Resident Students Research Articles

Considerations for a Holistic Model in Evaluating Medical Students for Cardiothoracic Surgical Residency

Program directors are tasked with selecting whom they think will be the best fit for residency and the next leaders of the field. While numerical metrics have played a vital role in this process, recent changes to student evaluation are reducing the availability of these metrics. This poses unique challenges for both applicants and program directors. Here we discuss how this will likely shift the focus on other parts of the application and the consequences (good and bad) of doing so.

Desenvolvimento e validação de uma ferramenta para avaliação por competência da inserção do dispositivo intrauterino

Abstract Objectives:. to develop and validate an instrument to assess the professional competence of nurses in the insertion of the intrauterine device (IUD) Methods: methodological study, developed in three stages: 1) tool development (Theoretical procedures); 2) evaluation of the tool by experts and judgment of the initially proposed items (Appearance validation and content validation); 3) test of the version resulting from the assessment by experts and assessment of internal consistency (Analytical procedures). Ten judges participated in the face and content validation, among obstetric nurses and gynecologists/obstetricians from the Sofa Feldman Hospital in Belo Horizonte (MG), while 38 nursing residency students were evaluated using the test tool, in the last stage of the study. Calculations of the Content Validity Index (CVI) and Cronbach’s alpha coefficient were performed as psychometric measures. Results: the initial tool covered 39 items. No item obtained CVI<0.8; however, through suggestions from the judges, items were merged, totaling 34 items. The total Cronbach’s alpha coefficient for this version was 0.828. Conclusion: the tool developed is valid and reliable. It is believed that the implementation of this tool will contribute to the training of professionals and the improvement of knowledge, behaviors, and skills in nursing consultations with a focus on reproductive planning with an emphasis on the insertion of the IUD.

Self-Assessment in General Surgery Applicants: An Insight Into Interview Performance.

Selecting medical students for residency is a competitive process, with a narrow range of scores separating middle-ranked applicants. Self-assessment is a fundamental skill for any competent physician with a demonstrated correlation to diagnostic ability, examination scores, and technical skills, but has yet to be investigated in residency selection. The objective of this study was to investigate the relationship between self-assessment and interview performance as a potential adjunct to discriminate between applicants. At the University of Ottawa in 2020, 55 applicants completed a 9-station interview circuit assessing different characteristics or skills important for a career in general surgery, followed by a self-assessment questionnaire evaluating their perceived performance at each station. Pearson's correlation was used to determine the relationship between self-assessment scores (SASs) and interviewer scores (ISs). There was a negative correlation between SASs and ISs for all interview stations. High performers underestimated their interview performance, and low performers overestimated their performance. Seven of the nine stations reached statistical significance (r=0.60-0.73, P<0.001). There was significant variability in the SAS of middle-ranked applicants, with a range three times greater than the range of ISs and demonstrating distinct self-assessment skills in candidates with very similar scores. Although we strive to select applicants who will succeed in residency to become competent physicians, self-assessment skills may be a useful adjunct during the interview process to assist in discriminating between applicants with similar scores.

University Students’ Perceptions of the Use of Technologies in Educational Activities and Mental Effort Invested

Different generations (digital natives, resident students, generation Y, X, or Z) show a preference towards technologies and the digital world. This "ex-post-facto" study is presented to learn the preferences that university students have regarding the use of different resources for various educational activities, as well as the investment of mental effort and perceived ease of learning concerning different means and technological resources. The sampling used is non-probabilistic, conventional, and intentional. 2,148 university students from different scientific fields of twelve Spanish public universities participate in it. To do this, an "ad hoc" instrument is designed whose data show high reliability and validity indices. The results indicate that students tend to have different perceptions regarding the various means and resources presented, in terms of the level of mental effort needed, along with the degree of easiness to learn through them. In this sense, the casuistry of the results is discussed and compared with the theory of mental effort proposed by Salomon (1981). The findings can be explained by the result of the interaction of three elements: the symbolic systems mobilized to elaborate messages, the message, and the technology that packages, formalizes, and transmits them. In the same way, it concludes by discussing the applicability of the results for the improvement of the digital competence of the students.

Using artificial intelligence reading label system in diabetic retinopathy grading training of junior ophthalmology residents and medical students

PurposeEvaluate the efficiency of using an artificial intelligence reading label system in the diabetic retinopathy grading training of junior ophthalmology resident doctors and medical students.MethodsLoading 520 diabetic retinopathy patients’ colour fundus images into the artificial intelligence reading label system. Thirteen participants, including six junior ophthalmology residents and seven medical students, read the images randomly for eight rounds. They evaluated the grading of images and labeled the typical lesions. The sensitivity, specificity, and kappa scores were determined by comparison with the participants’ results and diagnosis gold standards.ResultsThrough eight rounds of reading, the average kappa score was elevated from 0.67 to 0.81. The average kappa score for rounds 1 to 4 was 0.77, and the average kappa score for rounds 5 to 8 was 0.81. The participants were divided into two groups. The participants in Group 1 were junior ophthalmology resident doctors, and the participants in Group 2 were medical students. The average kappa score of Group 1 was elevated from 0.71 to 0.76. The average kappa score of Group 2 was elevated from 0.63 to 0.84.ConclusionThe artificial intelligence reading label system is a valuable tool for training resident doctors and medical students in performing diabetic retinopathy grading.

Teaching a graduate course on the acoustics of musical instruments over Zoom from my house during COVID-19

During Spring 2021, I taught a graduate course, Acoustics of Musical Instruments, to a blended enrollment of resident and distance students. Course content focused on wind (woodwind and brass) and stringed instruments with heavy reference to published literature. This was my third time teaching this course, but the first time teaching it entirely over Zoom from my house with all students also participating only on Zoom. It was also the first time teaching without access to laboratory equipment that would have allowed for interactive classroom demonstrations and out-of-class student projects. Although several students were accomplished musicians and had access multiple musical instruments in their homes, very few students had any access to test equipment that would have allowed for meaningful measurements or experimental projects. To offset this lack of access, I purchased several musical instruments for demonstrations and simple experiments that I could perform from my house and shifted the emphasis for student deliverables to written literature review summaries of published papers. This presentation will describe simple hands-on activities students carried out, demonstrations I was able to perform from my house with limited data analysis capabilities, and the benefits of having graduate students do literature reviews.

Formation of a spiritual worldview in students of art education specialties with the help of ethno-design technology

The aim of this study is to evaluate student views on the creation of spiritual well-being of art education residency students with the help of ethno-design technology. This research was designed in accordance with the qualitative research method. In order to collect data in the research, a semi-structured interview form was prepared by the researchers. The study group of the research consists of 20 graduate students studying in the field of art education at various universities in Kazakhstan in the 2021–2022 academic year. In the research, it was concluded that art education residency students frequently use ethno-design technologies in art education and find ethno-design technologies important in terms of art education. In addition, as a result of the research, it was observed that the art education residency students were undecided about their spiritual well-being and the majority of the students stated that ethno-design technology had a positive effect on their spiritual well-being. In order to popularise the use of ethno-design technologies by art education specialisation students, the education curricula should be enriched and seminars should be organised to increase the spiritual well-being of students.&#x0D; Keywords: Ethno-design technology, art education, spiritual well-being, students of art education specialties

Inter-Professional Education: Inter-Professional Learning Experience of Clinical Psychology and Psychiatry Residency Students

Objective: To explore the inter-professional learning experience of clinical psychology and psychiatry residency students. Design: Qualitative study Setting: This research was carried out at Addis Ababa University’s School of Medicine, College of Health Science, Department of Psychiatry, which offers clinical psychology and psychiatry residency programs. The research was carried out between September and April of 2020. Participants: The inter-professional learning experiences of 5 clinical psychology and 4 psychiatry residents were investigated. Methods: A theme analysis was used in a descriptive qualitative investigation. Semi-structured interviews were used to gather information, which was then evaluated thematically. Data was collected and analyzed at the same time. Results: The results revealed three main themes and five sub-themes reflecting clinical psychology and psychiatry students’ experiences. (a) IPE experience, (b) Factors affecting active involvement, and (c) Professional identity and IPE experience were the themes. Conclusion: The findings of this study revealed that IPE experiences vary and are the result of a complex combination of factors. Inter-professional education between participants with different professional status has a significant impact on their IPE experience. To meet the IPE objectives, the learning experience must include a balanced two-way interactive experience among participants.

Explaining Resident Medical Students’ Experiences of Performance During COVID-19: A Qualitative Study

Background: The COVID-19 crisis has created many problems, including a negative impact on student education. Objectives: The study aimed to understand the resident medical students' performance experiences during the COVID-19 pandemic, which is essential for future planning. Methods: The present qualitative study was performed on 15 resident medical students in Alborz University of Medical Sciences, Iran, from September to November 2020. Data were analyzed using conventional content analysis. Results: Analysis of the meaning units of interviews showed four categories describing the resident students' experiences of performance during COVID-19 as follows: Fear and anxiety, the need for support, the sense of responsibility, and the lack of educational facilities. Conclusions: The present study showed that the COVID-19 pandemic had posed incredible new challenges for resident students. Assessing the mental health of residents, providing adequate protective equipment, and support from authorities and community members can create empathy, reduce the feeling of fear, and increase their accompaniment with pandemic managing programs. Due to the problems created in the training of residents during the pandemic, it seems necessary to propose rehabilitation courses to improve the training program for residents in various fields.

Compliance with Regulatory Standard 32 in the units of a general hospital.

In Brazil, the Ministry of Labor and Employment created Regulatory Standard number 32 (Norma Regulamentadora 32, NR-32), instituted by Ordinance 485, of November 11th, 2005. It establishes measures to protect workers' safety and health in any health service. To quantify employees' compliance with NR-32 in the several units of a general hospital in the inland of the state of São Paulo, Brazil, reducing accidents related to work activity and allowing for the establishment of its fulfillment. This is an exploratory study with a qualitative and quantitative approach of data. Semi-structured questionnaires were applied to the volunteers. Thirty-eight volunteers participated, who were divided into a group of professionals with a higher education degree (53.5%), consisting of nurses, physicians, and resident students, and another group of professionals with technical and high school degree and nursing assistants. Among the volunteers, 96.4% reported that they knew NR-32 and 39.2% reported having experienced an occupational accident in the period before the study. The use of personal protective equipment was reported by 88% of volunteers, and needle recapping by 7.1% of them. Assimilation of NR-32 by health care professionals, regardless of schooling, as well as its application within the hospital, may be a way of protection against occupational accidents during the development of work activities. Allied to this, protection may be extended with constant training of these workers.

Food wastage management at the South African Military Academy officer’s mess

lobally, an estimated one-third of the total of food produced for human consumption is never consumed. This affects food security. South Africa has obligations to meet international commitments to reduce food wastage. The United Nations Sustainable Development Goal (SDG) 12.3 aims to reduce food loss through wastage by 30 per cent by 2030. To contribute to the achievement of this goal, South Africa has to formulate policies to reduce food loss to achieve national food security. The South African National Defence Force (SANDF), as an organ of the state, should align with national policies aimed at reducing food loss and waste. The current study was conducted at the South African Military Academy (SAMA), an institution of higher learning for SANDF members. The institution has a catering facility that serves approximately 350 resident students and other living-in members375 daily. To date, no research has been done on food wastage management either in the broader SANDF or at this institution. This lack of information and analysis on food wastage management in the military in South Africa prompted the current research. The study analysed food wastage management at the SAMA mess to identify the level of knowledge and skills of SAMA officers’ mess personnel regarding the status of food wastage and best management practices. Through this qualitative study, online semi-structured interviews, using Microsoft Teams, were utilised to collect data from SAMA mess personnel. The findings revealed that there are set measures in place at the SAMA mess for managing food wastage, such as booking meals in advance and being able to repurpose food. The participants also indicated that most SAMA chefs are trained in food wastage management and possess the necessary skills to reduce food wastage in the mess; yet, not optimally so. Recommendations from this research are that more and improved training of personnel, as well as awareness programmes among mess staff and SAMA students would further reduce food wastage. Implementing such food wastage management measures would benefit the SAMA and the SANDF, and would contribute to national food wastage management and the realisation of the United Nations SDG 12.3. Keywords: Food security, food wastage, food wastage management, South African Military Academy, semi-structured interviews

A COMPARATIVE STUDY OF RESIDENTIAL AND NON-RESIDENTIAL STUDENTS OF MADARIS ON SOCIAL SUPPORT, POSITIVE MENTAL WELLNESS AND SELF EFFICACY

Literature mentions that students residing in Madaris may experience lower social support as a resident group which may result in lower positive mental wellness and self-efficacy. This study compared resident and non-resident adolescents from the same Madaris on social support, positive mental wellness, and self-efficacy assuming that resident group from Madaris will have lower social support impacting their positive mental wellness and self-efficacy. Causal comparative design was implemented. Sampling method was purposive. Social Support Questionnaire (Sarason, Sarason, Sheerin, &amp; Plerce,1987) was administered to measure social support. Subjective Happiness Scale (Lyubomirsk &amp; Lepper, 1999), Satisfaction with Life Scale (Diener, Emmons, Larsen, &amp; Griffin, 1985) and Well Being Affectometer-2 Scale (Kammann &amp; Flett, 1983) were administered to measure aspects of Positive Mental Wellness while Generalized Self Efficacy Scale (Schwarzer &amp; Jerusalem, 1995) was administered to measure self-efficacy. The result indicated no significant difference between resident and non-resident groups with respect to social support, positive mental wellness and self-efficacy, consequently not supporting the hypothesis that resident group will be lower on all variables. Resident students in Madaris mentioned “ALLAH”(God) as the major supporter perceived by them in their lives. While social support predicted positive mental wellness in both groups. In this regard, student’s “Relationship with Allah” deeply enhancing their mental well-being might be very important to be analyzed in further studies. There was seen predictive relationship of “satisfaction with social support” with self-efficacy in both groups. Keywords: Social Support; Positive Wellness; Madrassah; Self-efficacy; Madaris; Resident.

Assessment of a Multifaceted Approach, Including Frequent PCR Testing, to Mitigation of COVID-19 Transmission at a Residential Historically Black University

COVID-19 posed an unprecedented threat to residential colleges in the fall of 2020. While there were mathematical models of COVID-19 transmission, there were no established or tested protocols of COVID-19 testing or mitigation for school administrators to follow. To investigate the association of a multifaceted COVID-19 mitigation strategy using social, behavioral, and educational interventions and a program of frequent testing with prevalence of disease spread. This cohort study was conducted as a retrospective review of COVID-19 positivity from August 16, 2020, to April 30, 2021, at Delaware State University, a publicly funded historically Black university. Participants included all students, faculty, and staff members with a campus presence. Positivity rates after use of mitigation strategies and testing on campus were compared with those of the surrounding community. Data were analyzed from July through September 2021. Mitigation strategies included education and outreach about social distancing, masking, and handwashing, and a COVID-19 testing plan consisted of twice-weekly polymerase chain reaction (PCR) screening using anterior nasal samples (fall and early spring semester) and then saliva-based samples (middle to late spring semester). Cumulative tests, infections, daily quarantine, and isolation residence hall occupancy were measured, and comparisons were made with statewide COVID-19 positivity rates. The campus cohort included 2320 individuals (1575 resident students, 415 nonresident students, and 330 faculty or staff members). There were 1488 (64.1%) women and 832 (35.9%) men; mean (SD) age was 27.5 (12.9) years. During the fall semester, 36 500 COVID-19 PCR tests were performed. Weekly positivity rates ranged from 0 of 372 tests to 16 of 869 tests (1.8%) (mean [SD] positivity rate, 0.5% [0.5%]; 168 positive results and 36 312 negative results). During the same period, statewide positivity ranged from 589 of 25 120 tests (2.3%) to 5405 of 54 596 tests (9.9%) (mean [SD] positivity rate, 4.8% [2.6%]). In the spring semester, 39 045 PCR tests were performed. Weekly positivity rates ranged from 4 of 2028 tests (0.2%) to 36 of 900 tests (4.0%) (mean [SD] positivity rate, 0.8% [0.9%]; 267 positive results and 38 767 negative results). During the same period, statewide positivity ranged from 1336 of 37 254 tests (3.6%) to 3630 of 42 458 tests (8.5%) (mean [SD] positivity rate, 5.1% [1.3%]). Compared with statewide rates, campus positivity rates were mean (SD) 4.4 (2.6) percentage points lower during the fall semester (P < .001) and mean (SD) 5.6 (1.6) percentage points lower during the spring semester (P < .001). Total daily quarantine and isolation residence hall occupancy ranged from 0 to 43 students in the fall and 1 to 47 students during the spring. This study found that the combination of campuswide mitigation policies and twice-weekly COVID-19 PCR screening was associated with a significant decrease in COVID-19 positivity at a residential historically Black university campus compared with the surrounding community. Given the socioeconomic demographics of many students at historically Black colleges and universities, keeping these resident campuses open is critical not only to ensure access to educational resources, but also to provide housing and food security.

Effectiveness of online mindfulness interventions on medical students\u2019 mental health: a systematic review

BackgroundMedical school typically presents students with a combination of academic and personal stressors that may lead to substandard mental health wellbeing. Meditation practices such as mindfulness facilitate a greater awareness of one's thoughts and feelings, thereby decreasing emotional reactivity. The use of mindfulness-based interventions delivered online has considerable potential in fostering self-care and helping medical students to handle mental health challenges. We examined the available evidence on the use of online mindfulness interventions in order to determine whether they are feasible and effective for improving medical students’ mental health.MethodsWe performed a systematic review guided by PRISMA guidelines and utilised the following databases: ProQuest, Medline, PubMed, PsycINFO, Web of Science, IEEE Explore, Cochrane, and CINAHL. The key search terms used include mindfulness, cognitive behavioural therapy, acceptance and commitment therapy, online, web, virtual, internet cyber, app, medical students, residency students, and residents. English-language articles published in the last ten years that described online interventions for medical students or residents were included in the review.ResultsTwo studies describing the impact of online mindfulness interventions on medical students’ mental health were identified. Research in this domain is nascent; available qualitative and quantitative evidence suggests benefits in self-compassion, perceived stress, cognitive skill use, mindfulness, creating coping mechanisms, and greater awareness of emotions and feelings. There was no evidence of the effectiveness of online mindfulness interventions on depression, anxiety and burnout. There was, however, general low program usage and participation tended to diminish near the conclusion of the interventions.ConclusionsThe evidence found in the systematic review exhibits the potential for online mindfulness interventions to be effective in addressing some mental health challenges of medical students. There was insufficient evidence to support the use of online mindfulness interventions for burnout, depression, and anxiety. Longitudinal studies with randomised controlled trials are required to generate stronger and robust evidence.

Examining doctor-patient communication skills among senior medical students based on calgary cambridge observation guide.

Background: This study aimed to determine the level of communication skills in residents of Shahid Beheshti University of Medical Sciences in the final year of the main courses in accordance with the Calgary Cambridge Observation Guide for the purpose of improving their skills and improving the quality and correcting the existing problems. Methods: In this cross-sectional study, 190 residents of 14 majors were evaluated using a checklist of patient and physician communication skills based on the Calgary Cambridge Guide that has been localized in Persian language and culture using the cross-cultural adaptation standard in 6 stages. Content validity was verified by the primary author. The skills within the 71-item checklist were examined via a 3-point Likert-type rating scale, with scores ranging from 1 to 3 (good to poor) and the data were analyzed using the SPSS 16 software. Results: Of the190 residents, 161 were enrolled in the study. Of them 74 were internal and 87 surgical residents, and 89 were male and 72 were female. The mean score of the total communication skills in 14 major courses was 128.68±37.2264; it was 121.7±36.990 in the Department of Surgery, and 136.8±36.073 in the Department of Internal Medicine, with p=0.010, in female students 126.6 and in male student 130.3 with p=0.500. Conclusion: The score of 71 communication skills points in the list was prepared using the Likert scale option 3. In the overall skills, the weak score is 71 to 118.33, the average score is 118.34 to 165.66, and the good score is 165.67 to 213. Based on the findings of the study and examining the educational curriculum, it can be stated that unlike in psychiatry with an average score of 168.83, which is at a good level, the other fields are not well-developed and overall the communication skills in the residents, with a mean score of 128.68, are moderately poor and therefore further education and training is needed in these fields for resident students.

Otolaryngology Residents' Attitudes, Experiences, and Barriers Regarding the Medical Research.

Objective:It was aimed to investigate the attitudes, experiences, and barriers towards scientific research among otolaryngology residents in Turkey.Methods:Anonymous data were collected via an online survey. The demographic characteristics and experience in scientific research were investigated in the first section of the survey. The attitudes of participants towards scientific research and the barriers to the scientific research were examined in the second section of the survey using 17 items.Results:The present study involved 119 otolaryngology residents continuing their education. It was determined that 68.1% of participants think that “participating in scientific research” is a part of otolaryngology training. In the present study, it was shown that the residents having journal club hours in clinics on regular basis participated in various steps of scientific research projects (p<0.05). Residents stated that they participated in the “literature review” stage of the preparation of a scientific publication (mean value of 2.58±1.88) most and in “verbal presentation in a congress” least (mean value of 0.74±1.44). It was determined that 80.7% of participants have not attended in any training on scientific research. It was found that the residents receiving structured scientific research training participated more in steps of scientific research projects which was statistically significantly (p<0.05).Conclusion:In our country, otolaryngology residents are very enthusiastic about having research education and participating in researches. However, residency students frequently have time deficiency, lack of knowledge-skill, and lack of financial support. Dedicated time should be allocated for research training and practice in specialty programs. Journal club activities should be organized on regular basis and integrated with research education. On the other hand, the scholarly activities of residents should be supported by means of various countrywide educational activities on research training.

Geographic mobility in the emergency medicine residency match and the influence of gender.

Women are underrepresented in emergency medicine (EM) leadership. Some evidence suggests that geographic mobility improves career advancement. We compared movement between medical school and residency by gender. Our hypothesis was that women move a shorter distance than men. We collected National Residency Matching Program (NRMP) lists of ranked applicants from eight EM residency programs from the 2020 Main Residency Match. We added the gender expressed in interviews and left the Association of American Medical Colleges (AAMC) number as the unique identifier. Applicant data for matched osteopathic and allopathic seniors in the continental United States was included. We obtained street addresses for medical schools from an AAMC database and residency program addresses from the ACGME website. We performed geospatial analysis using ArcGIS Pro and compared results by gender. NRMP approved the data use and our institutional review board granted exempt status. A total of 881 of 944 unique applicants met inclusion criteria and included 48.5% (830/1,713) of matched allopaths and 37% of all matched seniors; 48% (420) were female. There was no significant difference between genders for distance moved (p=0.31). Women moved a mean (±SD) 619 (±698) miles (median=341 miles, range=0-2,679 miles); and men, a mean (±SD) 641 (±717) miles (median=315 miles, range=0-2,671 miles). Further analysis of applicants traveling less than 50 miles (49 women, 51 men) and by census division showed no significant frequency differences. Women and men travel similar distances for EM residency with the majority staying within geographic proximity to their medical school. This suggests that professional mobility at this stage is not a constraint. Our study findings are limited because we do not know which personal and professional factors inform relocation decisions. Gender is not associated with a difference in distance moved by students for residency. This finding may have implications for resident selection and career development.

Roles and Responsibilities of Medicine Subinternship Directors : Medicine Subinternship Director Roles.

The internal medicine (IM) subinternship (also referred to as acting internship) plays a crucial part in preparing medical students for residency. The roles, responsibilities, and support provided to subinternship directors have not been described. We sought to describe the current role of IM subinternship directors with respect to their responsibilities, salary support, and reporting structure. Nationally representative, annually recurring thematic survey of IM core clerkship directors with membership in an academic professional association as of September 2017. A total of 129 core clinical medicine clerkship directors at Liaison Committee on Medical Education fully accredited U.S./U.S.-territory-based medical schools. Responsibilities, salary support, and reporting structure of subinternship directors. The survey response rate was 83.0% (107/129 medical schools). Fifty-one percent (54/107) of respondents reported overseeing both core clerkship inpatient experiences and/or one or more subinternships. For oversight, 49.1% (28/53) of subinternship directors also reported that they were the clerkship director, 26.4% (14/53) that another faculty member directed all medicine subinternships, and 18.9% (10/53) that each subinternship had its own director. The most frequently reported responsibilities for the subinternship directors were administration, including scheduling, and logistics of student schedules (83.0%, 44/53), course evaluation (81.1%, 43/53), and setting grades 79.2% (42/53). The modal response for estimated FTE per course was 10-20% FTE, with 33.3% (16/48) reporting this level of support and 29.2% (14/54) reporting no FTE support. The role of the IM subinternship director has become increasingly complex. Since the IM subinternship is critical to preparing students for residency, IM subinternship directors require standard expectations and adequate support. Future studies are needed to determine the appropriate level of support for subinternship directors and to define essential roles and responsibilities.

Sleep in Adolescents Attending Australian Boarding Schools: A Review and Interim Recommendations

Boarding schools, by definition, house students in residence either on campus or close by in residential facilities - where the sleep environment is likely to differ from their home environment. For boarders, being in the boarding environment occurs alongside a convergence of psychosocial and physiological factors likely to impact adolescent sleep. This paper comprises a review of the literature on sleep and boarding students in the Australian context. We also propose recommendations aligned with the scientific evidence base that can be used to promote healthy sleep in Australian boarding school students, focusing on staff training and sleep knowledge, daily routines, sleeping arrangements, and student mental health and wellbeing. It must be noted that these recommendations should be considered interim recommendations until further research is performed in the area. Further, we suggest the development of standardised practice guidelines, to ensure that student sleep is supported appropriately within the Australian boarding context.

A Targeted Needs Assessment for the Development of a Surgical Sub-internship Curriculum

Medical students often feel inadequately prepared for the responsibilities of surgical internship because of insufficient exposure to resident responsibilities prior to starting residency. This lack of preparation may contribute to burnout and attrition early in residency. Sub-internships should provide these experiences. Significant variation, however, exists in the structure of these rotations. We conducted a targeted needs assessment to inform the development of a didactic curriculum to address gaps in the surgical sub-internship experience and better prepare students for general surgery residency. A 25-item needs assessment survey was developed and distributed to senior medical students in their surgical sub-internship, current junior residents, and prior students (alumni) from the past 4 years who matched into general surgery residencies at other institutions. Geisel School of Medicine at Dartmouth/Dartmouth-Hitchcock Medical Center, a tertiary-care academic medical center. Nine senior medical students; 12 current residents and 14 alumni, including 9 PGY-1, 13 PGY-2, and 4 PGY-3 residents. The topics rated most important by medical students were floor management topics, specifically lines, tubes, and drains, hypotension, post-operative fever, chest pain, oliguria, and post-operative pain. In contrast, there was a wider variety of topics rated highly by residents. Residents emphasized non-technical communication and documentation skills. Residents at every training level rated presenting patients on rounds as the most important skill for incoming interns to acquire, whereas only one-third of medical students considered this to be an essential topic. Medical students rank management of common clinical problems as the most critical aspect in their preparation for residency. Residents recognized these topics as important, but also placed high emphasis on non-technical communication and documentation skills. The findings from this need's assessment can be used to guide content structure for a sub-intern curriculum.