Second Year Of Training Research Articles

Effects of PACK training on the management of asthma and chronic obstructive pulmonary disease by primary care clinicians during 2 years of implementation in Florianópolis, Brazil: extended follow-up after a pragmatic cluster randomised controlled trial with a stepped-wedge design

BackgroundTraining primary care doctors and nurses to use Practical Approach to Care Kit (PACK) improved management of asthma and chronic obstructive pulmonary disease (COPD) in a previous randomised trial. The...

Developing education in environmental health and medicine focusing on neurology: Initiatives in Sweden (the UPRISE model), France, and Turkey

BackgroundThe role of environmental factors in neurological disorders constitutes a topic of increasing importance. Teaching in European universities should expand and update this field gaining future health professionals including adjacent disciplines. AimTo describe recent efforts to create courses that cover crucial interdisciplinary content that we believe should be included in modern education, and to adapt modern pedagogic strategies. MethodsIn collaboration with RISE (Rencontres Internationales Santé Environnement), elective courses focused on Environmental Health and Medicine (EHM) were developed, in France, Sweden, and Turkey. The courses combined classic teaching methods and new pedagogic and digital solutions to create environment-related health awareness and facilitate future interprofessional collaboration in this field. ResultsUPRISE is an innovative elective course introduced in 2020 in Sweden's Uppsala University with the participation of lecturers from several countries and aim to recruit students from different universities. A total of 45, mainly female students (68%), participated in the course. In Strasbourg, France, a novel course on environmental medicine was held in 2019–2023 and examined 90 students, of which more than half were female. Nine graduate nurse students in Turkey attended ten seminar series focused on EHM. Overall, students expressed satisfaction with the courses. ConclusionsThis European project for courses in higher education arising from RISE was met with appreciation and challenges from academic institutions.However, due to considerable efforts to introduce the EHM concept, a unique compulsory course for all medical students in the second year of training started in 2023 in all French medical faculties. In 2023, UPRISE was integrated into ENLIGHT, the European University Network to promote equitable quality of Life, sustainability, and Global engagement through Higher education Transformation.

Remote cadaveric minimally invasive surgical training.

The aim of the study is to discuss the efficacy of live vs. remote cadaver surgical training (CST) for minimally invasive surgery (MIS). A cohort of 30 interns in their first and second years of training were divided into three groups: live observers (n = 12), live participants (n = 6), and remote observers: (n = 12). The interns had the opportunity to either observe or actively participate in two different surgical procedures, namely, laparoscopic lower anterior resection, performed by a colorectal surgical team, and laparoscopic fundoplication, performed by a pediatric surgical team. The procedures were conducted either at a base center or at a remote center affiliated with the institute. Some of the interns interacted directly with the surgical teams at the base center, and others interacted indirectly with the surgical teams from the remote center. All interns were administered questionnaires before and after completion of the CST in order to assess their understanding of various aspects related to the operating room layout/instruments (called "design"), accessing the surgical field (called "field"), understanding of anatomic relations (called "anatomy"), their skill of dissection (called "dissection"), ability to resolve procedural/technical problems (called "troubleshooting"), and their skill in planning surgery (called "planning") according to their confidence to operate using the following scale: 1 = not confident to operate independently; 4 = confident to operate with a more senior trainee; 7 = confident to operate with a peer; and 10 = confident to operate with a less experienced trainee. A p < 0.05 was considered statistically significant. All scores improved after CST at both the base and remote centers. The following significant increases were observed: for remote observers: "field" (2.67→4.92; p < .01), "anatomy" (3.58→5.75; p < .01), "dissection" (3.08→4.33; p = .01), and "planning" (3.08→4.33; p < .01); for live observers: "design" (3.75→6.17; p < .01), "field" (2.83→5.17; p < .01), "anatomy" (3.67→5.58; p < .01), "dissection" (3.17→4.58; p < .01), "troubleshooting" (2.33→3.67; p < .01), and "planning" (2.92→4.25; p < .01); and for live participants: "design" (3.83→6.33; p = .02), "field" (2.83→6.83; p < .01), "anatomy" (3.67→5.67; p < .01), "dissection" (2.83→6.17; p < .01), "troubleshooting" (2.17→4.17; p < .01), and "planning" (2.83→4.67; p < .01). Understanding of "design" improved significantly after CST in live observers compared with remote observers (p < .01). Understanding of "field and "dissection" improved significantly after CST in live participants compared with live observers (p = .01, p = .03, respectively). Out of the 12 remote observers, 10 participants (83.3%) reported that interacting with surgical teams was easy because they were not on-site. Although all the responses were subjective and the respondents were aware that observation was inferior to hands-on experience, the results from both centers were equivalent, suggesting that remote learning could potentially be viable when resources are limited.

Evaluation of a Summer Research Program for Medical Students on a Regional Medical Campus

In 2015, the University of Minnesota Medical School Duluth campus implemented a summer research program for medical students between their first and second years of training. The goal of the Medical Student Summer Research Program is to provide support for students who wish to participate in research as part of their medical training and to provide support for faculty for their ongoing research. The program is not a required part of the curriculum and students self-select to participate. We have fostered relationships with faculty mentors from our institution, two regional hospitals, as well as external institutions to support this program. Here we report on attitudes and assessments about this program over the first seven years. Student surveys indicate that the amount of additional stress of taking on a research project is manageable, overall critical thinking skills and communication skills improved by participating in research, and a greater appreciation for the importance and relevance of research to their practice was developed. Faculty survey results indicate that the stress of mentoring is manageable and many faculty report deliverable outcomes such as publications and grant submissions after having mentored students, however there are still some faculty needs that must be addressed. The overall survey results, and the continued support from faculty as mentors, highlight the culture of respect for research, training, and service at the Medical School Duluth and the importance of having a dedicated and sustainable Medical Student Summer Research Program available to our students.

Virtual global health through longitudinal case-based rounds.

The COVID-19 pandemic rapidly transferred medical education curricula to online platforms. Due to travel bans, students were cut off from traditional global health experiences. This project was developed to confront the travel restrictions, time restraints and cost barriers associated with global health during the pandemic. Now, with fewer travel restrictions, this programme continues to offer learning opportunities: it could be extended to practice medical language proficiency in non-English speaking countries, compliment in-person experiences and increase the sustainability of global health programs. We provided American and Tanzanian students with a longitudinal, global health experience through an interactive, online collaboration. The cohort engaged in bi-weekly meetings using live video conferencing. During the 3-hour calls, students presented and discussed de-identified patient-cases representative of cases seen in outpatient primary care clinics at their home institutions. Additionally, follow-up reports from previous cases were presented to incorporate an element of longitudinal care. Six medical students from an urban hospital in the United States (USA) and physician-assistant students from a rural Tanzanian hospital were led by an attending physician in their respective countries. The pilot program's efficacy was assessed through anonymously reviewed qualitative surveys at its initiation in December 2021, midpoint, and conclusion in April 2022. Student testimonies from the US cohort were acquired before and after the study using a Likert scale to determine student growth, global health interest and clinical skill acquisition. Although analysis was limited by the cohort's size, students indicated an increase in self-reported global health experiences, knowledge of health care limitations and benefits in resource-limited countries, primary care patient presentations proficiency and a decrease in student burnout. We have demonstrated the ability to deploy a virtual global health experience for medical students. This program is unique in its bi-directionality: students and attending physicians from two continents directly communicated and discussed cases, as opposed to traditional lecture-based global health courses. Along with the increased exposure to primary care cases, students expressed a sense of community and mentorship in these cohorts, as upper-class students provided points of guidance to students in their first and second years of training. To increase student interaction between countries and sense of community during the 6-month course, we implemented a brief introduction into each class called ‘About Me.’ Each week, two students would present a 5-minute talk describing their personal goals, hobbies and background to the group. Students experienced cultural variations in medical practice, as they were introduced to country-specific pathologies and guided through each country's approach to providing a diagnosis and treatment plans. Occasionally, there would be differences and innovations that justified additional discussion. At the end of classes, we allowed time for a student to briefly present a topic of their choosing discussed during the previous week. This program also lends itself to annual continuation, as students strengthen their bond with their international counterparts and naturally progress from inexperienced mentees to experienced mentors in the context of global health. The authors meet conditions 1, 2, 3 and 4. All authors have given final approval of the paper.

Racial and Ethnic Differences in Internal Medicine Residency Assessments

Previous studies have demonstrated racial and ethnic inequities in medical student assessments, awards, and faculty promotions at academic medical centers. Few data exist about similar racial and ethnic disparities at the level of graduate medical education. To examine the association between race and ethnicity and performance assessments among a national cohort of internal medicine residents. This retrospective cohort study evaluated assessments of performance for 9026 internal medicine residents from the graduating classes of 2016 and 2017 at Accreditation Council of Graduate Medical Education (ACGME)-accredited internal medicine residency programs in the US. Analyses were conducted between July 1, 2020, and June 31, 2022. The primary outcome was midyear and year-end total ACGME Milestone scores for underrepresented in medicine (URiM [Hispanic only; non-Hispanic American Indian, Alaska Native, or Native Hawaiian/Pacific Islander only; or non-Hispanic Black/African American]) and Asian residents compared with White residents as determined by their Clinical Competency Committees and residency program directors. Differences in scores between Asian and URiM residents compared with White residents were also compared for each of the 6 competency domains as supportive outcomes. The study cohort included 9026 residents from 305 internal medicine residency programs. Of these residents, 3994 (44.2%) were female, 3258 (36.1%) were Asian, 1216 (13.5%) were URiM, and 4552 (50.4%) were White. In the fully adjusted model, no difference was found in the initial midyear total Milestone scores between URiM and White residents, but there was a difference between Asian and White residents, which favored White residents (mean [SD] difference in scores for Asian residents: -1.27 [0.38]; P < .001). In the second year of training, White residents received increasingly higher scores relative to URiM and Asian residents. These racial disparities peaked in postgraduate year (PGY) 2 (mean [SD] difference in scores for URiM residents, -2.54 [0.38]; P < .001; mean [SD] difference in scores for Asian residents, -1.9 [0.27]; P < .001). By the final year 3 assessment, the gap between White and Asian and URiM residents' scores narrowed, and no racial or ethnic differences were found. Trends in racial and ethnic differences among the 6 competency domains mirrored total Milestone scores, with differences peaking in PGY2 and then decreasing in PGY3 such that parity in assessment was reached in all competency domains by the end of training. In this cohort study, URiM and Asian internal medicine residents received lower ratings on performance assessments than their White peers during the first and second years of training, which may reflect racial bias in assessment. This disparity in assessment may limit opportunities for physicians from minoritized racial and ethnic groups and hinder physician workforce diversity.

Abstract 12738: Tracking Fluoroscopic Time Amongst Cardiology Trainees

Introduction: ACC and ESC guidelines for cardiologists in training recommend 200-300 coronary angiographies as primary operator before completion of training. There are different ways to measure an operator's proficiency of performing a coronary angiogram including contrast volume, fluoroscopy time, and total time of procedure. Data from previous studies has shown that fluoroscopy time is the best measure of trainee progression. Fluoroscopy time is significantly longer in trainees who have performed less than 100 interventions. Objectives: Utilize fluoroscopy time during cardiac catheterization to help direct safety in cardiology trainees. Methods: Cardiac catheterization operator data from UCD cardiology fellows between 2014 - 2017. Data was categorized into 3 categories: left heart catheterizations (LHC) , right heart catheterization (RHC), and left and right catheterization combination (LHC + RHC). Data was excluded if the operator performed any other procedure in addition to catheterization. Data was analyzed using a One-way ANOVA analysis. Results: A total of 853 cardiac catheterizations performed by trainees. LHC fluoroscopic time declined from year 1 (9.64 mins) to year 2 (7.62 mins, p: 0.009) (figure 1). LHC + RHC fluoroscopic time declined from year 1 (12.89 mins) to year 2 (10.77 mins, p: 0.007). There was no statically significant change in fluoroscopic time in operators over their three years of training who performed RHC. Operators in their third year of training did not have any statistically significant improvement in their fluoroscopic time when compared to their second year of training. Conclusions: Fluoroscopic time decreases after first year of training in LHC and LHC + RHC cases. There is no significant change in fluoroscopic time amongst fellows who perform RHC regardless of years of experience. Safety efforts to minimize fluoroscopic time should be focused on fellows in their first year of training

The coat of arms, a tool for group cohesion

Teamwork, an essential component of quality care, is not always self-evident. Working together requires trust and shared objectives. As part of their preparation for the health service, aiming at learning to work in project mode, it is proposed to nursing students in their second year of training to use a pedagogical tool, the coat of arms, to work on group dynamics and the sharing of common values. The aim is to bring the team to give life to its collective identity, in the service of the implementation of its project, based on the individual characteristics of each of its members.

Requirements for technical preparation of volleyball players at the stage of initial training

The development of sportsmanship of volleyball players is directly related to the mastery of technique actions and the possibility of their use in competitions. This requires the study of the content of technical preparation starting from the stage of initial of preparation. Purpose: to determine the requirements for technical preparation of volleyball players at the stage of initial training on the basis of program and normative documents. Methods: theoretical analysis and generalization of data of scientific and methodical literature, synthesis, comparison, analogies, inductions and deductions, analysis of documentary materials, methods of mathematical statistics. Results. It have been clarified the basic tasks for the stage of initial training. They are mostly related to improving health, promoting proper physical development and versatile physical preparedness; development of special physical qualities and abilities; instilling a lasting interest to volleyball sessions; mastering the technique and tactics of the game (initial training, confident mastery); adaptation to game conditions and competition conditions; education of manifestations of volitional qualities in the conditions of variable resistance of the opponent. Determined shares within the technical preparation of young volleyball players, which are 39 hours, 44.82% (defensive actions) and 48 hours, 55.18% (offensive actions) in the first year of training, 44 hours, 44.00% (defensive actions) and 56 hours, 56.00% (offensive actions) in the second year of training and 43 hours, 46.24% (defensive actions) and 50 hours, 53.76% (offensive actions) in the third year of training at the stage of initial training in volleyball. The recommended stages of learning the technical elements are: getting acquainted with the techniques of playing volleyball, learning the techniques of the game and tactical interactions in simplified conditions, learning the techniques of the game and certain tactical interactions in conditions close to games, consolidating game techniques. Six tests are recommended to control the technical preparedness of volleyball players in all years of initial training. Conclusions. Implementation of technical preparation involves the study of a significant part of the technique actions during the stage of initial training. However, the implementation of the content of technical preparation does not have clear regulations on the use of tools and methods at the stage of initial training of volleyball players, which significantly expands the possibilities of scientific and practical search for effective methodological approaches.

The Relation of Grit and Surgical Specialty Interest Among Medical Students

The assessment of Grit among medical students applying to surgical residency programs may be useful, but the relationship between student Grit and surgical specialty interest is not clear. This study investigated whether medical student Grit differs based on interest in direct-entry surgical specialties. A literature search informed the development of a cross-sectional study assessing medical student ratings of the validated 6-item Short-Grit scale. Medical students also indicated their career preferences. Faculty of Medicine, Dalhousie University, Halifax, NS, Canada; a tertiary medical center. Surgical specialty interest and Grittiness were assessed among 297 (50.4%) pre-clerkship medical students in their first or second year of training. Data was collected from program applicants over 4 years. Medical students had high levels of Grit (M = 4.029, SD = 0.517). There was a significant difference in Grit level between medical students interested in cardiac surgery ([M = 4.197, SD = 0.471 vs M = 3.919, 0.518]; t(295) = 4.674, p < 0.001; Cohen's D = 0.556), general surgery ([M = 4.178, SD = 0.466 vs M = 3.916, 0.527]; t(295) = 4.434, p < 0.001; Cohen's D = 0.520), neurosurgery ([M = 4.238, SD = 0.457 vs M = 3.950, 0.518]; t(295) = 4.412, p < 0.001; Cohen's D = 0.575), plastic surgery ([M = 4.138, SD = 0.497 vs M = 3.967, 0.520]; t(295) = 2.747, p = 0.006; Cohen's D = 0.333), and vascular surgery (M = 4.248, SD = 0.368 vs M = 3.948, 0.541); t(295) = 4.570, p < 0.001; Cohen's D = 0.501). Medical students with a career interest in "poor lifestyle" surgical specialties have higher Grit than their peers. These findings may be noteworthy for surgical residency programs with high rates of attrition and burnout.

Expanding the Scope of Mentoring for Psychiatry Trainees in Northern Ireland

AimsThe Northern Ireland psychiatry mentoring scheme, in which higher trainees mentor core trainee year 1 (CT1) doctors, has been running for four years. In this year's scheme, implemented in August 2021, we have expanded the scope of the scheme and implemented an online platform to match and connect mentors and mentees. Our aim was to gather baseline data regarding the experiences of mentors and mentees and to capture information regarding the content of mentoring meetings and attitudes towards format of meetings.MethodsHigher psychiatry trainees were invited to sign up as mentors through the Northern Ireland Medical and Dental Training Agency (NIMDTA) and Royal College of Psychiatry Northern Ireland (RCPsych NI) mailing lists. Mentors were obliged to complete a theoretical module on training before meeting their mentees. Core trainees in the first and second year of training were asked to opt-out of the scheme if they preferred not to be involved. CT3 trainees were offered the opportunity to opt-in to the scheme. There were a total of 16 mentors and 22 mentees at the outset. The NIMDTA Professional Support Unit provided an online platform, Mentornet, which allowed mentors and mentees to complete a profile, for mentees to rank their preferences for mentor, and to facilitate meetings. One of the authors (M.M.) presented the developments in the scheme to a nationwide audience in the RCPsych webinar on mentoring.ResultsSix mentors and two mentees responded to the call to complete a baseline online questionnaire. 83% of mentors responded that they had found their role enjoyable and rewarding, whilst 67% of mentors indicated that their role had helped them develop in other skill areas. Both mentees responded that they had found the scheme beneficial and would recommend participation to other trainees.ConclusionMentorship is a valuable opportunity for senior psychiatry trainees to facilitate the professional development of junior trainees and to pass on their experience. This is the first year that all core trainees have been invited to participate and that a new web platform has been used to facilitate meetings. Baseline feedback response numbers have been limited although the responses were universally positive. We intend to obtain further feedback at the end of this year in order to devise quality improvement measures for the 2022/2023 cohort.

Executive MBA (EMBA) Degree–Oral and Maxillofacial Surgery Certificate Integrated Program at the University of Rochester: A Pathway to Earn a Specialized Finance Degree During Residency Training

Executive MBA (EMBA) Degree–Oral and Maxillofacial Surgery Certificate Integrated Program at the University of Rochester: A Pathway to Earn a Specialized Finance Degree During Residency Training

Assessing Whether Medical Students Consistently Ask Patients About Sexual Orientation and Gender Identity as a Function of Year in Training.

Purpose: The Institute of Medicine has suggested that teaching health care providers to inquire about and document the sexual orientation and gender identity (SOGI) of their patients will provide more accurate epidemiological data and allow for more patient-centered care, thus improving sexual and gender minority health. The purpose of this study was to determine whether medical students are asking about SOGI and to identify reasons why students were opting not to ask. Methods: In July 2020, an online survey was made available to second-, third-, and fourth-year medical students at a Midwestern medical school. Respondents were asked whether they consistently inquired about the SOGI of their patients, and the reasons they do not ask. The number of students asking about SOGI and reasons for not asking were analyzed using chi-square analyses as a function of year in training. Results: Of 1089 eligible participants, 364 completed the survey (33.4%). The number of students asking about sexual orientation significantly decreased with every year of training (92.8%, 82.2%, and 52.7%). The number of students asking about gender identity significantly decreased after the second year of training (69.9%, 40.6%, and 26.4%). Reasons that significantly increased across training included believing SOGI is irrelevant to encounters, limiting inquiries to patients with sexual health complaints only, and negative influence from their attendings. Conclusion: As medical students progressed into the clinical years of their training, they were less likely to ask their patients about SOGI and more likely to cite negative influence from their attendings and question the relevance of obtaining SOGI.

Improvement of basic techniques in volleyball in higher education institutions

The article presents a comparative analysis of the basic techniques of students who play volleyball as part of the university team. After analyzing the literature and Internet data, we identified the main techniques, namely: submission, 1st reception, attack, defense, second gear.&#x0D; The results obtained during the video analysis with further study of the dynamics of the main techniques of volleyball at the initial stage of the study showed that the athletes of the first year of training all indicators are less successful than the volleyball players of the second year. The worst indicator of technique for first-year students is "submission", as unsuccessfully submitted applications are 7.2% more than successful. Having received the data, we developed a program to improve the elements of volleyball players' equipment and tested its effectiveness.&#x0D; The program was implemented in the training process for two months, performed at each training session, twice a week.&#x0D; At the end of the experiment, we conducted a video recording of the participation of student-athletes in competitions of various levels of games with the subsequent processing of video materials. Comparative analysis of the performance of the main techniques of volleyball in the competitive activities of students-volleyball players at the beginning and end of the study allowed us to determine the effectiveness of our program. The introduction of our program to improve the basic techniques in the training process revealed that volleyball players in the first year of training all indicators increased by an average of 8.4%, and athletes in the second year of training by 6.96%. All of the above indicates the effectiveness of our program.

Use of Active Games in Physical and Tactical Training of Young Handball Players at the Initial Stage

The purpose of the study is to increase the effectiveness of physical and technical training of young handball players aged 10-11 by means of moving games, game exercises and relays at the stage of initial training during the pedagogical experiment in 2020-2021.&#x0D; Methodology. The following methods were used in the study: theoretical analysis and generalization of scientific and methodological literature, control and pedagogical checking (tests), pedagogical observations, anthropometry. Statistical processing of experimental data was performed using the statistical processing package STATGRAPHICS Plus for Windows (according to standard methods). The study involved young handball players aged 10-11, the first and second year of training in sport school №3 in Kharkiv during a year. The technique was implemented for 9 months (74 lessons), 3 times a week, and lasting 20 minutes.&#x0D; Results. We claim that the physical fitness of handball players is closely related to various aspects of training. The selected tests fully characterize the physical development and functional state of the main life support systems of a body and allow determining the effectiveness of the proposed authors’ method. The specially selected combinations with the use of moving games, game exercises and relays help to increase the level of technical training of young handball players. Analysis of the final indicators in the experimental group revealed a significant increase corresponding to the 5% level of significance in terms of execution of free throws and movement in the protective rack of the handball player. The average group values of the accuracy of free throws increased by 49.5%, and the average speed of movement in the protective rack of a handball player after the experiment increased by 8.3%. The rate of transfer of the ball to the wall in the experimental group increased by 25.1%, which indicates a significant increase in the result at P &lt;0,01.&#x0D; Conclusion. The results obtained during the experiment confirmed the effectiveness of our developed methods of training with the purposeful use of moving games, game exercises and relay races at the initial stage of training young handball players.

Cardiac Arrest in an Adolescent with Pulmonary Embolism.

The target audience of this simulation is emergency medicine residents and medical students. The simulation is based on a real case of a 13-year-old female who presented with seizures and hypoxia and was ultimately diagnosed with pulmonary embolism. The case highlights diagnosis and management of an adolescent with new onset seizures, deterioration in status, and treatment options in pediatric cardiac arrest due to pulmonary embolism. Pulmonary embolism (PE) is an uncommon cause of hypoxia in children making diagnosis difficult. A study looking at 23 years of admission and autopsy data on children found the incidence of clinically significant pulmonary embolism to be 25 per 100,000.1 However, when children present to the emergency department with hypoxia and altered mental status, a diagnosis of pulmonary embolism cannot be excluded. Risk factors such as use of estrogen containing oral contraceptives, immobilization, and recent surgery should raise suspicion for pulmonary embolism in the clinically deteriorating adolescent patient.2,3. By the end of the simulation, learners will be able to:1) develop a differential diagnosis for an adolescent presenting with hypoxia and seizure-like activity2) discuss the utility of bedside ultrasound in helping to differentiate causes of hypoxia3) discuss management of cardiac arrest due to PE in the pediatric patientSecondary learning objectives include:4) discuss indications for emergent use of thrombolytics and Extracorporeal Membrane Oxygenation (ECMO) while becoming aware of institution-based limitations5) demonstrate interpersonal communication with family, nursing, pharmacy, and consultants during high stress situations. This is a high-fidelity simulation that allows learners to manage the diagnosis and treatment of pulmonary embolism in an adolescent patient. Participants participated in a debriefing after the simulation.Research Methods:The effectiveness of this case was evaluated by surveys given to learners after debriefing. Learners gave quantitative and qualitative results of their feedback using a 1-5 rating scale and leaving written feedback. This case was performed with residents in their first and second years of training. Feedback was overall positive, with many of the residents giving the case high scores on effectiveness of the simulation in their education. They enjoyed the case and reported they would feel more comfortable in a comparable situation in the future. Pulmonary embolism is an uncommon but important diagnosis for emergency medicine physicians to consider in pediatric cardiac arrest. This case has multiple parts and was based on a real case in our emergency department in which a patient presenting with new seizure-like activity followed by cardiac arrest was ultimately diagnosed with a PE. The case was well received by our learners who felt it improved their identification of this diagnosis and its management. Pulmonary embolism, oral contraceptives, altered mental status, pediatric, adolescent, cardiac arrest, ECMO, thrombolytic, hypoxia, emergency medicine, medical simulation.

Ефективність експериментального змісту самостійних занять у підвищенні фізичних можливостей учнів основної школи

The usage of independent classes at home is important in solving the problems of physical education of secondary school students. The purpose of the study is to determine the effectiveness of the deve loped content of independent physical exercises in improving physical capabilities and forming a habit of systematic use of such classes in free time. Methods. One of the main methods of obtaining the necessary data was pedagogical testing. Tests widely used by researchers and teachers were used; the tests met the established metrological requirements and allowed to assess the state of development of basic physical capabilities. The latter were studied during the two two-year period of the formative pedagogical experiment. The effectiveness of the author’s development was tested, which was used by 25 students (11 boys and 14 girls) of the experimental group and 26 students (12 boys and 14 girls) of the control group; the age of each child was within 8.5 ± 0.3 years old. The obtained data were processed by adequate methods of mathematical statistics. The provisions of the Helsinki Declaration of the World Medical Association (WMA-2013) on the ethical principles of scientific research with human participation were carried out. The relevant protocol was approved by the Ethics Commission of Kamianets-Podilsky Ivan Ohiienko National University. Results. During the first school year in the experimental group significantly greater than in the control group, there was an improvement in the result in long jumps, running 20 m from the course, 6-minute running and standing dynamometry. During the second year of training, the trend was similar, but concerned 20 m running, 400 m running, long jump, standing, wrist dynamometry and pull-ups on the crossbar. The proposed content of independent classes allowed students to achieve much better indicators of physical capabilities than using the traditional approach to the formation and implementation of the content of independent physical exercises. Conclusion. Author’s development should be used in the practice of school physical education, in particular to teachers to convey the necessary information to students, as well as some elements of the proposed content in physical education lessons.

Identifying and preventing burnout in young oncologists, an overwhelming challenge in the COVID-19 era: a study of the Spanish Society of Medical Oncology (SEOM)

BackgroundYoung oncologists are at particular risk of professional burnout, and this could have a significant impact on their health and care of their patients. The coronavirus disease 2019 (COVID-19) pandemic has forced rapid changes in professionals' jobs and training, with the consequent physical and psychological effects. We aimed to characterize burnout levels and determinants in young oncologists, and the effects of the pandemic on their training and health.MethodsTwo online surveys were conducted among oncology residents and young oncology specialists in Spain. The first addressed professional burnout and its determinants before the COVID-19 pandemic, while the second analyzed the impact of the pandemic on health care organization, training, and physical and psychological health in the same population.ResultsIn total, 243 respondents completed the first survey, and 263 the second; 25.1% reported significant levels of professional burnout. Burnout was more common among medical oncology residents (28.2%), mainly in their second year of training. It was significantly associated with a poor work–life balance, inadequate vacation time, and the burnout score. Nearly three-quarters of respondents (72%) were reassigned to COVID-19 care and 84.3% of residents missed part of their training rotations. Overall, 17.2% of this population reported that they had contracted COVID-19, 37.3% had scores indicating anxiety, and 30.4% moderate to severe depression. Almost a quarter of young oncologists (23.3%) had doubts about their medical vocation.ConclusionsBurnout affects a considerable number of young oncologists. The COVID-19 pandemic has had a profound impact on causes of burnout, making it even more necessary to periodically monitor it to define appropriate detection and prevention strategies.

FEATURES OF TRAINING HOCKEY PLAYERS WITH HEARING IMPAIRMENT AT THE STAGE OF SPORTS SPECIALIZATION

Aim. The article aims to experimentally test the methodology for the development of the main physical qualities in hockey players with hearing impairment in their first and second year of training. Materials and methods. The study involved 38 young hockey players at the stage of sports specialization with hearing loss of 55 dB, which corresponds to an average and high degree of hearing loss. The experiment took place on the premises of the sports school for children and youth of the Gornyak Sports Club (Uchaly, Bashkortostan Republic) and Sports School No 3 named after M.M. Azamatova (Ufa, Bashkortostan Republic). In the control groups, training was carried out in accordance with the traditional ice hockey program developed in compliance with the Federal Standard. Our methodology was included in the training program of hockey players of the experimental group. The main training load was chosen in accordance with the sports school program. Results. Features of the sports training of hockey players with hearing impairment were established, which served as the basis for the development of methods for increasing their physical fitness and the formation of adaptive-compensatory responses of the body in the first and second years of training. The latter are associated with their specific morphofunctional features resulted from damage to the auditory analyzer and secondary changes in the psychoemotional status and functional systems of the body manifested in impaired coordination abilities and a lag in the development of speed-strength and speed qualities. The main physical qualities and their most significant components for adolescent hockey players with hearing impairment in the first and second years of training were identified. Conclusion. Our methodo­logy for training hockey players with hearing impairment aimed at the development of the main physical qualities and their components contributed to improving the coordination abilities of young hockey players, as well as their ability to maintain a vertical posture, dynamic and static balance. Hockey players of the experimental group better acquired the correct rhythm pattern of motor actions, showed better results in tests for the differentiation of muscle effort, intermuscular coordination and the ability to arbitrarily control muscle tension and relaxation.

Stanislavski and The Theatre of The Absurd

ABSTRACT This paper is based on a lecture/workshop I gave at the S-Word Symposium, held at the University of Malta in April 2019. The original lecture comprised of a PowerPoint presentation, outlining some of the most common problems faced by my BA Hons Acting and Actor Musician students at Rose Bruford College at the beginning of their second year of training. During this initial block of work in semester one they find themselves grappling with a variety of texts written by those playwrights, grouped together by Martin Esslin in his seminal study of 1961, as the key representatives of what he famously termed The Theatre of The Absurd. 1 Opening with an introductory summation of my developing practice at RBC, followed by an outline of some of the theory involved – and some contextual framing relating to the philosophical underpinning that runs through Esslin’s interpretation of these plays 2 – I worked with a trio of Theatre Studies students from the University of Malta, in an attempt to demonstrate some of the key ideas I have been exploring in practice over the past few years. My premise is that, while an attempt to apply certain foundational aspects of Stanislavski’s “system” to these Absurdist texts is clearly problematic – particularly any attempt to create a psychologically coherent through-line-of-action, rooted in a detailed backstory or character biography – other Stanislavskian concepts, such as the magic if for example, when utilized discretely, can still prove useful. Key terminology is written in italics.