Pre-course Score Research Articles

Exploring Trauma Simulation: Insights from the Simulation in Trauma Across Resident Training (START) Study and Trainee Experiences.

Introduction and objective Advancements in technology have presented an opportunity to incorporate simulation training into the trauma and orthopedic (T&O) curriculum. This study aimed to assess the perspective of T&Otrainees regarding the acceptability and perceived educational impact of simulation training before and after a training day. This includes identifying the resources that trainees are likely to use and find helpful when preparing for a new or unfamiliar procedure, as well as evaluating their opinions on different levels of simulation fidelity. The null hypothesis for this study is that there is no difference in educational value after exposure to various simulation modalities. Methods This was a three-arm crossover cohort observational study involving 18 T&O specialty trainees in their first three years of training who attended a simulation training course, involving four independent stations with simulation tasks of varying fidelities. Pre-course and post-course questionnaires with a 10-point Likert scale to determine if simulation training exposure affected the perception of educational value. Data were treated non-parametrically with median (±median absolute deviation; 95% Bonnett-Price CI). Statistical significance was calculated using the Mann-Whitney U test and set as p<0.05. Results Twelve trainees (67%) had not previously used orthopedic simulators to prepare for unfamiliar operations. Ninety-four percent of trainees thought that simulation training could support safe practice, and all trainees considered simulation to be useful for training. Trainees strongly emphasized the importance of simulation training (pre-course vs. post-course median score: 7 vs. 9, p=0.01), the necessity for it to be readily assessable (9 vs. 10, p=0.061), its role in formal assessment (4 vs. 8, p=0.006), and being able to become a better surgeon from it (7 vs. 8, p=0.078). Conclusions T&O trainees acknowledged the value of simulation training in complementing their operating numbers; however, their access to these resources was limited - a problem well recognized in current literature. The gap in the implementation of simulation training should be addressed for T&O trainees to benefit from these resources fully.

Rapid Root Cause Analysis: Improving OBGYN Resident Exposure to Quality Improvement and Patient Safety Curricula.

Introduction Each year, millions of patients in the United States experience harm as a result of the healthcare they receive. One mechanism used by health systems to learn how and why errors occur is root cause analysis (RCA). RCA teams develop action plans to create and implement systemic changes in healthcare delivery in order to prevent future harm. The American Council on Graduate Medical Education (ACGME) recognizes the importance of analyzing adverse events, and it requires that all residents participate in real or simulated patient safety activities, such as RCAs.Often, institutional RCAs necessitate the assimilation of participants on short notice and demand considerable time investment, limiting the feasible participation of graduate medical education (GME) trainees. This presents a gap between ACGME expectations and the reality of resident involvement in patient safety activities. We present the first iteration of a quality improvement project encompassing a three-hour resident physician training course with simulated RCA-experiential learning. The purpose of this project was to produce a condensed, educational RCA experience that adequately trains allGME learners to serve as informed healthcare safety advocates while also satisfying ACGME requirements. Methods The course ("rapid RCA") was conducted during protected weekly academic training. All residents of the San Antonio Uniformed Services Health Education Consortium (SAUSHEC) Obstetrics and Gynecology (OBGYN) residency program who had not previously participated in a real or simulated RCA were required to take the "rapid RCA." Pre- and post-course surveys were completed anonymously to assess baseline knowledge, new knowledge gained from the course, and attitudes toward the course and its importance to resident training. Results Fourteen OBGYN residents attended the "rapid RCA," indicating that 64% (14 out of 22) of the program had no previous experience or opportunity to participate in a real or simulated RCA. Participation in the course demonstrated a significant gain of new knowledge with an increase from 0/14 to 10/14 (71%) residents correctly answering all pre- and post-course questions, respectively (p < 0.001). Additionally, on a Likert scale from 1 to 5, with 5 indicating "expert level," residents indicated they felt more comfortable on patient safety topics after taking the course (mean pre-course score 1.85 to post-course score 3.64,p < 0.001). All participants indicated they would prefer to take the "rapid RCA" as opposed to the only available local alternative option for a simulated RCA, currently offered as a full-day intensive course. Conclusion A meaningful increase in patient safety knowledge and attitudes toward topics covered in an RCA was demonstrated through the implementation of a "rapid RCA" in OBGYN residents. We plan to incorporate this into our annual curriculum to satisfy ACMGE requirements. This format could be adapted for other specialties as applicable.

Evaluation of Knowledge among Medical Students Attending an Obstetrics and Gynecology Preparatory Course: A Non-Experimental Study.

Preparatory courses are frequently utilized strategies to assist, simplify, prepare, and give receivers a better understanding of varied knowledge. Nonetheless, data on this topic are rare throughout the Middle East, particularly in Saudi Arabia. This study aimed to look at the progress of students who took the "Obstetrics and Gynecology (OBGYN) Made Easy" course, a preparatory course for the fifth-year medical students studying OBGYN for the first time, at our institute. This is a non-experimental study performed in August 2021 among fifth-year medical students who attended the course at our university institute in Jeddah, Saudi Arabia. An online questionnaire with 13 questions covering various course contents was used to collect data. Each student completed the identical questionnaire twice with randomized assortment: as a pretest and as a post-test of their knowledge. The qualitative data were described using the mean and standard deviation. P < 0.05 was considered significant when used to determine whether the difference in scores was statistically significant. This research involved a total of 66 female students. These students' mean pre-course test score was 7.32 ± 1.807 out of 13. The mean post-course test score was 9.52 ± 2.054. There was a significant difference between the pre- and post-course outcomes when they were compared (P = 0.01). According to this study's findings, the students who took the course improved their post-course exam performance. The "OBGYN Made Easy" course should be offered for medical students to assist and guide them in preparing for their rotation in OBGYN.

Implementation and Assessment of a Hybrid Training Course on Point-of-Care Pediatric Ultrasound in Vietnam During the COVID-19 Pandemic.

Background As point-of-care ultrasound (POCUS) has gained popularity, some educational guidelines have been developed. However, in Vietnam, no training course in pediatric POCUS has yet been developed. This was challenging, especially during the COVID-19 pandemic. Objectives This study aimed to implement a three-month hybridtraining course for pediatric POCUS training in Vietnam using both online and face-to-face hands-on sessions and to assess participants' self-efficacy level and change in their attitudes towards pediatric POCUS. Methods A hybrid training course in pediatric POCUS was implemented at a children's hospital in Vietnam. This study developed a standardized training course, including online learning, live lectures, hands-on sessions, and skill assessment based on the POCUS consensus educational guidelines. Physicians interested in pediatric POCUS were recruited for participation. They completed a self-evaluation survey before and after the course using a Likert score to assess their background, self-efficacy in performing POCUS, overall satisfaction with the course, and change in their attitudes towards POCUS three months after the course. Results A total of 19 physicians participated in the course. The mean post-training self-efficacy score was significantly higher than the pre-course assessment score: 73.1 (standard deviation (SD): 7.2) vs. 48.9 (SD: 12.5) (p <0.05). The efficacy level was retained three months after the course. Furthermore, overall satisfaction with the course was high at 9.5 (SD: 0.6). After the course, almost all participants strongly agreed to increase the use of POCUS in their clinical practice. Conclusion A hybrid training course in pediatric POCUS was successfully implemented in Vietnam and found the participants' self-efficacy level to be significantly higher after the course and the effect to be retained after the course. The training course could positively affect the participants' attitudes towards POCUS, encouraging them to use POCUS more frequently in their clinical practice.

Online seizure first aid certification program is an effective means of improving student knowledge and self efficacy surrounding epilepsy

IntroductionEpilepsy is a neurological disorder, characterized by recurring seizures, affecting more than 3.4 million adults and children throughout the United States. Still, there are sizable gaps in awareness and knowledge of this disorder, and persistent misunderstandings and stigmas surrounding epilepsy and seizure first aid (SFA) pose a risk to those living with this condition. The Epilepsy Foundation, with support from the Centers for Disease Control and Prevention (CDC), has developed programs to address the issue of insufficient public education and awareness surrounding epilepsy. One of these programs is a free, accessible online Seizure Recognition and First Aid Certification program, established in 2021. We aimed to evaluate the effectiveness of the Epilepsy Foundation’s online Seizure Recognition and First Aid Certification program in improving student knowledge of epilepsy and appropriate bystander-intervention methods to assist a person experiencing a seizure. MethodsThe Epilepsy Foundation’s online Seizure Recognition and First Aid Certification course evaluates student performance via a 16-question knowledge assessment and six question self-efficacy assessment provided both before and after completion of the course. Pre- and post-course scores of students who enrolled between December of 2021 and September of 2022 were collected. Average score improvement was evaluated via the difference in pre-course and post-course first-attempt scores. Statistical significance was evaluated using paired sample, two-tailed t-tests of pre-course and post-course scores. ResultsAverage pre-course knowledge score was 74.33% (n = 10,371, σ2 = 3.04%), post-course score was 88.04% (n = 10,371, σ2 = 0.83%), and score difference was 13.71% (p < 0.001). Average pre-course self-efficacy score was 63.44% (n = 8,046, σ2 = 4.71%), post-course score was 87.08% (n = 8,046, σ2 = 1.68%), and score difference was 23.64% (p < 0.001). ConclusionWe found a significant increase in knowledge and self-efficacy assessment scores after students completed the online Seizure Recognition and First Aid Certification course, suggesting that the program is an effective method of improving the understanding of epilepsy and bystander interventions to assist a person who is experiencing a seizure. In the future, awareness should continue to be promoted through SFA training programs and improving accessibility to such programs so that the risks associated with experiencing a seizure without receiving assistance are reduced for people living with epilepsy.

Evaluating the Knowledge, Readiness, and Satisfaction Level of Emergency Medical Service Personnel after an Online Chemical Mass Casualty Response Training Program

Introduction:Compared to trauma-based injuries, chemical injuries can inflict widespread and persistent injuries to exposed victims. Emergency medical services (EMS) personnel are vulnerable to chemical injuries. Specialized training is required, including zone setup, personal protective equipment (PPE), decontamination, and antidote use, beyond simple advanced trauma life support. The purpose of this study is to evaluate the educational effectiveness of the online chemical-mass casualty incident response education module (C-MCIREM) for EMS personnel.Method:This study is a retrospective pre-and post-test comparison. Subjects were EMS personnel who enrolled in the C-MCIREM program at the EMS Korea online conference between August 27, 2021 and September 5, 2021. Subjects provided demographic data and completed pre-course and post-course knowledge tests and self-assessments of readiness, as well as a satisfaction survey after the course. For readiness and satisfaction surveys, an 11-point Likert scale was used. The Wilcoxon Rank Sum test was used to compare the two samples.Results:A total of 322 respondents were enrolled. Two-hundred (62.1%) responded that they were most motivated to take the course because of curiosity about the subject. The median pre-course knowledge score was 57/100 (47, 66) and the post-knowledge score was 80/100 (66, 91) (p&lt;0.001). Participants stated they felt their readiness to provide triage, treatment, transport, decontamination, to select correct antidotes, and to use correct PPE (all p&lt;0.001) increased. 90.4% stated they were satisfied with the course. Participants were overall satisfied with the use of the online format (7.71/10 SD 2.05), and were willing to recommend the training to other EMS providers (7.63/10 SD 2.1).Conclusion:The online C-MCIREM program showed high satisfaction with a significant increase in knowledge and self-assessed readiness to respond to a chemical mass casualty incident.

E-learning and practical performance in musculoskeletal ultrasound: a multicenter randomized study.

To examine the effect of pre-course e-learning on residents' practical performance in musculoskeletal ultrasound (MSUS). Multicentre, randomized controlled study following the CONSORT statement. Residents with no or little MSUS experience were randomized to either an e-learning group or a traditional group. One week before a 2-day face-to-face MSUS course, the e-learning group received access to an interactive platform consisting of online lectures, assignments, and practical instruction videos aligned with the content of the course. The traditional group only received standard pre-course information (program, venue, and time). All participants performed a pre- and post-course practical MSUS examination and were assessed by two individual raters, blinded to the group allocation, using the validated Objective Structured Assessment of Ultrasound skills (OSAUS) tool. Twenty-eight participants completed the study. There were no statistically significant differences in the pre- or post-course practical MSUS performance between the e-learning group and the traditional group; the mean pre-course OSAUS score (±SD) in the e-learning group was 5.4 ± 3.7 compared with 5.2 ± 2.4 in the traditional group, p= 0.8, whereas the post-course OSAUS score in the e-learning group was 11.1 ± 2.8 compared with 10.9 ± 2.4 in the traditional group, p= 0.8. There was a significant difference between the mean pre- and post-course scores (5.74-point p< 0.001). The OSAUS assessment tool demonstrated good inter-rater reliability (ICC = 0.84). We found no significant impact of pre-course e-learning on novices' acquisition of practical MSUS skills. Hands-on training is of utmost importance and improves MSUS performance significantly. The OSAUS assessment tool is an applicable tool with high interrater reliability. https://clinicaltrials.gov/ NCT04959162.

Robotic-assisted surgery training (RAST) program: module 1 of a three-module program. Assessment of patient cart docking skills and educational environment.

There is currently no standardized robotic surgery training program in General Surgery Residency. RAST involves three modules: ergonomics, psychomotor, and procedural. This study aimed to report the results of module 1, which assessed the responsiveness of 27 PGY (postgraduate year) 1-5 general surgery residents (GSRs) to simulated patient cart docking, and to evaluate the residents' perception of the educational environment from 2021 to 2022. GSRs prepared with pre-training educational video and multiple-choice questions test (MCQs). Faculty provided one-on-one resident hands-on training and testing. Nine proficiency criteria (deploy cart; boom control; driving cart; docking camera port; targeting anatomy; flex joints; clearance joints; port nozzles; emergency undocking) were assessed with five-point Likert scale. A validated 50-item Dundee Ready Educational Environment Measure (DREEM) inventory was used by GSRs to assess the educational environment. Mean MCQ scores: (90.6 ± 16.1 PGY1), (80.2 ± 18.1PGY2), (91.7 ± 16.5 PGY3) and (PGY4, 86.8 ± 18.1 PGY5) (ANOVA test; p = 0.885). Hands-on docking time decreased at testing when compared to base line: median 17.5 (range 15-20) min vs. 9.5 (range 8-11). Mean hands-on testing score was 4.75 ± 0.29 PGY1; 5.0 ± 0 PGY2 and PGY3, 4.78 ± 0.13 PGY4, and 4.93 ± 0.1 PGY5 (ANOVA test; p = 0.095). No correlation was found between pre-course MCQ score and hands-on training score (Pearson correlation coefficient = -0.359; p = 0.066). There was no difference in the hands-on scores stratified by PGY. The overall DREEM score was 167.1 ± 16.9 with CAC = 0.908 (excellent internal consistency). Patient cart training impacted the responsiveness of GSRs with 54% docking time reduction and no differences in hands-on testing scores among PGYs with a highly positive perception.

Basic emergency care course and longitudinal mentorship completed in a rural Neno District, Malawi: A feasibility, acceptability, and impact study.

Frontline providers mostly outside specific emergency areas deliver emergency care around the world, yet often they do not receive dedicated training in managing emergency conditions. When designed for low-resource settings, emergency care training has been shown to improve provider skills, facilitate efficient use of available resources, and reduce death and disability by ensuring timely access to life-saving care. The WHO/ICRC Basic Emergency Care (BEC) Course with follow up longitudinal mentorship for 6 months was implemented in rural Neno District Malawi from September 2019-April 2020. We completed a mixed-methods analysis of the course and mentorship included mentor and participant surveys and feedback, mentorship quantification, and participant examination results. Simple descriptive statistics and boxplot visuals were used to describe participant demographics and mentorship quantification with a Wilcoxon signed-rank test to evaluate pre- and post-test scores. Qualitative feedback from participants and mentors were inductively analyzed using Dedoose. The median difference of BEC course examination percentage score between participants before the BEC course and immediately following the course was 18.0 (95% CI 14.0-22.0; p<0.001). Examination scores from the one-year post-test was lower but sustained above the pre-course test score with a median difference of 11.9 (95% CI 4.0-16.0; p<0.009). There were 174 mentorship activities with results suggesting that a higher number of mentorship touches and hours of mentor-mentee interactions may assist in sustained knowledge test scores. Reported strengths included course delivery approach leading to improved knowledge with mentorship enhancing skills, learning and improved confidence. Suggestions for improvement included more contextualized training and increased mentorship. The BEC course and subsequent longitudinal mentorship were feasible and acceptable to participants and mentors in the Malawian low resource context. Follow-up longitudinal mentorship was feasible and acceptable and is likely important to cementing the course concepts for long-term retention of knowledge and skills.

Evaluation of Chemical, Biological, Radiological, Nuclear, Explosives (CBRNE) Knowledge Change and Skills Confidence Among Frontline-Line Providers During the Russia-Ukraine War.

The aim of this study was to evaluate the change in knowledge and skill confidence after implementation of a chemical, biological, radiological, nuclear, and explosive (CBRNE) training course during the Russia-Ukraine War. Pre/post-test study in the Ukrainian cities of Kyiv, Dnipro, Zaporizhzhia, and Odesa. Fifteen CBRNE courses were conducted over a 3-mo period, August to October 2022. Change in knowledge and skills confidence were evaluated with pre/post-course written exams and practical skill assessments that were observed during the training exercises. Changes were analyzed based on nonparametric Wilcoxon matched-pairs signed-rank testing. Pre/post self-efficacy surveys were analyzed with McNemar's test for paired data. Course evaluations were conducted with standardized questions which assessed instruction quality, teaching relevance, knowledge gained, and post-course skills confidence. A total of 523 participants registered and completed 1 of the 15 courses. Overall mean pre-course test score: 57.8% (SD 20.7%); mean post-course test score: 81.4% (SD 11.3%); participants with increasing test scores: 90.7%; mean difference in score (95% confidence interval) 23.6% (21.2%-25.9%), P < 0.0001. Pre/post self-efficacy surveys (4-point Likert scale) noted participants recognized signs and symptoms of a CBRNE incident, and necessary skills to manage CBRNE exposures, P < 0.0001. The implementation of this CBRNE course for front-line providers in Ukraine was successful. To our knowledge, it was the first implementation of a field course during the current Russian-Ukraine war. Future research should evaluate knowledge retention and impact of our innovative Train-the-Trainer model. Further iterations should emphasize expanding the quantity of training equipment and practical skill sessions.

Distance learning training in genetics and genomics testing for Italian health professionals: results of a pre and post-test evaluation

&#x0D; Background&#x0D; Progressive advances in technologies for DNA sequencing and decreasing costs are allowing an easier diffusion of genetic and genomic tests. Physicians’ knowledge and confidence on the topic is often low and not suitable for manage this challenge. Tailored educational programs are required to reach a more and more appropriate use of genetic technologies.&#x0D; Methods&#x0D; A distance learning course has been created by experts from different Italian medical associations with the support of the Italian Ministry of Health. The course was directed to professional figures involved in prescription and interpretation of genetic tests. A pretest-post-test study design was used to assess knowledge improvement. We analyzed the proportion of correct answers for each question pre and post-test, as well as the mean score difference stratified by gender, age, professional status and medical specialty.&#x0D; Results&#x0D; We reported an improvement in the proportion of correct answers for 12 over 15 questions of the test. The overall mean score to the questions significantly increased in the post-test, from 9.44 to 12.49 (p-value &lt; 0.0001). In the stratified analysis we reported an improvement in the knowledge of all the groups except for geneticists; the pre-course mean score of this group was already very high and did not improve significantly.&#x0D; Conclusion&#x0D; Distance learning is effective in improving the level of genetic knowledge. In the future, it will be useful to analyze which specialists have more advantage from genetic education, in order to plan more tailored education for medical professionals.&#x0D;

Assessment of a massive open online course (MOOC) incorporating interactive simulation videos on residents\u2019 knowledge retention regarding mechanical ventilation

BackgroundUnderstanding respiratory physiology and mechanical ventilation is a challenge for healthcare workers, particularly, medical residents. A team of French-speaking experts developed an innovative MOOC incorporating interactive simulation-based videos and serious games aiming at improving knowledge and skills in mechanical ventilation. Our objective was to evaluate the long-term knowledge retention regarding key concepts presented in this MOOC.MethodsFrench residents registered for the MOOC 2020’s winter session were invited to participate in a two-step study. The first step consisted in evaluating students’ pre-course knowledge of respiratory physiology and mechanical ventilation fusing a 20 five-item multiple choice questions test with a total score ranging from 0 to 100. For the second step, the same students answered the same test (after shuffling the questions) six months after the completion of the course. We assessed the impact of this MOOC on the students’ knowledge retention by comparing pre-course and post-course scores.ResultOf the 102 residents who agreed to participate in the study, 80 completed the course and their mean ± SD pre-course score was 76.0 ± 8.0. Fifty-one respondents also completed the second and their post-course score was significantly higher than the baseline one (83.1 ± 7.3 vs. 77.5 ± 7.6, p < 0.001). Scores of the first and second rounds did not differ upon comparing respondents’ background specialty or number of years of residency. For the vast majority of individual questions (96%), the success rate was higher at the post-course than at the pre-course assessment.ConclusionAn innovative MOOC incorporating simulation-based videos was effective in teaching medical residents basic mechanical ventilation knowledge and skills, especially in the field of respiratory physiology and ventilatory modes. We observed effective long-term knowledge retention with a higher score at the post-course assessment six months after the completion of the course compared with the pre-course score.

Use of an Online Ultrasound Simulator to Teach Basic Psychomotor Skills to Medical Students During the Initial COVID-19 Lockdown: Quality Control Study.

BackgroundTeaching medical ultrasound has increased in popularity in medical schools with hands-on workshops as an essential part of teaching. However, the lockdown due to COVID-19 kept medical schools from conducting these workshops.ObjectiveThe aim of this paper is to describe an alternative method used by our medical school to allow our students to acquire the essential psychomotor skills to produce ultrasound images.MethodsOur students took online ultrasound courses. Consequently, they had to practice ultrasound exercises on a virtual simulator, using the mouse of their computer to control a simulated transducer. Our team measured the precision reached at the completion of simulation exercises. Before and after completion of the courses and simulator’s exercises, students had to complete a questionnaire dedicated to psychomotor skills. A general evaluation questionnaire was also submitted.ResultsA total of 193 students returned the precourse questionnaire. A total of 184 performed all the simulator exercises and 181 answered the postcourse questionnaire. Of the 180 general evaluation questionnaires that were sent out, 136 (76%) were returned. The average precourse score was 4.23 (SD 2.14). After exercising, the average postcourse score was 6.36 (SD 1.82), with a significant improvement (P<.001). The postcourse score was related to the accuracy with which the simulator exercises were performed (Spearman rho 0.2664; P<.001). Nearly two-thirds (n=84, 62.6%) of the students said they enjoyed working on the simulator. A total of 79 (58.0%) students felt that they had achieved the course’s objective of reproducing ultrasound images. Inadequate connection speed had been a problem for 40.2% (n=54) of students.ConclusionsThe integration of an online simulator for the practical learning of ultrasound in remote learning situations has allowed for substantial acquisitions in the psychomotor field of ultrasound diagnosis. Despite the absence of workshops, the students were able to learn and practice how to handle an ultrasound probe to reproduce standard images. This study enhances the value of online programs in medical education, even for practical skills.

Implementation and assessment of a pediatric point-of-care ultrasound training course in Japan: a pilot study.

PurposeThe popularity of point-of-care ultrasound (POCUS) has led to the creation of educational guidelines for its use. In Japan, however, a comprehensive training course for POCUS use in pediatric emergency medicine has yet to be developed. The present study aimed to implement a pilot course for pediatric POCUS training in Japan and to compare participants’ self-efficacy level before and after the course.MethodsA half-day training course in pediatric POCUS was implemented at a meeting of the Japan Society of Point-of-Care Ultrasound. A standardized training course, including pre-learning materials, live lectures, and hands-on sessions, was developed based on the US consensus educational guidelines. Physicians interested in pediatric POCUS were recruited for participation and completed a self-evaluation survey before and after the course to access their background, self-efficacy in performing selected ultrasound procedures before and after the course, and their overall satisfaction with the course.ResultsIn total, 31 physicians participated. Of these, 25 completed the survey. Ten participants were in post-graduate year (PGY) 1–2, 13 were in PGY 3–5, and eight were in PGY 6 or higher. The post-training self-efficacy score was significantly higher than the pre-course assessment score (86.0 [standard deviation (SD): 19.2] vs. 35.6 [SD 17.6], p = < 0.05, mean difference: 49.6 [95% confidence interval 39.6–61.2]). Furthermore, overall satisfaction with the course was high at 8.6 (SD 1.8).ConclusionThe present study implemented a pilot training course in pediatric POCUS and found the participants’ self-efficacy level to be significantly higher after the course.

Evaluation of Ultrasound Teaching Curriculum in Tanzania by First Year Medical Students: A Comparison of Language on Learning Outcomes

Introduction Advanced medical imaging is often lacking in rural countries, including Tanzania. Few studies have evaluated POCUS teaching to healthcare providers in Tanzania. Our objective was to determine if clinical officers could be taught POCUS by first-year medical students. A second objective was to determine if students learned better in English or Kiswahili. Methods Clinical officers were recruited from the Tandabui Institute of Health Sciences and Technology in Mwanza, Tanzania. Subjects took a pre-course, post-course, and practical exam. Between testing, students were taught an ultrasound course by first-year medical students. The students were randomly assigned into the Kiswahili or English group with identical examinations. Results 78 subjects were included in the final data collection. 42 were in the Kiswahili course and 36 in the English course. The median pre-course exam score was 26.9 (Min: 7.7, Max: 53.9) for the English group and 30.8 (Min: 0, Max: 61.5) for the Kiswahili group (All scores are in 0-100 scale). The median Post- course score rose to 93.3 (Min: 20.0, Max: 100.0) in English (P&lt;0.001) and 80.0 (Min: 33.3, Max: 100.0) in Kiswahili (P&lt;0.001). No significant score difference was found between the two groups (P= 0.19). Conclusions Our study found that POCUS can be taught to clinical officers in Tanzania using first-year medical students. There was no difference in the ability of students to learn ultrasound in English or Kiswahili. Future large scale studies are needed to validate these findings and evaluate long-term retention.

Dr QI - A quality improvement (QI) approach to designing and delivering QI training

AimsTo develop and implement a QI training programme for trainees, Trust grade doctors and Consultants in Nottinghamshire Healthcare NHS Trust (NHFT) to enable them to deliver change in practice through acquisition of new knowledge and practical application of skills in QI projects using Model for Improvement.BackgroundQI is crucial to improve patient care. Doctors are uniquely placed to input into patient safety and service delivery of healthcare. The skills required to be future clinical leaders and undertake improvement work are not innate and formal teaching and support is required.What is DrQI?DrQI is a trainee-led QI teaching programme developed in collaboration with Trainees improving patient safety through QI (TIPSQI) in North West deanery.MethodA pre-implementation survey amongst doctors in NHFT in February 2019 (33 responses) suggested that 90% of doctors were interested in learning QI and about 48% preferred face-face workshops with support from the QI team.A list of change ideas were created using a driver diagram with QI education and project support identified as key primary drivers.PDSA cyclesNine interactive workshops teaching key QI concepts (based on model for improvement) in NHFT, training more than 100 doctors. A workshop in Derbyshire Healthcare NHS Foundation Trust (70 doctors) and Nottingham University Hospital (20 doctors). Workshops were continually adapted based on qualitative and quantitative feedback. Different formats were tried including virtual sessions, game-based and problem-based learning approaches using small group activities.ResultPre-course and post-course questionnaires were used to assess change in understanding of individual components of QI methodology (SMART Aim, Driver diagram, PDSA cycles, outcome and process measures and run charts). Mean pre-course self-assessment score collated from seven QI workshops in NHFT (2019-2020) was 3.3 and mean post-course score was 7.68, showing an improvement in understanding of QI methodology.Participants were asked to score the relevance (8.4) and quality of teaching (8.4) and the support from the QI team (7.4) on a scale of 1-10 (1 = poor and 10 = excellent). Additional free text feedback was obtained to help us improve the teaching programme.ConclusionCollaborative leadership trainee-led initiative to increase the QI capacity. A bottom up approach to complement the top down approach from the Trust QI team. Future steps include further collaboration and expansion of the scheme to other Trusts, Train the trainer sessions and building a network of QI champions.

Risk factors for injuries along an infantry commanders course

ABSTRACT To determine the influence of prevention programme on somatosensory ability in combat soldiers during 14-weeks of an infantry commanders course, two cohorts were recruited (INT-group, n = 196; CONT-group, n = 169). Soldiers were tested pre-and post-course for anthropometric measurements, proprioceptive ability, dynamic postural balance, and filled CAIT questionnaire. The INT-group performed injury prevention exercises and the CONT-group continued with their routine physical fitness lessons. All musculoskeletal injuries were recorded along the course. In the CONT-group 24.2% and in the INT-group 19.9% suffered injury during the course. The rates of injuries were not significantly different between groups (χ2(1) = .677 p = .411). Previous injury (OR = 3.349, 95% CI = 1.283–8.740), pre-course BMI (OR = 1.216, 95% CI = 1.064–1.389), and pre-course proprioception ability (OR = .870, 95% CI = .810-.935) were factors associated with injury in the CONT-group. Pre-course proprioception ability (OR = .769, 95% CI = .699-.846) and pre-course CAIT score (OR = .087, 95% CI = .027-.276) were factors in the INT-group. Soldiers who received injury prevention exercises had a similar prevalence of total musculoskeletal injuries as those who did not receive these exercises. Risk factors for injuries were different in the two groups.

Closing the knowledge gap in pelvic neuroanatomy: assessment of a cadaveric training program

BackgroundThe objective of this study is to characterize participants in a laparoscopic cadaveric neuroanatomy course and assess knowledge of pelvic neuroanatomy before and after this course.MethodsThis is a survey-based cohort study with a setting in a university educational facility. The participants are surgeons in a multiday laparoscopic cadaveric pelvic neuroanatomy course. Participants completed a precourse survey, including demographics and comfort with laparoscopic surgery. They then completed an identical precourse and postcourse anatomic knowledge test. Main outcomes are scores on the anatomic knowledge test precourse and postcourse.Results44 respondents were included: 25 completed fellowship, 15 completed residency, 2 were residents, and 2 were fellows. Participants were on average 11.09 years post training, with an average of 8.67 years from training if they completed fellowship and 18.62 years if they completed residency only. 22 of 42 respondents strongly agreed or agreed they are comfortable performing complex laparoscopic hysterectomies. The average precourse score was 32.18/50 points and the mean difference score (MDS, defined as mean of Postcourse scores minus Precourse scores) was 9.80, showing significant improvement (p < 0.001). Precourse and MDS scores were not significantly different when comparing country of practice, level of training, or time since training.ConclusionBaseline knowledge of pelvic neuroanatomy was similar among groups when comparing fellowship status, place of training, or time since training. There was significant improvement in knowledge after training in this dissection method. This course garnered interest from surgeons with broad training backgrounds.

The Effectiveness of a Foundation Year 1 Doctor Preparation Course for Final Year Medical Students.

Background:Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training.Objectives:To evaluate the effectiveness of a novel foundation year one (FY1) doctor preparation course focusing on certain core topics, practical tips and components of the hidden curriculum. The primary objective was to improve the confidence level and knowledge of final year medical students transitioning to FY1 doctors.Method:A 2-day, practical course titled ‘Preparation 2 Practice’ delivering hands-on, small-group and lecture-based teaching, covering core medical student undergraduate curriculum topics in medicine and surgery. The course content spanned therapeutics, documentation skills and managing acute clinical tasks encountered by FY1 doctors during an on-call shift. A pre- and post-course survey and knowledge assessment were carried out to assess the effectiveness of the course. The assessment was MCQ-based, derived from topics covered within our course. The 20-question test and a short survey were administered electronically.Results:Twenty students from a single UK medical school attended the course. 100% participation was observed in the pre- and post-course test and survey. The median post-course test result was 22 (IQR 20.25-23.75) which was higher than the median pre-course test score of 18.75 (IQR 17-21.75). A Wilcoxon sign rank test revealed a statistically significant difference between the pre- and post-course test results (P = .0003). The self-reported confidence score of delegates on starting work as a junior doctor was also significantly higher following the course (P = .004).Conclusion:The results show a significant improvement in perceived confidence and knowledge on core curriculum topics amongst final year medical students having attended our FY1 doctor preparation course. We conclude that there is scope for similar supplementary courses as an adjunct to the undergraduate medical curriculum.

Are battlefield and prehospital trauma scenarios an effective educational tool to teach leadership and crisis resource management skills to undergraduate medical students?

IntroductionLeadership and crisis resource management (CRM) skills are important skills for doctors, however there is a recognised lack of undergraduate leadership education. There remains debate over how best to teach...