% (min. = 0.00%; max. = 63.10%). From section2 "medical knowledge, clinical skills and professional attitudes", learning objectives from chapters14b "clinical practical skills" (15.49 ± 7.78%, min. = 0.00%; max. = 41.30%) and 14c "medical counseling technique" (22.98 ± 16.47%, min. = 0.00%; max. = 70.69%) were primarily named. There were no significant differences between the sexes, the surgical specialty or the size of the teaching hospital. Students state that they mainly achieve learning objectives in the area of medical roles and clinical practical skills during an internship. Additional teaching formats seem to be necessary to teach specific surgical skills, diagnostics and treatment.

A Proactive Agent Collaborative Framework for Zero‐Shot Multimodal Medical Reasoning

The adoption of large language models (LLMs) in healthcare has garnered significant research interest, yet their performance remains limited due to a lack of domain‐specific knowledge, medical reasoning skills, and their unimodal nature, which restricts them to text‐only inputs. To address these limitations, we propose MultiMedRes, a multimodal medical collaborative reasoning framework that simulates human physicians’ communication by incorporating a learner agent to proactively acquire information from domain‐specific expert models. MultiMedRes addresses medical multimodal reasoning problems through three steps i) Inquire: The learner agent decomposes complex medical reasoning problems into multiple domain‐specific sub‐problems; ii) Interact: The agent engages in iterative “ask‐answer” interactions with expert models to obtain domain‐specific knowledge; and iii) Integrate: The agent integrates all the acquired domain‐specific knowledge to address the medical reasoning problems (e.g., identifying the difference of disease levels and abnormality sizes between medical images). We validate the effectiveness of our method on the task of difference visual question answering for X‐ray images. The experiments show that our zero‐shot prediction achieves state‐of‐the‐art performance, surpassing fully supervised methods, which demonstrates that MultiMedRes could offer trustworthy and interpretable assistance to physicians in monitoring the treatment progression of patients, paving the way for effective human–AI interaction and collaboration.

Simulator transesophageal echocardiography: the new horizon of training?

Abstract Background trans-esophageal echocardiography (TEE) plays a crucial role in the diagnosis of cardiovascular diseases. In recent years, the importance of theoretical-practical training based on advanced simulation systems in learning specific medical skills has emerged but evidence for the effectiveness for TEE are limited. Purpose evaluate the impact of a theoretical-practical course with simulator for TEE in the diagnostic interpretation of morpho-functional images and acquisition of projections according to standard protocol of the American Society of Echocardiography (ASE). Methods cardiologist specialists and resident cardiologists who participated in the TEE course at a center of simulation and advanced training center from 2018 to 2023, were retrospectively enrolled in the study. Before the course, participants underwent a question multiple-choice based test, aimed at assessing theoretical knowledge and clinical interpretation of morpho-functional images and clips recorded during interventional procedures. During the course, learners where divided into three groups: one utilizing the simulator to conduct exams with clinical cases and acquisition of clips according to ASE protocol, another one participating in interactive discussions of the first group's TEE hands-on activities, and the last one attending lectures with clinical cases. The activities were switched during the two days of the course. Following the course, the same test was administered to evaluate changes in results. Results 290 hospital cardiologists and resident cardiologists (95.2% and 4.8%, respectively) participated in the course. Among them, mean age was 45.2 ± 11 years old, 164 were male (57%). Before the course, the learners answered correctly the 77.6% of questions, while after the course this value increase to 89.5% (p value < 0.001). This improved result was driven by the group above 54 years (p = 0.026) and by the one with an age between 45 and 54 years (p = 0.042), as shown in Figure 1. 205 learners (71.9%) improved their test results after the course, while 41 (14.4%) lowered the score and 39 (13.7%) achieved the same result. In the learners that improved (205), 79% wronged ≥3 questions at the first evaluation and after the course this number decreased to 15% (p < 0.001); on the other hand, in the ones that not improved (80), 14% wronged ≥ 3 questions and this value grew to 45% after the course (p < 0.001), as shown in Figure 2. Moreover, at the end of the training, all the learners were able to complete the sequence of 28 projections of the standard protocol of trans-esophageal echocardiographic recommended by international society of echocardiography. Conclusions In our cohort of cardiologist specialists and fellows, a two-day theoretical-practical course with a TEE-based simulator improved competencies in interpretation of TEE clips and images. These findings should therefore encourage greater use of advanced training with simulation TEE training.

Competencies of nurses to participate in safe medication management practices for biologics: A scoping review.

To review the existing literature relating to nurse competence in safe medication management practices for biologics, identify evidence, and develop a competency framework to clarify the role of nurses in these practices. With the widespread use of biological agents in disease treatment, ensuring the safe and economical use of high-cost medicines is particularly important. Even though nurses are essential in patient care, detailed knowledge regarding their competence and role in the safe administration of biologics is lacking. A scoping review was performed following the methodology of Arksey and O'Malley and the PRISMA ScR guidelines. Electronic databases, including PubMed, CINAHL, Embase, Scopus, and Web of Science, were searched using accepted keywords, and relevant articles were identified using inclusion and exclusion criteria. A total of 3,422 studies were retrieved, 24 of which were eligible for inclusion. The required competencies for nurses were summarized into six areas: clinical specialized knowledge, critical thinking and problem-solving skills, safe medication skills, health education skills, communication and coordination skills, and technological literacy. We provide insights into the competencies of nurses involved in the safe medication management of biologics. These competencies can be used to assess the actual competency level of nurses and facilitate the maximization of biological treatment goals and outcomes. This plays a vital role in optimizing the use of healthcare resources and demonstrating outcomes.

The application of mind mapping in the standardized education of inpatient physicians in nephrology

This study aims to investigate the effectiveness of mind mapping in the standardized training and education of internal medicine resident physicians in nephrology. Sixty trainees undergoing rotations in the Nephrology Department at Chengdu University Affiliated Hospital between January 2021 and December 2023 were randomly assigned to control and observation groups, each comprising 30 trainees. The observation group received mind mapping teaching, while the control group received traditional teaching methods. The clinical thinking training of the two groups was then compared. The observation group outperformed the control group in all aspects of the Mini-CEX assessment, including medical interviews, humanistic care, clinical judgment, communication skills, overall performance, and total score, with statistical significance (P < 0.05). However, there were no statistically significant differences between the two groups in the areas of physical examination and organizational effectiveness (P > 0.05). Furthermore, the observation group achieved higher scores than the control group in the final theory exam, skill exam results, and satisfaction, with statistically significant differences (P < 0.05). Mind mapping not only aids in the consolidation of fundamental memorized knowledge but also enhances clinical thinking skills, thereby playing a pivotal role in assisting resident physicians in establishing a comprehensive knowledge base in nephrology and improving the effectiveness of their training.

Simulated Patient as a Learner: Medical Volunteers Gain Knowledge by Participating in a Wilderness Medicine Training Session.

-A multifaceted approach to wilderness medicine education and training is necessary to provide a high-quality learning experience, often requiring innovative instructional techniques. Using volunteers to act as patients in medical education is a well-established practice that helps teach crucial skills. However, more is needed to know if there is potential knowledge acquisition through participation. This study examined the educational benefits for medical students serving as a simulated patient (SP), hypothesizing that these individuals will improve self-assessed knowledge and confidence and demonstrate improved performance of injury-management skills while participating in a medical education course. -A descriptive feasibility pilot study was conducted with 10 SPs to assess knowledge and skill acquisition. Study participants were evaluated before and after participating as an SP in 2 scenarios involving hemorrhage control and wrist injury assessment and management, with a subjective confidence survey and an objective skill and knowledge demonstration, as measured by a critical action checklist. -The subjects all reported self-assessed knowledge improvement from the pre- to postintervention survey, with an average increase of 17 points. They also demonstrated improved objective skill and knowledge demonstration, with an average increase of 4.6 points for the wrist injury scenario and 2.5 points for the hemorrhage control scenario. -This study demonstrated that volunteer medical students acting as SPs in a medical training course passively acquire knowledge and improve their medical skills and self-perceived confidence. The findings contribute to a broader understanding of medical education, suggesting that participating as SPs offers educational benefits. The results encourage consideration of simulated patient roles as a valuable adjunct to medical education, warranting further scholarly exploration to substantiate and expand on these preliminary findings.

Case-Based Virtual Reality Simulation for Severe Pelvic Trauma Clinical Skill Training in Medical Students: Design and Pilot Study.

Teaching severe pelvic trauma poses a significant challenge in orthopedic surgery education due to the necessity of both clinical reasoning and procedural operational skills for mastery. Traditional methods of instruction, including theoretical teaching and mannequin practice, face limitations due to the complexity, the unpredictability of treatment scenarios, the scarcity of typical cases, and the abstract nature of traditional teaching, all of which impede students' knowledge acquisition. This study aims to introduce a novel experimental teaching methodology for severe pelvic trauma, integrating virtual reality (VR) technology as a potent adjunct to existing teaching practices. It evaluates the acceptability, perceived ease of use, and perceived usefulness among users and investigates its impact on knowledge, skills, and confidence in managing severe pelvic trauma before and after engaging with the software. A self-designed questionnaire was distributed to 40 students, and qualitative interviews were conducted with 10 teachers to assess the applicability and acceptability. A 1-group pretest-posttest design was used to evaluate learning outcomes across various domains, including diagnosis and treatment, preliminary diagnosis, disease treatment sequencing, emergency management of hemorrhagic shock, and external fixation of pelvic fractures. A total of 40 students underwent training, with 95% (n=38) affirming that the software effectively simulated real-patient scenarios. All participants (n=40, 100%) reported that completing the simulation necessitated making the same decisions as doctors in real life and found the VR simulation interesting and useful. Teacher interviews revealed that 90% (9/10) recognized the VR simulation's ability to replicate complex clinical cases, resulting in enhanced training effectiveness. Notably, there was a significant improvement in the overall scores for managing hemorrhagic shock (t39=37.6; 95% CI 43.6-48.6; P<.001) and performing external fixation of pelvic fractures (t39=24.1; 95% CI 53.4-63.3; P<.001) from pre- to postsimulation. The introduced case-based VR simulation of skill-training methodology positively influences medical students' clinical reasoning, operative skills, and self-confidence. It offers an efficient strategy for conserving resources while providing quality education for both educators and learners.

Impact of station number and duration time per station on the reliability of Objective Structured Clinical Examination (OSCE) scores: a systematic review and meta-analysis

BackgroundThe Objective Structured Clinical Examination (OSCE) is a systematic and structured assessment tool that evaluates candidates’ professional medical skills in a simulated environment through a series of time-limited stations. The aim of this meta-analysis was to determine the optimal station number and duration time per station of OSCE to achieve good reliability.MethodsA comprehensive search was conducted across PubMed and Embase from inception until August 2024, without language restrictions. Studies were included if they provided data on the station number and duration time of OSCE, along with Cronbach’s alpha. A random-effects model was used to pool the data.ResultsA total of 23 studies encompassing 26 Cronbach’s alpha were finally included. Cronbach’s alpha values ranged from 0.43 to 0.93, and 11 studies demonstrated good internal consistency (Cronbach’s alpha ≥ 0.8). The analysis indicated that a design of 5–10 stations, with each station lasting less than 10 min, yielded the best internal consistency (Cronbach’s alpha = 0.88, 95% CI: 0.86, 1.00).ConclusionsThis meta-analysis suggests that the station number of OSCE falling in between 5 and 10, with each station time lasting no more than 10 min are likely to yield good reliability and strong internal consistency.

Analysis of Self-Regulated Learning and Learning Style Preference of First-Year Medical Students for E-Learning Optimization

First-year medical students adapt to hybrid education, combining online and offline learning in the new standard era. The various features of e-learning need to accommodate students' skills in self-regulated learning and their preferences, such as learning style preference. Therefore, this research aims to analyze first-year medical students' self-regulated learning skills and learning style preferences in online learning to identify e-learning optimization needs that can facilitate their adaptation to medical education. A descriptive quantitative and qualitative narrative method was conducted through document analysis. The Online Self-Regulated Learning Questions (OSRLQs) were used to obtain quantitative descriptive data on students' self-regulated learning skills, and the learning style preference questionnaire was used to obtain data on first-year medical students. The results showed that first-year medical students require optimization in four domains of the self-regulated learning skills in online learning, including task strategies, time management, help-seeking, and self-evaluation. The analysis yielded 19 categories with three main learning style preferences: a combination of visual and auditory and a combination of visual, auditory, and kinesthetic. This analysis recommends optimizing several e-learning features to improve first-year medical students' self-regulated learning skills and learning style preferences.

The Expanding Role of the U.S. Army Paramedic.

The combat medic (68W) will play a critical role in medical operations in the event of future large-scale combat operations (LSCOs). However, the combat medic is largely not prepared for LSCOs. The revised Medical Education and Demonstration of Individual Competence (TC 8-800) state 68Ws much be able to provide advanced airway and trauma management, medication administration, and advanced casualty movement. To meet the increased prehospital medical demands under LSCOs, the U.S. Army should require the Battalion, Brigade, and Division Medical Readiness Noncommisioned Officers (NCOs) to be Nationally Registered Paramedics (who are identified with the 3P Additional Skill Identifier [ASI]). They should have the responsibility to oversee the wartime medical skills sustainment of Combat Medic Specialists (68W) within their organization. These paramedics should drive medical simulation training events and improve current operation medical skills training. These medical readiness NCOs should attend the Medic Master Training Course and serve as advisors to commanders on the status of medic skill readiness within their organization. Commanders will be able to utilize these paramedics to augment the ongoing medical training of their medics to ensure they are operating at the fullest extent of their scope of practice.

Application of ChatGPT-assisted problem-based learning teaching method in clinical medical education

IntroductionArtificial intelligence technology has a wide range of application prospects in the field of medical education. The aim of the study was to measure the effectiveness of ChatGPT-assisted problem-based learning (PBL) teaching for urology medical interns in comparison with traditional teaching.MethodsA cohort of urology interns was randomly assigned to two groups; one underwent ChatGPT-assisted PBL teaching, while the other received traditional teaching over a period of two weeks. Performance was assessed using theoretical knowledge exams and Mini-Clinical Evaluation Exercises. Students’ acceptance and satisfaction with the AI-assisted method were evaluated through a survey.ResultsThe scores of the two groups of students who took exams three days after the course ended were significantly higher than their scores before the course. The scores of the PBL-ChatGPT assisted group were significantly higher than those of the traditional teaching group three days after the course ended. The PBL-ChatGPT group showed statistically significant improvements in medical interviewing skills, clinical judgment and overall clinical competence compared to the traditional teaching group. The students gave highly positive feedback on the PBL-ChatGPT teaching method.ConclusionThe study suggests that ChatGPT-assisted PBL teaching method can improve the results of theoretical knowledge assessment, and play an important role in improving clinical skills. However, further research is needed to examine the validity and reliability of the information provided by different chat AI systems, and its impact on a larger sample size.

The Development of Medical Skills Through Human Resources Management in Griya Sehat Shareeah, Depok City

In the era of globalization, traditional therapy clinics are required to ensure high personnel performance in providing services to the community, especially patients as the object of service. The low level of knowledge of health workers regarding health credential management affects the performance and quality of services in clinics. The aim of the health workers credential training activity is to improve the quality of health services at Griya Sehat Shareeah, Depok City. The community service activity was attended by 13 health workers from Griya Sehat Shareeah. Training is carried out with several practice sessions and an ongoing training program that focuses on technical and moral support efforts. The results of training show that there are differences in the level of knowledge after being given training to health workers. Thus, credential management training using lectures and practice methods can increase health workers knowledge about credential management and strengthen knowledge of the competence and authority of health workers at Griya Sehat Shareeah in providing health services so as to improve service quality. In the end, Griya Sehat Shareeah became an exemplary model that was able to combine traditional medicine with modern medicine in society.

Addressing Ophthalmology Training Gaps in Medical School and Practical Fundoscopy Skills

Addressing Ophthalmology Training Gaps in Medical School and Practical Fundoscopy Skills

The Shadow Economy of Effort: Unintended Consequences of Pass/Fail Grading on Medical Students' Clinical Education and Patient Care Skills.

The shift to pass/fail grading in undergraduate medical education was designed to reduce medical students' stress. However, this change has given rise to a "shadow economy of effort," as students move away from traditional didactic and clinical learning to engage in increasing numbers of research, volunteer, and work experiences to enhance their residency applications. These extracurricular efforts to secure a residency position are sub-phenomena of the hidden curriculum. Medical schools do not officially require all the activities students need to be most competitive for residency selection; therefore, students, as rational actors, participate in the activities they think will most help them succeed.Here, the authors frame residency application and selection as a complex adaptive system (CAS), which self-organizes without centralized control or hierarchical intent. Individuals in a CAS operate in environments marked by volatility, randomness, and uncertainty-all of which are abundant in the residency selection process. Outcomes in such systems, like the development of a shadow economy, are novel, emergent, and cannot always be anticipated. To address these challenges, the authors suggest the need for deep understanding of the system's elements, interrelationships, and dynamics, including feedback loops and emergent properties. Optimizing the results of a CAS requires incentivizing outcomes over activities, ensuring open information flow, and engaging in continuous monitoring and evaluation.The current pass/fail era and resultant shadow economy of effort risk creating a triple harm by devaluing clinical excellence, burning out medical students, and potentially producing superficial, or worse inauthentic, academic and community work. Medical educators must optimize residency application and selection for cooperative outcomes and design incentives to ensure the outputs of medical education align student, institutional, patient, and societal goals. Without a set of predictive "answers," the authors suggest a process of determining actions to advance this ultimate aim and reduce harm.

The Feasibility and Efficacy of Video Education with Individual Review in Early Surgical Education

Use of video-based education (VBE) to teach surgical skills has increased rapidly and been shown to accelerate students' and residents' time to satisfactory skill acquisition while also improving trainees' satisfaction. However, its implementation is limited by logistical factors such as: video quality, view obstruction, and excessive motion. We aim to study the feasibility of using VBE to teach medical students basic suturing skills. Medical students viewed standardized videos to learn multiple suturing techniques, which they performed on a skin model. They recorded and sent their best attempt at subcuticular technique to a plastic surgery resident who provided synchronous, virtual feedback. Following feedback, students re-attempted the technique and again recorded their best attempt. Both videos were graded by a blinded reviewer. A previously-validated grading scale was used to score students on 1) number of completed suturing steps, 2) economy of time and motion, and 3) final rating (proficient or requires practice). All fifteen students agreed that this activity was either "fairly" or "very" useful for their learning. Seven students were rated as proficient prior to feedback and remained proficient following feedback. Of the remaining eight students, five students (62.5%) achieved proficiency following feedback. On average, the students demonstrated significant improvement in number of successfully completed suture steps (4.3 ± 1.10 vs 4.8 ± 1.01 post-feedback, p = 0.028) and economy of time and motion (2.6 ± 1.24 vs 3.2 ± 0.94 post-feedback, p = 0.029). When adjusting for student interest in pursuing a surgical residency, baseline scores were similar, but those who intend to pursue surgery demonstrated greater economy of motion scores following feedback (3.56 ± 0.73 vs 2.67 ± 1.03 among students not interested in surgery, p = 0.035). This pilot study shows that use of VBE is feasible in teaching medical students basic suturing skills. Efficacy may be influenced by career interests.

Evidence of the usefulness of clinical simulation in building the professional competencies of medical students

Introduction: clinical simulation is a key tool for balancing medical skills development and patient safety.Objective: to identify possible points for improvement in the learning of medical skills in clinical simulation within the IAU as judged by students.Methods: a cross-sectional, descriptive study was conducted. UAI students who had taken the rotating internship and received simulation sessions were selected. The study setting will be exclusively university and data will be collected by means of surveys. The surveys were elaborated according to McGaghie's 12 sections.Results: the survey was administered to 57 students, with a gender distribution of 33 % male and 67 % female. 57 % had previous experience in a health center outside the IAU. Seventy-five percent considered the simulation to be effective in acquiring skills, and 79 % thought that the evaluations reflected their competencies. However, 63 % thought that the transfer to clinical practice could be improved, and 47 % saw teamwork as ineffective.Conclusions: although the simulations are valued for their realism and effectiveness, areas for improvement were identified, such as curricular integration, evaluation methods, exposure time, and instructor training. It is also suggested to optimize the transfer of skills to real clinical practice and teamwork training

Novel educational strategies to improve the telemedicine clinical skills of medical students.

Test educational interventions to increase the quality of care in telemedicine. Telemedicine (TM) has become an essential tool to practise medicine around the world. However, education to address clinical skills in TM remains an area of need globally across the health professions. We aim to evaluate the impact of a pilot online learning platform (OLP) and standardized coaching programme on the quality of medical student TM clinical skills. A randomized pilot study was conducted with fourth-year medical students (n = 12). All participants engaged in video-recorded standardized patient (SP) simulated encounters to assess TM clinical skills before and after the intervention. Participants were randomized to either the OLP or OLP + Virtual Coaching Institute (VCI) intervention cohort. Quantitative and qualitative data were collected to address self-reported skills, attitudes, and self-efficacy before the 1st SP encounter and after the 2nd SP encounter. SP encounter recordings were scored by two blinded non-investigator raters based on a standardized rubric to measure the change in TM care delivered pre- and post-intervention. Statistical analysis of quantitative data included descriptive statistics and mixed effects ANOVA. Recruitment and retention of participants exceeded expectations, pointing to significant enthusiasm for this educational opportunity. Self-reported skills and scored simulation skills demonstrated significant improvements for all participants receiving the interventions. Both OLP and VCI interventions were well received, feasible, and demonstrated statistically significant efficacy in improving TM clinical skills. Participants who received coaching described more improvements in self-efficacy, confidence, and overall virtual clinical skills. This study provides evidence that virtualized clinical learning environments can positively impact the development of TM clinical skills among medical students. As TM continues to evolve, the implementation of innovative training approaches will be crucial in preparing the next generation of healthcare professionals for the demands of modern healthcare delivery.

Developing a Mobile Application-based System for Enhancing Medical Skill Training.

In a regional hospital in Southern Taiwan, an average of 25 heart surgeries are performed annually, with surgical education conducted one-on-one. This indicates that opportunities for paramedics to participate in surgical procedures are quite limited. Although 80 paramedics in the hospital can perform surgical procedures, 69 have more than two years of experience, and only 19 are selected by surgeons to perform surgical procedures. Consequently, paramedics without hands-on experience are likely to feel panicked and helpless. The present study employed a systematic software development approach to create a mobile application-based medical skill training system. Initially, we conducted a comprehensive needs analysis through in-depth interviews with cardiac surgery nurses and administrators to accurately identify the key training requirements. In the system architecture design phase, we chose Windows Server as the operating system, combined PHP and Apache to handle web service requests, used MariaDB for data storage and management, and applied FastAPI to facilitate data exchange with other services. Client-side development utilized the Flutter framework, ensuring a consistent user experience across iOS and Android platforms. We also designed complex data structures to accommodate testing and recording needs, including exam data, question types, and option records. For user flow implementation, we developed a complete process including user registration, subject management, test preparation, and evaluation. Finally, we implemented core functionalities such as the login interface, question selection, and test interface to ensure the system's comprehensiveness and practicality. This multi-stage development approach aimed to create an efficient, user-friendly, and adaptive training platform to meet the specific needs of cardiac surgery nursing staff. The development and implementation of the mobile application-based system for enhancing medical skill training has demonstrated significant potential in addressing the challenges of paramedics in cardiac surgery settings. While the initial results are promising, further long-term studies are needed to assess the impact on actual surgical outcomes and patient care quality.

Developing and applying a training needs analysis tool for healthcare workers managing snakebite envenoming: A cross-sectional study in Eswatini.

A considerable number of patients present to hospitals in Eswatini each year following bites by venomous snakes. Effectively diagnosing and treating patients with snakebite envenoming requires healthcare workers to have a variety of generic and snakebite-specific medical skills. In several countries, however, healthcare workers have been found to have limited skills in managing snakebite patients. We used the Delphi method to adapt the Hennessy-Hicks training needs analysis questionnaire to the context of snakebite envenoming and subsequently used the adapted questionnaire to assess the self-perceived training needs of 90 healthcare workers from ten hospitals in Eswatini. Two-thirds (63%) of participants were nursing staff and one third (34%) medical doctors. Overall, 74% of healthcare workers had previously received training on snakebite. Although a training need was reported for all skills included in the survey, the extent of the training need varied between different skills and groups of healthcare workers. The highest average training need was registered in the domains 'research and audit' and 'clinical tasks' with the latter accounting for nine of the ten skills with the highest training need. Nurses reported a higher training need than doctors, especially for clinical tasks. Receiving snakebite training before as well as after obtaining the primary qualification was associated with the lowest average training need, particularly in clinical skills. Ninety-three percent of interviewed healthcare workers would welcome more frequent training opportunities on the clinical management of snakebite patients. This newly developed snakebite training needs analysis tool can aid in adapting training initiatives to a dynamic and evolving healthcare workforce and it is designed to be transferrable to snakebite endemic settings worldwide.

The Impact of Patient-Centered, Structured Interdisciplinary Bedside Rounds on Medical Staff Satisfaction, Education, and Experience.

Background Daily interdisciplinary rounds in hospitals are becoming standardized to maximize the multidisciplinary approach to hospitalized patient care. We hypothesize that structured Interdisciplinary Bedside Rounds (IDRs) increase the satisfaction, education, and experience of medical staff and thus detailactionable recommendations for IDR implementation or delineate measurable long-term impacts. Methods This observational study was performed in a 300-bed community hospital. Participants included internal medicine physicians, nurses, case managers, social workers, physical therapists, clinical pharmacists, and nurse leaders. Surveys were used to assess the impact of structured IDRson medical education, clinical skills, and experience. Results We sent 100 surveys and received 72 completed surveys. Results varied among healthcare providers (physicians, nurses, pharmacists, and case managers), reflecting that physicians and nurses reported the highest benefits. There was a positive response on the impact of multidisciplinary rounds on medical staff education, skills, and experience. Conclusion Structured IDRspositively impact healthcare providers' (physicians, nurses, pharmacists, and case managers) medical education, clinical skills, and experience, as reported by participants' responses. Implementing IDRs in the health care system and medical school curriculum may impact medical education, clinical skills, experience, and patient care. However, more studies are required to examine the long-term impact of IDRs.