Training Requirements Research Articles

Fostering consensus for the implementation of a clinical pharmacy specialization: a nominal group technique approach with pharmacy stakeholders.

To explore the need for a specialization in clinical pharmacy and the model to be adopted, as perceived by Portuguese stakeholders. A nominal group technique through two online meetings addressed four questions: pros and cons of specialization models used internationally; preferred model for Portugal; and success factors for implementation. All nine stakeholders recognized the need to train pharmacists in clinical pharmacy and agreed specialization is essential, through a model including strong clinical undergraduate education, supplemented with postgraduate training. The postgraduate component considered most suited comprised a balanced approach to theoretical and practical training, where the relative weigh of theory (20%-60%) could progressively decrease with the implementation of the European directive 2024/782 establishing the minimum training requirements for the professions of pharmacists, where the clinical pharmacy is to be strengthened at the undergraduate level. Success factors for implementing this model include, establishing a regulatory framework for the career and the desired characteristics of the graduates from the postgraduate programme. This study led to a consensus among key Portuguese stakeholders on the model to be adopted for a clinical pharmacy specialization in Portugal and, the information gathered will be used to guide future implementation.

Survey to assess present practice and address challenges in gynaecological brachytherapy in Australia and New Zealand.

This survey assessed gynaecological brachytherapy caseloads, local training requirements and quality assurance processes across Australia and New Zealand. The survey was developed by the Gynaecological Oncology Radiation Oncology Collaboration (GOROC) and emailed to all centres offering gynaecological brachytherapy across Australia and New Zealand. It covered 9 areas including caseloads per centre and per radiation oncologist, techniques practised, local training requirements and quality assurance processes over a 2-year period - 2019 and 2020. The response rate was 18 out of 25 centres. All centres offered vaginal vault brachytherapy and 89% treated an average of at least 10 patients per annum. Intracavitary and/or interstitial brachytherapy was offered at 89% of centres of which 31% treated less than an average of 10 patients per annum and 23% of radiation oncologists did less than an average of 5 or more insertions per annum as recommended in the GOROC guidelines. Most centres required only Fellowship from the Royal Australian and New Zealand College of Radiologist to practice gynaecological brachytherapy. Peer review of volumes and dosimetry was routinely performed in 28% and 17% of centres, respectively. This survey adds to the limited literature available regarding practice patterns of brachytherapy worldwide. Ensuring adequate training and robust quality assurance processes with volume and dosimetry review may support all centres and clinicians to continue to safely offer this complex technique.

Dental Anesthesia Guidelines and Regulations of US States and Major Professional Organizations: A Review.

This summary reviews guidelines and regulations pertaining to dental anesthesia across the United States, including guidelines of the American Dental Association (ADA), American Association of Oral and Maxillofacial Surgeons (AAOMS), and American Society of Anesthesiologists (ASA). The analysis addresses a range of requirements, including definitions of anesthesia and requirements for training and certification across professional societies and the 50 US states, with a focus on office-based settings. Strikingly, substantial variation exists among state rules and regulations and the ADA, AAOMS, and ASA guidelines with implications for variations of care, outcomes, and patient safety. We examined definitions of sedation and general anesthesia, patient selection and evaluation, fasting requirements, emergency preparedness, drug administration, monitoring, equipment, procedure selection, education and training requirements, permit requirements, life support certifications, reporting of adverse events, and inspection requirements. This comprehensive analysis serves to educate dental practitioners and office staff, patients, primary care providers, and state dental boards about the regulatory landscape of dental anesthesia. Our findings establish a foundation for future research and policy development aimed at improving consistency, best practices, and safety in dental anesthesia practices.

Digital technologies and circularity: trade-offs in the development of life cycle assessment

Abstract Purpose This research aims to develop a critical understanding of the employment of digital technologies (DTs) for LCA studies, outlining both the opportunities and challenges associated with circular strategies. Two research questions are thus addressed: (1) What circular loops and aspects are addressed when digital technologies are integrated in the development of a Life Cycle Inventory? (2) Which trade-offs are revealed in the integration of digital technologies in Life Cycle Inventory development addressing circularity along a life cycle? Methods This study is based on the problematisation approach, which critically examines existing assumptions in the LCA literature, structured into six principles: defining a domain of investigation, articulating and evaluating assumptions, developing alternative perspectives, involving the audience through qualitative interviews, and assessing the alternative assumptions. A systematic literature review (SLR) and semi-structured interviews with experts were conducted to explore these issues and suggest future research directions. Results and discussion It emerges that the DTs are mainly integrated in the Life Cycle Inventory phase capturing closing and narrowing loops, whereas a limited number of cases investigate slowing loops with different aspects investigated. However, even if DTs can facilitate and improve the trustworthiness of the inventory, they can also lead to an increase in complexity because more competencies are needed, it is more difficult to control data collection and elaboration, and more social interactions along the supply chain are needed. At the same time, DTs can reduce flexibility because further improvements are blocked, interfaces can be rigid to connect, and technical and normative updates can be more difficult to implement. Conclusions DTs improve the development of the Life Cycle Inventory phase, particularly in the context of the circular economy. However, they also introduce new complexities and challenges. The use of blockchain, digital twins, and IoT sensors, for instance, has significantly improved data transparency and traceability, which are critical for circular economy practices, but complexity and training requirements can limit their benefits, so careful consideration must be given to their implementation to maximise benefits and minimise drawbacks.

Competency-based training in anaesthesiology: train the trainers first. A descriptive cross-sectional survey by the committee of the European Society of Anaesthesiology and Intensive Care (ESAIC) Teach the Teachers Masterclass

IntroductionThe level of competence in teaching among trainers expected to deliver training according to the European Training Requirement in anaesthesiology is unknown. The aim of this descriptive cross-sectional survey, performed from 1 September 2021 until 31 October 2021, and promoted by the European Society of Anaesthesiology and Intensive Care (ESAIC) was to establish the current level of knowledge and faculty development among European countries regarding competency-based education and training (CBMET) in anesthesia and intensive care.ResultsA total of 711 responses of anaesthesiologists working in 46 European countries were analyzed. The great majority (530/74.64%) had more than 10 years of experience in anesthesia, were experienced specialists, or held more senior positions (645/90.97%), worked in academic hospitals (451/63.5%), and claimed to be involved in teaching residents (561/79.01%). Most respondents declared either not sure or no knowledge (115/546; 21.06% and 232/546; 42.49%) about European training requirements in anaesthesiology. One-third claim to know about CBMET. Formal training in teaching has 21% of respondents. Lack of time (369/506; 72.92%) and overload with work (351/506; 69.36%) are reported as the most important obstacles in teaching residents. A disparity in the answers is present between, but within the countries too.ConclusionsThe results of the presented survey reveal that even among experienced anesthesia professionals dedicated to medical education there is still a lack of knowledge on CBMET as well as systemic support for faculty development in European countries. The differences within and between European countries regarding the perception of CBMET. Dedication to faculty development is necessary to improve European anesthesia and intensive care education.

Intrathecal Morphine for Postoperative Analgesia: Balance of Efficacy and Safety.

Intrathecal morphine (ITM) has been a reliable technique for postoperative pain management since 1979. As a key component of multimodal analgesia, ITM provides long-lasting pain relief. ITM's simplicity, lack of need for expensive equipment, and minimal training requirements contribute to its wide use. In this article, we highlight the current state of affairs in terms of ITM for postoperative analgesia, including aspects that are still under debate. In particular, we emphasize the doses that are efficacious while minimizing the risk of respiratory depression. Further, we believe that when used in low doses (<200mcg) and without the administration of potential augmenting medications, intrathecal morphine does not pose a greater risk of respiratory depression than systemic opioid therapies commonly used in routine clinical practice. We particularly emphasize that standard nursing care is sufficient for postanesthesia monitoring of patients in such cases.

Training in infection prevention and control: survey on the volume and on the learning demands of healthcare-associated infections control figures in the Emilia-Romagna Region (Northern Italy).

In the context of Infections Prevention and Control activities, the training of healthcare-associated infection control figures is crucial; the COVID-19 pandemic further emphasized the necessity of ensuring a widespread and stable level of skills over time for such professionals. The present work aims to identify the number and training needs of the personnel working in the Emilia-Romagna Region's healthcare facilities as "healthcare-associated infection control figures". Data were collected through a survey created by experts from the Regional Group "Training in the prevention and control of antibiotic resistance". The questionnaire explored the number, professional and educational background, and training requirements of Healthcare-associated infections control figures in Emilia-Romagna. With 73 figures dedicated to Healthcare-associated infections control, the Emilia-Romagna Region appears to be in line with the European standard ratio (1 professional every 125 beds). Professionals with a nursing background, over 50 years old and of female sex prevail in the group, while the training needs expressed include both theoretical and practical aspects. Healthcare assistants and nursing staff represent a fundamental resource for the implementation of infection prevention and control programs in our healthcare facilities; continuous, multidisciplinary and targeted training of these professionals is confirmed as necessary.

European training requirements in Neonatology 2021-towards a unified training standard for Neonatologists.

The European Society for Paediatric Research (ESPR) first developed recommendations for a Neonatology specific European training curriculum in 1998, with updates in 2007 and 2021. The aim of these recommendations was to define a common, European standard of training for national educational programmes for Neonatologists. Following the Union of European Medical Specialists' (UEMS) framework of European Training Requirements (ETR), and similar to the American Board of Pediatrics (ABP) recommendations, graduates of training programmes conforming to the ETR will be eligible throughout Europe for recognition of equality of training, and with that should be enabled to freedom-of-movement. This concept also accounts for neonatal specialists. We therefore present the pan-European work on the ETR Neonatology in its third iteration (ETR III), summarising the basic requirements for contemporary training programmes, trainers, and training centres in neonatology. We highlight the European School of Neonatology (ESN) as a comprehensive online educational platform which provides the theoretical and practical background to satisfy the ETR-III. Lastly, we introduce the European Board of Neonatal & Child Health Research (EBNCHR) as a committee dedicated to gaining acceptance for the concept of harmonising education and training in Neonatology and recognising Neonatology as a Paediatric subspecialty in every European Union member state. IMPACT: Neonatology currently is not uniformly recognised as a Paediatric subspecialty throughout the 27 European countries. Hence, training in Neonatology formerly followed no commonly agreed standard throughout the European Union (EU). To ensure a minimum standard of care, an agreed minimum standard of training is required. The European Society for Paediatric Research (ESPR) has led on generating an EU-accredited, pan-European Syllabus for Neonatal training in Europe, the European Training Requirements (ETR) in Neonatology (2021). This article presents the ETR Neonatology from commissioning to accreditation and discusses means of how high-grade post-graduate education, aligned with the ETR can be achieved by practitioners.

The Relevance of Trust in the Implementation of AI-Driven Clinical Decision Support Systems by Healthcare Professionals: An Extended UTAUT Model

Background. In the healthcare sector clinical decision support powered by artificial intelligence is rapidly expanding. It can help medical personnel make better-informed decisions while saving time. The opposition of healthcare professionals to AI initiatives in the healthcare industry might prove to be a significant barrier, due to the combination of optimism and fear related to the technology. Professionals in the sector may be apprehensive about AI due to job security worries and the general public's lack of faith in the technology. Objective. A primary objective of this study is to examine how trust influences healthcare professionals' willingness to use AI-driven CDSS, particularly at well-known tertiary hospitals in Delhi-NCR region India, as well as to expand the Unified theory of acceptance and use of technology (UTAUT) by including constructs such as perceived risk and self-efficacy. Method. The UTAUT model provided the basis for the construction of a new model, which was developed by integrating the variables of perceived risk and self-efficacy. The model had eight components which were assessed using 31 survey questions. Two hundred and twenty participants filled out the surveys for the study. Results. The findings indicate that there are significant relationships between (PE) and (AI), (EE) and(AI), (PR) and (AI) and (SE) and (AI). This study reveals that trust fully mediates the relationship between AI which means that fostering trust in AI technology is essential for the successful adoption and implementation of AI-CDSS technology. There was no significant relationship between social influence and adoption of AI-powered CDSS nor between intention to adopt and actual use. Conclusion. The result of this study shed light on the factors influencing healthcare professionals to adopt AI-CDSS. The outcomes of this study provide insight into how individuals' performance expectancy, effort expectancy, social influence, perceived risk, and self-efficacy determine whether they embrace AI-CDSS. This study highlights the importance of trust in the deployment of these technologies in the healthcare sector. Furthermore, it highlights the significance of addressing perceived risk and self-efficacy. Although social influence plays a crucial role in technology adoption its impact may be limited in the case of AI-CDSS deployment in India. This could be due to the complexities of AI-CDSS implementation, the requirement for training, or the fact that healthcare personnel are unaware of the benefits of AI-CDSS or have limited exposure to it.

P-705. Non-Clinicians Effectively Perform Lung Ultrasound in Patients with Influenza-like Illness

Abstract Background Point-of-care ultrasound (POCUS) is a low-cost, portable imaging modality with greater sensitivity than chest x-ray to evaluate acute respiratory infections including influenza-like illness (ILI). However, clinical scale has been limited by the availability of proficient operators and unclear training requirements. We aim to assess the feasibility of implementing study coordinator-performed lung POCUS into a longitudinal study of patients with ILI. Methods From November 2021 to December 2023, we conducted an observational study to characterize the pathophysiology of ILI among outpatients. Patients were recruited from two urban academic hospital emergency departments and affiliated clinics. Study coordinators were trained through a 4-hour didactic session reviewing ultrasound physics and lung anatomy and pathology, together with a hands-on training session. Peer proctoring of two POCUS enrollment encounters followed. POCUS lung scans were obtained from patients by study coordinators at their enrollment visit (Day 0) and follow-up visits (Day 7, 14, 28). Scans were evaluated by blinded expert image reviewers. Data was analyzed using descriptive statistics including the proportion of images deemed technically adequate. Results Fifteen study coordinators without previous ultrasound experience completed POCUS training over the course of the study. Using a standardized 12-zone imaging protocol, a total of 5311 POCUS lung scans were collected from 340 encounters. POCUS images were reviewed by study physicians and 100% of studies were considered adequate for diagnosis, with 96.0% of individual lung ultrasound clips judged to be technically adequate. Conclusion Our study demonstrated that after a 4-hour training session, non-clinical research staff could successfully acquire protocolized lung POCUS images during a 2-year study to longitudinally monitor patients with ILI. This supports the feasibility of implementing POCUS into infectious diseases research and demonstrates the potential effectiveness for training new POCUS users to assess ILI. Disclosures Richard E. Rothman, MD, PhD, abbvie: Grant/Research Support|CEPHEID: Advisor/Consultant|CEPHEID: Grant/Research Support|CEPHEID: Honoraria

Speech-Language Pathology Preservice Preparation for Working in School-Age Literacy: International Perspectives.

This narrative review of preservice training of speech-language pathologists (SLPs) to work in school-age literacy contexts examines (a) studies regarding SLPs' perceptions of their preservice training and (b) accreditation requirements for preservice training in selected nations. A review of the literature examining (a) SLPs' perspectives about their preservice training; (b) SLPs' beliefs, confidence, and self-efficacy; and (c) speech-language pathology preservice program content was conducted via analysis of studies published after the year 2010. Policy documents and websites outlining accreditation requirements in the United States, Canada, the United Kingdom, Australia, and New Zealand were reviewed. The literature search resulted in a total of 13 studies: nine from the United States and four from Australia. Twelve of the studies investigated SLP perceptions of preservice training. The perspectives of university faculty were included in one of these. One study directly examined preservice program coursework. In the United States, there appears to have been an increase in course content related to literacy in recent years. However, SLPs in both the United States and Australia consistently report feeling underprepared by their preservice training to address the full continuum of school-age literacy service provision that could be expected of SLPs on graduation. Between the different international contexts, there is significant variability in the clarity and specificity of requirements for preservice training in literacy for SLPs. Published research is limited to cross-sectional survey evaluations of preservice training. A qualitative lens to examine in more depth and breadth the experiences of preservice training from the perspectives of both recipients and providers is needed. Policy documents for speech-language pathology would benefit from increased coherence and accountability regarding accreditation requirements for SLPs in school-age literacy.

Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb in acute and subacute Stroke (RHOMBUS II): results of a feasibility randomised controlled trial

ObjectiveTo investigate the safety, feasibility and acceptability of the Neurofenix platform for upper-limb rehabilitation in acute and subacute stroke.DesignA feasibility randomised controlled trial with a parallel process evaluation.SettingAcute Stroke Unit...

Advanced Hemodynamic Monitoring in Polytraumatized Patients: A Comprehensive Review

INTRODUCTION Advanced hemodynamic monitoring plays a crucial role in optimizing the perioperative management of polytraumatized patients, allowing for real-time assessment of cardiovascular status and guiding goal-directed therapy. Traditional monitoring methods, while widely used, have significant limitations that may hinder their effectiveness in dynamic trauma scenarios. The introduction of non-invasive technologies such as continuous non-invasive arterial pressure monitoring and impedance cardiography has improved hemodynamic assessment, providing valuable insights with reduced procedural risks. Despite these advancements, challenges remain in terms of accuracy, clinical integration, and training requirements. OBJETIVE To evaluate the efficacy and applicability of advanced hemodynamic monitoring techniques during anesthesia in polytraumatized patients, highlighting their impact on perioperative outcomes. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Polytrauma anesthesia” AND “Advanced hemodynamic monitoring” OR “Goal-directed therapy” OR “Non-invasive cardiac output monitoring” OR “Trauma resuscitation strategies” in the last years. RESULTS AND DISCUSSION Results demonstrate that the application of advanced hemodynamic monitoring techniques enhances intraoperative hemodynamic stability and reduces perioperative complications by enabling individualized fluid management and early detection of deterioration. Studies indicate that dynamic indices such as stroke volume variation and pulse pressure variation offer superior predictive value for fluid responsiveness compared to static parameters. However, the widespread implementation of these technologies is influenced by economic constraints, technological limitations, and the need for specialized expertise. CONCLUSION In conclusion, advanced hemodynamic monitoring significantly contributes to improving outcomes in polytraumatized patients under anesthesia by providing continuous and accurate cardiovascular data. Addressing the challenges of implementation through structured training programs and cost-benefit analyses is essential for broader clinical adoption. Future research should focus on refining these technologies to enhance their reliability and applicability across diverse trauma care settings.

The Association Between Disordered Eating and Musculoskeletal Injury Among Marine Officers Upon Entry to the Basic School.

Active duty service members (ADSMs) may be at heightened risk for eating disorders (EDs) and sub-clinical disordered eating (DE). ADSMs are also at a high risk for musculoskeletal injury (MSK-I). Given the risk for EDs/DE among ADSMs as well as robust physical requirements of military training, additional research is needed to elucidate links between DE and risk for MSK-I among ADSMs. The aim of the present study was to assess the prevalence of DE and associations with MSK-I among Marine Corps officers entering a 6 month leadership course. The current cross-sectional study is part of a large, prospective study, the Initiation of Marine Physiological Assessment of Combat Training (IMPACT) study. Participants completed the Eating Disorder Examination-Questionnaire Short (EDE-QS) and self-reported the presence of a recent (≤6 months) MSK-I upon entry to an officer training course. A logistic regression was used to assess the association between elevated DE (EDE-QS ≥15) and recent MSK-I, adjusting for age, race, sex, and commissioning source. N = 1,382 officers (11.6% female, MAge: 24.8 ± 2.9 years, 26.6% racial/ethnic minority) completed the questionnaires. Seven percent had elevated DE (EDE-QS score ≥15) (female: 10.6%, male: 6.9%, P = .10); 18.3% self-reported recent MSK-I (female: 26.3%, male: 17.3%; P = .009). Females had 17% greater odds of MSK-I compared to males (aOR: 1.17, 95% CI: 1.03-1.33, P = .02). Moreover, females with elevated DE had greater odds of MSK-I than males with elevated DE (aOR= 1.38); among females, odds of MSK-I were greatest among those with elevated DE (aOR= 1.35). In this sample of Marine officers, DE was associated with greater odds of a recent MSK-I among women only. Results align with previously reported relationships between DE and skeletal health in female athletes. Prospective research is needed to elucidate the temporal nature of these relationships.

Dimensionality of food safety and hygiene training programs for food handlers in Lusaka, Zambia

Globally, foodborne illnesses pose a substantial threat to public health, contributing significantly toillness and death. The behaviors, awareness, and attitudes of food handlers are critical determinantsof food safety. This research aimed to investigate the comprehensiveness and scope of food safetyand hygiene training initiatives targeting food handlers in Lusaka, Zambia. To this end, weconducted a two-phase qualitative analysis and evaluation of available training materials. Thisincluded interviews with 18 food establishment managers/ Human resource officers" should not becapitalized unless it is part of a proper noun. The analysis was conducted manually to identifyemerging themes and understanding the materials to assess the entry requirements for participants,duration of training, qualifications of trainers, topics covered and the delivery methods used. Thestudy found no uniform format for the training materials which also lacked important topics on foodsafety systems and Good Agricultural Practices and Good Agricultural Practices topics.Additionally, the study found poor uptake of the training due to a lack of awareness of legalrequirements, high attrition, training costs, and a lack of established institutions offering the trainingon a regular basis. This study recommends the standardization of food safety and hygiene trainingprograms in Zambia, tailored to the local context. Specifically, the development of a Participant'sHandbook and a Facilitator's Manual is recommended. These resources should outline qualificationsand competencies required for trainers, duration and format of training and entry requirements andprerequisites for trainees

Communicative competence of a lawyer as an important component of the profession

The article emphasizes the importance of developing a lawyer’s communication skills to ensure the effective provision of legal assistance, the formation of trusting relationships with clients, and successful interaction with participants in procedural relations. However, modern legal education focuses mainly on the technical aspects of law and pays insufficient attention to the development of communication skills, which creates a gap between theoretical training and practical requirements of the profession. That is why the study of a lawyer’s communicative competence, as a component of his profession, is relevant both from the point of view of professional development and to ensure the effective provision of legal assistance. In order for a lawyer to carry out professional activities at a high professional level and be competent, he needs to have a set of basic knowledge on the basis of which professional activities will be carried out, to have social ideas about what can be done and what cannot be done, to have abilities, skills, to exert willpower, emotional effort. The article proposes to highlight such basic elements of competence as industry knowledge, practical skills, ethical and moral values, emotional and volitional component. Based on the conducted study of the essence of communicative competence, we suggest considering it as a person’s ability to effectively interact with other people in the process of communication, taking into account the context, social norms and individual characteristics of the interlocutor. Communicative competence plays an important role in the professional activity of a lawyer - it helps to build a relationship of trust with the client, ensures effective interaction with process participants, helps in resolving conflicts, and builds professional authority. The author focuses attention on a number of problems in the development of communication competence of lawyers. Among them – paying insufficient attention to the formation of communicative competence in educational programs, lack of a sufficient number of practical trainings, low level of self-esteem of lawyers. It is proposed to start solving the mentioned problems by revising approaches to the formation of communicative competences at the level of basic legal education students, and improving the communication skills of practicing lawyers is possible due to the organization and conduct of trainings and seminars, the use of simulation games, modeling of court sessions, the involvement of communication specialists in the training of lawyers, conducting psychological trainings.

Redesign of the Digital Literacy Program for Older Adults, validating Desirable Skills with Generative Artificial Intelligence

The research described in this article aims to evaluate and redesign the digital literacy program for older adults by validating desirable skills with AI. The same redesign is based on the execution of the specific objectives of this research, highlighting among them: 1) identifying the training requirements so that older adults can break the digital gaps in access and use of ICTs; 2) redesign the digital didactic management model of the digital literacy program and 3) validate the redesign proposal by incorporating feedback with artificial intelligence. The applied methodology is based on the analytical observation of three years of experience of the digital literacy program, which takes into account the virtualization factor of the learning experience, to motivate the transformation of the digital culture of older adults, taking into account The validation of the thematic axes includes comparisons made against the results of queries to information search and analysis tools based on generative artificial intelligence. The results have led to maintaining references of the experience worldwide, but also enriched with its own factors and lessons learned that make the digital literacy experience for older adults in Panama innovative.

Essential characteristics of the formation of readiness of future officers to use combat knives in extreme conditions of service and combat activity

The article examines the essential characteristics of the formation of future officers' readiness to use "Bladed weapons" in extreme conditions of service and combat activity. The relevance of the study is due to the growing requirements for professional training of military personnel, capable of effectively acting in complex and dangerous situations. Research methods: abstraction, analysis and synthesis, hypothetical-deductive method, induction and deduction, historical method, classification and systematization, comparative (comparative) method, logical method, modeling, forecasting, generalization and concretization, formalization. In addition, during the theoretical study, personal experience in organizing the system of special physical training of military personnel. The research identified key components of readiness to use edged weapons, including psychophysical preparedness, tactical literacy, legal awareness, and moral and ethical stability. Existing approaches to the formation of these competencies in the military education system are analyzed. Particular attention is paid to the integration of theoretical knowledge and practical skills, which provides future officers with the opportunity to adequately assess the situation, make informed and balanced decisions, and act in accordance with legislative norms. The results of the study can be used to improve the educational and training process of future officers in special physical training (tactical and tactical-special training), in particular for the development of specialized training programs aimed at preparing for the performance of assigned tasks in extreme conditions of service and combat activity. Prospects for further research include determining the criteria, levels (components) of forming the readiness of future officers to use "Bladed weapons" in extreme conditions of service and combat activity.

General Surgery Residents Competence and Autonomy in Core Vascular Surgery Procedures.

As vascular surgery has become increasingly sub-specialized, the scope of vascular care that general surgeons can be trained to provide has come into question. Thus, we sought to understand the competence and autonomy of general surgery residents (GSR) in core vascular surgery procedures. Three core operations in vascular surgery were identified: lower extremity (LE) amputations, arteriovenous fistula (AVF) creation, and LE embolectomy and thrombectomy (thromboembolectomy). Assessment of GSRs autonomy and performance for these operations were obtained from the System for Improving and Measuring Procedural Learning (SIMPL) application from 2018 to 2022. Data were analyzed using a combination of descriptive statics and chi-square tests. Logistic generalized linear mixed models (GLMM) were also performed. 1950 SIMPL operative assessments were analyzed. Senior residents were found to be meaningfully autonomous and competent in 82% (n = 237) and 66% (n = 189) of LE amputation assessments and 50% (n = 225) and 32% (n = 142) of AVF assessments, respectively. The majority of senior residents failed to achieve meaningful autonomy (n = 99, 67%) and competence (n = 116, 80%) for LE thromboembolectomy cases, while the majority of junior and midlevel residents failed to achieve meaningful autonomy and competence for all 3 procedures. For an average case, a senior resident had an 86% (95% CI: 79% - 89%) chance of achieving competence during LE amputation, 41% (95% CI: 43% - 62%) chance during AVF, and 21% (95% CI: 27% - 52%) chance during LE thromboembolectomy. In this study, GSR failed to achieve competence and meaningful autonomy for 3 core procedures, including AVF creation. Notably, the creation of an AVF was recently included within the new Entrustable Professional Activities (EPAs) for general surgery. However, the results of this study suggest that GSR will fail to demonstrate the competence needed for entrustment. Training requirements for general surgery residents in vascular surgery may need to be reassessed.

Advancing Pediatric Robotic Colorectal Surgery: Trends, Outcomes, and Future Directions-A Comprehensive Review.

Pediatric robotic colorectal surgery has rapidly evolved, offering enhanced precision and safety for treating complex conditions such as Hirschsprung disease (HSCR), anorectal malformations (ARMs), and inflammatory bowel disease (IBD). This review analyzes recent trends, outcomes, and complications in robotic colorectal procedures for pediatric patients. A systematic review was performed using PubMed, yielding 1,112 articles related to pediatric robotic colorectal surgery. After applying exclusion criteria, 35 papers were analyzed, focusing on patient characteristics, procedure types, and clinical outcomes. Since 2001, approximately 700 pediatric patients have undergone robotic colorectal procedures, with HSCR being the most commonly treated condition (n = 421). The review highlights that 1.7% of patients experienced Clavien-Dindo grade III complications, while 11.5% had grade I to II complications, indicating a favorable safety profile. The use of robotic platforms facilitated improved precision during perirectal dissection and reduced the risk of damage to adjacent structures, particularly in cases requiring complex pelvic dissections. Despite promising outcomes, the uptake of robotic colorectal surgery remains lower than that for urologic procedures due to challenges such as cost, instrument size, and specialized training. Robotic colorectal surgery in children is a safe and effective approach, particularly for complex conditions like HSCR, IBDs, and ARMs. While adoption is currently limited by cost and training requirements, ongoing advancements in technology and techniques promise to broaden its application and improve outcomes in pediatric surgery.