Postgraduate Residency Research Articles

Knowledge Among Junior Doctors About the Collection and Transport of Samples for Tuberculosis Diagnosis in a Medical College Hospital in Coastal Karnataka, India.

Background The accuracy of the TB diagnosis depends on the quality of the collected and transported samples. Inadequate knowledge and practices regarding the collection and transport of sputum samples can lead to false-negative results and delay the diagnosis and treatment of TB.This study was conducted to assess the knowledge of residents and interns about the collection and transport of sputum and other samples for the diagnosis of tuberculosis in a medical college hospital. Methods This was a cross-sectional study conducted among 120 medical interns and postgraduate residents of a medical college hospital in coastal Karnataka, India. Participants were interviewed using a pre-designed and structured questionnaire. The data was analyzed using IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. Descriptive statistics like the mean, standard deviation, and chi-square test were used. A p-value less than 0.05 was considered statistically significant. Results Most of the study participants (76, 63.3%) belonged to the age group of 22 to 25 years and were interns. Nearly three-quarters of the participants (85, 70.8%) were female. Based on the mean score, 69.2% of the participants exhibited good knowledge. Among the socio-demographic characteristics, being a postgraduate resident was associated with good knowledge about the collection and transport of samples (p-value< 0.05). Conclusion Seven out of ten participants had good knowledge about the collection and transport of sputum and other samples for the diagnosis of tuberculosis. Strengthening the training of this category of health workers needs to be prioritized.

Change in pharmacy resident familiarity, attitudes, comfort, and knowledge regarding digital health

Background: Digital health is a growing area of interest in healthcare however. There is limited evidence to support this topic is being covered in pharmacy education, including postgraduate residency training programmes. This study aimed to determine if exposure to digital health topics throughout a teaching certificate programme leads to a significant change in resident familiarity, attitudes, comfort, and knowledge regarding digital health. Methods: The resident cohort was exposed to digital health content during a teaching certificate. Residents completed a questionnaire regarding their familiarity, attitudes, comfort, and knowledge regarding digital health at the beginning and end of the teaching certificate. Responses to each section of the questionnaire, as well as an overall score, were calculated and analysed. Results: Eighteen residents completed both the pre-and post-questionnaire. The median scores for familiarity and comfort increased significantly (p &lt; 0.0001) after the yearlong intervention. Median scores for attitudes and knowledge did not see a significant change after intervention. Conclusion: After exposure to digital health in a teaching certificate programme, pharmacy residents demonstrated a significant increase in familiarity and comfort with digital health, however there was not a significant change in attitudes or knowledge.

Standard ophthalmology residency training in China: an evaluation of resident satisfaction on training program in Guangdong Province

BackgroundNational standardized training for resident doctors (STRD) in mainland China has been formally established since 2014 as a kind of postgraduate education. The purpose of this survey was to assess the satisfaction of the training residents in Guangdong Province on the ophthalmology STRD program after a duration of 5 years.MethodA 48-item survey was sent to all postgraduate ophthalmology residents from bases in Guangdong Province to inquire about their attitude towards the program. The survey contained questions about demographic and work-related information, job satisfaction, psychological resilience, and job performance. All responses were verified, and invalid questionnaires were excluded. Statistical analyses were performed using SPSS software version 22.0 (SPSS, Inc., Chicago, IL). Multiple logistic regression analysis was used to evaluate the factors (demographic information, working environment, clinical exposure, supervision and hands-on training opportunities, and involvement in academic activities) impacting the overall satisfaction. P < 0.05 was considered statistically significant.ResultsA total of 471/635 (74.17%) valid questionnaires were returned from all the STRD bases of Guangdong Province, which included 38 hospitals. 60.3% of the respondents reported overall satisfaction with their training. The satisfaction with operative teaching (60.7%) was slightly lower than the other settings of teaching experience (above 65%). Meanwhile, the satisfaction on different secessions of operative experience was all below 70%, of which in the areas of cornea and orbit were 55.42% and 57.53%, respectively. Some potential factors were found to affect general satisfaction, including the training grade, marriage, working time, income level, the doctor-patient relationship, family members working as doctors, the time proportion spent on writing medical documents during clinical work, and the frequency of attending academic meetings. Improvement was observed in both performing and reporting clinical examinations in the last year of training in comparison to the first year. Finally, 82.8% of the residents acknowledged this training was helpful for future clinical work. The first five career preferences for residents were cataract (67.1%), refractive surgery (42.3%), vitreo-retina (36.5%), optometry (28.7%), and oculoplastic (27.2%).ConclusionOphthalmology residents in Guangdong Province expressed comparable satisfaction with the STRD program. To further improve satisfaction, factors such as resident subsidy, harmonious marriage, the patient-doctor relationship, and chances of attending academic conferences should be emphasized.

Detour or New Direction: The Impact of the COVID-19 Pandemic on the Professional Identity Formation of Postgraduate Residents.

The COVID-19 pandemic has resulted in numerous disruptions to health professions education training programs. Much attention has been given to the impact of these disruptions on formal learning opportunities in training; however, little attention has been given to the impact on professional socialization and professional identity formation. This study explored the impact of the pandemic and resultant curricular changes on the professional identity of family medicine residents. 23 family medicine residents at the University of Toronto were interviewed between September 2020 and September 2022. Using symbolic interactionism as a theoretical framework, thematic analysis explored the meanings residents attributed to both experiences that were disrupted due to the pandemic, and new experiences that resulted from these disruptions. Participant responses reflected that disruptions in training did not always align with their expectations for family medicine and plans for future practice; however, these new experiences also reinforced their understanding of what it means to be a family physician. While participants felt the pandemic represented a loss of agency and negatively impacted relationships in their training program, it also provided a sense of belonging and membership in their profession. Finally, these new experiences continually blurred the line between professional and personal identities through the impact of the pandemic on participants' sense of well-being and safety. The impact of the pandemic on training experiences extends beyond the loss of formal learning opportunities. Participant responses reflect the collective influence of the formal, informal, and hidden curriculum on the professional socialization and professional identity formation of residents-and how these different curricular influences were disrupted due to the pandemic. These training experiences have important implications for the future practice of residents who completed their training during the pandemic and highlight the role of training programs in supporting the professional identity formation of residents.

Burnout and Health Related Quality of Life among emergency physicians working at emergency at Tertiary Care Hospital in Lahore Pakistan.

To determine frequency of burnout in emergency physicians and to identify its impact on their health-related quality of life (HRQOL). In this cross-sectional study, physicians from departments with emergency cover of Jinnah Hospital Lahore were included. Their burnout and HRQOL scores using Maslach Burnout Inventory (MBI) and Short Form (SF)-36 respectively were determined in March 2022. Burnout scores were graded as low, moderate and high and were correlated with domains of HRQOL using chi X2 and analysis of variance (ANOVA). One hundred fifty physicians were included with mean age 26.2 (±2.59), male to female ratio 0.78:1 (66/84) and House Officer (HO) to Postgraduate Resident (PGR) ratio 1.94:1 (99/51). High burnout was identified in 76 (50.7%) participants while 48 (32%) had moderate and 26 (17.3%) had low burnout. Males scored better than female physicians in vitality (0.008), general mental health (0.004), and mental component summary (0.01) domains of HRQOL. Doctors with high burnout had significantly lower scores in both physical component summary (p-value 0.004) and mental component summary (p-value < 0.0001) domains of HRQOL. Physicians working in emergency settings have high frequency of burnout and it adversely affects their mental and physical health related quality of life.

Attitudes of Anesthesiology Postgraduate Residents Toward the Influential Factors in Their Success in the Iranian National Board Exam.

One of the prominent indicators of academic success in postgraduate medical education is the "Residents' Pass Rate" in the "National Board Exam." This study was designed and implemented to assess the attitudes of the anesthesiology residents toward factors affecting their success in the National Board Exam. After the Institutional Review Board (IRB) approval, in an attitude assessment study, 20 of the 21 recently graduated anesthesiology residents were asked about the factors affecting their success quantitatively and qualitatively. A self-administered questionnaire with 19 closed questions and a personal virtual WhatsApp Messenger® interview were used for the study. The respondents' viewpoints demonstrated that a step-by-step multifaceted integrative program in combination with psychological support (both from the family and the department) and individual motivation positively affected their success and their endurance to overcome the high load of the mandatory texts. In contrast, unplanned stressors leading to program shifts (mainly due to COVID-19) had adverse effects on their success. Anesthesiology residents believed that a well-designed and appropriately implemented study plan with psychological support and personal motivating factors could facilitate passing the National Board Exam, and unplanned external stressors could hinder it.

The Imposter Syndrome In Surgical Residents.

Imposter syndrome (IS) is an internal sensation of intellectual phoniness in persons who feel fraudulence and worthlessness. The purpose of this study was to assess the prevalence of imposter syndrome among surgical residents. A web-based survey was conducted among all surgical residents of PGMI, Khyber Pakhtunkhwa, Pakistan, from May 1, 2022 to May 30, 2022. Of the 156 respondents, 104 (66.7%) were males and 52 (33.3%) were females. Moderate imposterism was seen in 81(51.9%) of the respondents and 57 (36.5%) respondents reported severe or intense imposterism. Among postgraduate residents, no significant differences in Clance Imposter Phenomenon Scale score by year was noted (p = 0.291). Imposter syndrome was highly prevalent among surgical residents, i.e. 138(88.5%) falling in the range of either moderate, severe, or intense imposterism. Prevalence was more among female residents as compared to male residents. Year of training didn't have any impact on the grades of imposterism.

The 2022 European postgraduate (residency) programme in neurology in a historical and international perspective.

Neurology residency programmes, which were first established at the beginning of the 20th century, have become mandatory all over Europe in the last 40-50 years. The first European Training Requirements in Neurology (ETRN) were published in 2005 and first updated in 2016. This paper reports the most recent revisions of the ETRN. Members of the EAN board performed an in depth revision of the ETNR 2016-version, which was reviewed by members of the European Board and Section of Neurology of the UEMS, the Education and Scientific Panels, the Resident and Research Fellow Section and the Board of the EAN, as well as the presidents of the 47 European National Societies. The new (2022) ETRN suggest a 5-year training subdivided in three phases: a first phase (2 years) of general neurology training, a second phase (2 years) of training in neurophysiology/neurological subspecialties and a third phase (1 year) to expand clinical training (e.g., in other neurodisciplines) or for research (path for clinical neuroscientist). The necessary theoretical and clinical competences as well as learning objectives in diagnostic tests have been updated, are newly organized in four levels and include 19 neurological subspecialties. Finally, the new ETRN require, in addition to a programme director, a team of clinician-educators who regularly review the resident's progress. The 2022 update of the ETRN reflects emerging requirements for the practice of neurology and contributes to the international standardization of training necessary for the increasing needs of residents and specialists across Europe.

Resident Sleep During Traditional Home Call Compared to Night Float.

Purpose This article aims to compare resident sleep while on night float with a traditional home call. Methods We conducted a crossover observational study assessing sleep patterns of seven postgraduate year-2 ophthalmology residents at the University of Washington from 2019 to 2021 using the Fitbit Alta HR device. Overnight call was scheduled from 5 p.m. to 8 a.m. on weekdays, and 8 a.m. to 8 a.m. on weekends. The residency program implemented a partial night float rotation, during which two to three nights of consecutive call were assigned to a resident without other clinical duties. Sleep was recorded using the Fitbit Alta HR for residents while on a 5-week partial night float rotation, on 10-week home call rotations, with postcall relief, and for stretches of seven or more days without call responsibilities. Mixed model regression analysis was used to compare average sleep on home call, night float, and periods without call. Results Sleep data were recorded for a total of 1,015 nights, including 503 nights on home call rotation and 230 nights on night float rotation. Residents slept more during periods away from call compared to either night float or home call rotations ( p < 0.001). Residents experienced increased average overall sleep during 10-week rotations on night float compared to home call ( p = 0.008). While there was no difference in overnight sleep on call between night float and home call ( p = 0.701), residents experienced more sleep overall while on call on night float compared to home call due to more sleep being recorded during postcall naps ( p = 0.016). Conclusion Implementing a night float system can increase resident sleep by allowing for more sleep recovery during time away from clinical duties.

Awareness Regarding Cross-Contamination Control among Post-Graduate Residents

Background: Cross-infection during clinical training can occur when an infectious pathogen is transmitted between a medical staff and a patient in the clinical setting. Dental professionals, including dental/oral hygienists, doctors and P. A’s, are always at high risk of getting HIV and / or hepatitis B. Cross-infection is well-defined as “spread/transfer of infection amongst staff and patients in clinic or hospital setting”. Methods: Questionnaire based Cross-sectional study was done on post-graduate residents of the Multan dental college Multan. 58 post-graduate residents took part in our research. Universal sampling was done for collection of data. Partakers signed an informed consent. Results: Fifty-eight postgraduate residents completed the form. Males were eighteen while ladies were forty.79% participants believe that dental setups/hospitals are more liable to contamination compared to other healthcare areas. All PGR’s believe that vaccination against the hepatitis B virus is obligatory for a dental professional and they maintain additional precautions generally whenever dealing AIDS &amp; hepatitis B, C patients. 93% residents wash their hands regularly after treating each &amp; every patient and indicated that use of PPE plays an important role in preventing cross-contamination. 96.5% of subjects were conscious whenever handling sharp instruments. Majority of these PGR’s use facemask &amp; gloves nevertheless Protective eyewear, aprons &amp; head-caps were not used by most of them. Conclusion: Participants showed satisfactory awareness about cross-contamination control. Knowledge gained must also be transferred to their daily practice. Dental institutes should also focus on establishing policies to control cross-contamination at the institutional level.

Leadership skills in postgraduate medical residents

Background of the Study: Safe patient care is the fundamental objective of every healthcare facility by the services provided by high performing healthcare providers with effective leadership skills. Leadership competencies are considered now as essential for all medical trainees, not only to face challenges at individual level but it also helps them solving certain institutional and interpersonal challenges. Aim: To assess the current leadership training needs of postgraduate medical resident undergoing training in different hospitals of the Pakistan. Methods: This was a cross-sectional online quantitative survey. A request link of online google survey form was sent to the residents through social media residents’ groups and through email addresses of residents to fill the form. Results: A total of 67 residents of all years completed the survey. Mean age of the residents was 30.63 ±3.87, with about 81% being male and 84% were getting done their residency training in specialty related to medicine and allied. On a Likert scale (1 = strongly disagree, 3 = neutral, 5 = strongly agree), residents rated the importance of leadership skills in the clinical setting as high (4.15 of 5).

Revisiting the relationship between examination pass rate and eligibility pathway among candidates for pharmacist board certification

BackgroundPharmacists with specialized knowledge and skills are able to seek board certification from the Board of Pharmacy Specialties (BPS). In 2018, BPS conducted research to evaluate the relationship between eligibility pathways (i.e., completion of a postgraduate year 2 [PGY-2] specialty residency, completion of a postgraduate year 1 [PGY-1] residency plus 2 years of practice experience, or 4 years of practice experience) and certification examination pass rate. The study found statistically significant differences in pass rate based on eligibility criteria across all 6 specialties studied. There was a trend for higher pass rates in cohorts of examinees eligible for board certification based on completion of postgraduate residency training. ObjectivesThis study aimed to compare examination pass rates among different eligibility cohorts for board certification in recognized pharmacy practice specialties and compare contemporary findings with previously published findings. DesignThis cross-sectional study was conducted on data retrieved from BPS certification applications and examination administration records. Setting and participantsExaminees in the United States and Canada for 9 BPS certification programs. Outcome measuresA chi-square analysis was used to identify whether there were differences in pass rate among eligibility pathway cohorts. ResultsA total of 14,894 examinees met inclusion criteria; 6312 (42.4%) of the 14,894 examinees analyzed were eligible via practice experience, 5768 (38.7%) were eligible via PGY-1 completion, and 2814 (18.9%) were eligible via PGY-2 completion. A statistically significant difference was found for the relationship between pass rate and eligibility pathway for 8 of 9 BPS certification examinations analyzed (significant: ambulatory care pharmacy, critical care pharmacy, cardiology pharmacy, infectious diseases pharmacy, oncology pharmacy, psychiatric pharmacy, pediatric pharmacy, pharmacotherapy; not significant: solid organ transplantation pharmacy). Post hoc analyses showed that, in most cases, the PGY-2 eligibility cohort outperformed the PGY-1 eligibility cohort, which in turn outperformed the practice experience pathway cohort. ConclusionAnalysis of contemporary BPS certification examination administration data yields statistically significant differences among the pass rates by eligibility pathway, replicating previous findings and expanding the scope of the analysis.

Racial disparities in pharmacy postgraduate residency match rates and beyond: Implications for clinical pharmacists

Racial disparities in pharmacy postgraduate residency match rates and beyond: Implications for clinical pharmacists

Prevalence and Determinants of Smoking among Healthcare Professionals in Hyderabad

Objective: To evaluate the prevalence of cigarette smoking in doctors, nurses and paramedics and to study different aspects related with it. Study Design: Cross-sectional survey Place and Duration of Study: Liaquat University Hospital Jamshoro/Hyderabad from 1st March 2021 to 30th April 2021. Methodology: Seven hundred health care professionals and staff including consultants, postgraduate residents, house officers, medical officers &amp; paramedics, nurses, dispensers, ward boys and sweepers. A self-made questionnaire was used to collect information from the participants. The first part of questionnaire has demographics followed by smoking status and certain set of questions regarding smoking habits from smokers. All reasons to fail to quit smoking and factors influencing to quit smoking were also analysed. Results: The mean age of all participants was 38.15±8.85. 85% of the participants were males and 15% were females. The prevalence of smoking in health care professionals was 24.17%. The reasons for failure to quit smoking were lack of will power in 35.38% participants, friends smoking circle in 27.69%, withdrawal symptoms after quitting in 26.15% and smoker family member in 10.76%. The factors influencing to quit smoking in ex-Smokers were will power in 20%, fear of Health hazards in 16.92%, insistence of partner 12.3%, friends in 10.7%, bad effect on patients 9.23%, kids 7.69% and multiple factors in 23.07% participants were reported. Conclusion: The smoking prevalence was 24.17% among our hospital workers. Friend circle was the leading influencing factor to begin smoking and lack of will power was main hurdle to quit smoking habit. Keywords: Smoking, Prevalence, Health care professionals, Smoking attitudes, Pakistan

“I wish I had known what I was getting into”: a qualitative study exploring the experiences of Canadians who study medicine abroad

BackgroundAn increasing number of Canadians are choosing to study medicine abroad (CSA); however, many CSA are not fully informed of the challenges that exist in returning to Canada to practice and relatively little information is known on the topic. This study explores CSA experiences in choosing to study abroad and their attempts to navigate a return to Canada to practice medicine.MethodsWe conducted semi-structured qualitative interviews with CSA who were attending medical school abroad, waiting to obtain or in a post-graduate residency program, or practicing in Canada. We asked participants about their decision to study medicine abroad and choice of school, medical school experiences, activities they engaged in to increase their likelihood of returning to Canada, perceived barriers and facilitators, and alternative plans if they were unable to return to Canada to practice. Interviews were transcribed and analyzed using a thematic analysis approach.ResultsFourteen CSA participated in an interview. Expedited timelines (i.e., direct entry from high school) and a lack of competitiveness for medical school in Canada were the main justifications for CSAs’ decision to study abroad and a number of key factors (e.g., location, reputation) influenced their choice of school. Participants reported not fully anticipating the challenges associated with obtaining residency in Canada. CSA relied upon a variety of informal and formal supports and employed numerous methods to increase their likelihood of returning to Canada.ConclusionsStudying medicine abroad remains a popular choice for Canadians; however, many trainees are unaware of the challenges associated with returning to Canada to practice. More information on this process as well as the quality of these medical schools is needed for Canadians considering this option.

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States.

Personalized care models are dominating modern medicine. These models are rooted in teaching future physicians the skill set to keep up with innovation. In orthopedic surgery and neurosurgery, education is increasingly influenced by augmented reality, simulation, navigation, robotics, and in some cases, artificial intelligence. The postpandemic learning environment has also changed, emphasizing online learning and skill- and competency-based teaching models incorporating clinical and bench-top research. Attempts to improve work-life balance and minimize physician burnout have led to work-hour restrictions in postgraduate training programs. These restrictions have made it particularly challenging for orthopedic and neurosurgery residents to acquire the knowledge and skill set to meet the requirements for certification. The fast-paced flow of information and the rapid implementation of innovation require higher efficiencies in the modern postgraduate training environment. However, what is taught typically lags several years behind. Examples include minimally invasive tissue-sparing techniques through tubular small-bladed retractor systems, robotic and navigation, endoscopic, patient-specific implants made possible by advances in imaging technology and 3D printing, and regenerative strategies. Currently, the traditional roles of mentee and mentor are being redefined. The future orthopedic surgeons and neurosurgeons involved in personalized surgical pain management will need to be versed in several disciplines ranging from bioengineering, basic research, computer, social and health sciences, clinical study, trial design, public health policy development, and economic accountability. Solutions to the fast-paced innovation cycle in orthopedic surgery and neurosurgery include adaptive learning skills to seize opportunities for innovation with execution and implementation by facilitating translational research and clinical program development across traditional boundaries between clinical and nonclinical specialties. Preparing the future generation of surgeons to have the aptitude to keep up with the rapid technological advances is challenging for postgraduate residency programs and accreditation agencies. However, implementing clinical protocol change when the entrepreneur-investigator surgeon substantiates it with high-grade clinical evidence is at the heart of personalized surgical pain management.

Causal attributions of failure among post graduate medical residents in exit fellowship examination in Pakistan: A qualitative study.

Causal attributions are reasons given to certain events in life including failure and success. The objective of this qualitative study was to explore the attributions perceived as the cause of failure by post graduate residents, failing the final clinical exit examination of Fellowship of College of Physicians and Surgeons Pakistan (FCPS). This exploratory study was conducted from July 2021 to July 2022, at Jinnah Hospital, Lahore. Study population was selected by purposeful maximal variation sampling. A total of ten post graduate residents from four specialties, failing in FCPS part two clinical examination were included. After written informed consent, semi structured face to face, in depth interviews were conducted. Data saturation was achieved after eight interviews after which two more interviews were carried out. All interviews were recorded and transcribed verbatim. Thematic analysis of the data was done by synthesizing codes into categories and themes. A total of 17 attributions noted were grouped into five categories namely 'Inadequate exam preparation', 'Personal factors,' 'Exam related factors,' 'Training related factors and 'Luck'. Two main themes of External and Internal factors emerged from these. Common attributions were; lack of effort (8/10), inadequate knowledge (8/10), family commitments (7/10), luck (8/10) and examiner's attitude (5/10). Most of the residents attributed internal, unstable and controllable factors like inadequate knowledge and lack of effort. In addition, external uncontrollable factors of bad luck and harsh attitude of examiners were considered as contributory factors towards failure.

Impact of metacognition on attitudes toward epilepsy in medical students

PurposeThis study evaluated medical students’ knowledge and attitudes toward epilepsy and the influence of metacognition thereon. MethodValid questionnaires were administered to medical students including undergraduate, professional postgraduate, and standardized residency training students (N = 503). The questionnaire had 4 parts: demographic information, knowledge of epilepsy, attitudes toward epilepsy, and metacognitive assessment. The Chinese Public Attitudes Toward Epilepsy scale and 30-Item Metacognition Questionnaire were used to assess attitudes and metacognition, respectively. ResultsAlmost all participants had heard of epilepsy; 38.8% had witnessed a seizure and 25% were acquainted with a person with epilepsy. The proportion of correct answers to epilepsy-related knowledge ranged from 40.6% (Putting an object into the mouth of a person experiencing an epileptic seizure) to 97% (Convulsion is a symptom of epilepsy). However, knowledge of epilepsy was not able to affect attitudes toward epilepsy. Age, years of clinical experience, having witnessed a seizure, positive belief of worry, and need to control thinking were correlated with the different domains of attitude toward epilepsy. When participants were divided into 2 groups—i.e., those with high and low knowledge of epilepsy, participants in the former group who had a positive belief of worry or had not witnessed any seizures were more likely to have negative attitudes toward epilepsy. ConclusionMedical students showed good awareness of the etiology and symptoms of epilepsy. Overall, attitudes toward epilepsy were negative. A positive belief of worry was associated with a more negative attitude toward epilepsy among respondents with greater knowledge of epilepsy.

Effectiveness of a Mobile App (PIMPmyHospital) in Reducing Therapeutic Turnaround Times in an Emergency Department: Protocol for a Pre- and Posttest Study.

Delays in reviewing issued laboratory results in emergency departments (EDs) can adversely affect efficiency and quality of care. One opportunity to improve therapeutic turnaround time could be to provide real-time access to laboratory results on mobile devices available to every caregiver. We developed a mobile app named "Patients In My Pocket in my Hospital" (PIMPmyHospital) to help ED caregivers automatically obtain and share relevant information about the patients they care for including laboratory results. This pre- and posttest study aims to explore whether the implementation of the PIMPmyHospital app impacts the timeliness with which ED physicians and nurses remotely access laboratory results while actively working in their real-world environment, including ED length of stay, technology acceptance and usability among users, and how specific in-app alerts impact on its effectiveness. This single-center study of nonequivalent pre- and posttest comparison group design will be conducted before and after the implementation of the app in a tertiary pediatric ED in Switzerland. The retrospective period will cover the previous 12 months, and the prospective period will cover the following 6 months. Participants will be postgraduate residents pursuing a ≤6-year residency in pediatrics, pediatric emergency medicine fellows, and registered nurses from the pediatric ED. The primary outcome will be the mean elapsed time in minutes from delivery of laboratory results to caregivers' consideration by accessing them either through the hospital's electronic medical records or through the app before and after the implementation of the app, respectively. As secondary outcomes, participants will be queried about the acceptance and usability of the app using the Unified Theory of Acceptance and Use of Technology model and the System Usability Scale. ED length of stay will be compared before and after the implementation of the app for patients with laboratory results. The impact of specific alerts on the app, such as a flashing icon or sound for reported pathological values, will be reported. Retrospective data collection gathered from the institutional data set will span a 12-month period from October 2021 to October 2022, while the 6-month prospective collection will begin with the implementation of the app in November 2022 and is expected to cease at the end of April 2023. We expect the results of the study to be published in a peer-reviewed journal in late 2023. This study will show the potential reach, effectiveness, acceptance, and use of the PIMPmyHospital app among ED caregivers. The findings of this study will serve as the basis for future research on the app and any further development to improve its effectiveness. Trial Registration:ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331. ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331. PRR1-10.2196/43695.

Assessment of the competence in electrocardiographic interpretation among Arabic resident doctors at the emergency medicine and internal medicine departments: A multi-center online cross-sectional study.

This study aims to assess the electrocardiographic interpretation abilities of resident doctors at internal medicine and emergency medicine departments in eight Arabic countries. An online cross-sectional study was conducted between October 7, 2022 and October 21, 2022 in eight Arabic countries. The questionnaire consisted of two main sections: the first section included sociodemographic information, while the second section contained 12 clinical case questions of the most severe cardiac abnormalities with their electrocardiography (ECG) recordings. Out of 2,509 responses, 630 were eligible for the data analysis. More than half of the participants were males (52.4%). Internal medicine residents were (n = 530, 84.1%), whereas emergency medicine residents were (n = 100, 15.9%). Almost participants were in their first or second years of residency (79.8%). Only 36.2% of the inquired resident doctors had attended an ECG course. Most participants, 85.6%, recognized the ECG wave order correctly, and 50.5% of the participants scored above 7.5/10 on the ECG interpretation scale. The proportions of participants who were properly diagnosed with atrial fibrillation, third-degree heart block, and atrial tachycardia were 71.1, 76.7, and 56.6%, respectively. No statistically significant difference was defined between the internal and emergency medicine residents regarding their knowledge of ECG interpretation (p value = 0.42). However, there was a significant correlation between ECG interpretation and medical residency year (p value < 0.001); the fourth-year resident doctors had the highest scores (mean = 9.24, SD = 1.6). As well, participants in the third and second years of postgraduate medical residency have a probability of adequate knowledge of ECG interpretation more than participants in the first year of residency (OR = 2.1, p value = 0.001) and (OR = 1.88, p value = 0.002), respectively. According to our research findings, resident doctors in departments of internal medicine and emergency medicine in Arabic nations have adequate ECG interpretation abilities; nevertheless, additional development is required to avoid misconceptions about critical cardiac conditions.