Resident Scores Research Articles

Assessing cyberchondria and eHealth literacy differences in urban and rural China

Abstract Background and Objectives This study aimed to explore the association between cyberchondria and eHealth literacy in the general Chinese population, and to assess how this relationship changes between urban and rural residents. Methods Data obtained from a web-based, cross-sectional survey that evaluate cyberchondria and its impact on health in February 2024. The Cyberchondria Severity Scale - 12 item was used to measure the cyberchondria, while the eHealth Literacy Scale was used to evaluate eHealth literacy. Descriptive analysis was used to describe the background characteristics of the participants. Then, a multivariable linear regression model was then performed for urban and rural subsample to examine the relationship between cyberchondria and eHealth literacy, respectively, providing a comparative analysis between the urban and rural populations. Results A total of 634 individuals completed the questionnaire. The average age was 33.2 years (SD = 7.4), with approximately 50.3% (n = 319) being female. Urban residents made up 71.4% (n = 451) of the participants. The mean eHEALS scores for urban and rural residents were 31.9 (SD = 4.3) and 30.4 (SD = 4.2), respectively. The CSS-12 scores for urban residents were 40.3 (SD = 7.58) and for rural residents were 39.1 (SD = 7.2). Linear regression analyses showed a significant association between eHealth literacy and cyberchondria for urban residents (Beta = 0.30, p < 0.001), but age and education level had no significant impact. For rural residents, a statistically significant association between eHealth literacy and cyberchondria was also observed (Beta = 0.40, p = 0.002). Conclusions Overall, eHealth literacy consistently predicts cyberchondria severity in both urban and rural samples. Higher eHealth literacy is linked to greater cyberchondria, especially in rural areas. Future research should explore other potential mediators, including psychological factors, internet usage patterns, and access to healthcare services. Key messages • eHealth literacy strongly predicts cyberchondria severity in both urban and rural populations, with a notably stronger impact observed in rural settings. • Urban and rural differences highlight the need for customized digital health literacy programs to effectively address region-specific challenges and behaviors.

Evaluating the Value of Eye-Tracking Augmented Debriefing in Medical Simulation-A Pilot Randomized Controlled Trial.

Debriefing after simulation facilitates reflective thinking and learning. Eye-tracking augmented debriefing (ETAD) may provide advantages over traditional debriefing (TD) by leveraging video replay with first-person perspective. This multisite randomized controlled trial compared the impact of ETAD with TD (without eye-tracking and without video) after simulation on 4 outcomes: (1) resident metacognitive awareness (the primary outcome), (2) cognitive load (CL) of residents and debriefers, (3) alignment of resident self-assessment and debriefer assessment scores, and (4) resident and debriefer perceptions of the debriefing experience. Fifty-four emergency medicine residents from 2 institutions were randomized to the experimental (ETAD) or the control (TD) arm. Residents completed 2 simulation stations followed by debriefing. Before station 1 and after station 2, residents completed a Metacognition Awareness Inventory (MAI). After each station, debriefers and residents rated their CL and completed an assessment of performance. After the stations, residents were interviewed and debriefers participated in a focus group. There were no statistically significant differences in mean MAI change, resident CL, or assessment alignment between residents and debriefers. Debriefer CL was lower in the experimental arm. Interviews identified 4 themes: (1) reflections related to debriefing approach, (2) eye-tracking as a metacognitive sensitizer, (3) translation of metacognition to practice, and (4) ETAD as a strategy to manage CL. Residents reported that eye tracking improved the specificity of feedback. Debriefers relied less on notes, leveraged video timestamps, appreciated the structure of the eye-tracking video, and found the video useful when debriefing poor performers. There were no significant quantitative differences in MAI or resident CL scores; qualitative findings suggest that residents appreciated the benefits of the eye-tracking video review. Debriefers expended less CL and reported less perceived mental effort with the new technology. Future research should leverage longitudinal experimental designs to further understand the impact of eye-tracking facilitated debriefing.

Video Review Can Measure Surgical Robotic Skill Development in a Resident Robotic Hernia Curriculum: A Retrospective Cohort Study

Background: Hernia repairs are one of the most common general surgery procedures and an essential part of training for general surgery residents. The widespread incorporation of robotic hernia repairs warrants the development of a procedure-specific robotic curriculum to assist novice surgeons in improving technical skills. Objective: To evaluate a robotic hernia simulation-based curriculum for general surgery residents using video review. Methods: Retrospective cohort study of PGY-3 general surgery residents from the University of Chicago from 2019 to 2021. The residents completed inguinal hernia repair (IHR) and ventral hernia repair (VHR) drills as part of a robotic simulation curriculum. The drills were recorded and graded according to the modified objective structured assessment of technical skills (OSATS) and time to completion. The drills were completed by 3 attending surgeons to establish gold-standard benchmarks. Results: In total, 20 residents started the curriculum, 19 completed all IHR drills and 17 completed all VHR drills. Attending surgeon total OSATS scores and time to completion were significantly better than the trainees on the first attempt (P < 0.05). When comparing 1st to 4th attempt, resident OSATS scores improved significantly for IHR (15.5 vs 23.3; P < 0.001) and VHR (16.8 vs 23.3; P < 0.001). Time also improved over 4 attempts (IHR: 28.5 vs 20.5 minutes; P < 0.001 and VHR: 29.6 vs 21.2 minutes; P < 0.001). Residents achieved attending-level OSATS scores by their fourth attempt for VHR, but not for IHR. Residents did not achieve attending-level times for either hernia drills. Conclusions: The robotic hernia curriculum improved resident performance on hernia repair drills and was well-received by the residents.

A study of the correlation between residents’ humanistic care skills and their level of emotional intelligence—A cross-sectional survey

BackgroundThere is variability in the structure of junior doctors’ knowledge of humanistic medicine. The level of residents’ emotional intelligence affects their professional development and the doctor-patient relationship. Currently, there is a paucity of research examining the humanistic competence and emotional intelligence of medical residents, both domestically and internationally.The primary objective of this study was to scrutinize the prevailing status of residents’ humanistic competence and emotional intelligence levels, aiming to assess the correlation between humanistic competence and emotional intelligence.MethodsA cross-sectional survey using the Demographic Characteristics Questionnaire, the Humanistic Care Competence Scale, and the Emotional Intelligence Scale was conducted in September 2022 among residents of a tertiary general hospital in Sichuan Province. The relationship between humanistic care competence scores and emotional intelligence scores among residents was analyzed using Pearson correlation analysis and multiple linear regression analysis.ResultsThe mean score of residents’ humanistic care competence was 188.82 ± 20.80, and the mean score of emotional intelligence was 87.08 ± 13.49.The Pearson correlation results demonstrated a significant correlation (r = 0.400, p = 0.000) between the level of emotional intelligence and humanistic care competence. The results of multiple linear regression analysis indicated that self-emotional appraisal, emotional appraisal of others, emotional control, emotional use, and school community work experience independently predicted humanistic care competence.ConclusionThe scores for residents’ humanistic care competence were notably low, influenced by a multitude of factors that also exhibited varying levels of impact on emotional intelligence development. Emotional intelligence was positively associated with humanistic care competence. Emotional intelligence is an important consideration in the development, implementation, and evaluation of humanistic care interventions. Residency programs should provide education and training in humanistic competencies to improve residents’ levels of emotional intelligence and promote the overall health of society.

Enhanced interactions within microenvironment accelerates dismal prognosis in HBV-related HCC after TACE.

Transarterial chemoembolization (TACE) is the first-line treatment for patients with advanced HCC, but there are limited studies on the microenvironment alterations caused by TACE. Six fresh HBV-related HCC specimens with or without TACE intervention were used to perform single-cell RNA sequencing. The 757 bulk samples from 3 large-scale multicenter cohorts were applied for comprehensive analysis. The biological functions of the biomarkers were further validated by phenotypic experiments. Using single-cell RNA sequencing analysis, we delineated the global cell atlas of post-TACE and demonstrated elevated tumor heterogeneity and an enhanced proinflammatory microenvironment induced by TACE. Cell-cell communication analysis revealed that markedly elevated interactions between NABP1+ malignant hepatocytes, neutrophils, and CD8+ T cells after TACE might accelerate the shift from CD8+ effector memory T cells to CD8+ effector T cells. This result was substantiated by the developmental trajectory between the 2 and dramatically decreased resident scores along the pseudotemporal trajectory. Integrating bulk data, we further found that the increased estimated proportion of NABP1+ malignant hepatocytes was related to poor TACE response and dismal prognosis, and its biomarker role could be replaced by NABP1. In vitro, multiple biological experiments consistently verified that NABP1 knockdown significantly inhibited the proliferation and migration of HCC cells. Based on our depicted global map of post-TACE, we confirmed that the enhanced interactions within the microenvironment after TACE may be the culprits for postoperative progression. NABP1 may become an attractive tool for the early identification of patients sensitive to first-line TACE in clinical practice.

Simulation of indoor space thermal energy circulation in architectural environment design detail features based on visual object tracking algorithm

The heat circulation of interior space plays a crucial role in the design of the built environment, affecting energy efficiency and residential comfort. With the development of science and technology, visual target tracking algorithm provides a new possibility for optimizing thermal energy cycle. The purpose of this paper is to study the simulation method of indoor space thermal energy cycle based on visual target tracking algorithm to improve the efficiency of thermal energy management in building environment design and ensure indoor comfort. The research uses laboratory Settings, combined with high-performance cameras and advanced visual target tracking algorithms, to monitor indoor heat source distribution and personnel movement in real time. Through data acquisition and analysis, the indoor heat cycle model was constructed and simulated by computational fluid dynamics (CFD) software to evaluate the influence of different design parameters on the heat cycle. Through the optimization of the design scheme, the efficiency of indoor heat use is significantly improved, and the comfort score of residents is significantly improved. Therefore, the simulation of indoor space thermal energy cycle based on visual target tracking algorithm provides an effective tool for building environment design, which can realize efficient energy management and improve living comfort.

Association Between Resident In-Service Exam Scores by Postgraduate Year and Subsequent Board Qualifying Exam.

Prior work notes the AUA In-Service Exam (ISE) percentile ranking of chief residents correlates with the American Board of Urology Qualifying Exam (QE) performance. We present a 5-year analysis of resident performance on the ISE and subsequent QE to determine if earlier time points in training may identify those needing additional educational support. Participant ISE scores over a 5-year period from 2014 to 2018 and subsequent QE scores in 2019 were recorded. Pearson's correlation coefficient measured the association between percentage questions correct for each ISE year and QE. Youden Index calculated the optimal cut point for yearly ISE percentage correct that would predict scoring greater than the lowest quartile and decile on the QE. Median percent questions correct on ISE increased over postgraduate year (PGY) 1 (47%), PGY2 (56.5%), and PGY3 (70%) but remained stable thereafter (PGY4-PGY5) at approximately 70%. Median QE percent correct in 2019 was 66% (SD 7.6%). Correlation of percent questions correct between ISE and QE improved from 0.31 to 0.53 over training duration. The lowest decile and quartile percent correct scores on the QE were 56% and 60%, respectively. Percent correct ISE score predicting performance above the lowest decile 2019 QE score increased from 38% in PGY1 to 57% in PGY2 and leveled off after PGY3 (∼70%). Similar observations were noted with lowest quartile QE score. Scoring approximately 70% of questions correct on the ISE during PGY3 and later years was associated with a low risk of failing the QE. Such information provides benchmarks for residency programs to offer targeted educational content for at-risk candidates.

Improving Resident Comfort With Peripartum Cesarean Hysterectomy Through the Use of Low-Fidelity Simulation Models.

Introduction Cesarean hysterectomy is a relatively rarely performed, complex, life-saving procedure considered during post-partum hemorrhage and other obstetric complications. This multi-site study aimed at validating a low-cost, low-fidelity cesarean hysterectomy model to support resident proficiency and increase their confidence in performing this critical procedure. Materials and methods We developed a low-fidelity, anatomically representative model for cesarean hysterectomy simulation purposes. Obstetrics and Gynecology residents at two residency programs were offered a simulation experience using the model, with a performance assessment via two validated assessment tools. The clinical case involved a 38 y/o woman with a delivery complicated by postpartum hemorrhage who failed conservative therapy and required a peripartum hysterectomy. Participants included 26 residents, postgraduate year (PGY)1 through PGY4, at two midwestern university-based obstetrics and gynecology residency programs. Results The median resident scores on the Task Specific Checklist (TSC) and Global Rating Scale (GRS) correlated with increasing PGY levels. The combined TSC+GRS score was a median of 40 out of 49 total for the PGY4 class, while the PGY1 class had a median combined TSC+GRS score of 12 of 49. The PGY2 and -3 classes had TSC+GRS scores of 14 and 28, respectively. The simulation model was well-received with a median 4/5 rating for improving comfort level with cesarean hysterectomy and a median 4/5 rating for model realism. Conclusion This study validated a cost-effective, easily reproducible model that highlights the vital anatomy relevant to a cesarean hysterectomy. The model and simulation offer a way to introduce cesarean hysterectomies to residents while in training, particularly at sites that may not perform a substantial number of these procedures.

Artificial intelligence in orthopaedic education: A comparative analysis of ChatGPT and Bing AI's Orthopaedic In‐Training Examination performance

AbstractBackgroundThis study evaluated the performance of generative artificial intelligence (AI) models on the Orthopaedic In‐Training Examination (OITE), an annual exam administered to U.S. orthopaedic residency programs.MethodsChatGPT 3.5 and Bing AI GPT 4.0 were evaluated on standardised sets of multiple‐choice questions drawn from the American Academy of Orthopaedic Surgeons OITE online question bank spanning 5 years (2018–2022). A total of 1165 questions were posed to each AI system. The performance of both systems was standardised using the latest versions of ChatGPT 3.5 and Bing AI GPT 4.0. Historical data of resident scores taken from the annual OITE technical reports was used as a comparison.ResultsAcross the five datasets, ChatGPT 3.5 scored an average of 55.0% on the OITE questions. Bing AI GPT 4.0 scored higher with an average of 80.0%. In comparison, the average performance of orthopaedic residents in national accredited programs was 62.1%. Bing AI GPT 4.0 outperformed ChatGPT 3.5 and Accreditation Council for Graduate Medical Education examinees, and analysis of variance analysis demonstrated p < 0.001 among groups. The best performance was by Bing AI GPT 4.0 on OITE 2020.ConclusionGenerative AI can provide a logical context across answer responses through its in‐depth information searches and citation of resources. This combination presents a convincing argument for the possible uses of AI in medical education as an interactive learning aid.

Neurological Surgery Resident ABNS Written Exam Scores Before and After Introduction of a Weekly Didactic Educational Intervention: A 12-Year Single-Institution Retrospective Study.

United States neurological surgery residency education has undergone substantive changes over the past 2 decades. Neurosurgical professional bodies have developed numerous initiatives providing standardized assessments and training opportunities for residency programs. However, there have been few studies using standardized measures to assess core components of educational programming in individual programs. We conducted a 12-year retrospective review of resident American Board of Neurological Surgery (ABNS) board scores using our institutional data from 2010 to 2021 to determine the effect of introducing a weekly didactic resident education hour (REH) on resident scores in the ABNS written in-training examination. ABNS scaled scores were analyzed before (2010-2016) and after (2017-2021) REH introduction. To account for a practice effect, we used a 2-factor linear regression model with an interaction term. We obtained ABNS scores from 43 residents representing 132 test attempts. The average ABNS scaled score significantly improved after the introduction of REH (319 vs 410, t = -3.44, P = .0008). Accounting for the practice effect revealed a significant interaction effect between the number of attempts taking the ABNS examination and whether formal didactics were taught, accounting for 46.2 points on the examination (t = 2.309, P = .023); however, REH alone did not have a significant effect on the scaled scores (t = -1.649, P = .102). ABNS written board scores represent a standardized metric by which educational initiatives within training programs may be assessed for efficacy. Further research is needed to identify educational approaches that are effective to meet the goal of demonstrated mastery of fundamental knowledge in neurosurgery across a diversity of neurological surgery residency programs.

Analysis of surgical oncology-educator perspectives for the development of a contemporary curriculum for the outpatient learning environment

PurposeThe purpose of this study was to perform a targeted needs assessment of surgical oncology stakeholders engaged in surgical education of students and trainees. The aim was to determine the appropriate elements of a formal curriculum to be administered to students and residents rotating in the outpatient surgical oncology setting.MethodsA 10-min survey was sent to surgical oncologists around the country that are a part of the Society of Surgical Oncology (SSO). Data obtained from this survey were analyzed to distinctly identify limitations to education in Surgical Oncology and will allow us to determine which educational goals to prioritize in a curriculum.Results189 responses to the needs assessment were received (7% response rate). Most surgeons were in academic practice (77%) and felt that trainees were not fully prepared for an outpatient clinic (57%) and did endorse the need for a curriculum (74%). Barriers identified to teaching and learning included time, abbreviated contact with learners and the volume of patients. Higher yield topics to be included in a future curriculum were identified. More than half of respondents felt that a curriculum could improve feedback, NBME Surgery Subject Exam scores, resident ABSITE scores and patient comfort.ConclusionsThis study represents a novel effort in assessing the unique needs of surgical oncologists within the outpatient learning environment. Building upon the insights gleaned from our survey, the next phase will entail conducting focus groups with respondents to delve deeper into the intricacies of designing an outpatient surgical oncology clinical curriculum tailored for medical students and junior residents. By fostering collaborative discussions among stakeholders, we aim to refine curriculum components in an iterative process and address identified gaps in educational resources and ultimately improve the quality of patient care in the outpatient setting.

Evaluation of case based simulation teaching to improve the Family Medicine residents urgent care management skills at a teaching hospital.

Simulation based teaching is effective strategy to allow trainees to acquire skills, develop clinical judgment and to become competent in order to manage the patients in a safe environment. The Case-based simulation improves the assessment and management skills of the trainees to prepare them as a competent physician. Evaluation of case based simulation teaching to improve the Family Medicine residents urgent care management skills at a teaching hospital. An Interventional study (Pre and post design) was conducted on the residents of the Family Medicine department of the Aga Khan University hospital Karachi. After getting their consent, pre intervention Objectively structured clinical examination (OSCE) was conducted at the Center for Innovation in medical education, AKUH. The scenarios were based on urgent care problems presenting in the Family Medicine setting. It was followed by the case based simulation teaching intervention by the facilitators and debriefing. The post intervention OSCE was conducted in order to assess the resident's performance. Statistical Analysis: The data was analyzed in Stata version15 software in two stages; descriptive and inferential. In descriptive analysis frequency and proportion were calculated for categorical variables. Median and inter quartile range were reported for continuous variable. Paired T-tests were applied to compare the pre and post test results. The resident's scores significantly improved after case based simulation in majority of the post intervention OSCE stations proving the effectiveness of the intervention. Case based simulation is an effective teaching strategy for the learning process of the Family Medicine residents regarding the urgent care management skills. It is advised to use this strategy in the teaching and learning process of other Family medicine residency programs.

Performance of three artificial intelligence (AI)-based large language models in standardized testing; implications for AI-assisted dental education.

The emerging rise in novel computer technologies and automated data analytics has the potential to change the course of dental education. In line with our long-term goal of harnessing the power of AI to augment didactic teaching, the objective of this study was to quantify and compare the accuracy of responses provided by ChatGPT (GPT-4 and GPT-3.5) and Google Gemini, the three primary large language models (LLMs), to human graduate students (control group) to the annual in-service examination questions posed by the American Academy of Periodontology (AAP). Under a comparative cross-sectional study design, a corpus of 1312 questions from the annual in-service examination of AAP administered between 2020 and 2023 were presented to the LLMs. Their responses were analyzed using chi-square tests, and the performance was juxtaposed to the scores of periodontal residents from corresponding years, as the human control group. Additionally, two sub-analyses were performed: one on the performance of the LLMs on each section of the exam; and in answering the most difficult questions. ChatGPT-4 (total average: 79.57%) outperformed all human control groups as well as GPT-3.5 and Google Gemini in all exam years (p < .001). This chatbot showed an accuracy range between 78.80% and 80.98% across the various exam years. Gemini consistently recorded superior performance with scores of 70.65% (p = .01), 73.29% (p = .02), 75.73% (p < .01), and 72.18% (p = .0008) for the exams from 2020 to 2023 compared to ChatGPT-3.5, which achieved 62.5%, 68.24%, 69.83%, and 59.27% respectively. Google Gemini (72.86%) surpassed the average scores achieved by first- (63.48% ± 31.67) and second-year residents (66.25% ± 31.61) when all exam years combined. However, it could not surpass that of third-year residents (69.06% ± 30.45). Within the confines of this analysis, ChatGPT-4 exhibited a robust capability in answering AAP in-service exam questions in terms of accuracy and reliability while Gemini and ChatGPT-3.5 showed a weaker performance. These findings underscore the potential of deploying LLMs as an educational tool in periodontics and oral implantology domains. However, the current limitations of these models such as inability to effectively process image-based inquiries, the propensity for generating inconsistent responses to the same prompts, and achieving high (80% by GPT-4) but not absolute accuracy rates should be considered. An objective comparison of their capability versus their capacity is required to further develop this field of study.

Neurosurgical Patient's Quality of Life: A Questionnaire-Based Study.

The burden of disease, as well as social and epidemiological factors, have a clear impact on a patient's quality of life. Especially in neurosurgery, patients commonly experience a decline in their quality of life. This study aims to assess the quality of life of neurosurgical patients and evaluate the impact of epidemiologic and disease-related factors. Adult, non-trauma neurosurgical patients were included in the study, which took place in the Neurosurgical Departmentat AHEPA University Hospital. Self-administered questionnaires including the 36-Item Short Form Survey Instrument (SF-36) and the EQ-5D-5L were usedto assess the overall patient's quality of life. Additionally, all patients were asked to provide data on the perceived severity of the disease and the extent of information regarding their health condition. Epidemiologic factors including gender, age, education level, and rural or urban living environment were also taken into account. Statistical analysis was performed to assess the impact of the aforementioned parameters on the patient's quality of life. In total, 74 patients were included in the study (56.9% male, mean age: 51 years). In general, better mean scores were observed in general health perception, vitality, social role functioning, and mental health, whereas the lowest values were detected in the reported physical and emotional role functioning. No statistically significant differences were observed among genders. Age was found to impact the general health perception and EQ-VAS (visual analog scale) score, while physical functioning presented significant differences depending on the patient's living environment and education level, with better scores for rural residents and secondary education graduates. The perceived severity of the health condition presented a significant negative effect on the EQ-VAS score, while it affected significantly physical functioning, with better outcomes reported by patients dealing with more serious diseases.Finally, in most of the evaluated categories, the level of information seemed to increase the reported quality of life, even though statistical significance was not confirmed. Quality of life should be taken into account when treating neurosurgical patients, and utilizing measuring tools assists in objectively evaluating their well-being. Most parameters that influence the patient's quality of life are fixed. Therefore, based on our study results, healthcare professionals should prioritize providing comprehensive information regarding the patient's disease and treatment, as the level of information seems to improve the overall patient's quality of life.

Evaluating the application of ChatGPT in China’s residency training education: An exploratory study

Objective The purpose of this study was to assess the utility of information generated by ChatGPT for residency education in China. Methods We designed a three-step survey to evaluate the performance of ChatGPT in China’s residency training education including residency final examination questions, patient cases, and resident satisfaction scores. First, 204 questions from the residency final exam were input into ChatGPT's interface to obtain the percentage of correct answers. Next, ChatGPT was asked to generate 20 clinical cases, which were subsequently evaluated by three instructors using a pre-designed Likert scale with 5 points. The quality of the cases was assessed based on criteria including clarity, relevance, logicality, credibility, and comprehensiveness. Finally, interaction sessions between 31 third-year residents and ChatGPT were conducted. Residents’ perceptions of ChatGPT's feedback were assessed using a Likert scale, focusing on aspects such as ease of use, accuracy and completeness of responses, and its effectiveness in enhancing understanding of medical knowledge. Results Our results showed ChatGPT-3.5 correctly answered 45.1% of exam questions. In the virtual patient cases, ChatGPT received mean ratings of 4.57 ± 0.50, 4.68 ± 0.47, 4.77 ± 0.46, 4.60 ± 0.53, and 3.95 ± 0.59 points for clarity, relevance, logicality, credibility, and comprehensiveness from clinical instructors, respectively. Among training residents, ChatGPT scored 4.48 ± 0.70, 4.00 ± 0.82 and 4.61 ± 0.50 points for ease of use, accuracy and completeness, and usefulness, respectively. Conclusion Our findings demonstrate ChatGPT's immense potential for personalized Chinese medical education.

Improving OBGYN resident CREOG scores

Background: OBGYN residents take an annual in-service training exam from the Council on Resident Education in Obstetrics and Gynecology (CREOG). The CREOG exam is used within the residency program to identify areas of improvement in education and to help residents prepare for passing the written boards. Introduction: This study’s aim was to improve knowledge and preparation for the CREOG exam through an improved didactic schedule and more focused test preparation strategy. This included incorporating a question bank and CREOG preparation throughout the year. Methods: The average standardized scores per resident class year for Corewell Health East- Dearborn were reviewed from 2019 to 2024. Study Design: The didactic schedule emphasized areas of weakness identified in the prior year, a question bank gamified, and CREOG preparation was initiated at the beginning of the academic year. Residents were also given a personal analysis with areas of improvement from prior years and a faculty liaison. Results: From 2019 to 2024, scores of each class year increased. In the PGY1 class year, the score increased from 54% in 2019 to 60% in 2024. In the PGY2 class year, the score increased from 57% in 2019 to 69% in 2024. In the PGY3 class year, the score increased from 55% in 2019 to 70% in 2024. In the PGY4 class year, the score increased from 58% in 2019 to 71% in 2024. The overall score has increased from 56% in 2019 to 67% in 2024. Discussion: Over six years, our residency didactic schedule and learning environment was revamped by our residents and faculty which resulted in improved scores in the CREOG exam. Conclusion: The improvement in CREOG scores will continue to guide future changes in our didactic schedule.

Development and Evaluation of a Cesarean Hysterectomy Simulation Model

Introduction: Cesarean hysterectomy is a life-saving procedure considered during postpartum hemorrhage in cases of uterine atony refractory to management, placenta accreta spectrum, or other obstetric complications. The procedure has high morbidity and mortality despite the rising rates of worldwide and in the United States. A high percentage of OB/GYN residents graduate without preparedness to perform this procedure post-residency, citing insufficient residency exposure as the primary contributor. This study aims to use evaluation and assessment tools to validate a low-cost, low-fidelity cesarean hysterectomy model at multiple OB/GYN residency training sites across the United States to increase resident confidence and proficiency in performing this critical procedure. Materials and Methods: Model Design and Development: Gynecologic surgeons from two OB/GYN residencies reviewed the literature for cesarean hysterectomy education and simulation. A low fidelity, anatomically accurate model was developed for cesarean hysterectomy simulation purposes. Efforts were made to optimize for anatomic layout and realistic feel, particularly for the anatomic structures relevant to cesarean hysterectomy: uterine vessels, anterior and posterior peritoneum, relation of anterior uterus to the bladder and ureters. Study Design: The study received institutional board review exemption at the Loyola University Medical Center (LUMC) and the University of Toledo (UT). During the last two months of the academic calendar, OB/GYN residents were offered the opportunity to perform a cesarean hysterectomy on the model. Demographics were collected in addition to the number of cesarean and abdominal hysterectomies performed as well as the confidence in cesarean hysterectomies independently. A uniform set of surgical instruments with both appropriate and inappropriate tools were made available for residents to choose from. Throughout the simulation, residents were asked to verbalize each step being performed. One faculty rater at each institution was trained to use the objective and standardized assessment tools and had completed an inter- and intra-rater reliability assessment. All residents were evaluated using the same two objective assessment tools. The two validated assessment tools used to evaluate resident performance using the model were the Task Specific Checklist and the Global Rating Scale. The former assessed residents on a “performed or not” basis on 14 surgical steps specific to cesarean hysterectomy. The latter used a scale of 1 to 5, with higher values representing more advanced skill, to evaluate respect for tissue handling, time and motion, instrument handing, knowledge of instrument selection, operation flow, assistant use, and familiarity with the procedure. Results: A total of 26 residents, 18 of 19 at LUMC and 8 of 17 at UT, completed the cesarean hysterectomy simulation between May and June 2022. At LUMC, no graduating residents had performed a cesarean hysterectomy in their residency. At UT, graduating residents had performed up to 2. All of the residents, including PGY-4s, stated that they either disagree or strongly disagree with the statement “I feel confident performing cesarean hysterectomy independently.” As hypothesized, the median resident scores on the Task Specific Checklist and Global Rating scale correlated with increasing PGY level. The combined TSC+GRS score was a median of 40 out of 49 total for the PGY-4 class, while the PGY-1 class had a median combined TSC+GRS score of 12 of 49. The PGY-2 and -3 class had TSC+GRS scores of 14 and 28 respectively. The simulation model was well-received with a median 4/5 rating for improving comfort level with cesarean hysterectomy and a median 4/5 rating for model realism. Each uterine model cost $6.00 and took approximately 20 minutes to build. The optional base constructed for supporting the model, cost a one-time fee of $160. All materials used for construction were easily available online. Discussion: This study validated an affordable, easily reproducible model that highlights the most important anatomy relevant to a cesarean hysterectomy. The model was developed, produced, and tested at two residency programs with a total of 26 residents participating in the study. This is the first low-fidelity cesarean hysterectomy model inclusive of relevant surgical steps and offers near-real visceral feel that has been developed and assessed for validity. This multisite study created a realistic model with high reproducibility at a low cost. Limitations of this study included the fact that only 27 residents participated in the study from only two institutions. In addition, faculty evaluators were not blinded to the residents they rated. The model is a reliable and affordable way to introduce this procedure at residency programs, particularly those that do not perform a substantial number of cesarean hysterectomies.

A Randomized Crossover Trial Evaluating the Impact of Cultural Dexterity Training on Surgical Residents' Knowledge, Cross-Cultural Care, Skills, and Beliefs: The Provider Awareness and Cultural Dexterity Training for Surgeons (PACTS) Trial.

This trial examines the impact of the Provider Awareness and Cultural dexterity Toolkit for Surgeons (PACTS) curriculum on surgical residents' knowledge, cross-cultural care, skills, and beliefs. Cross-cultural training of providers may reduce health care outcome disparities, but its effectiveness in surgical trainees is unknown. PACTS focuses on developing skills needed for building trust, working with patients with limited English proficiency, optimizing informed consent, and managing pain. The PACTS trial was a randomized crossover trial of 8 academic general surgery programs in the United States: The Early group ("Early") received PACTS between periods 1 and 2, while the Delayed group ("Delayed") received PACTS between periods 2 and 3. Residents were assessed preintervention and postintervention on Knowledge, Cross-Cultural Care, Self-Assessed Skills, and Beliefs. χ 2 and Fisher exact tests were conducted to evaluate within-intervention and between-intervention group differences. Of 406 residents enrolled, 315 were exposed to the complete PACTS curriculum. Early residents' Cross-Cultural Care (79.6%-88.2%, P <0.0001), Self-Assessed Skills (74.5%--85.0%, P <0.0001), and Beliefs (89.6%-92.4%, P =0.0028) improved after PACTS; knowledge scores (71.3%-74.3%, P =0.0661) were unchanged. Delayed resident scores pre-PACTS to post-PACTS showed minimal improvements in all domains. When comparing the 2 groups in period 2, Early residents had modest improvement in all 4 assessment areas, with a statistically significant increase in Beliefs (92.4% vs 89.9%, P =0.0199). The PACTS curriculum is a comprehensive tool that improved surgical residents' knowledge, preparedness, skills, and beliefs, which will help with caring for diverse patient populations.

Integrated cardio-thoracic imaging curriculum for residents: Design, implementation, and analysis of test and evaluation results

As the field of cardiac imaging has demonstrated exceptional growth over the past several decades, radiology departments and residency programs have struggled to integrate cardiac imaging instruction into training curricula. PurposeTo create an integrated cardio-thoracic teaching and lecture curriculum and resident rotation in accordance with AGGME and Society of Thoracic Radiology (STR) guidelines. Materials and methodsConsecutive PGY-2 to PGY-4 residents (n = 14) rotating through our Cardiothoracic Imaging (CTI) section from 1/1/2021 to 04/18/2022 were give pre- and post- rotation tests of knowledge and feedback evaluations. Attending feedback of the curriculum was obtained at 3-months and 9-months post curriculum implementation. A Wilcxon test was used to evaluate differences in improvement between pre- and post- rotation resident feedback scores, test scores for thoracic and cardiac test questions in addition to attending feedback scores at 3 and 9-months post curriculum implementation. ResultsThe overall post-rotation scores in addition to thoracic only and cardiac only scores improved, with the difference between improved versus stable or decreased scores being statistically significant overall (P = 0.039) and for cardiac scores (P = 0.003), but not for thoracic scores (P = 0.22). The overall (P = 0.002), thoracic (P = 0.027), and cardiac (P = 0.026) resident feedback scores were significantly improved post-rotation. Similarly, the overall attending feedback scores significantly improved over time (P = 0.021). ConclusionAn integrated Cardio-thoracic Imaging teaching curriculum was well received by both residents and attendings with significant improvement in post rotation feedback scores by both groups. Moreover, residents demonstrated improved scores on knowledge tests post rotation.

How Effective Are In-Hospital Training Workshops on Infection Control for Physicians? First Report in Iran

Background: The treatment staff should properly understand infection prevention and control (IPC) methods. Adherence to IPC has significant implications and outcomes for maintaining treatment staff safety, patient protection, and environmental care. Objectives: This study was conducted to examine infection control training in doctors. Methods: This study was conducted in Imam Khomeini Hospital in Tehran, Iran, and practitioners in internal and surgical departments participated. The research focused on infection prevention and control (IPC) through specialized workshops and questionnaires using a pre-and post-test design. The sessions included topics such as infection control, transmission, hospital-acquired infections, and components of the IPC program. Questionnaires based on the KAP method evaluated participants' knowledge, attitude, and performance. This study was approved by the university's research vice department and the research ethics committee. Data were analyzed using SPSS software, and the significance of P &lt; 0.05 was emphasized. Results: Of the 251 medical residents, 189 completed the study, 122 of whom were in internal medicine and 67 in surgery. Among the 158 faculty members, 60 completed the study, 39 were in internal medicine, and 21 were in surgery. The mean pre-test scores for internal medicine residents were 15.63 (out of 30) and 13.11 for surgical residents, respectively, which increased to 22.41 and 18.09 in the post-test. Conclusions: The results showed that regular and standard periodic training can improve doctors' knowledge and performance in implementing infection prevention and control programs.