Training Of Medical Professionals Research Articles

Current State and Outlook in Medical 3D Printing and the Role of Radiology.

Medical three-dimensional (3D) printing is playing an increasingly important role in clinical practice. The use of 3D printed models in patient care offers a wide range of possibilities in terms of personalized medicine, training and education of medical professionals, and communication with patients. DICOM files from imaging modalities such as CT and MRI provide the basis for the majority of the 3D models in medicine. The image acquisition, processing, and interpretation of these lies within the responsibility of radiology, which can therefore play a key role in the application and further development of 3D printing.The purpose of this review article is to provide an overview of the principles of 3D printing in medicine and summarize its most important clinical applications. It highlights the role of radiology as central to developing and administering 3D models in everyday clinical practice.This is a narrative review article on medical 3D printing that incorporates expert opinions based on the current literature and practices from our own medical centers.While the use of 3D printing is becoming increasingly established in many medical specialties in Germany and is finding its way into everyday clinical practice, centralized "3D printing labs" are a rarity in Germany but can be found internationally. These labs are usually managed by radiology departments, as radiology is a connecting discipline that - thanks to the imaging technology used to produce data for 3D printing - can play a leading role in the application of medical 3D printing. Copying this approach should be discussed in Germany in order to efficiently use the necessary resources and promote research and development in the future. · 3D printing in medicine is a rapidly growing field.. · Image acquisition and processing provides an important basis for high-quality 3D models.. · Radiology, as the specialist discipline responsible for imaging, has a crucial role to play.. · Radiology should play a leading role in the introduction of 3D printing in everyday clinical practice. . · Streckenbach A, Schubert N, Streckenbach F et al. Current State and Outlook in Medical 3 D Printing and the Role of Radiology. Fortschr Röntgenstr 2024; DOI 10.1055/a-2436-7185.

Generative adversarial networks (GANs) to produce synthetic 12-lead electrocardiogram signals for specific and rare diseases: a novel, powerful tool towards clinical advancements

Abstract Background Remarkable technological advancements in electrocardiogram (ECG) analysis face challenges due to insufficiently diverse and extensive real-world datasets. This limitation hampers both the development of sophisticated deep learning (DL) models for ECG analysis and the exposure of new physicians to substantial training examples. Purpose To leverage Generative Adversarial Networks (GANs), a novel AI algorithm type, to generate synthetic yet realistic ECG signals resembling specific diseases. Methods We initially employed a general-purpose GAN on more than 21,000 ECG samples from the PTB-XL database, encompassing normal and abnormal ECGs across various diseases. The GAN outputs served as inputs for training "DeceptionECG", a novel GAN model inspired by the InceptionTime architecture (code available online). DeceptionECG focused on generating disease-specific ECG signals, trained on annotated ECGs validated by two electrophysiologists. Post-training, we generated synthetic ECGs for common diseases like atrial fibrillation (AF) and anterior ST-segment elevation myocardial infarction (STEMI), as well as rarer conditions like Wolf-Parkinson White (WPW) syndrome. Authentication involved an independent discriminator DL model and two cardiologists who were asked to distinguish real from synthetic ECGs. Additionally, a DL model, a variant of the InceptionTime architecture, discerned specific diseases in the ECG signals to assess their realism. Finally, we trained a DL model for detecting abnormalities in ECGs with the augmented dataset to evaluate potential performance improvement. Results We generated sets of 5,000 synthetic ECGs for various abnormalities, at a rate of 2,500 12-lead ECG signals per minute. The generated ECGs were indistinguishable from real ones, evidenced by low accuracy (Accuracy, ACC: 48.9%) of the discriminator model and two clinicians (ACC: 56% and 51%), on test sets with anterior STEMI. A DL model trained on real ECGs accurately differentiated between synthetic normal ECGs and those hosting the target disease in nearly 9 out of 10 cases (ACC: 88.7%). Furthermore, the employed DL model detector trained on the augmented dataset, encompassing both real (n=1,589) and synthetic (n=5,000) ECGs, outperformed its counterpart trained solely on real ECGs, when tested on a 1,000-sample set of real signals (ACC: 94.6% vs. 89.3%). Conclusion Our GAN-based approach showcases the potential of generating high-quality synthetic ECGs tailored for specific diseases, overcoming data scarcity challenges, and enhancing the training and performance of machine learning models. Additionally, it holds promise in advancing medical professional training by providing diverse signals with distinct "disease stamps" at massive amounts, addressing privacy concerns associated with extensive data exposure. Further testing is warranted for the applicability of the approach, especially in exceedingly rare conditions with limited available training data.Project workflow and outcomesGAN-generated ECGs: Which is fake?

Systematic review of musculoskeletal ultrasound learning methodologies

AbstractIntroduction/PurposeAs the frequency and morbidity of musculoskeletal (MSK) disorders increase, the use of MSK ultrasound has become an important diagnostic and procedural tool. This has amplified the importance of quality MSK ultrasound training for medical professionals. This systematic review evaluated and compared peer‐reviewed journal articles on learning methodologies for MSK ultrasound training.MethodsThirty‐three articles met inclusion and exclusion criteria and were evaluated.ResultsResults showed a lack of randomised studies that compared learning methodologies.ConclusionThere was wide variability of methodology used based on educational and institutional needs. Further randomised control trials need to be conducted to ascertain best educational practices.

Bringing patients out of the gloom: Examining the effects of patient power and affect labeling on emotional experience reflected in emotional judgement

ObjectiveNegative emotions are common among patients in medical settings. It is important to investigate impacts of patient power and affect labeling on emotional experience in patients. MethodsBehavioral judgments and event-related potentials (ERPs) were recorded while participants with high or low patient power made emotional judgments (positive, negative) about neutral faces, as well as investigating how affect labeling (affect labeling, viewing) influenced emotional judgments about neutral faces in participants with low patient power. ResultsIndividuals with low patient power made more and faster negative emotion judgements. A larger late positive component (LPC) amplitude was found in negative emotion judgments for individuals with low patient power, a component related to allocation of attentional resources to motivationally salient stimuli. Affect labeling elicited less and slower negative emotion judgments in individuals with low patient power. ConclusionsThese results suggest that low patient power triggers negative emotion, which can be reduced by affect labeling. Practice implicationsThe current findings provide valuable insights into reducing negative emotions in patients, fostering promising targets for training for medical professionals and education for patients aiming to ensure more humanistic and higher-quality care delivery.

Teledermatology: an evidence map of systematic reviews

BackgroundAlthough the number of teledermatology studies is increasing, not all variables have been researched in equal depth, so there remains a lack of robust evidence for some teledermatology initiatives. This review describes the landscape of teledermatology research and identifies knowledge gaps and research needs. This evidence map can be used to inform clinicians about the current knowledge about teledermatology and guide researchers for future studies.MethodsOur evidence map was conducted according to the Campbell Collaboration checklist for evidence and gap maps. Eight databases were searched (CINAHL, Embase, PubMed, Scopus, Web of Science, Cochrane Library, JBI Database of Systematic Reviews and Implementation Reports, and OpenGray), and only included systematic reviews of teledermatology involving humans published in English; while excluding non-systematic reviews (i.e., abstracts, conference proceedings, editorials, commentaries, or letters). From 909 records, 14 systematic reviews published between 2004 and 2022 were included. Our analysis focused on the systematic reviews’ characteristics, dermatological conditions studied, rate of overlap and quality assessment of primary studies reviewed, and main findings reported.ResultsTeledermatology was reportedly comparable with clinic dermatology and generally accepted by patients as a mode of care delivery for dermatological conditions. However, there are concerns about privacy, communication, completeness of information transmitted, familiarity with the technology, and technical problems. Healthcare professionals were generally satisfied with teledermatology but found telemedicine consultations longer than face-to-face consultations, and less confident in asynchronous teledermatology than conventional consultations. Teledermatology was reportedly more cost-effective than clinic dermatology; especially considering the distance traveled by patients, referral volume to teledermatology, and clinic dermatology costs. Although patients and providers are satisfied with teledermatology, face-to-face dermatology has higher diagnostic and management accuracy. Teledermatology was also used for training medical professionals. Regarding the validity and reliability of teledermatology outcome measures, no significant discussions were found.ConclusionsCOVID-19 spotlighted telemedicine in clinical care, and we must ensure telemedicine continually improves with robust research. Further research is necessary for establishing a standardized outcome set, enhancing accuracy, concordance, cost-effectiveness, and safety, comparing teledermatology with non-dermatologist care, examining its effectiveness in non-Western low and middle-income countries, and incorporating patient involvement for improved study design.Systematic review registrationhttps://www.researchregistry.com/ (Unique Identifying Number: reviewregistry878).

MSK ultrasound imaging–assisted clinical examination

Musculoskeletal disorders are a significant global health concern, affecting over 1.71 billion individuals worldwide, with a considerable impact on quality of life and economic burden due to healthcare costs and productivity losses. In the United Kingdom, approximately one-third of the population suffers from musculoskeletal disorders, underscoring the need for effective diagnostic and management strategies. Musculoskeletal ultrasound imaging emerges as a preferred diagnostic modality, offering a balance between technical capabilities and cost-effectiveness, owing to its non-invasive nature, portability and lack of radiation exposure. However, the operator-dependent nature of musculoskeletal ultrasound imaging necessitates specialised training for medical and healthcare professionals. The integration of musculoskeletal ultrasound imaging into traditional clinical examinations, known as ultrasound imaging–assisted clinical examination (UIACE), enhances traditional diagnostic processes by providing immediate visual feedback, facilitating a more accurate and comprehensive assessment of musculoskeletal conditions. This approach not only refines diagnosis in cases with ambiguous symptoms or overlapping signs but also significantly improves patient reassurance and management strategies. In addition, incorporating musculoskeletal ultrasound imaging into medical education through ultrasound imaging–assisted clinical examination offers students a dynamic, interactive learning experience, fostering a deeper understanding of clinical anatomy and examination skills. By advocating for its systematic inclusion in the undergraduate medical curriculum, the study highlights the potential to enhance the competence and confidence of future professionals in utilising ultrasound imaging, ultimately improving patient outcomes in musculoskeletal care.

The Impact Of Simulation Training of Medical Professionals on Clinical Practice

The data of a study evaluating the quality and clinical effectiveness of the strategy of approaches to improve neonatal resuscitation in the delivery room in full-term newborns born in a state of asphyxia and who underwent neonatal resuscitation in the delivery room, under the conditions of regular simulation retreats of medical specialists are presented.

Experience of Using Immersive Technologies in Medical Education

The report "Experience with Immersive Technologies" covers advanced approaches in medical education using virtual and augmented reality. Specific examples of the implementation of immersive technologies in the training of medical students and professionals will be considered, including the simulation of complex clinical situations, virtual operations and distance learning. The report will also touch on the assessment of the effectiveness of these methods, their impact on the level of training of specialists and prospects for further development.

AI Governance in Healthcare: Best Practices, Solutions, and Unresolved Issues

What challenges are presented by AI adoption in healthcare? What role should AI governance play in regard to the opportunities and risks for generative AI (large language models like ChatGPT-4, etc.) in health? How do we responsibly evaluate new technology and ensure guardrails for its deployment, but without stifling innovation? How do we address societal fears and biases? What level of reliability and robustness should algorithms achieve before being adopted with confidence across healthcare? How can AI support health equity and expand access? We will explore these questions and more with some of the nation’s leading experts on these topics. Learning Objectives Understand key opportunities and challenges for AI governance in healthcare, particularly in regard to rapidly emerging generative AI applications Discuss various responsible AI and AI governance frameworks that seek to ensure safety and efficacy in AI adoption Explore the role of government, legislation, and regulators in supporting safe and equitable adoption of AI in healthcare Explore opportunities for government, industry, and academic partnerships to accelerate AI validation, development, and adoption of safety standards Consider the potential impact of AI on the healthcare workforce and provider and patient experiences Identify the risks we should be most concerned with and what approaches can we take to mitigate those risks? By the end of the presentation, participants should have a sense of the opportunities and challenges of adopting AI in healthcare, key risks and frameworks for mitigating them, and the potential role of government, academia, and industry in addressing these issues Generative AI application examples Patient Communication and Engagement Intelligent chatbots interacting with patients, answering their queries, providing health advice, and helping them manage their conditions Mental Health Support Provide psychological support to patients, helping them manage stress, anxiety, depression, and other mental health issues. Provide interventions based on CBT and other therapeutic techniques Automated Medical Documentation Note-taking can allowing doctors to focus more on patient care Education and Training Create educational content and personalized training for medical students and healthcare professionals, potentially simulating things like patient cases and providing guidance on diagnosis, etc. Synthesis and Summarization of Medical Research Make it easier for people to keep up with the latest developments Public Health Communication In a public health emergency, help craft health messages, FAQs, and timely and accurate updates for the public Generative AI challenges and limitations Ensuring the accuracy of AI-generated information Maintaining patient privacy Handling the ethical implications of AI and human-machine interactions in healthcare “Hallucinations” (false or inaccurate information) can occur when model has limited knowledge of a particular domain “Distraction” (losing track of earlier inputs) can occur when inputs go beyond allowable token count for model “context window” and models start to produce responses not relevant to queries and context.

Understanding cultural dynamics shaping clinical reasoning skills: A dialogical exploration.

Our study examined the influence of national cultural predispositions on training medical professionals and doctor-patient dynamics using a dialogical approach, guided by Hofstede's framework. This framework provided valuable insights into how cultural tendencies shape the learning and application of clinical reasoning skills in different cultural contexts. We found that dimensions such as power distance and individualism versus collectivism significantly influenced clinical reasoning, while other dimensions had more nuanced effects. Junior doctors in Southern nations, despite initially lagging behind, developed advanced clinical reasoning skills with experience, eventually matching their Northern counterparts. The study highlighted the link between cultural norms and educational practices, variations in family involvement during reasoning, adherence to clinical guidelines and doctors' emotional engagement in clinical care between Southern and Northern contexts. Additionally, we recognised that effective clinical reasoning extends beyond technical knowledge, involving an understanding and integration of cultural dynamics into patient care. This highlights the pressing need to prioritise this topic.

Customization of Computed Tomography Radio-Opacity in 3D-Printed Contrast-Injectable Tumor Phantoms.

Medical Imaging Phantoms (MIPs) calibrate imaging devices, train medical professionals, and can help procedural planning. Traditional MIPs are costly and limited in customization. Additive manufacturing allows for customizable, patient-specific phantoms. This study examines the CT attenuation characteristics of contrast-injectable, chambered 3D-printed phantoms to optimize tissue-mimicking capabilities. A MIP was constructed from a CT of a complex pelvic tumor near the iliac bifurcation. A 3D reconstruction of these structures composed of three chambers (aorta, inferior vena cava, tumor) with ports for contrast injection was 3D printed. Desired attenuations were 200 HU (arterial I), 150 HU (venous I), 40 HU (tumor I), 150 HU (arterial II), 90 HU (venous II), and 400 HU (tumor II). Solutions of Optiray 350 and water were injected, and the phantom was scanned on CT. Attenuations were measured using ROIs. Mean attenuation for the six phases was as follows: 37.49 HU for tumor I, 200.50 HU for venous I, 227.92 HU for arterial I, 326.20 HU for tumor II, 91.32 HU for venous II, and 132.08 HU for arterial II. Although the percent differences between observed and goal attenuation were high, the observed relative HU differences between phases were similar to goal HU differences. The observed attenuations reflected the relative concentrations of contrast solutions used, exhibiting a strong positive correlation with contrast concentration. The contrast-injectable tumor phantom exhibited a useful physiologic range of attenuation values, enabling the modification of tissue-mimicking 3D-printed phantoms even after the manufacturing process.

Legal training of medical professionals and the branch of Medical Law

Legal training of medical professionals and the branch of Medical Law

Prevalence of Intestinal Parasitic Infections among Food Handlers from Greater Cairo, Egypt

Abstract Background Foodborne illnesses caused by intestinal parasitic infections (IPIs) are among the major health problems especially in developing countries. Food handlers play an important role in transmission of IPI during manufacturing, processing, handling, and serving of foodstuff. Objectives The aim of the present study was to determine the prevalence of IPIs among food handlers in Greater Cairo, Egypt and their associated risk factors. Methodology A cross sectional study was designed whereby 250 food handlers attending four provision health offices from different governorates of Greater Cairo were examined. The demographic data, job title and position, health certification as well as risk factors that might increase the transmission of IPIs were collected in a pre-designed questionnaire. Stool samples were collected from all participants and examined by direct wet/iodine mounts, formol diethyl acetate and modified Ziehl_Neelsen staining techniques. Results 65 food handlers (26%) were found to have IPIs. The commonest parasites detected were Entamoeba histolytica (24.6%), Entamoeba coli (20%), Blastocystis hominis (16.9%), Giardia intestinalis (12.3%), followed by Enterobius vermicularis (10.8 %), Ascaris lumbricoides (7.7 %) and Schistosoma mansoni (3.1%). Higher, statistically significant (P < 0.001), prevalence of IPIs was found among food handlers from rural areas, having low educational levels, not having previous health certificates and among those working in popular restaurants and those having poor personal hand hygienic measures. While no differences in prevalence of IPIs was found regarding age, sex, and work experience duration. Conclusion It was concluded that implementation of governmental policies ensuring routine medical checkup and continuous professional training and education of food handlers are essential for prevention of IPIs among food handlers.

Смешанное, гибридное обучение как необходимый компонент современного обучения медицинских работников.

The article presents a review of the literature on the introduction of mixed, hybrid training in educational programs of additional professional education of medical workers. Definitions of mixed and hybrid learning are given. Publications, research and best practices related to mixed, hybrid training of medical professionals are considered. Attention is focused on the importance of this approach and information is provided that can be useful for teachers, educational institutions and medical professionals seeking to update their skills and knowledge.

The role of the service and technical department of the simulation center in the educational process

The technical service department at the simulation center plays an important role in ensuring the safety and effectiveness of training for medical professionals. He is responsible for the technical support of simulation programs and equipment, as well as their maintenance and repair. Employees of the service and technical department must have knowledge in the field of medical equipment, electronics, programming and mechanics, and must also be able to set up and calibrate equipment, troubleshoot problems and ensure its smooth operation.

Insight into The Status of Cardiothoracic and Vascular Surgery Training in Nepal

Cardiothoracic and Vascular Surgery is at a developing stage in Nepal. In Nepal, training of CTV surgeons started in the beginning of the 21st century. Nevertheless, there is already a decrease in trainee’s interest in this specialization leading CTVS training to a gasping state at its very neonatal age. Globally, training of medical professionals, in particular CTV surgeons, has been under continuous evolution since its inception. Analogously, in Nepal, the duration of the CTVS training and academic curriculum needs upgrading to meet international standards. Introduction of new concepts, learning advanced diagnostic and therapeutic techniques is important for CTV surgeons in Nepal, to become a competent member of the multidisciplinary Heart Team.

TraumaFlow-development of a workflow-based clinical decision support system for the management of severe trauma cases.

The treatment of severely injured patients in the resuscitation room of an emergency department requires numerous critical decisions, often under immense time pressure, which places very high demands on the facility and the interdisciplinary team. Computer-based cognitive aids are a valuable tool, especially in education and training of medical professionals. For the management of polytrauma cases, TraumaFlow, a workflow management-based clinical decision support system, was developed. The system supports the registration and coordination of activities in the resuscitation room and actively recommends diagnosis and treatment actions. Based on medical guidelines, a resuscitation room algorithm was developed according to the cABCDE scheme. The algorithm was then modeled using the process description language BPMN 2.0 and implemented in a workflow management system. In addition, a web-based user interface that provides assistance functions was developed. An evaluation study was conducted with 11 final-year medical students and three residents to assess the applicability of TraumaFlow in a case-based training scenario. TraumaFlow significantly improved guideline-based decision-making, provided more complete therapy, and reduced treatment errors. The system was shown to be beneficial not only for the education of low- and medium-experienced users but also for the training of highly experienced physicians. 92% of the participants felt more confident with computer-aided decision support and considered TraumaFlow useful for the training of polytrauma treatment. In addition, 62% acknowledged a higher training effect. TraumaFlow enables real-time decision support for the treatment of polytrauma patients. It improves guideline-based decision-making in complex and critical situations and reduces treatment errors. Supporting functions, such as the automatic treatment documentation and the calculation of medical scores, enable the trauma team to focus on the primary task. TraumaFlow was developed to support the training of medical students and experienced professionals. Each training session is documented and can be objectively and qualitatively evaluated.

Introduction of Hybrid Additive Manufacturing for Producing Multi-Material Artificial Organs for Education and In Vitro Testing

The evolution of 3D printing has ushered in accessibility and cost-effectiveness, spanning various industries including biomedical engineering, education, and microfluidics. In biomedical engineering, it encompasses bioprinting tissues, producing prosthetics, porous metal orthopedic implants, and facilitating educational models. Hybrid Additive Manufacturing approaches and, more specifically, the integration of Fused Deposition Modeling (FDM) with bio-inkjet printing offers the advantages of improved accuracy, structural support, and controlled geometry, yet challenges persist in cell survival, interaction, and nutrient delivery within printed structures. The goal of this study was to develop and present a low-cost way to produce physical phantoms of human organs that could be used for research and training, bridging the gap between the use of highly detailed computational phantoms and real-life clinical applications. To this purpose, this study utilized anonymized clinical Computed Tomography (CT) data to create a liver physical model using the Creality Ender-3 printer. Polylactic Acid (PLA), Polyvinyl Alcohol (PVA), and light-bodied silicone (Polysiloxane) materials were employed for printing the liver including its veins and arteries. In brief, PLA was used to create a mold of a liver to be filled with biocompatible light-bodied silicone. Molds of the veins and arteries were printed using PVA and then inserted in the liver model to create empty channel. In addition, the PVA was then washed out by the final product using warm water. Despite minor imperfections due to the printer’s limitations, the final product imitates the computational model accurately enough. Precision adjustments in the design phase compensated for this variation. The proposed novel low-cost 3D printing methodology successfully produced an anatomically accurate liver physical model, presenting promising applications in medical education, research, and surgical planning. Notably, its implications extend to medical training, personalized medicine, and organ transplantation. The technology’s potential includes injection training for medical professionals, personalized anthropomorphic phantoms for radiation therapy, and the future prospect of creating functional living organs for organ transplantation, albeit requiring significant interdisciplinary collaboration and financial investment. This technique, while showcasing immense potential in biomedical applications, requires further advancements and interdisciplinary cooperation for its optimal utilization in revolutionizing medical science and benefiting patient healthcare.

THE ISSUE OF INFECTIOUS DISEASE INCIDENCE AMONG MEDICAL STUDENTS

Introduction. The training of future medical professionals involves not only development of skills and professional background, but also maintaining a sufficient health status; therefore the relevance of studying an incidence of infectious pathologies in medical students is exceptionally important. The purpose of the study is to investigate, analyze, and compare incidence of some infectious diseases among medicine students. Materials and methods. We utilized various research methods including analysis of scientific sources, synthesis and comparison of studies by other researchers, surveys, observations, interviews, and statistical data on the incidence of infectious diseases in Ukraine and worldwide. Additionally, we conducted a poll among first-year students of the medical faculty at Vinnytsia National Pirogov Memorial Medical University using Google Forms to gather data on the incidence of respiratory and digestive system infections. The study revealed that approximately 65% of the surveyed students had experienced coronavirus disease, mostly in a mild form. Among acute respiratory viral infections, flu (55.3%), sore throat (31.3%), and rhinopharyngitis (21.3%) were the most common (79.1%) among medical students. About 74% of respondents reported no chronic diseases of the upper and lower respiratory tract, while the rest mentioned conditions such as allergic rhinitis (10%), chronic tonsillitis (10%), chronic pharyngitis (3.4%), and vocal cord diseases (2%). In terms of infectious pathologies of the digestive system, food poisoning of unspecified etiology (33.3%) and viral intestinal infections (11.7%) were the most prevalent. Conclusion. The relevance of the issue of infectious disease incidence among medical students necessitates further investigation and analysis to identify contributing factors, develop monitoring methods, and promote healthy lifestyles to maintain optimal health status.

Cardiological emergency and acute myocardial infarction: physician and physiotherapist perceptions of immediate care, use of prehospital ECGS and patient referrals

Doctors and physiotherapists play a key role in reducing the rate of morbidity and mortality from acute myocardial infarction through well-applied care, as well as through the key point of health education, given that most of the risk factors are modifiable. This article is a literature review, which aims to explore the challenges faced by patients with acute myocardial infarction. This review shows that heart attacks are a serious problem. The study proves that this damage can be reduced or minimized with the training of medical and physiotherapy professionals in recognizing the signs and symptoms in good time, as well as the best treatment.