Resident Skills Research Articles

Effectiveness of video-based teaching in surgery residents: A randomized control trial

Objective: To determine the effectiveness of video-based teaching in surgery residents by comparing it to the routine operating room traditional teaching. Methodology: The randomized control trial was done at four institutions from September 2022 to March 2023. Interventional group underwent video-based instruction of basic surgical skills whereas the control group was taught through traditional operating room teaching. Pre and post-test mean scores were analyzed on SPSS version 20 through paired t-test. Learning gain was calculated. Supervisors’ perceptions were recorded on survey form regarding direct observations and recorded video evaluations of resident skills on post-test. Results: Out of sixty (n=60), fifty-five newly inducted surgical residents completed the study including both females (n=13) and male residents (n=42). Video intervention Group (27.93±3.72) and control group (23.07±4.62) both showed improvements in their post-test scores as compared to pretest scores of 13.68±3.25 and 13.52±3.60 respectively. Mean score difference improvement was more in video intervention group (13.9±3.8) in comparison to control group (9.5±4.3) provided both groups exhibits improvements in all seven domains of the global rating system (reflected by the p <0.0001). However, learning gain of 65% was observed in intervention group as compared to learning gain (41%) of control group. Evaluators(n=5) observed that recorded video evaluations helped to provide integrated feedback, despite being time (40%) and resource intensive (60%). Conclusion: Video-based teaching has higher learning gain irrespective of the fact that both groups exhibit statistically significant results in all seven domains of the global rating system. Recorded video evaluation was found feasible and reliable tool for formative assessment. doi: https://doi.org/10.12669/pjms.40.10.7856 How to cite this: Niaz K, Mahboob U, Masood D, Maqbool A. Effectiveness of video-based teaching in surgery residents: A randomized control trial. Pak J Med Sci. 2024;40(10):2373-2378. doi: https://doi.org/10.12669/pjms.40.10.7856 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

UPAYA PENINGKATAN NILAI EKONOMIS PRODUK UMKM MELALUI SOSIALISASI BISNIS DIGITAL DI DESA CILANGKARA

Technological developments, especially in digital business, have had a positive impact on Micro, Small and Medium Enterprises (MSMEs) in rural areas, such as Cilangkara Village. Even though the growth trend of internet users in Indonesia shows a significant increase, observations and interviews show that the majority of village residents have not shown sufficient interest in entrepreneurship, especially in facing current developments. In this context, the community service program by Islamic University 45 Bekasi students aims to provide education and increase village residents' interest and skills in entrepreneurship, especially by implementing digital business. Implementation methods, such as observation, outreach and training, are expected to stimulate interest and provide support to village residents, including providing business tools to MSMEs that are not yet running. Digital business education is the key to increasing the competitiveness of MSMEs and driving economic potential at the local level, as is being pursued through community service activities in Cilangkara Village. The latest evaluation shows an improvement in the quality of life of the community, especially among MSMEs in Cilangkara Village, through increasing operational capabilities of digital applications for analysis, marketing and product production. It is hoped that the success of this program will be a sustainable first step to improve and produce MSMEs that are able to compete and develop along with the times.

Enhancing Team Dynamics and Leadership Skills for Residents Leading Multidisciplinary In-Patient Cardiac Arrest Teams

Background: Cardiac arrest is a prevalent event with low survival rates, both in out-of-hospital and in-hospital settings. There is a lack of specific training programs addressing team dynamics and leadership skills during resuscitation events, creating a clinical gap. This project aimed to enhance team dynamics and improve leadership skills during IHCA resuscitation events. Methods: We implemented the Mock Code Project for resident physicians from our Internal Medicine Residency Programs in the simulation center (i.e., in a controlled environment) to address this gap. Multidisciplinary team mock code scenarios were created for residents, allowing them to lead resuscitation simulations. The scenarios were based upon common conditions encountered during codes (Cardiac arrest). Trained evaluators provided real-time feedback, and pre-and post-surveys were conducted to assess team perception and gather feedback. Results: Baseline data revealed that 98.6% (143 of 145 residents total) felt uncertain or lacked confidence in leading effective codes in our hospital prior to the intervention. Post-test survey outcome data revealed that 95.1% of participants (136 residents of 143) reported that the sessions challenged their skills at leading codes and improved their skills at managing resuscitation teams. Conclusion: Organized codes with clear roles, responsibilities, bed positioning, and clear leadership significantly improve closed-loop communication, effective team interaction, and patient outcomes. The Mock Code Project fills the gap in training programs by focusing on team dynamics and leadership skills during IHCA resuscitation. Ongoing evaluations and feedback ensure continual improvement in resident confidence and skills. Implementing organized codes benefits residents and healthcare teams, ultimately improving patient care during IHCA. Well-designed mock code scenarios with real-time feedback from senior physicians are an effective way for trainees to develop these skills and this awareness without compromising patient safety.

Learning curves of novice residents on cataract surgery simulator: the E3CAPS pedagogic study

IntroductionTraining novice ophthalmology residents on the EyeSi® simulator increases cataract surgery safety. However, there is no consensus regarding how much training residents should perform before their first time on patients. We evaluated the French national training program through the analysis of the learning curves of novice residents.MethodsThis prospective multicentric pedagogic study was conducted with French novice residents. Each resident completed the recommended four two-hour training sessions and performed a standardized assessment simulating standard cataract surgery before the first session (A0), at the end of the first (A1), second (A2), third (A3) and fourth (A4) sessions. For each surgical step of each attempt, the following data were collected: score, odometer, completion time, posterior capsular rupture and cumulative energy delivered (ultrasounds) during phacoemulsification. A performance threshold was set at a score of 80/100 for each surgical step, 400/500 for the overall procedure. Only descriptive statistics were employed.ResultsSixteen newly nominated ophthalmology residents were included. Median score progressively increased from 95 [IQR 53; 147]) at A0 to 425 [IQR 411; 451] at A4. Despite a significant progression, the “emulsification” step had the lowest A4 scores 86 [IQR 60; 94] without reduction in completion time, odometer or ultrasounds delivered. The rate of posterior capsular rupture decreased linearly from 75% at A0 to 13% at A4 during “emulsification” and from 69 to 0% during “irrigation and aspiration”. At A4, only 25% [8; 53] of residents had > 80 at each step and only 75% [47; 92] had > 400/500 overall.ConclusionA training program consisting of four two-hour sessions on the EyeSi simulator over four consecutive days effectively enhances the surgical skills of novice ophthalmology residents. Undergoing more training sessions may improve scores and decrease the incidence of surgical complications, particularly at the emulsification step of cataract surgery. The learning curves presented here can reassure residents who are progressing normally and help identify those who need a further personalized training program. Trial registrationClinicalTrials registration number: NCT05722080 (first submitted 22/12/2022, first posted 10/02/2023).

Promoting leadership and communication skills in emergency medicine residents: the role of High-Fidelity Simulation

The residency program in Emergency Medicine should include formal training in Non-Technical Skills (NTS). We evaluated the effectiveness of a program based on High-Fidelity Simulation (HFS) to improve the leadership and communication skills of residents in Emergency Medicine. In this prospective observational study, we performed 6 simulation sessions, each with 3 scenarios about the management of the critically ill. In the second to the fifth session, participants received specific training about: the ABCDE (Airway, Breathing, Circulation, Disability, Exposure) approach, leadership, communication, and situation awareness, one topic per session. Technical Skills (TS) were measured as the percentage of critical actions correctly performed by participants during the primary examination. NTS were rated by the Leadership Behavior Description Questionnaire (LBDQ), Communication Competence Questionnaire (CCP), and Clinical Teamwork Scale (CTS). The trend over the following sessions was evaluated. We examined 90 scenarios, 15 scenarios per session (three scenarios repeated 5 times). The LBDQ score reached in the fifth and sixth sessions (fifth: 25 [20-30]; sixth: 25 [22-29]), was significantly higher than that obtained in the first, second, and third ones (first: 23 [18-24]; second: 22 [16-26]; third: 20 [14-26], all p<0.05). The percentage of correctly performed actions during ABCDE assessment (10 [7-14] vs. 17 [15-19]), as well as CCQ scores (46 [42-48] vs. 51 [47-52]) and CTS scores (82 [64-88] vs. 94 [91-101], all p<0.01), increased significantly between the first and the last session. HFS confirmed to be an effective instrument to allow Emergency Medicine residents to acquire NTS skills in a safe environment.

Oral Health Knowledge, Attitudes, and Learned Clinical Skills in Pediatric Medicine Residents and Nurse Practitioner Students: A Pre-Post Design.

(1) Background/Objective: California has one of the highest rates of pediatric dental caries in the nation. One way to combat this problem is through non-dental provider training programs that focus on prevention. However, there are limited data on healthcare provider training program integration and evaluation of oral health curricula focused on prevention of early childhood caries. This study will assess the change in healthcare providers' attitudes, knowledge, and skills by implementing an interprofessional educational (IPE) oral health curriculum in medicine and nurse practitioner programs at one university in Southern California. (2) Methods: A mixed method design was employed using a pre- and post-educational survey, and end-of-program focus group interviews. Descriptive statistics and paired t-tests were used to assess group differences and thematic analyses for the focus groups. (3) Results: A total of 81 students (14 pediatric medicine residents, 18 pediatric, and 49 family nurse practitioners) completed the curriculum and surveys. Attitudes related to oral hygiene remained unchanged, with the nurse practitioner group showing improved clinical skills (all questions; p < 0.021). Knowledge scores significantly improved across all groups (paired t-test; p < 0.001). All focus groups expressed the helpfulness of the educational modules, the usefulness of the skills learned, and the benefits of IPE activities. (4) Conclusion: Healthcare providers showed improved oral health knowledge and clinical skills acquired through the oral health program and can serve as a model to educate across disciplines on the prevention of early childhood caries.

Defining characteristics of categorical general surgery resident lateral transfers

BackgroundFew studies describe rationales for intraspecialty (‘lateral’) general surgery (GS) resident program transfers.ObjectiveWe aimed to describe the key features of GS residency programs reporting lateral transfers, to characterize reasons behind...

Designing, Implementing, and Evaluating a Basic Surgical Skills Bootcamp: An Effective Approach to Enhance Competency in Surgical Residency Training

IntroductionRecent technological advances have facilitated the development of new educational methods, such as simulation-based learning, in specialized bootcamps to enhance the learning of surgical residents. This study aimed to design, implement, and evaluate a basic surgical skills bootcamp for residents in general surgery, orthopedics, neurosurgery, and gynecology based on the learning gap in the current educational program. MethodsThis intervention study focused on the design, implementation, and evaluation of a basic surgical skills bootcamp in a simulated operating room for first-year surgical residents in general surgery, orthopedics, neurosurgery, and gynecology. ResultsThe study resulted in the creation of a comprehensive course plan and the execution of a 6-day training program. Evaluation of educational outcomes confirmed high learner satisfaction, improvement in Multiple Choice Questions (MCQ) exam scores, and acceptable scores in the Objective Structured Clinical Examination (OSCE). ConclusionThe findings of this study suggest that surgical bootcamps, when designed based on needs assessment and in line with scientific bootcamp design principles, play a crucial role in enhancing the satisfaction, knowledge, and skills of surgical residents.

Medical record-keeping educational interventions for medical students and residents: a systematic review.

Medical records, encompassing patient histories, progress notes, and more, play a crucial role in patient care and treatment, healthcare communication, medico-legal matters, and supporting financial documentation. Despite their significance, literature suggests inconsistencies in record quality and insufficient formal medical record-keeping education for medical students and residents. The study aimed to identify and evaluate the effectiveness of educational interventions by conducting a systematic review. A literature search covering 2003-2023 and review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken. The literature search identified 44 relevant studies for inclusion. Educational methods, including lectures, feedback, workshops and discussions, addressed different components of the clinical record. The review revealed positive impacts on participant satisfaction, skills and attitudes related to record-keeping. However, some studies reported no significant positive outcomes, emphasising the need for higher-level evidence. Most studies adopted a single-group pretest-posttest design, presenting challenges in control group implementation. The Kirkpatrick evaluation levels were primarily at level 2, with few studies reaching level 3. The absence of studies at level 4 suggested the need for more robust evidence. Studies targeted medical residents more frequently than medical students, with a lack of interventions during the first year of medical education. Despite limitations including language bias and methodological variations, the review revealed diverse educational strategies and highlighted the necessity for more randomised controlled trials and studies providing higher-level evidence to enhance clinical record-keeping skills among medical students and residents. Medical record-keeping educational interventions can significantly improve the documentation skills of medical students and residents, thereby enhancing patient care, communication and medico-legal compliance.

Crowdsourced Feedback to Improve Resident Physician Error Disclosure Skills

Residents must prepare for effective communication with patients after medical errors. The video-based communication assessment (VCA) is software that plays video of a patient scenario, asks the physician to record what they would say, engages crowdsourced laypeople to rate audio recordings of physician responses, and presents feedback to physicians. To evaluate the effectiveness of VCA feedback in resident error disclosure skill training. This single-blinded, randomized clinical trial was conducted from July 2022 to May 2023 at 7 US internal medicine and family medicine residencies (10 total sites). Participants were second-year residents attending required teaching conferences. Data analysis was performed from July to December 2023. Residents completed 2 VCA cases at time 1 and were randomized to the intervention, an individual feedback report provided in the VCA application after 2 weeks, or to control, in which feedback was not provided until after time 2. Residents completed 2 additional VCA cases after 4 weeks (time 2). Panels of crowdsourced laypeople rated recordings of residents disclosing simulated medical errors to create scores on a 5-point scale. Reports included learning points derived from layperson comments. Mean time 2 ratings were compared to test the hypothesis that residents who had access to feedback on their time 1 performance would score higher at time 2 than those without feedback access. Residents were surveyed about demographic characteristics, disclosure experience, and feedback use. The intervention's effect was examined using analysis of covariance. A total of 146 residents (87 [60.0%] aged 25-29 years; 60 female [41.0%]) completed the time 1 VCA, and 103 (70.5%) completed the time 2 VCA (53 randomized to intervention and 50 randomized to control); of those, 28 (54.9%) reported reviewing their feedback. Analysis of covariance found a significant main effect of feedback between intervention and control groups at time 2 (mean [SD] score, 3.26 [0.45] vs 3.14 [0.39]; difference, 0.12; 95% CI, 0.08-0.48; P = .01). In post hoc comparisons restricted to residents without prior disclosure experience, intervention residents scored higher than those in the control group at time 2 (mean [SD] score, 3.33 [0.43] vs 3.09 [0.44]; difference, 0.24; 95% CI, 0.01-0.48; P = .007). Worse performance at time 1 was associated with increased likelihood of dropping out before time 2 (odds ratio, 2.89; 95% CI, 1.06-7.84; P = .04). In this randomized clinical trial, self-directed review of crowdsourced feedback was associated with higher ratings of internal medicine and family medicine residents' error disclosure skill, particularly for those without real-life error disclosure experience, suggesting that such feedback may be an effective way for residency programs to address their requirement to prepare trainees for communicating with patients after medical harm. ClinicalTrials.gov Identifier: NCT06234085.

The Impact of Simulator Training of Vascular Anastomosis and Video Assessment for Surgical Residents

IntroductionThe rapid increase of minimally invasive surgery and the shortened training period for surgical residents has resulted in limited opportunities to acquire proficiency in open surgical techniques, such as vascular anastomosis. However, vascular anastomosis remains an essential skill in every surgery for bleeding control. This study aimed to validate the effectiveness of surgical education model for vascular anastomosis and assess the impact on the comprehension, skill, and confidence of surgical residents in performing vascular anastomosis. MethodsA total of 21 surgical residents with 1st to 3rd years of experience at Seoul National University Hospital participated in a four-week vascular anastomosis training program. The program included an educational lecture and the performance of an end-to-side anastomosis on a procedural model, with evaluations being conducted using the Objective Structured Assessment of Technical Skills (OSATS) and the End Product Rating Score (EPRS) in pre- and post-training surveys. ResultsSignificant improvement was observed in the OSATS score (from 9.22 ± 2.4 in week 1 to 12.87 ± 3.1 in week 4; P < 0.001) and the EPRS score (from 12.47 ± 4.1 in week 1 to 17.57 ± 2.2 in week 4; P < 0.001). Additionally, the surgical performance time significantly decreased from 20.99 ± 4.6 minutes to 16.33 ± 4.2 minutes (P = 0.019) ConclusionsSimulator training of in vitro vascular anastomosis, when accompanied by expert-led instruction, can effectively enhance the surgical proficiency, confidence, and overall surgical outcomes of residents, as inferred from the observed improvements in OSATS and EPRS scores. The results suggest that integration of this training model into surgical curricula could be a promising strategy for enhancing vascular surgical training.

Evaluating the effects of comprehensive simulation on central venous catheterization training: a comparative observational study

BackgroundSimulation-based training (SBT) is vital to complex medical procedures such as ultrasound guided central venous catheterization (US-IJCVC), where the experience level of the physician impacts the likelihood of incurring complications. The Dynamic Haptic Robotic Trainer (DHRT) was developed to train residents in CVC as an improvement over manikin trainers, however, the DHRT and manikin trainer both only provide training on one specific portion of CVC, needle insertion. As such, CVC SBT would benefit from more comprehensive training. An extended version of the DHRT was created, the DHRT + , to provide hands-on training and automated feedback on additional steps of CVC. The DHRT + includes a full CVC medical kit, a false vein channel, and a personalized, reactive interface. When used together, the DHRT and DHRT + systems provide comprehensive training on needle insertion and catheter placement for CVC. This study evaluates the impact of the DHRT + on resident self-efficacy and CVC skill gains as compared to training on the DHRT alone.MethodsForty-seven medical residents completed training on the DHRT and 59 residents received comprehensive training on the DHRT and the DHRT + . Each resident filled out a central line self-efficacy (CLSE) survey before and after undergoing training on the simulators. After simulation training, each resident did one full CVC on a manikin while being observed by an expert rater and graded on a US-IJCVC checklist.ResultsFor two items on the US-IJCVC checklist, “verbalizing consent” and “aspirating blood through the catheter”, the DHRT + group performed significantly better than the DHRT only group. Both training groups showed significant improvements in self-efficacy from before to after training. However, type of training received was a significant predictor for CLSE items “using the proper equipment in the proper order”, and “securing the catheter with suture and applying dressing” with the comprehensive training group that received additional training on the DHRT + showing higher post training self-efficacy.ConclusionsThe integration of comprehensive training into SBT has the potential to improve US-IJCVC education for both learning gains and self-efficacy.

Strategi Peningkatan Literasi Digital Masyarakat dalam Mencegah Penyebaran Hoaks di Era Digital

The community service program carried out in RT 038, Sukarami Village, aimed to enhance the digital literacy of residents to prevent the spread of hoaxes. The main issue faced was the low awareness and skills of residents in verifying digital information, leading to a high spread of hoaxes. The methods used in this program included initial surveys, program planning meetings, digital literacy education and training, as well as discussion and evaluation sessions. The results of the program showed a significant increase in residents' digital literacy, with 80% of respondents able to verify information after the program. There was a decrease in the spread of hoaxes, from 60% before the program to 20% after the program. Residents also became more critical and inclusive in receiving and disseminating information, and more vigilant against potential online threats. Thus, this program successfully built a stronger and more resilient community in facing information challenges in the digital era.

Implementation of the MIT KKN Program Group 56 Caruban Village in Improving Economic Empowerment, Education, and the Social Environment of the Community

Community Service (KKN) activities are a form of community service carried out by students as part of the tridharma of higher education. This article describes the KKN activities carried out by the KKN team of the State Islamic University (UIN) Walisongo Semarang in Caruban Village, Ringinarum District, Kendal. The focus of this service is to improve the quality of education and health of the village community, as well as increasing the potential of Caruban Village. The results of the activities show an increase in the knowledge and skills of residents in the fields of education and health, as well as the creation of several sustainable programs to utilize the potential of the village initiated by the KKN team.

Social entrepreneurship as alternative form of employment in rural areas

For rural labor market, it should be noted the specific nature of the demand and supply of labor, imbalance between them, low level of professional training, lack of high degree of readiness for innovation, and lack of labor resources. In this regard, we can consider an alternative form of social entrepreneurship that increases employment of the rural population. The goal is to show the most important aspects of development of corporate social responsibility as the best option for improving the quality of life of the population in rural areas through access to education, healthcare and cultural leisure opportunities, disseminating the entrepreneurial skills of rural residents, increasing their self-esteem and self-sufficiency. Social entrepreneurs use local resources and create new markets for agricultural products, handicrafts, and tourism services. Methods – statistical and economic, scientific analysis, comparison. The study is based on the analysis of information obtained from domestic and foreign scientific publications, statistical data from the Bureau of National Statistics of the Agency of the Republic of Kazakhstan for Strategic Planning and Reforms. Results - the author presents indicators of demographic trends and the impact of the state of labor potential on employment in the country and in rural areas over the past 5 years, including the current state of employment and unemployment in rural areas and expanding the range of social and entrepreneurial activities based on entrepreneurial activity aimed at solving social problems. Social entrepreneurship is distinguished by the following main features: innovation, self-sufficiency and financial sustainability, entrepreneurial approach. Conclusions - the author has given proposals that increase social and economic security, employment opportunities in rural regions, stimulating the investment initiative of business entities.

Analysis of the Current Situation and Optimization Strategies of Surgical Skill Training of Primary Orientation Training Residents

This paper analyzed the current situation of surgical skills training of grassroots orientation training residents, and found that there are deficiencies in training contents, faculty allocation, resource allocation and training evaluation. Given these problems, optimization strategies such as improving the training system, strengthening faculty, optimizing resource allocation and improving training evaluation are proposed. By strengthening the combination of theory and practice, improving the teaching ability of faculty, rationally utilizing and allocating resources, and building scientific evaluation system, the study aims to improve the surgical skills of primary care residents and enhance the service quality of medical care. This study provides valuable references for the talent training of primary medical and is of great significance in promoting the balanced development of primary medical care.

Optimalisasi Pengelolaan Sampah Organik di Kelurahan Balongsari melalui Pemberdayaan Masyarakat dengan Metode Kompos Takakura

The majority of waste produced by residents in the Balongsari Subdistrict is organic waste from household activities. The waste problem becomes more complex if public awareness about the importance of waste management remains low. To address this, Balongsari Subdistrict authorities and officials RW 4, 5, and 6, along with the community service team, agreed to conduct a waste management socialization activity using the Takakura method, targeting the PKK Mobilization Team. This activity aims to increase community knowledge and skills in managing kitchen waste, revive the community's enthusiasm for composting waste, and reduce waste volume. The method used is a participatory approach involving socialization, education, demonstrations, and hands-on practice with residents to create compost using the Takakura method. The results show that this community service activity improved residents' awareness and skills in converting household waste into compost. The increased active participation of 26 participants and the commitment of 85% of participants to implement the Takakura method at home demonstrate the success of this activity. The Takakura method offers an effective solution for reducing organic waste volume and producing high-quality compost. This practical introduction hopes to encourage more efficient and environmentally friendly waste management practices at the household level.

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

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

Knowledge and skills of pediatric residents in managing pediatric foreign body airway obstruction using novel airway clearance devices in Spain: A randomized simulation trial

AimRecent emergence of airway clearance devices (ACDs) as a treatment alternative for foreign body airway obstructions (FBAO) lacks substantial evidence on efficacy and safety. This study aimed to assess pediatric residents’ knowledge and skills in managing a simulated pediatric choking scenario, adhering to recommended protocols, and using LifeVac© and DeCHOKER© ACDs. MethodsRandomized controlled simulation trial, in which 60 pediatric residents from 3 different hospitals (median age 27 [25.0–29.9]; 76.7% female) were asked to solve an unannounced pediatric simulated choking scenario using three interventions to manage (randomized order): 1) following the recommended protocol of the European Resuscitation Council (encouraging to cough or combination of back blows and abdominal thrusts); 2) using LifeVac©; and 3) using DeCHOKER©. A Little Anne QCPR™ manikin (Laerdal Medical) was used. The variable compliance rate (%) was calculated according to the correct/incorrect execution of the steps constituting the proper actions for each test. ResultsParticipants demonstrated a correct compliance rate only ranging between 50–75% in following the recommended protocol for managing partial FBAO progressing to severe. Despite unfamiliarity with the ACDs, pediatric residents achieved rates between 75% and 100%, with no significant difference noted between the two devices (p = 0.173). Both scenarios were successfully resolved in under a minute, with LifeVac© demonstrating a significantly shorter response time compared to DeCHOKER© (39.2 [30.4–49.1] vs. 45.1s [33.7–59.2], p = 0.010). ConclusionsOnly a minority of pediatric residents were able to adhere to the recommended FBAO protocol, whereas 70% of them were able to adequately use the ACDs. However, since a significant proportion could not, it seems that ACDs themselves do not address all issues.

Inter- and Intrarater Reliability of the Gap-Kalamazoo Communication Skills Assessment Form Among Occupational Therapy Interns.

Effective communication skills (CS) are essential for occupational therapists. The Gap-Kalamazoo Communication Skills Assessment Form (GKCSAF) is a standard tool for assessing the CS of medical residents. However, the interrater reliability for the nine CS domain scores ranges from poor to good. The intrarater reliability remains unclear. To examine the inter- and intrarater reliability of the GKCSAF's nine domain scores and total score among occupational therapy interns. Repeated assessments with the GKCSAF. Medical center psychiatry department. Twenty-five interns and 49 clients with mental illness, recruited from August 2020 to December 2021. The transcripts of 50 evaluation interviews between clients and interns were used. Three independent raters assessed each transcript twice, at least 3 mo apart. The GKCSAF demonstrated poor interrater reliability for the nine domain scores (weighted κ = .08-.30) and the total score (intraclass correlation coefficient [ICC] = .22, 95% confidence interval [CI] [.10, .35]). The GKCSAF showed poor to intermediate intrarater reliability for the nine domain scores (weighted κ = .27-.73) and fair reliability for the total score (ICC = .69, 95% CI [.60, .77]). The GKCSAF demonstrates poor interrater reliability and poor to intermediate intrarater reliability for the nine domain scores. However, it demonstrates fair intrarater reliability in assessing the overall CS performance of occupational therapy interns. Significant variations were observed when different raters assessed the same interns' CS, indicating inconsistencies in ratings. Consequently, it is advisable to conservatively interpret the CS ratings obtained with the GKCSAF. Plain-Language Summary: It is essential for occupational therapists to effectively communicate with clients. The Gap-Kalamazoo Communication Skills Assessment Form (GKCSAF) is a standard tool that is used to assess the communication skills of medical residents. The study authors used the GKCSAF with occupational therapy interns in a medical center psychiatry department to assess how effectively they interviewed clients with mental illness. This study aids occupational therapy personnel in the interpretation of GKCSAF results. The study findings also highlight the importance of developing reliable and standardized measures to assess communications skills in the field of occupational therapy.