Assessment Survey Research Articles

Financial Distress Screening and Navigation in Pediatric Oncology Within the National Cancer Institute Community Oncology Research Program

PURPOSE Cancer-related financial hardship is associated with poor quality of life, risk of household material hardship, and psychological distress for families affected by pediatric cancer. Current processes on financial distress screening and financial navigation across the pediatric National Cancer Institute Community Oncology Research Program (NCORP) network remain unknown. METHODS Financial distress screening and financial navigation services among NCORP practices were assessed using two survey items from the 2022 NCORP Landscape Assessment Survey. Practices answering yes to providing oncology care for pediatric patients were included. Univariable models were used to test associations between practice characteristics and financial screening and financial navigation. RESULTS Of the 53 NCORP practices serving pediatric patients with cancer that responded to the survey, 44 (83%) reported routinely conducting financial distress screening. Most of the practices reported that financial screening is completed by social workers (n = 40/44, 91%). One third of practices reported financial screening using a survey completed by patients/caregivers (n = 14/44, 32%). Almost all practices (n = 51/53, 96%) reported responding to financial needs through a social worker. One third of the practices reported having a cancer-specific financial navigator (n = 17/53, 32%) or a nondedicated (not cancer-specific) financial navigator (n = 19/53, 36%). Practices that served a proportion of new patients with cancer at or above the national average of Hispanic individuals in the United States were as likely to screen for financial distress as practices below the national average (odds ratio, 2.42 [95% CI, 0.45 to 13.03]; P = .30). CONCLUSION Most pediatric NCORP practices report screening for financial distress. Fewer groups offer dedicated cancer-specific financial navigation, and practices vary. Further research is needed to explore the development and implementation of standardized financial distress measures and financial navigation interventions within pediatric cancer care.

Microlearning in Complex Surgical Oncology: Proof of Concept and Impact on Surgical Skills Acquisition During Residency.

Recent structural changes to residency programs, such as workforce shortages and work-hour restrictions, have reduced operating room exposition for residents in surgical specialties. Complementary strategies need to be developed to support surgical educators and provide residents with the optimal learning environment. This study aimed to assess the feasibility of integrating microlearning in a general surgery residency program and to evaluate its impact on surgical skills acquisition in surgical oncology. An online module structured in six different microlearning units was created. Each unit was designed to present key concepts of a specific surgical procedure, including anatomic landmarks, series of standardized steps, and a narrated video. The procedures included were right and left hepatectomy, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, total/subtotal gastrectomy, pancreatoduodenectomy, and distal pancreatectomy. The study included 20 general surgery residents completing a 3-month rotation in complex surgical oncology, 10 of whom had access to the online module. The participants in both groups completed a self- assessment survey at the conclusion of the study. The residents who had access to the online module exhibited greater comfort regarding theoretical aspects of the procedures (p = 0.0322) and increased confidence performing procedural steps of the procedures (p = 0.0433) at the end of their rotation. Most of the residents considered the module to be highly beneficial to their learning. All the residents considered the online module helpful in preparing for real-life scenarios. The study demonstrated the feasibility and potential benefits of introducing a microlearning environment to enhance residents' knowledge and behavior in complex surgical oncology.

Multi-dimensional evidence from the UK Biobank shows the impact of diet and macronutrient intake on aging.

The role of diet in aging is crucial, yet research findings on how specific diets influence human aging remain inconsistent. Understanding the relationship between dietary factors and aging could inform interventions to promote healthier aging outcomes. We analyzed data from the UK Biobank baseline survey and a 24-hour dietary assessment survey to investigate the association between diet and aging. The study examined 18 individual food intakes, 6 dietary patterns, 3 macronutrient intakes, and 3 dietary quality scores. High-dimensional Fixed Effects (HDFE) models were used to assess associations between dietary factors and aging measures, including telomere length, phenotypic age, and brain grey/white matter volumes. Multivariable Mendelian Randomization (MVMR) was employed to explore causal links between macronutrient consumption and aging outcomes. Our results show that healthier diets are generally associated with improved aging outcomes from HDFE analyses. Plant-based food consumption correlates with increased telomere length and reduced phenotypic age, while animal-based food intake is linked to adverse aging effects. MVMR results confirm the causal benefits of carbohydrate intake, including reductions in phenotypic age (β = -0.0025; 95% CI = [-0.0047, -0.0003]; p = 0.0253) and increases in whole-brain grey matter volume (β = 0.0262; 95% CI = [0.007, 0.046]; p = 0.0087). The latter association remains significant after multiple testing correction. This study underscores the significant role of diet in biological aging and provides robust evidence for the benefits of carbohydrate intake in promoting healthier aging. These findings highlight the potential of dietary interventions to improve aging-related outcomes.

The Relationship of Physical Activity to Anxiety and Resilient Coping Among Higher Education Employees

Background: Physical activity (PA) can positively affect mental health, yet many aspects of this relationship (degree of effectiveness across populations and conditions, biological mechanisms, etc.) remain unexplored. Aim: This study seeks to understand how PA is associated with anxiety, a common mental health condition, and resilient coping, the ability of an individual to overcome personal stress; and, how PA can be utilized to alleviate anxiety and strengthen resilient coping. Methods: Data collected from Health Assessment surveys assessed how several types of PA (moderate, vigorous, moderate-to-vigorous, and strength training) are related to anxiety and resilient coping. Results: Analysis revealed statistically significant relationships between PA and anxiety and PA and resilient coping. The findings from this study establish positive associations between PA and anxiety and resilient coping, emphasizing the powerful influence of PA as a mental health therapeutic. Such results suggest that PA could become a key component for attenuating mental health crises of workforces within higher education institutions. Conclusion: These findings serve as convincing evidence that organizations should assess ways to incorporate PA into their policies and programs for the health and well-being of employees, namely those of higher education institutions.

Changes in circulating filarial antigen status in previously positive individuals: Lessons for treatment monitoring and pre-transmission assessment surveys.

The Global Programme to Eliminate Lymphatic Filariasis has made significant gains through mass drug administration (MDA) of Ivermectin/Albendazole. Periodic evaluation of the MDA programme in lymphatic filariasis elimination is particularly useful in determining end points for stopping the programme. This is a follow-up study that sought to examine the effects of additional time and MDA intake on antigenemia seroreversion in persons who had previously tested positive for LF using the Filarial Test Strip (FTS) and the TropBio ELISA over a period of 1-5 years. A total of 542 individuals, from the Kassena Nankana East Municipal (N = 340) and Nabdam districts (N = 202) in the Upper East Region of Ghana, who had previously tested either positive (N = 446) or negative (N = 96) for FTS-CFA, participated in the study. Two follow-up visits were conducted; 1-4 years (follow-up-1) and 2-5 years (follow-up-2) after the baseline visit. Of the 446 FTS-CFA positives, 175 (39.2%) did not receive additional MDA (ivermectin/Albendazole) after the baseline visit. Overall, from the two follow-up visits, 159/175 (90.9%) FTS-CFA+ participants who did not receive any additional Ivermectin/Albendazole and 226 out of the 271 (83.4%) with additional MDA treatment became CFA negative. A total of 120 randomly selected baseline FTS-CFA+ samples were tested with Og4C3 TropBio ELISA and only 44/120 (36.7%) were found positive. Of these 44 participants, 12 (27.3%) completely became CFA negative and an additional 18 (40.9%) had reduced antigen levels during the follow-up. Likewise, all three previously/baseline microfilariae positive persons had become amicrofilaremic. In the present work, it has been shown that >90% of the previous CFA positive individuals seroreverted in 1 to 5 years post-baseline without additional MDA. The FTS is a more sensitive diagnostic tool that plausibly detects residual CFA in blood. The impact and influence of time as compared to additional ivermectin/Albendazole intake, on CFA seroreversion in this study was significant (p < 0.001).

Virtual reality in stated preference survey for walkability assessment

Virtual reality in stated preference survey for walkability assessment

The Healthcare Subsidy Assessment Survey: A Novel and Validated Poverty Assessment Tool to Inform Medical Cost Subsidization in Rural Uganda.

Approximately 30% of the global burden of disease is surgical, but two-thirds of the world's population cannot access safe, affordable, and timely surgical care. An ambulatory surgical center (ASC) in Uganda offers subsidized and free care to some patients, but identifying patients in greatest need is challenging. We aimed to develop an unbiased tool appropriate for medical settings to determine subsidy eligibility to prevent catastrophic healthcare expenditure (CHE) for ASC's patients. Utilizing a modified simple poverty scorecard (SPS), expert opinions, and literature review, the center developed a new poverty assessment tool (PAT), the healthcare subsidy assessment (HSA). The HSA was implemented alongside the SPS at ASC. Principal component analysis (PCA) was used to refine the HSA and establish a correlation between the original HSA and SPS to predict CHE likelihood. A 21-question HSA was developed, and 175 patients completed both the HSA and SPS. The questionnaires had a correlation of R2=0.294, p<0.001. PCA identified six distinct components, and the HSA was refined to an 11-question survey (rHSA). After rescaling to 100 for comparison to the SPS and the original HSA, rHSA scores were significantly different between both (p<0.001) but had an improved correlation with the SPS (R2=0.457, p<0.001) and a strong correlation with the original HSA (R2=0.621, p<0.001). We successfully developed and validated the rHSA, a novel PAT tailored for a healthcare setting to better identify and support patients at risk.

Evaluating the role and future direction of the Japanese association for surgical education: a needs assessment survey among participants in the annual meetings

Evaluating the role and future direction of the Japanese association for surgical education: a needs assessment survey among participants in the annual meetings

P-962. Designing ID Elective Goal and Learning Objectives Based On Need Assessment From Learners

Abstract Background Comprehensive Infectious disease (ID) education is indispensable for clinicians, given challenges posed by antimicrobial resistance, pandemics, expanding immunocompromised population, and the effect of climate change. ID fellowship applications have failed to match the demand for training programs. While numerous factors contribute to the prevailing challenges in ID workforce, enhancing clinical education in ID holds promise for bridging this gap. Need Assessment Survey Results Methods An anonymous survey was conducted to understand the reasons learners in undergraduate (UME) and graduate medical education (GME) choose ID electives, what and how they want to learn during the rotation. In the academic year 2023, there were 59 GME and 10 UME learners enrolled in ID elective at our institution. 38 responded to the survey (55% response rate). Results The survey showed 93% of respondents opted for electives to augment their knowledge. 24% sought networking and mentorship from faculty members, and 21% wanted to explore career options in ID. However, only 8% plan to apply to ID fellowship programs. Learners expressed interest in exploring outpatient ID clinics (63%), antimicrobial stewardship initiatives (81%), and infection control activities (42%), alongside inpatient consultation services. Moreover, a majority (87%) expressed a desire for structured didactics. Conclusion While most pursue ID electives to address knowledge gaps, 21% of learners seem to be in an exploratory phase, seeking mentorship and contemplating a career in ID. ID electives have potential to serve as a platform for early trainees and students to explore their interests in the field. To optimize their experience, we could provide interactive didactics and diversifying clinical activities such as antimicrobial stewardship initiatives, and subspecialty clinics. Such initiatives not only provide learners with comprehensive insights into the field but also foster a deeper appreciation for the multifaceted nature of infectious diseases. Limitations from this study include small sample size and low response rate which impact generalizability of this finding. Conducting longitudinal surveys and evaluations with elective learners could provide further insights into how to improve the curriculum and better meet the needs of participants. Disclosures All Authors: No reported disclosures

584. Implementation and Evaluation of an Interactive Infectious Diseases Online Curriculum for Trainees on ID electives

Abstract Background Infectious Diseases Online Curriculum (IDOC) is an online asynchronous interactive educational resource for trainees on ID electives to augment their ID knowledge and complement their clinical training. The curriculum mapping with details of modules and methods of assessment are elaborated in TABLE 1. A program evaluation of the IDOC with the aim to analyze program outcomes was done in 2023.Table 1:Curriculum mapping including goals, objectives, conceptual framework, educational strategies and assessments for Infectious Diseases Online Curriculum Methods IDOC was piloted with medical students and residents from August 2022 to December 2022 and assesses Kirkpatrick level 2 learning. The primary assessment was of Program Outcome, set up using a Pragmatism paradigm with Mixed Methods research methodology to assess quantitative and qualitative data. Following IRB approval, data collection was conducted through web-based surveys (Qualtrics). Each surveyor was asked to assign a unique alphanumeric number to their pre and post survey so these could be used for comparison. The primary outcome assessed was change in knowledge. Each question in the pre- and post-assessment was awarded 1 for correct answer and 0 for incorrect answer. A paired sample t test was used to compare pre and post cumulative scores and analyzed using SPSS v26.Table 2:Paired sample T test analysis of quantitative outcomes Results During the pilot phase 16 pre- and 20 post assessment surveys were received (8 phase-3 students, 4 phase-2, 3 phase-1, 3 interns, 2 with no level of training). 11 respondents had allotted the same alphanumeric number to both pre- and post-surveys and these were used for comparative analyses of knowledge change. Interest in pursuing ID as a career prior to and after revision of modules was sought on a 5-point Likert scale and received 12 responses. Paired t test showed significant improvement in knowledge and increase in interest of trainees to pursue ID as a career (TABLE 2). Majority of trainees also rated the modules to be extremely clear and relevant to clinical practice (TABLE 3). Qualitative feedback was overwhelmingly positive (TABLE 4).Table 3:Results of self-perceived clarity and self perceived relevance of the modules by the trainees Conclusion IDOC functions as a novel, accessible, quick, engaging, and effective way to improve ID related knowledge in trainees and is an adjunct to their clinical elective experience. Although this was a small study, the results are significant and transferable, and IDOC can be disseminated to smaller training programs where educators and ID learning resources are not available.Table 4:Qualitative feedback for Infectious Diseases Online Curriculum as well as individual interview response from trainee Disclosures All Authors: No reported disclosures

Neuropathic corneal pain following refractive surgery: risk factors, clinical manifestations, imaging and proteomic characteristics

Background/aimsTo identify the risk factors for neuropathic corneal pain (NCP) following corneal refractive surgery and to report its clinical manifestations, imaging and proteomic characteristics.MethodsThis 1 year prospective cohort study included...

A sensor-based study on the environmental determinants of sleep in older adults.

The residential environment is hypothesized to influence sleep quality within urban settings. Factors associated with the residential environment include air and noise pollution, area socioeconomic status, green and blue spaces, and other neighborhood features. This study seeks to quantify the association of selected environmental factors with sleep quality in the daily lives of 211 older adults residing in the Paris metropolitan area with sensor-based methods. Participants' sleep and physical activity were monitored over a 7-day period using 2 accelerometers. Ecological momentary assessment (EMA) surveys were administered 4 times a day to assess depressive and anxiety symptoms. Environmental factors surrounding participants' residential addresses, including noise and air pollution, walkability, green and blue space availability, median income, and population density, were computed using geoprocessing methods. Hierarchical mixed models with a random intercept at the individual level were fitted to estimate the adjusted association between residential environmental factors and sleep outcomes [total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO)]. Potential effect modification of or mediation by physical activity and depression and anxiety levels were explored in the analyses. We observed an effect size of 1.4 more minutes of sleep for each increase of one thousand euro in neighborhood median income (Confidence Intervals: 0.35, 2.45). The average adjusted difference in total sleep time between the 10th and 90th percentiles of neighborhood median income was 23.6 minutes of sleep. Other environmental factors and depression and anxiety levels did not exhibit correlations with sleep outcomes. The results reveal a positive association between median income at the residential level and TST, while no associations were identified for SE and WASO. In conclusion, these findings underscore the impact of neighborhood socioeconomic status on total sleep time within the context of urban living, highlighting the need for further research.

High unmet needs for cervical cancer screening among women living with HIV in six African countries: A population-based study.

Cisgender women living with HIV (WLWH) are disproportionately impacted by cervical cancer. Nevertheless, disparities in uptake and implementation of cervical cancer services persist in sub-Saharan Africa, where population-level estimates of screening coverage remain scarce. We pooled data from nationally representative Population-based HIV Impact Assessment (PHIA) surveys conducted in Ethiopia, Malawi, Rwanda, Tanzania, Zambia, and Zimbabwe (2015-2019). After estimating the prevalence of self-reported lifetime cervical cancer screening (overall and by country), survey-weighted multivariable log-binomial regression identified socio-demographic and clinical correlates of screening uptake among WLWH aged 25-64years. Overall, 6933 WLWH (mean age: 39.6years) were included in the multi-country sample. The pooled prevalence of lifetime cervical cancer screening was 18.5% (range: 8.5% [Rwanda] to 25.3% [Zambia]). Screening uptake varied by HIV clinical status, with serostatus-aware (21.3% vs 9.0%), antiretroviral therapy-experienced (22.0% vs 10.5%), and virally suppressed (22.1% vs 11.6%) WLWH, respectively, reporting significantly (p < 0.001) higher screening rates. Screening was especially low among WLWH aged <35years (14.7%), with no formal education (12.1%), in the poorest households (7.9%), and residing in rural areas (14.0%). Fewer than one-fifth of WLWH had ever screened for cervical cancer, suggesting expanded availability and access to tailored, integrated services are critically needed.

Addressing unmet mental health needs of older adults in Turbo, Colombia: a multi-component psychosocial intervention feasibility study

BackgroundOlder adults have lived through extreme and stressful live events in Colombia, including during the armed conflict. Without adequate mental health resources in place, the aim of this study was to feasibility test a co-produced community-integrated intervention for older adults to improve their mental health and well-being in Turbo, Colombia.MethodsBased on a systematic review and meta-analysis of community-based mental health interventions for older adults in LMICs, qualitative interviews with older adults and local stakeholders, as well as a mental health needs assessment survey of the local older adult population in Turbo, Colombia, we consulted older adults in the region to co-produce a community-based intervention. The co-produced intervention ran for three months in 2023, with two sessions provided per week in a community centre (26 sessions in total). The multi-component intervention included social engagement, educational interventions, physical activities, and peer support. Older adults were recruited from the local community. Twelve participants were interviewed about their experiences of the intervention and its feasibility.ResultsEighteen older adults participated in the intervention, with 13 completing the 12 weeks. Attendance rate was high, with 10 participants attending between 90 to 100% of all 26 sessions. Qualitative interviews with 12 participants showed that participants valued the intervention and the activities it offered, that the intervention was feasible, and expressed a keen interest for the intervention to be continued.ConclusionsThis co-produced and evidence-based intervention for older victims of ‘La Violencia’ in Colombia has the potential to provide affordable, acceptable and relevant community-based resources supporting mental health and wellbeing within the community; providing care and support with trained facilitation. Normally, this group would not be able to access services to address their social and psychological isolation and distress. In light of limited mental health support across LMICs, this intervention could provide mental health for older adults in other communities in Colombia and elsewhere developed through co-production, cultural adaptation, subject to further evaluation.

Impacts of Ethical Dilemmas and Moral Distress in Pediatric Hematology Oncology Nurses.

To assess the level of moral distress (MD) and perceptions of ethical climate among pediatric hematology/oncology (PHO) nurses and to identify bioethics topics where increased education was desired. In this cross-sectional study, we administered the 26-item Swedish Moral Distress Scale-Revised (sMDS-R), specifically revised and validated for pediatric oncology, in conjunction with the Clinical Ethics Needs Assessment Survey (CENAS). Electronic surveys were sent to inpatient and outpatient PHO nurses. Analysis included descriptive statistics, Spearman correlation, and the Mann-Whitney U test. Of 123 nurse respondents, the overall mean MDS-R score was 2.75 (range: 0-16). Distressing encounters occurred infrequently (frequency mean 0.96, range: 0-4), resulting in relatively low distress (mean 2.24, range: 0-4). The scenarios resulting in the highest overall MD included performing painful procedures on children (2.46), lack of meaningful conversations due to time constraints (2.41), and poor team communication (2.68). Inpatient nurses reported higher levels of MD compared to outpatient nurses (p = 0.0002). The overall CENAS score was greater than 3 (range: 1-4), suggesting a positive ethical climate. There was a moderate negative relationship between sMDS-R combined scores and CENAS scores (p<0.0001). Inpatient nurses reported a less positive ethical climate compared to outpatient nurses (p = 0.01). Nurses expressed a need for additional ethics education around withholding/withdrawing of life-sustaining treatments, providing end-of-life care, and working with challenging patients/families. Although the ethical climate was overall positive, several clinical situations appear to result in higher moral distress despite their infrequency, especially on inpatient units. Additional resources and education in navigating ethical dilemmas were requested by the nurses.

Synesis as a framework to enable safety interventions in complex healthcare environments

BackgroundDespite wide adoption in the healthcare of safety event report (SER) systems, there is a paucity of unified structures for prompt analysis and action while retaining reporter confidentiality. We used...

Engaging with young professionals in transfusion medicine: Insights from a needs assessment survey targeting an international cohort.

Professionals who work or study in transfusion medicine under 40 years of age are considered young professionals (YPs) by the International Society of Blood Transfusion (ISBT). While the ISBT provides opportunities for YPs, their needs have to be assessed to customize initiatives in a way that could potentially improve their engagement. This survey aimed to assess the needs of YPs in transfusion medicine and understand their perspectives on future ISBT initiatives. Between January and February 2023, a 28-question online survey was accessible through a generalized link across the ISBT network. Skip-logic responses from 352 YPs, including 151 ISBT members and 201 non-members, were analysed. Each question varied in the number of responders and, consequently, the number of responses. Firstly, the most important needs of YPs from the survey were educational opportunities and training programmes, with 70% of respondents indicating for educational content in specific fields of transfusion. Secondly, Transfusion Today published by the ISBT (46.9%) ranked the highest in engagement, while ISBT Academy and Academy funding ranked the lowest (12.8%). ISBT members reported attending ISBT activities or using ISBT resources more often than non-members, although this was not statistically significant. The primary barrier preventing both non-members and ISBT members from engaging in ISBT activities was a lack of awareness. Raising awareness on a regular basis, a customized communication style (e.g., by a representative or different languages) and activities for non-members may be key to improving YP engagement and expanding the ISBT network.

Assessing health systems' capacities to provide post-abortion care: insights from seven low- and middle-income countries.

Abortion-related complications significantly contribute to maternal morbidity and mortality globally. Post-abortion care (PAC) services are essential to safeguarding women's rights by substantially mitigating the health risks associated with abortions - a step which is fundamental to achieving reproductive and maternal health-related Sustainable Development Goals. We conducted a secondary analysis of data from the nationally representative Service Provision Assessment (SPA) surveys conducted between 2015 and 2024 across three regions in seven low- and middle-income countries: Afghanistan, Bangladesh, Nepal, the Democratic Republic of Congo (DRC), Ethiopia, Senegal, and Haiti. We included 2951 primary facilities and 473 referral facilities offering normal delivery services. We used PAC signal functions to report capacity to provide basic and comprehensive PAC services in primary and referral facilities, respectively. Of all primary facilities offering normal delivery services, 50% in Afghanistan, 1% in Bangladesh, 8% in Nepal, 5% in DRC, 34% in Ethiopia, 38% in Senegal, and 19% in Haiti had the capacity to provide basic PAC services. Of the referral facilities, 47% in Afghanistan, 16% in Bangladesh, 50% in Nepal, 52% in DRC, 75% in Ethiopia, 46% in Senegal, and 32% in Haiti had the capacity to provide comprehensive PAC services. Primary facilities in Bangladesh, DRC, and Nepal had critical gaps in referral, ie, effective communication with referral centres and availability of a functional vehicle for emergency transportation. In referral facilities, 74% in Bangladesh and 59% in Nepal had the provision of blood transfusion. In terms of basic PAC services in primary facilities, the capacity of Senegal (from 16% in 2015 to 38% in 2019; P = 0.001) and Haiti (from 12% in 2013 to 19% in 2018; P = 0.007) increased, but the capacity of Bangladesh decreased (from 4% in 2014 to 1% in 2017; P = 0.016) over time. There are substantial gaps in the capacity to provide basic and comprehensive PAC services in the selected countries. Investing in primary healthcare and improving communication and transportation should be the priority for enhancing basic PAC services, while strengthening referral hospitals to effectively handle emergencies and conduct major surgeries could significantly bolster their capacity to provide comprehensive PAC services.

Orthopedic Resident Intern Foundations: A Cross-Institutional, Month-Long Skills Training Boot Camp for PGY-1 Residents.

Orthopedic residents are tasked with rapidly acquiring clinical and surgical skills, especially during their PGY-1 year. However, resource constraints and other factors frequently cause skills training to fall short of established guidelines. We aimed to design and evaluate a cross-institutional, month-long curriculum aimed at pooling resources to optimize training. The O.R.I.F. (Orthopaedic Resident Intern Foundations) Boot Camp was created to teach foundational residency skills and knowledge through daily didactic and simulation-based training covering 6 domains: orthopedic knowledge, orthopedic skills, nonorthopedic clinical knowledge (e.g. radiology), day-to-day hospital tasks, academic research, and social aspects of medicine. Content was based on ACGME milestones and core competencies. The program ran 8 hours each weekday throughout November 2022 and 2023. Before and after the curriculum, participants were administered a 65-question orthopedic knowledge assessment and self-reported competency surveys. Additionally, graduates from the O.R.I.F. 2022 class and a cohort of peer residents from nonparticipating institutions were administered a follow-up survey 1 year after Boot Camp. Comparative testing was performed using Wilcoxon signed-rank analysis (α = 0.05). The curriculum was hosted at a Level 1 urban trauma center. Over the study period 40 residents from the Chicagoland institutions participated in Bootcamp: 25 PGY-1 residents from 5 programs in 2022 and15 residents from 3 programs in 2023. Orthopedic assessment scores increased from 45.7 (SD = 8.3) precurriculum to 60.1 (SD = 7.6) postcurriculum (p < 0.001). Additionally, self-rated competence increased in 5/6 domains-all except the social aspects of medicine. One year after O.R.I.F. 2022, a higher proportion of graduates reporting that skills training provided good or very good preparation for intern year and allowed them to network with peers at other institutions compared to non-Boot Camp residents. The O.R.I.F. Boot Camp improves PGY-1 clinical knowledge and skills in a resource-efficient model while also providing an environment that cultivates cross-institutional camaraderie.

Enhancing Caseworker Job Satisfaction Through Empowerment: An Innovative Tool for Employee Retention

Child welfare caseworkers typically have high turnover rates, and little is known about how to increase their job satisfaction. Utilizing structural equation modeling, this study investigates the connections between empowerment, leadership, learning culture, physical environment, and job satisfaction among social workers in child welfare organizations. We employ a dataset from a comprehensive organizational health assessment survey of 2801 individuals to analyze the direct and indirect effects of empowerment variables on job satisfaction, as well as the influence of leadership, learning culture, and the caseworkers’ physical environment. The findings highlight the potential for empowerment as a tool for strengthening culture and increasing job satisfaction. Specifically, trust and self-determination had the strongest relationship with the empowerment construct in this study.