Training Of Medical Professionals Research Articles

Understanding cultural dynamics shaping clinical reasoning skills: A dialogical exploration.

Our study examined the influence of national cultural predispositions on training medical professionals and doctor-patient dynamics using a dialogical approach, guided by Hofstede's framework. This framework provided valuable insights into how cultural tendencies shape the learning and application of clinical reasoning skills in different cultural contexts. We found that dimensions such as power distance and individualism versus collectivism significantly influenced clinical reasoning, while other dimensions had more nuanced effects. Junior doctors in Southern nations, despite initially lagging behind, developed advanced clinical reasoning skills with experience, eventually matching their Northern counterparts. The study highlighted the link between cultural norms and educational practices, variations in family involvement during reasoning, adherence to clinical guidelines and doctors' emotional engagement in clinical care between Southern and Northern contexts. Additionally, we recognised that effective clinical reasoning extends beyond technical knowledge, involving an understanding and integration of cultural dynamics into patient care. This highlights the pressing need to prioritise this topic.

Legal training of medical professionals and the branch of Medical Law

Legal training of medical professionals and the branch of Medical Law

Prevalence of Intestinal Parasitic Infections among Food Handlers from Greater Cairo, Egypt

Abstract Background Foodborne illnesses caused by intestinal parasitic infections (IPIs) are among the major health problems especially in developing countries. Food handlers play an important role in transmission of IPI during manufacturing, processing, handling, and serving of foodstuff. Objectives The aim of the present study was to determine the prevalence of IPIs among food handlers in Greater Cairo, Egypt and their associated risk factors. Methodology A cross sectional study was designed whereby 250 food handlers attending four provision health offices from different governorates of Greater Cairo were examined. The demographic data, job title and position, health certification as well as risk factors that might increase the transmission of IPIs were collected in a pre-designed questionnaire. Stool samples were collected from all participants and examined by direct wet/iodine mounts, formol diethyl acetate and modified Ziehl_Neelsen staining techniques. Results 65 food handlers (26%) were found to have IPIs. The commonest parasites detected were Entamoeba histolytica (24.6%), Entamoeba coli (20%), Blastocystis hominis (16.9%), Giardia intestinalis (12.3%), followed by Enterobius vermicularis (10.8 %), Ascaris lumbricoides (7.7 %) and Schistosoma mansoni (3.1%). Higher, statistically significant (P < 0.001), prevalence of IPIs was found among food handlers from rural areas, having low educational levels, not having previous health certificates and among those working in popular restaurants and those having poor personal hand hygienic measures. While no differences in prevalence of IPIs was found regarding age, sex, and work experience duration. Conclusion It was concluded that implementation of governmental policies ensuring routine medical checkup and continuous professional training and education of food handlers are essential for prevention of IPIs among food handlers.

Смешанное, гибридное обучение как необходимый компонент современного обучения медицинских работников.

The article presents a review of the literature on the introduction of mixed, hybrid training in educational programs of additional professional education of medical workers. Definitions of mixed and hybrid learning are given. Publications, research and best practices related to mixed, hybrid training of medical professionals are considered. Attention is focused on the importance of this approach and information is provided that can be useful for teachers, educational institutions and medical professionals seeking to update their skills and knowledge.

Insight into The Status of Cardiothoracic and Vascular Surgery Training in Nepal

Cardiothoracic and Vascular Surgery is at a developing stage in Nepal. In Nepal, training of CTV surgeons started in the beginning of the 21st century. Nevertheless, there is already a decrease in trainee’s interest in this specialization leading CTVS training to a gasping state at its very neonatal age. Globally, training of medical professionals, in particular CTV surgeons, has been under continuous evolution since its inception. Analogously, in Nepal, the duration of the CTVS training and academic curriculum needs upgrading to meet international standards. Introduction of new concepts, learning advanced diagnostic and therapeutic techniques is important for CTV surgeons in Nepal, to become a competent member of the multidisciplinary Heart Team.

TraumaFlow-development of a workflow-based clinical decision support system for the management of severe trauma cases.

The treatment of severely injured patients in the resuscitation room of an emergency department requires numerous critical decisions, often under immense time pressure, which places very high demands on the facility and the interdisciplinary team. Computer-based cognitive aids are a valuable tool, especially in education and training of medical professionals. For the management of polytrauma cases, TraumaFlow, a workflow management-based clinical decision support system, was developed. The system supports the registration and coordination of activities in the resuscitation room and actively recommends diagnosis and treatment actions. Based on medical guidelines, a resuscitation room algorithm was developed according to the cABCDE scheme. The algorithm was then modeled using the process description language BPMN 2.0 and implemented in a workflow management system. In addition, a web-based user interface that provides assistance functions was developed. An evaluation study was conducted with 11 final-year medical students and three residents to assess the applicability of TraumaFlow in a case-based training scenario. TraumaFlow significantly improved guideline-based decision-making, provided more complete therapy, and reduced treatment errors. The system was shown to be beneficial not only for the education of low- and medium-experienced users but also for the training of highly experienced physicians. 92% of the participants felt more confident with computer-aided decision support and considered TraumaFlow useful for the training of polytrauma treatment. In addition, 62% acknowledged a higher training effect. TraumaFlow enables real-time decision support for the treatment of polytrauma patients. It improves guideline-based decision-making in complex and critical situations and reduces treatment errors. Supporting functions, such as the automatic treatment documentation and the calculation of medical scores, enable the trauma team to focus on the primary task. TraumaFlow was developed to support the training of medical students and experienced professionals. Each training session is documented and can be objectively and qualitatively evaluated.

Introduction of Hybrid Additive Manufacturing for Producing Multi-Material Artificial Organs for Education and In Vitro Testing

The evolution of 3D printing has ushered in accessibility and cost-effectiveness, spanning various industries including biomedical engineering, education, and microfluidics. In biomedical engineering, it encompasses bioprinting tissues, producing prosthetics, porous metal orthopedic implants, and facilitating educational models. Hybrid Additive Manufacturing approaches and, more specifically, the integration of Fused Deposition Modeling (FDM) with bio-inkjet printing offers the advantages of improved accuracy, structural support, and controlled geometry, yet challenges persist in cell survival, interaction, and nutrient delivery within printed structures. The goal of this study was to develop and present a low-cost way to produce physical phantoms of human organs that could be used for research and training, bridging the gap between the use of highly detailed computational phantoms and real-life clinical applications. To this purpose, this study utilized anonymized clinical Computed Tomography (CT) data to create a liver physical model using the Creality Ender-3 printer. Polylactic Acid (PLA), Polyvinyl Alcohol (PVA), and light-bodied silicone (Polysiloxane) materials were employed for printing the liver including its veins and arteries. In brief, PLA was used to create a mold of a liver to be filled with biocompatible light-bodied silicone. Molds of the veins and arteries were printed using PVA and then inserted in the liver model to create empty channel. In addition, the PVA was then washed out by the final product using warm water. Despite minor imperfections due to the printer’s limitations, the final product imitates the computational model accurately enough. Precision adjustments in the design phase compensated for this variation. The proposed novel low-cost 3D printing methodology successfully produced an anatomically accurate liver physical model, presenting promising applications in medical education, research, and surgical planning. Notably, its implications extend to medical training, personalized medicine, and organ transplantation. The technology’s potential includes injection training for medical professionals, personalized anthropomorphic phantoms for radiation therapy, and the future prospect of creating functional living organs for organ transplantation, albeit requiring significant interdisciplinary collaboration and financial investment. This technique, while showcasing immense potential in biomedical applications, requires further advancements and interdisciplinary cooperation for its optimal utilization in revolutionizing medical science and benefiting patient healthcare.

THE ISSUE OF INFECTIOUS DISEASE INCIDENCE AMONG MEDICAL STUDENTS

Introduction. The training of future medical professionals involves not only development of skills and professional background, but also maintaining a sufficient health status; therefore the relevance of studying an incidence of infectious pathologies in medical students is exceptionally important. The purpose of the study is to investigate, analyze, and compare incidence of some infectious diseases among medicine students. Materials and methods. We utilized various research methods including analysis of scientific sources, synthesis and comparison of studies by other researchers, surveys, observations, interviews, and statistical data on the incidence of infectious diseases in Ukraine and worldwide. Additionally, we conducted a poll among first-year students of the medical faculty at Vinnytsia National Pirogov Memorial Medical University using Google Forms to gather data on the incidence of respiratory and digestive system infections. The study revealed that approximately 65% of the surveyed students had experienced coronavirus disease, mostly in a mild form. Among acute respiratory viral infections, flu (55.3%), sore throat (31.3%), and rhinopharyngitis (21.3%) were the most common (79.1%) among medical students. About 74% of respondents reported no chronic diseases of the upper and lower respiratory tract, while the rest mentioned conditions such as allergic rhinitis (10%), chronic tonsillitis (10%), chronic pharyngitis (3.4%), and vocal cord diseases (2%). In terms of infectious pathologies of the digestive system, food poisoning of unspecified etiology (33.3%) and viral intestinal infections (11.7%) were the most prevalent. Conclusion. The relevance of the issue of infectious disease incidence among medical students necessitates further investigation and analysis to identify contributing factors, develop monitoring methods, and promote healthy lifestyles to maintain optimal health status.

Cardiological emergency and acute myocardial infarction: physician and physiotherapist perceptions of immediate care, use of prehospital ECGS and patient referrals

Doctors and physiotherapists play a key role in reducing the rate of morbidity and mortality from acute myocardial infarction through well-applied care, as well as through the key point of health education, given that most of the risk factors are modifiable. This article is a literature review, which aims to explore the challenges faced by patients with acute myocardial infarction. This review shows that heart attacks are a serious problem. The study proves that this damage can be reduced or minimized with the training of medical and physiotherapy professionals in recognizing the signs and symptoms in good time, as well as the best treatment.

Design and evaluation of an anthropomorphic neck phantom for improved ultrasound diagnostics of thyroid gland tumors.

Thyroid cancer is one of the most common cancers worldwide, with ultrasound-guided biopsy being the method of choice for its early detection. The accuracy of diagnostics directly depends on the qualifications of the ultrasonographers, whose performance can be enhanced through training with phantoms. The aim of this study is to propose a reproducible methodology for designing a neck phantom for ultrasound training and research from widely available materials and to validate its applicability. The phantom was made using polyvinyl chloride mixed with additives to reproduce different levels of brightness on ultrasound screens. 3D printing and casting were used to create the neck model and various structures of the neck, including bones, cartilage, arteries, veins, lymph nodes, thyroid gland, and soft tissues. The small objects, such as tumor and lymph node models, were shaped manually. All the phantom's materials were carefully selected to match the ultrasonic speed and attenuation values of real soft tissues and bones. The thyroid gland contains models of a cancerous and cystic nodule. In the neck, there are models of carotid arteries and jugular veins filled with ultrasound-transparent gel. Additionally, there are replicas of lymph nodes and bone structures such as hyoid bone, thyroid cartilage, trachea, and vertebrae. The resulting phantom covers the entire neck area and has been positively received by practicing ultrasound specialists. The proposed manufacturing technology offers a reliable and cost-effective approach to produce an anthropomorphic neck phantom for ultrasound diagnosis of the thyroid gland. The realistic simulation provided by the phantom enhances the quality and accuracy of ultrasound examinations, contributing to better training for medical professionals and improved patient care. Subsequent research efforts can concentrate on refining the fabrication process and exploring additional features to enhance the phantom's capabilities.

Reflecting on 12 years of training medical students in rural longitudinal integrated clerkships.

Longitudinal integrated clerkships (LICs) are effective in promoting careers in rural primary health care environments. This model of training medical professionals involves longer clinical placements of medical students and a different approach to learning which better prepares them for primary health care practice. Stellenbosch University created a LIC in 2011 for this purpose and has trained almost 100 doctors in their yearlong LIC since then. The past 12 years have brought about a lot of learning as this model of training was implemented, developed, and refined to suit the needs of students and the clinical environments.Contribution:Countries across the globe face challenges in recruiting and retaining doctors in rural primary health care environments. Longitudinal integrated clerkships have several educational benefits in addition to increase recruitment and retention of rural doctors, and 12 years of experience have led to a greater understanding regarding implementation and outcomes of an LIC in the South African context.

Razvitie medicinskoj terminografii v Rossii v XI–XIX vv.

This article examines the history of the emergence and development of medical terminography in Russia, the key stages of the formation of the terminological foundation, the establishment of the first medical dictionaries, and the influence of intercultural exchange. The research presents the importance of medical terminological dictionaries in training and preparation of medical professionals during that time, the evolution and maturation of the concept of terminography in Russia.

Diagnosis of Cystic Fibrosis Beyond Childhood in India

Abstract Cystic fibrosis (CF) is a life-limiting genetic condition with multisystemic manifestations. However, there are vast phenotypic as well as genotypic variations. This contributes to delay in diagnosis, especially in pancreatic-sufficient patients who may not manifest typical symptomatology. The last decade has witnessed significant breakthroughs in CF therapeutics. This in combination with early diagnosis through newborn screening, and aggressive supportive care can offer near-normal life expectancy for a majority of patients with CF (pwCF) worldwide. Even while addressing disparities in CF care around the world, it is crucial to train medical professionals to suspect and diagnose CF in children as well as in adults. Here, we share our experience of pwCF diagnosed beyond 16 years of age with an aim to highlight the clinical presentations in young adults, the need for screening family members of a newly diagnosed pwCF, and the negative effects of late diagnosis of CF.

Training of young medical professionals: implementation of modern training concepts, taking into account the changed framework conditions for training—a pilot project for operational subjects

IntroductionFor years, generations of medical students have complained that practice-oriented learning is neglected in medical studies. Further training assistants also complain about limited opportunities to learn subject-specific practical activities.Material and techniquesWe are presenting a pilot project at the University Women’s Hospital in Homburg, in which medical students complete an endoscopic hands-on course as part of the block internship gynaecology and obstetrics. During the course the students perform classic skills training and hand–eye coordination exercises and learn the first steps in endoscopic suturing (suture and rows of knots). The training concepts used can be implemented on simple boxing trainers and can therefore also be reproduced in clinics or in a private setting.OutcomeAltogether, 73 medical students did participate in the laparoscopy course. We were able to prove that the knotting time for a simple knot can be reduced from an average of 247 s to 40 s (80%) after completing our training programme. Based on the evaluation sheet that the students filled out after the course, we found a very-high acceptance for surgical simulation training within the student cohort.DiscussionPractical surgical exercises can complement the curriculum well and, as we can show with our work, are rated very positively by the students. For students in higher semesters, such practical courses can also provide an insight into the respective subject area and thus counteract the lack of skilled workers in surgical subjects. The practical year should not be the first contact with these practical courses, as at this timepoint a certain favoured subject has often already being chosen by the students.

Novel Integration of a Health Equity Immersion Curriculum in Medical Training.

Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice.

The Impact of Health Communication Research on Medical and Health Professional Education and Training

ABSTRACT In this essay, we review how health communication scholarship has been translated into various communication skills trainings (CSTs), we present four case studies of how health communication research informed the development and implementation of specific CSTs, and we reflect on how we can productively define “impact” in looking back as well as looking forward within this line of research.

Is insufficient introspection a reason to terminate residency training? – Scrutinising introspection among residents who disputed dismissal

Introduction Insufficient introspection as part of the 4I’s model of medical professionalism (introspection, integrity, interaction, and involvement) is considered an important impediment in trainees. How insufficient introspection relates to decisions to terminate residency training remains unclear. Insights into this subject provide opportunities to improve the training of medical professionals. Methods We analysed the Dutch Conciliation Board decisions regarding residents dismissed from training between 2011 and 2020. We selected the decisions on residents deemed ‘insufficient’ regarding introspection as part of the CanMEDS professional domain and compared their characteristics with the decisions about residents without reported insufficiencies on introspection. Results Of the 120 decisions, 86 dismissed residents were unable to fulfil the requirements of the CanMEDS professional domain. Insufficient introspection was the most prominent insufficiency (73/86). These 73 decisions described more residents’ insufficiencies in CanMEDS competency domains compared to the rest of the decisions (3.8 vs. 2.7 p < 0.001), without significant differences regarding gender or years of training. Conclusions Insufficient introspection in residents correlates with competency shortcomings programme directors reported in dismissal disputes. The 4I’s model facilitates recognition and description of unprofessional behaviours, opening avenues for assessing and developing residents’ introspection, but further research is needed for effective implementation in medical education.

Adverse Effects After Prehospital Administration of Naloxone by Bystanders: A Preliminary Study.

Opioid use disorder is a cause of significant morbidity and mortality. In order to reverse opioid overdose as quickly as possible, many institutions and municipalities have encouraged people with no professional medical training to carry and administer naloxone. This study sought to provide preliminary data for research into the rates of adverse effects of naloxone when administered by bystanders compared to Emergency Medical Services (EMS) personnel, since this question has not been studied previously. This was a retrospective cohort study performed at an urban, tertiary, academic medical center that operates its own EMS service. A consecutive sample of patients presenting to EMS with opioid overdose requiring naloxone was separated into two groups based on whether naloxone was administered by bystanders or by EMS personnel. Each group was analyzed to determine the incidence of four pre-specified adverse events. There was no significant difference in the rate of adverse events between the bystander (19%) and EMS (16%) groups (OR = 1.23; 95% CI, 0.63 - 2.32; P = .499) in this small sample. Based on these initial results, a study would need a sample size of 6,188 in order to reach this conclusion with 80% power. Similarly, there were no significant differences in the rates of any of the individual adverse events. Secondary analysis of patients' demographics showed differences between the two groups which generate hypotheses for further investigation of disparities in naloxone administration. This preliminary study provides foundational data for further investigation of naloxone administration by bystanders. Adverse events after the prehospital administration of naloxone are rare, and future studies will require large sample sizes. These preliminary data did not demonstrate a statistically significant difference in adverse event rates when comparing naloxone administration by bystanders and EMS clinicians. This study provides data that will be useful for conducting further research on multiple facets of this topic.

State of the art: Simulation in US

Technical simulation of diagnostic and therapeutic procedures is of growing relevance for student education and advanced medical training and has already been introduced in the field of ultrasound. This review gives a broad overview on different levels of simulation for ultrasound diagnostics and highlights the technical background of the methodology. A critical review of the literature reveals recommendations for implementing simulation techniques in medical studies and professional ultrasound training. An analysis of strengths and weaknesses shows the advantages of simulation especially in the context of individual learning situations and COVID-19-related restrictions for personal interaction. However, simulation techniques cannot replace the experiences of complex clinical examinations with direct interaction to real patients. Therefore, future applications may focus on repetition and assessment of achieved competencies by using standardized feedback mechanisms in order to preserve the limited resources for practical medical training.

Educating primary care physicians about eating disorders: Pilot data from a microlearning programme.

Over two-thirds of people present to their primary care physician (or general practitioner; GP) as a first point of contact for mental health concerns. However, eating disorders (EDs) are often not identified in a primary care setting. A significant barrier to early detection and intervention is lack of primary care physician training in EDs; compounded by the significant time commitments required for training by already time-poor general practitioners. The aim of the current study was to pilot and evaluate a microlearning programme that can be delivered to general practitioners with high workloads to help support patients with, or at risk of, developing an ED. Fifty-one Australian general practitioners aged between 25-to-60years old were recruited. Participants completed a baseline questionnaire to ascertain their experience working in general practice and with EDs. Participants then completed an online programme consisting of a series of 10 case studies (vignettes) delivered over a 6-10week period related to various facets of ED care. Following conclusion of the programme, participants were asked to complete an evaluative questionnaire related to the content of the programme; perceived knowledge, confidence, willingness-to-treat, skill change; and their overall experience of microlearning. All 51 GPs completed the programme and reached completion criteria for all vignettes, 40 of whom completed the programme evaluation. Participants indicated improved skill, confidence, willingness-to-treat, and knowledge following the completion of the pilot programme. Almost all (97.5%; n=39) found microlearning to be an effective method to learn about EDs; with 87.5% (n=35) of participants reporting they felt able to apply what was learnt in practice. Qualitative feedback highlighted the benefit of microlearning's flexibility to train general practitioners to work with complex health presentations, specifically EDs. Findings from the current study lend support to the use of microlearning in medical health professional training; notably around complex mental health concerns. Microlearning appears to be an acceptable and effective training method for GPs to learn about EDs. Given the significant time demands on GPs and the resulting challenges in designing appropriate training for this part of the workforce, this training method has promise. The pre-existing interest in EDs in the current study sample was high; future studies should sample more broadly to ensure that microlearning can be applied at scale.