Skills Of Physicians Research Articles

Communication skills of residents: are they as good as they think?

ABSTRACT Purpose To evaluate the current communication skills of resident physicians and identify areas for improvement. Study design Using a cross-sectional design, data from medical students, residents, fellows, and faculty were assimilated at one of the largest academic medical centers in a low-and-middle-income country via a self-administered, validated survey with a 5-point LIKERT scale. One-way ANOVA was used to compare intra-group means, followed by the Bonferroni test, with a p-value <0.05 considered significant. Heat maps using means were generated and color-coded to signify the level of communication skills expertise. Results A total of 320 participants (119 residents, 34 fellows, 78 medical students and 89 attendings) completed the survey. Most residents (58%) reported not having received formal communication skills training. Major barriers impeding effective patient-resident communication were long working hours, inadequate time, and difficulty understanding patients’ language (p < 0.001). Residents’ self-evaluation of communication skills was significantly higher than observer evaluations from faculty, fellows, and students, reflecting a lack of self-awareness and overestimation of communication expertise. Observer cohorts rated residents moderately on para-verbal communication skills while giving the lowest ratings for breaking bad news (mean 2.8, p-value <0.001) and residents’ experience in dealing with workplace conflicts (mean 2.8, p-value = 0.023). Conclusions Our study identified a clear and critical need for a structured, longitudinal, competency-based communication skills program for residents. Targeted efforts towards bridging the gaps in communication skills identified in this study can improve trainee communication skills expertise and augment patient satisfaction rates to improve the quality of care in developing countries.

Duties, tasks, knowledge and skills of an obesity medicine physician: A practice analysis

BackgroundGiven the evolving nature of obesity medicine, periodic evaluation of its clinical practice is needed to ensure that certification requirements address real-world experience. Practice analysis is a systematic approach to define a field's body of knowledge, and its results can inform the content outline and examination blueprint for a certification examination. This study describes the 2023 practice analysis conducted by the American Board of Obesity Medicine (ABOM). MethodsInitially, 14 obesity medicine physicians participated in a practice analysis panel, resulting in 3 duties and 30 tasks required for competent practice of obesity medicine physicians. Each task included steps, knowledge, skills, and abilities needed to perform the task. ABOM then recruited 645 certified obesity medicine physicians from its database to participate in a validation survey to rate the frequency [scale: never (0) to very frequently (5)] and importance [scale: not important (0) to very important (3)] of each task. Survey participants could also provide open-ended comments. ResultsAmong validation survey participants (n = 645), the most common primary medical specialties reported were internal medicine (46.0 %), family medicine (33.8 %), and pediatrics (11.2 %). Years practicing obesity medicine varied with 45.3 % reporting 1–4 years, 26.0 % 5–9 years, and 28.7 % ≥ 10 years in practice. Most tasks were performed frequently (mean score ≥4.0) and rated as important (mean score ≥2.0). All tasks were retained based on the frequency and importance ratings. Survey results informed the weighting in the examination blueprint. ConclusionThere was consensus among practicing ABOM-certified physicians who participated in the validation survey in the tasks required for competent obesity medicine practice. Our practice analysis approach was a structured process that engaged obesity medicine physicians and captured the breadth and depth of knowledge required for obesity medicine. The new content outline and examination blueprint developed will be implemented with the 2025 ABOM certification exam administration.

Searching Method for Three-Dimensional Puncture Route to Support Computed Tomography-Guided Percutaneous Puncture.

In CT-guided percutaneous punctures-an image-guided puncture method using CT images-physicians treat targets such as lung tumors, liver tumors, renal tumors, and intervertebral abscesses by inserting a puncture needle into the body from the exterior while viewing images. By recognizing two-dimensional CT images prior to a procedure, a physician determines the least invasive puncture route for the patient. Therefore, the candidate puncture route is limited to a two-dimensional region along the cross section of the human body. In this paper, we aim to construct a three-dimensional puncture space based on multiple two-dimensional CT images to search for a safer and shorter puncture route for a given patient. If all puncture routes starting from a target in the three-dimensional space were examined from all directions (the brute-force method), the processing time to derive the puncture route would be very long. We propose a more efficient method for three-dimensional puncture route selection in CT-guided percutaneous punctures. The proposed method extends the ray-tracing method, which quickly derives a line segment from a given start point to an end point on a two-dimensional plane, and applies it to three-dimensional space. During actual puncture route selection, a physician can use CT images to derive a three-dimensional puncture route that is safe for the patient and minimizes the puncture time. The main novelty is that we propose a method for deriving a three-dimensional puncture route within the allowed time in an actual puncture. The main goal is for physicians to select the puncture route they will use in the actual surgery from among the multiple three-dimensional puncture route candidates derived using the proposed method. The proposed method derives a three-dimensional puncture route within the allowed time in an actual puncture. Physicians can use the proposed method to derive a new puncture route, reducing the burden on patients and improving physician skills. In the evaluation results of a computer simulation, for a 3D CT image created by combining 170 two-dimensional CT images, the processing time for deriving the puncture route using the proposed method was approximately 59.4 s. The shortest length of the puncture route from the starting point to the target was between 20 mm and 22 mm. The search time for a three-dimensional human body consisting of 15 CT images was 4.77 s for the proposed method and 2599.0 s for a brute-force method. In a questionnaire, physicians who actually perform puncture treatments evaluated the candidate puncture routes derived by the proposed method. We confirmed that physicians could actually use these candidates as a puncture route.

Anti-Maintenance of Certification laws and older physician supply

The American Board of Medical Specialties (ABMS) mandates Maintenance of Certification (MOC) exams every ten years to improve patient care and physician skills, but some states consider it expensive and burdensome and have introduced anti-MOC laws. We exploited state-level staggered adoption of anti-MOC laws and found an additional 1.4–1.9 percentage point biannual increase in older physicians aged 60+ in states with anti-MOC laws, with no effect on younger physicians under 60. Our study suggests that anti-MOC laws improve the supply of older physicians.

Low-Cost, Scalable Simulations in Obstetric Trauma and Resuscitative Hysterotomy for Emergency Medicine Residents.

Simulation-based learning is essential for health care providers to prepare for rare obstetric emergencies, such as severe trauma and maternal cardiac arrest. These situations demand rapid and prompt actions, often testing the skill of emergency physicians. Resuscitative hysterotomy (RH), a critical procedure in maternal cardiac arrest, requires technical expertise, coordination, and anatomical knowledge. The high cost of commercial trainers and complex existing models restricts accessibility. This resource introduces a low-cost anatomically accurate RH task trainer and assesses its effectiveness in improving skills and confidence among trainee emergency physicians. A 20-minute-long case scenario depicted the resuscitation of a pregnant trauma patient with tension pneumothorax and uterine rupture, culminating in maternal cardiac arrest necessitating RH. Residents performed RH on the task trainer under faculty guidance. Feedback followed the Pendleton model, and an online questionnaire gauged the residents' experiences. Thirty emergency medicine residents participated in the simulation. The questionnaire revealed positive responses, confirming the session's relevance and enhancement of clinical skills and confidence. Our results underscore the RH task trainer's critical role in improving residents' skills and confidence during obstetric trauma simulations. Its realism and effectiveness were notably well received. Future refinements aim to augment fidelity while preserving affordability and integrating regular reinforcement sessions. This innovative educational approach equips health care professionals to respond adeptly to rare and challenging obstetric emergencies, ultimately elevating outcomes for mothers and infants during critical situations.

Evolving Paradigms in Physician Skills

Evolving Paradigms in Physician Skills

Development and Implementation of a Novel Emergency Department Based Procedure Team for Inpatient Hospital Procedures

BackgroundEmergency medicine (EM) demands proficiency in a broad set of procedural skills for emergency physicians (EPs). However, there is a literature gap on integrating EM expertise into procedure teams, especially in inpatient settings ObjectivesThis study aims to outline the development and implementation of a novel ED-based procedure team for inpatient care MethodsThis retrospective study conducted between June 6, 2022 and December 31, 2023, describes the development and implementation of an ED-based procedure team. Key procedures included central lines, arterial lines, and non-tunneled dialysis catheters, with specific guidelines to ensure safety and consistency ResultsDuring the study, the procedure team conducted 525 procedures. Midline insertions and paracentesis were the most common. The team performed an average of 27.3 procedures per month. Additional provider hours needed to complete the procedures averaged 4.8 per month and showed a trend toward stabilization over time. Financially, the team secured reimbursements for 516 cases at $98 per case, observing a positive trend in gross payments ConclusionsThe ED Procedure team has played a pivotal role in delivering essential bedside procedures for the patient, demonstrating improvements in provider proficiency, resident training, and favorable revenue outcomes. The interdepartmental collaborative and well-coordinated efforts have ensured the timely completion of necessary procedures.

Effectiveness of a training program in improving knowledge and skills about selected common neurological disorders among primary healthcare doctors: The Karnataka Brain Health Initiative (KaBHI) in India.

Neurological disorders are the leading causes of death and disability globally. In low-middle-income countries such as India, there is a wide treatment gap for neurological disorders. To address this gap, an initiative known as the Karnataka Brain Health Initiative (KaBHI) was developed in collaboration with the public health system of the state of Karnataka in India. A structured hybrid training program was conducted for 120 medical doctors working in the Primary Health Centers (PHCs) in the public health system in three districts of Karnataka. Pre- and post-training evaluation was conducted to assess physicians' knowledge and skills for evaluating patients with common neurological conditions. Of 120 PHC doctors, 111 (92%) scored below the passing score of 50 points out of 100 before the training program. After the training, all trainees scored above this cut-off. The study found a significant improvement in knowledge and skills after the training (before training: 40.48 ± 7.92, after training: 66.28 ± 8.98 (P < 0.001) mean difference = 25.81), and was comparable among the PHC doctors in all three districts. Our study shows the feasibility of training primary care doctors in the public health system to manage selected common neurological disorders. The training program can potentially help to reduce the treatment gap for neurological disorders in India.

Validation of the Bangla version of the Communication Skills Attitude Scale with the medical students of Bangladesh.

Effective communication skill of physicians is an important component of high-quality healthcare delivery and safe patient care. Communication is embedded in the social and cultural contexts where it takes place. An understanding of medical students' attitudes and learning communication skills would help to design and deliver culturally appropriate medical education. The Communication Skills Attitude Scale (CSAS) is a widely used and validated tool to measure the attitude of medical students toward learning communication skills in different populations, settings, and countries. However, there is no culturally adapted and validated scale in Bangla in the Bangladesh context. This study aims to culturally adapt the CSAS into Bangla, and validate it in a cohort of medical students in Bangladesh. This study used a cross-sectional survey design to collect data from purposively selected 566 undergraduate medical students from the Rajshahi division. The survey was conducted from January to December 2023. Descriptive statistics like frequency distribution and measures of central tendency were used to measure perception regarding communication skills. The sample adequacy was measured through the Kaiser-Meyer-Olkin test. The internal consistency of the items was identified using Cronbach's alpha (α) coefficients. The results of the study show that the Bangla version of the scale is feasible, valid, and internally consistent in the context of a developing country, Bangladesh. The overall internal consistency of the Bangla version is good since the value of Cronbach's alpha (α) is 0.882. For PAS, the internal consistency is 0.933. While, for NAS, the value is 0.719. The item-wise average scores in the PAS indicate that female medical students are more willing to learn communication skills compared with male students (α = 0.933). While, the scores in the NAS indicate that the male students tend to have more negative attitude toward learning communication skills compared with female students (α = 0.719). The CSAS-Bangla is a valid and reliable tool for assessing communication skill attitudes among Bangla speaking medical students. This scale can be used in future studies to measure the attitude of students, designing and evaluating communication skills training programs in medical colleges.

New test for systematic skills enhancement and improvement in maxillofacial surgery training: multicentre pilot study

We know of few studies in the international scientific literature that specifically address the evaluation of surgical and clinical progress among physicians undergoing specialist training in maxillofacial surgery. Identifying a reliable tool to accurately assess both theoretical knowledge and surgical skills of trainees is essential. The primary aim of this study therefore was to design a comprehensive assessment tool that is capable of evaluating both the theoretical and practical skills of physicians undergoing specialist training in maxillofacial surgery. The methodology employed aims to ensure fairness and effectiveness in skills development, thereby optimising training activities. To meet this need, an evaluation and self-assessment test was developed for maxillofacial surgery trainees at the Ospedali Riuniti of Ancona. Data collection involved digitally administered evaluations and self-assessment tests focused on maxillofacial traumatology, based on AO trauma surgery references. Data were processed into graphs which revealed a progressive learning trend following an initial adjustment phase, leading to optimal outcomes in both clinical and surgical domains. The evaluation and self-assessment test proved to be a valuable learning tool with which to gauge advancements in clinical and surgical skills among maxillofacial surgery residents.

Contribution of water, sanitation, hygiene and basic education to reduce under-five mortality in Sudan

ABSTRACT Until 2015, the under-five mortality rate (U5MR) in Sudan was 65.9 per 1,000 livebirths, higher than the MDG4 target, and it has to be reduced by 5.04% per year from its 2020 level to achieve the SDG3.2 by 2030. This target cannot be achieved without improvements in access to safe drinking water (ASW), sanitation and hygiene (ISF) (WASH) and basic education. An estimated autoregressive distributed lag bounds test model confirms a long-run equilibrium relationship between U5MR, WASH, basic education, economic growth and health care. In the short run, U5MR decelerates itself with a coefficient of 0.56. Sanitation and basic education significantly reduce U5MR. Collectively, health care and economic growth affect U5MR adversely. In the long run, declines of U5MR are driven respectively by access to sanitation, hygiene and basic education (a factor of 1.79), economic growth (a factor of 0.21), and health care (a factor of 0.18). The study recommends promotion of access to safe drinking water with investments in sanitation and hygiene of 32 million $US annually between 2020 and 2030, in order to meet the SDG3.2 in Sudan. Skilled physicians and full vaccination of children can be more effective in reducing U5MR, dependent on progress in safe WASH.

Awareness of Opioid Use for Pain Control among Healthcare Practitioners: A Systematic Review

Objectives: To compile the recent literature's findings and shed light on knowledge of healthcare personnel about the use of opioids in pain management. Methods: A thorough search of pertinent databases was done in order to find studies that satisfied the requirements for inclusion. A thorough search of PubMed, Web of Science, SCOPUS, and Science Direct was conducted to find pertinent literature. Results: Ten studies, including a total of 58,234 participants and 21,769 (37.4%) of them were females, were included in our data. There were notable differences found between the clinical skills of physicians in managing pain and prescribing opioids and their self-perceived knowledge in these areas. Many studies reported that nearly half of the participants had poor knowledge about using opioids for pain management. Physicians with higher clinical knowledge ratings prescribed fewer opioids. Only two studies reported that professionals with advanced degrees were found to have a sufficient level of understanding regarding pain and opiate use. Conclusion: This study demonstrated a lack of and insufficient knowledge about opioids on pain management among healthcare personnel. Prospective investigations ought to concentrate on crafting customized instructional curricula and decision-assistance instruments for primary care practitioners, as well as analyzing the influence of interdisciplinary pain treatment groups on patient results.

Use of Case-Based Clinical Reasoning in Medical Education at Libyan International University: A quantitative Study.

Background: Clinical instruction in medical education is a complex and challenging task for educators. It requires students to not only possess theoretical knowledge but also a range of competencies such as clinical reasoning, technical skills, decision-making, ethics, leadership, and time management. Clinical reasoning, which encompasses the cognitive process and decision-making in clinical practice, is a fundamental skill for physicians. The aim of the study was to understand students' views on the use of case-based clinical reasoning (CBCR) in their medical training and evaluate their satisfaction with its application as an instructional approach for developing clinical reasoning abilities. Participants and Methods: A descriptive quantitative study was conducted at the Libyan International Medical University (LIMU) to gather data on the utilization of case-based clinical reasoning (CBCR) in medical training. The study focused on 412 medical students in the clinical phase, including 4th and 5th-year students and intern doctors at LIMU. Data were collected through an online questionnaire over a two-month period from January to March 2023. The analysis was based on 129 responses, representing a 30.1% response rate. The questionnaire consisted of 22 questions, including multiple-choice and Likert scale inquiries, and aimed to assess students' satisfaction in three dimensions: perceived benefits and drawbacks of CBCR in medical education, skill enhancement and its impact on self-assurance and teamwork, and the role of LIMU in successfully implementing the program. Data analysis was performed using the SPSS software, with a statistical significance level set at p &lt; 0.05. Results: The study found that students perceive several benefits of using case-based clinical reasoning (CBCR) in their medical training. These benefits include the accumulation of knowledge and the improvement of skills such as teamwork, communication, critical thinking, reasoning, and self-directed learning abilities. A significant majority of students, approximately three-quarters of the sample, endorsed the use of CBCR with their peers and colleagues. Almost all respondents agreed that CBCR helps them make informed decisions in their daily practice and boosts their confidence in advancing their medical careers (93% and 86.8% agreement, respectively). Higher satisfaction levels were reported among fifth-year students and during the internship phase. However, fourth-year students expressed more dissatisfaction with CBCR, finding it time-consuming and facing challenges in formulating hypotheses for data collection. In conclusion, the study highlights the importance of adopting a proactive approach in medical education to promote educational innovation. Employing case-based clinical reasoning (CBCR) is found to be effective in developing clinical competencies, fostering collaboration, enhancing self-assurance, and cultivating critical thinking abilities among students.

Attitudes and Confidence in Communication Skills of Fourth-Year Medical Students After Online Small Group Discussion and Peer Role-Play: A Survey Study.

This study investigated the impact of online small group discussions and peer role-play on medical students' attitudes toward and confidence in communication skills. The study involved a 3-hour instructional design that integrated small group discussions and role-plays to enhance the communication abilities of fourth-year medical students. The data were obtained from students through a post-activity online survey. Likert scale responses were quantified as percentages. Students' narrative feedback on their learning achievements was subjected to content analysis. Codes and categories were agreed upon by investigators and reviewed by an external auditor. A total of 151 medical students responded to the survey, representing a 47.94% response rate. The majority strongly agreed that good communication skills help physicians obtain reliable information (94.00%) and that practicing questioning skills is essential (92.1%). Content analysis revealed that nearly half (48.34%) considered that the learning activities fostered positive attitudes toward communication. These attitudinal improvements included increased empathy and emotional care (37.75%), recognition of communication as a trainable skill (10.57%), and recognition of the necessity of communication skills for physicians (8.61%). Additionally, most students (75.5%) reported increased confidence in their communication skills. In alignment with transformative learning theory, online small group discussions combined with peer role-play may potentially enhance the attitudes and confidence of medical students in relation to communication skills.

Promoting clinical reasoning in undergraduate Family Medicine curricula through concept mapping: a qualitative approach.

Clinical reasoning is a crucial skill for physicians, enabling them to bridge theoretical knowledge with practical application. The gap between basic sciences and clinical practice persists as a challenge, with traditional teaching methods yet to effectively bridge it. Concept maps (CMs), visual tools for organizing and connecting knowledge, hold promise for enhancing clinical reasoning in the undergraduate medical curriculum. However, further research is required to ascertain if CMs facilitate clinical reasoning development in medical students transitioning from basic sciences to clinical practice. This study aims to delineate how CMs can facilitate clinical reasoning in patients with multimorbidity within undergraduate Family Medicine curricula, as perceived by students and tutors, and to understand the implementation process and resources required. This exploratory qualitative study formed a part of an action research project. While introducing an educational intervention to 5th-year medical students, we conducted a qualitative evaluation. Subsequently, semi-structured group interviews were conducted with students, and a focus group was conducted with tutors. Three main educational impacts were identified: integration of clinical information, support for patient management and care plan, and collaborative learning. Key aspects for successful CM implementation included clear instructions for map construction, using user-friendly software, allocating sufficient time for the task, encouraging group discussion of CMs, and incorporating tutor feedback. CMs are pedagogical tools that facilitate clinical information integration and support management and treatment plans, helping students better understand multimorbidity patients and promoting some components of clinical reasoning in undergraduate medical education.

A Measure of the Impact on Real-Time Patient Care of Evidence-based Medicine Logs.

Evidence-based medicine (EBM) is a critical skill for physicians, and EBM competency has been shown to increase implementation of best medical practices, reduce medical errors, and increase patient-centered care. Like any skill, EBM must be practiced, receiving iterative feedback to improve learners' comprehension. Having residents document patient interactions in logbooks to allow for residency program review, feedback, and documentation of competency has been previously described as a best practice within emergency medicine (EM) to document practice-based learning (PBL) competency. Quantifying how residents use the information they query, locate, evaluate, and apply while providing direct patient care can measure the efficacy of EBM education and provide insight into more efficient ways of providing medical care. Practice-based learning logs were surveys created to record resident EBM activity on-shift and were placed into our residency management software program. Residents were required to submit 3-5 surveys of EBM activity performed during a 28-day rotation during which additional information was sought. This study included all PBL logs completed by EM residents from June 1, 2013-May 11, 2020. Using qualitative methodology, a codebook was created to analyze residents' free-text responses to the prompt: "Based on your research, would you have done anything differently?" The codebook was designed to generate a three-digit code conveying the effect of the researched information on the patient about whom the log was written, as well as whether the information would affect future patient care and whether these decisions were based on scientific evidence. A total of 10,574 logs were included for primary analysis. In total, 1,977 (18.7%) logs indicated that the evidence acquired through research would affect future patient care. Of these, 392 (3.7%) explicitly stated that the EBM activity conducted as part of our project led to real-time changes in patient care in the ED and would change future management of patients as well. We present a proof of concept that PBL log activity can lead to integration of evidence-based medicine into real-time patient care. While a convenience sample, our cohort recorded evidence of both lifelong learning and application to patient care.

Immersive Leadership Training for Physicians: Comparing Retrospective Pre- and Post-Test Virtual vs in-Person 6-Month Follow-Up of Learning.

Little is known about the long-term efficacy of virtual leadership training for physicians. This study compares two highly similar groups of Obstetricians-Gynecologists' (OB-GYN) 6-month post-program changes in competency and skills after experiencing equity-centered leadership training in a virtual or in-person format. Using a retrospective pre- and post-test method, we collected 6-month post-program data on 14 competencies for knowledge gains and skills use, comparing the virtual cohort (2021, n = 22) to the in-person cohort (2022, n = 33) in 55 total participants. Qualitative data from open-ended feedback questions informed on skills relevancy and professional impact since program participation. Data indicate strong, statistically significant knowledge and skills retention in both cohorts, with 63% of the virtual and 85% of the in-person participants responding. Data indicate participants report the course having a positive impact on their healthcare provision and nearly all report they made changes to their communication and leadership approaches in the 6-months after the program. 59% of the virtual and 55% of the in-person cohorts report new leadership opportunities since their participation and that the course helped prepare them for those roles. Qualitative data support the need for the training, specific elements of the training these physicians found particularly helpful, and that the learning was "sticky", in that it stayed with them in the months post-program. There was a clear stated preference for in-person experiences. Either virtual or in-person leadership training can result in long-term (6-month) significant retention and application of knowledge and skills in physicians. While limited in size, this study suggests that in-person experiences seem to foster more effective bonds and also greater willingness to participate in post-program follow-up. Physicians find equity-centered leadership training to impact their subsequent communication and leadership practices and they report career benefits even in 6-month follow-up.

Determining Risk Management Priorities and Suggesting Strategies in the Management of Family Health Centres

Aim: The purpose of this study is to identify the risks faced by decision-makers in the management of Family Health Center (FHC) and to propose strategies according to their relative importance. Materials and Methods: Eight different risks were identified as a result of the literature review. In order to evaluate the identified risks, four different physicians with at least ten years of managerial experience in FHCs and two health managers with at least ten years of experience in their field were included in the study. SWARA (Stepwise Weight Assessment Ratio Analysis) method was used to evaluate and analyze the opinions. SWARA method is a weight calculation method based on expert opinions developed for the finalization of decision problems. Results: According to the results of the analysis, experts ranked financial risks (%27), clinical and patient safety risks (%21), and operational risks (%15) as the most important risks, respectively. Hazard risks (%4) were assessed as the least risky in relative terms. For FHCs to carry out their activities effectively, financial risks should be minimized first. Conclusions: Additional measures should be taken by the public for the use and rental of FHCs. Diversification of other sources of income can be ensured by expanding the health services provided beyond the resource transfer linked to the public budget. Regional investment and incentives can be developed by municipalities. Strengthening data protection policies to assess the compliance of medical practices with legal standards and to ensure the security of personal patient data can also reduce legal risks. In FHCs, general safety issues, especially patient safety, are also priority issues that should be investigated and legislation should be developed. In addition, management courses/training can be added to the family medicine specialty curriculum to improve the managerial skills of physicians.

Attributes of leadership skill development in high-performance pre-hospital medical teams: results of an international multi-service prospective study

BackgroundsTeam leadership skills of physicians working in high-performing medical teams are directly related to outcome. It is currently unclear how these skills can best be developed. Therefore, in this multi-national cross-sectional prospective study, we explored the development of these skills in relation to physician-, organization- and training characteristics of Helicopter Emergency Medicine Service (HEMS) physicians from services in Europe, the United States of America and Australia.MethodsPhysicians were asked to complete a survey regarding their HEMS service, training, and background as well as a full Leader Behavior Description Questionnaire (LBDQ). Primary outcomes were the 12 leadership subdomain scores as described in the LBDQ. Secondary outcome measures were the association of LBDQ subdomain scores with specific physician-, organization- or training characteristics and self-reported ways to improve leadership skills in HEMS physicians.ResultsIn total, 120 HEMS physicians completed the questionnaire. Overall, leadership LBDQ subdomain scores were high (10 out of 12 subdomains exceeded 70% of the maximum score). Whereas physician characteristics such as experience or base-specialty were unrelated to leadership qualities, both organization- and training characteristics were important determinants of leadership skill development. Attention to leadership skills during service induction, ongoing leadership training, having standards in place to ensure (regular) scenario training and holding structured mission debriefs each correlated with multiple LBDQ subdomain scores.ConclusionsOngoing training of leadership skills should be stimulated and facilitated by organizations as it contributes to higher levels of proficiency, which may translate into a positive effect on patient outcomes.Trial registrationNot applicable.

Empathy Among Medical Students: An Exploratory Cross-Sectional Survey.

Context In the context of healthcare, effective communication and empathy are fundamental skills for physicians, as empathy correlates positively with patient satisfaction, compliance, treatment adherence, and lower rates of physician burnout, depression and anxiety. This study aimed to assess empathy levels and related factors among undergraduate medical students. Methods A cross-sectional study in a Central Indian medical institute examined empathy levels and factors associated with it among medical students, utilizing various scales and statistical analyses. Results This study found that while empathy levels were relatively high among undergraduate students, there was a decline as they progressed through medical education, particularly after the first year of clinical exposure. The study identified several factors associated with empathy levels, including perceived stress, emotional separation, and social support. Notably, individuals experiencing higher levels of stress and emotional separation tended to have higher empathy levels. Conclusions The study's findings suggest that medical education should incorporate interventions to enhance empathy, including addressing stress, providing social support, and exposing students to the emotional aspects of patient care.