Training Of Medical Professionals Research Articles

Design and evaluation of an anthropomorphic neck phantom for improved ultrasound diagnostics of thyroid gland tumors.

Thyroid cancer is one of the most common cancers worldwide, with ultrasound-guided biopsy being the method of choice for its early detection. The accuracy of diagnostics directly depends on the qualifications of the ultrasonographers, whose performance can be enhanced through training with phantoms. The aim of this study is to propose a reproducible methodology for designing a neck phantom for ultrasound training and research from widely available materials and to validate its applicability. The phantom was made using polyvinyl chloride mixed with additives to reproduce different levels of brightness on ultrasound screens. 3D printing and casting were used to create the neck model and various structures of the neck, including bones, cartilage, arteries, veins, lymph nodes, thyroid gland, and soft tissues. The small objects, such as tumor and lymph node models, were shaped manually. All the phantom's materials were carefully selected to match the ultrasonic speed and attenuation values of real soft tissues and bones. The thyroid gland contains models of a cancerous and cystic nodule. In the neck, there are models of carotid arteries and jugular veins filled with ultrasound-transparent gel. Additionally, there are replicas of lymph nodes and bone structures such as hyoid bone, thyroid cartilage, trachea, and vertebrae. The resulting phantom covers the entire neck area and has been positively received by practicing ultrasound specialists. The proposed manufacturing technology offers a reliable and cost-effective approach to produce an anthropomorphic neck phantom for ultrasound diagnosis of the thyroid gland. The realistic simulation provided by the phantom enhances the quality and accuracy of ultrasound examinations, contributing to better training for medical professionals and improved patient care. Subsequent research efforts can concentrate on refining the fabrication process and exploring additional features to enhance the phantom's capabilities.

Reflecting on 12 years of training medical students in rural longitudinal integrated clerkships.

Longitudinal integrated clerkships (LICs) are effective in promoting careers in rural primary health care environments. This model of training medical professionals involves longer clinical placements of medical students and a different approach to learning which better prepares them for primary health care practice. Stellenbosch University created a LIC in 2011 for this purpose and has trained almost 100 doctors in their yearlong LIC since then. The past 12 years have brought about a lot of learning as this model of training was implemented, developed, and refined to suit the needs of students and the clinical environments.Contribution:Countries across the globe face challenges in recruiting and retaining doctors in rural primary health care environments. Longitudinal integrated clerkships have several educational benefits in addition to increase recruitment and retention of rural doctors, and 12 years of experience have led to a greater understanding regarding implementation and outcomes of an LIC in the South African context.

Razvitie medicinskoj terminografii v Rossii v XI–XIX vv.

This article examines the history of the emergence and development of medical terminography in Russia, the key stages of the formation of the terminological foundation, the establishment of the first medical dictionaries, and the influence of intercultural exchange. The research presents the importance of medical terminological dictionaries in training and preparation of medical professionals during that time, the evolution and maturation of the concept of terminography in Russia.

Diagnosis of Cystic Fibrosis Beyond Childhood in India

Abstract Cystic fibrosis (CF) is a life-limiting genetic condition with multisystemic manifestations. However, there are vast phenotypic as well as genotypic variations. This contributes to delay in diagnosis, especially in pancreatic-sufficient patients who may not manifest typical symptomatology. The last decade has witnessed significant breakthroughs in CF therapeutics. This in combination with early diagnosis through newborn screening, and aggressive supportive care can offer near-normal life expectancy for a majority of patients with CF (pwCF) worldwide. Even while addressing disparities in CF care around the world, it is crucial to train medical professionals to suspect and diagnose CF in children as well as in adults. Here, we share our experience of pwCF diagnosed beyond 16 years of age with an aim to highlight the clinical presentations in young adults, the need for screening family members of a newly diagnosed pwCF, and the negative effects of late diagnosis of CF.

Training of young medical professionals: implementation of modern training concepts, taking into account the changed framework conditions for training—a pilot project for operational subjects

IntroductionFor years, generations of medical students have complained that practice-oriented learning is neglected in medical studies. Further training assistants also complain about limited opportunities to learn subject-specific practical activities.Material and techniquesWe are presenting a pilot project at the University Women’s Hospital in Homburg, in which medical students complete an endoscopic hands-on course as part of the block internship gynaecology and obstetrics. During the course the students perform classic skills training and hand–eye coordination exercises and learn the first steps in endoscopic suturing (suture and rows of knots). The training concepts used can be implemented on simple boxing trainers and can therefore also be reproduced in clinics or in a private setting.OutcomeAltogether, 73 medical students did participate in the laparoscopy course. We were able to prove that the knotting time for a simple knot can be reduced from an average of 247 s to 40 s (80%) after completing our training programme. Based on the evaluation sheet that the students filled out after the course, we found a very-high acceptance for surgical simulation training within the student cohort.DiscussionPractical surgical exercises can complement the curriculum well and, as we can show with our work, are rated very positively by the students. For students in higher semesters, such practical courses can also provide an insight into the respective subject area and thus counteract the lack of skilled workers in surgical subjects. The practical year should not be the first contact with these practical courses, as at this timepoint a certain favoured subject has often already being chosen by the students.

Novel Integration of a Health Equity Immersion Curriculum in Medical Training.

Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice.

The Impact of Health Communication Research on Medical and Health Professional Education and Training

ABSTRACT In this essay, we review how health communication scholarship has been translated into various communication skills trainings (CSTs), we present four case studies of how health communication research informed the development and implementation of specific CSTs, and we reflect on how we can productively define “impact” in looking back as well as looking forward within this line of research.

Is insufficient introspection a reason to terminate residency training? – Scrutinising introspection among residents who disputed dismissal

Introduction Insufficient introspection as part of the 4I’s model of medical professionalism (introspection, integrity, interaction, and involvement) is considered an important impediment in trainees. How insufficient introspection relates to decisions to terminate residency training remains unclear. Insights into this subject provide opportunities to improve the training of medical professionals. Methods We analysed the Dutch Conciliation Board decisions regarding residents dismissed from training between 2011 and 2020. We selected the decisions on residents deemed ‘insufficient’ regarding introspection as part of the CanMEDS professional domain and compared their characteristics with the decisions about residents without reported insufficiencies on introspection. Results Of the 120 decisions, 86 dismissed residents were unable to fulfil the requirements of the CanMEDS professional domain. Insufficient introspection was the most prominent insufficiency (73/86). These 73 decisions described more residents’ insufficiencies in CanMEDS competency domains compared to the rest of the decisions (3.8 vs. 2.7 p < 0.001), without significant differences regarding gender or years of training. Conclusions Insufficient introspection in residents correlates with competency shortcomings programme directors reported in dismissal disputes. The 4I’s model facilitates recognition and description of unprofessional behaviours, opening avenues for assessing and developing residents’ introspection, but further research is needed for effective implementation in medical education.

Adverse Effects After Prehospital Administration of Naloxone by Bystanders: A Preliminary Study.

Opioid use disorder is a cause of significant morbidity and mortality. In order to reverse opioid overdose as quickly as possible, many institutions and municipalities have encouraged people with no professional medical training to carry and administer naloxone. This study sought to provide preliminary data for research into the rates of adverse effects of naloxone when administered by bystanders compared to Emergency Medical Services (EMS) personnel, since this question has not been studied previously. This was a retrospective cohort study performed at an urban, tertiary, academic medical center that operates its own EMS service. A consecutive sample of patients presenting to EMS with opioid overdose requiring naloxone was separated into two groups based on whether naloxone was administered by bystanders or by EMS personnel. Each group was analyzed to determine the incidence of four pre-specified adverse events. There was no significant difference in the rate of adverse events between the bystander (19%) and EMS (16%) groups (OR = 1.23; 95% CI, 0.63 - 2.32; P = .499) in this small sample. Based on these initial results, a study would need a sample size of 6,188 in order to reach this conclusion with 80% power. Similarly, there were no significant differences in the rates of any of the individual adverse events. Secondary analysis of patients' demographics showed differences between the two groups which generate hypotheses for further investigation of disparities in naloxone administration. This preliminary study provides foundational data for further investigation of naloxone administration by bystanders. Adverse events after the prehospital administration of naloxone are rare, and future studies will require large sample sizes. These preliminary data did not demonstrate a statistically significant difference in adverse event rates when comparing naloxone administration by bystanders and EMS clinicians. This study provides data that will be useful for conducting further research on multiple facets of this topic.

State of the art: Simulation in US

Technical simulation of diagnostic and therapeutic procedures is of growing relevance for student education and advanced medical training and has already been introduced in the field of ultrasound. This review gives a broad overview on different levels of simulation for ultrasound diagnostics and highlights the technical background of the methodology. A critical review of the literature reveals recommendations for implementing simulation techniques in medical studies and professional ultrasound training. An analysis of strengths and weaknesses shows the advantages of simulation especially in the context of individual learning situations and COVID-19-related restrictions for personal interaction. However, simulation techniques cannot replace the experiences of complex clinical examinations with direct interaction to real patients. Therefore, future applications may focus on repetition and assessment of achieved competencies by using standardized feedback mechanisms in order to preserve the limited resources for practical medical training.

Educating primary care physicians about eating disorders: Pilot data from a microlearning programme.

Over two-thirds of people present to their primary care physician (or general practitioner; GP) as a first point of contact for mental health concerns. However, eating disorders (EDs) are often not identified in a primary care setting. A significant barrier to early detection and intervention is lack of primary care physician training in EDs; compounded by the significant time commitments required for training by already time-poor general practitioners. The aim of the current study was to pilot and evaluate a microlearning programme that can be delivered to general practitioners with high workloads to help support patients with, or at risk of, developing an ED. Fifty-one Australian general practitioners aged between 25-to-60years old were recruited. Participants completed a baseline questionnaire to ascertain their experience working in general practice and with EDs. Participants then completed an online programme consisting of a series of 10 case studies (vignettes) delivered over a 6-10week period related to various facets of ED care. Following conclusion of the programme, participants were asked to complete an evaluative questionnaire related to the content of the programme; perceived knowledge, confidence, willingness-to-treat, skill change; and their overall experience of microlearning. All 51 GPs completed the programme and reached completion criteria for all vignettes, 40 of whom completed the programme evaluation. Participants indicated improved skill, confidence, willingness-to-treat, and knowledge following the completion of the pilot programme. Almost all (97.5%; n=39) found microlearning to be an effective method to learn about EDs; with 87.5% (n=35) of participants reporting they felt able to apply what was learnt in practice. Qualitative feedback highlighted the benefit of microlearning's flexibility to train general practitioners to work with complex health presentations, specifically EDs. Findings from the current study lend support to the use of microlearning in medical health professional training; notably around complex mental health concerns. Microlearning appears to be an acceptable and effective training method for GPs to learn about EDs. Given the significant time demands on GPs and the resulting challenges in designing appropriate training for this part of the workforce, this training method has promise. The pre-existing interest in EDs in the current study sample was high; future studies should sample more broadly to ensure that microlearning can be applied at scale.

Psychology of doctor-patient interaction in the context of medical specialist's communicative tolerance

The relevance of the study is due to the need to find ways to ensure high-quality interaction between a doctor and a patient in the context of a medical professional's communicative tolerance. The purpose of the study was to determine the psychological characteristics of the interpersonal relationship between a doctor and his/her patients. The basis of the theoretical and methodological approach was a qualitative combination of methods of structural and functional analysis of the problem of psychological training of medical professionals and analytical research on the formation of constructive relationships between doctor and patient. Several surveys were conducted on the tolerance of healthcare professionals and their emotional well-being in the context of individual psychological characteristics. The results are presented, which reflect the methods of doctor's influence on the psychological state of the patient and his/her family. The question of how trust in a doctor and his/her professional competences is formed is highlighted. The problem of ethical principles, professional motivation of medical professionals and the specifics of their communication in the team are revealed. The subjective feelings of doctors about the work they do are revealed. The issues of modernization of medical education and digitalization of services are revealed. The conditions, components, and approaches to effective interaction between doctor and patient in the healthcare system are identified. The problems of developing diagnostic tools for assessing the psychological state of a medical professional in his/her professional activity are detailed. An experiment was conducted to substantiate the need to implement programmes to improve the communication skills of healthcare professionals, including interns and nurses. The practical value of the results of the research work is the possibility of using the outlined approach to improve the methods of improving the communication competencies of doctors in their professional activities

Assessment of the emotional intelligence and its dimensions of medical interns

Background: Emotional intelligence (EI) is multidimensional and includes maturity, sensitivity and competency. It is the skill to identify and understand own and others’ emotions to respond appropriately. Medical interns are expected to have a high degree of EI to face their professional career challenges. During the medical professional training cognitive and clinical skills are evaluated but their EI and its dimensions are nor assessed; hence this study was planned to assess the EI and its dimensions in medical interns. Methods: Objectives were to assess the EI and its dimensions of 140 medical interns. Study design was a descriptive and cross-sectional study. Ethical approval from institutional ethics committee and informed written consent from participants was obtained; administered a questionnaire-based EI test. Data obtained was analysed by ANOVA. Results: Eighty (62.0%) participants were females and 49 (38.0%) males. The mean age of them was 23 years. The mean total EI score was 343.72. It was slightly higher (344.00) in the female interns than in males (343.27). Among the emotional dimensions majority (79.1%) of interns had significantly high (p=0.0001) percentile scores in competency. 67.4% were having significantly lower (p=0.0001) percentile scores in maturity dimension of EI. Sensitivity percentile score was high in 54.3% and low in 45.7% (p=0.7724). Conclusions: This study provides insight about the EI and its dimensions in the medical interns. The maturity and sensitivity are the weaker dimensions of EQ requiring improvement or further development.

CONCEPTS OF CREATING AN INTELLIGENT MEDICAL DIAGNOSTIC SYSTEM TO ASSIST IN THE WORK AND TRAINING OF DOCTORS BASED ON ARTIFICIAL INTELLIGENCE

Abstract. The article is devoted to the development of intelligent medical diagnostic systems using information systems and technologies. The article provides an overview of the current state and development of information systems, technologies and artificial intelligence in the medical field, analyzes existing intelligent diagnostic systems in medicine and cardiology in particular, and proves the need to create intelligent systems to help primary care physicians and cardiologists. The purpose of the publication was to investigate the current state of intelligent medical diagnostic systems, analyze the shortcomings of such systems, determine the feasibility of creating a new diagnostic system, and formulate principles and criteria for its operation. The scientific novelty of the article is a new approach for diagnosing and treating patients, as well as training medical professionals using an intelligent medical system based on artificial intelligence. Leveraging advanced AI algorithms, the system analyzes vast datasets encompassing patient records, medical literature, and real-time clinical data to provide accurate and timely diagnostic insights. The intelligent medical diagnostic system operates as a supportive tool, aiding doctors in the diagnostic process by offering refined suggestions, identifying potential anomalies, and recommending personalized treatment plans. By harnessing machine learning and deep learning techniques, the system continuously adapts and evolves, learning from each diagnostic scenario and refining its predictive accuracy over time. Through interactive simulations and case-based learning modules, aspiring and practicing doctors can engage in immersive, realistic scenarios, honing their diagnostic skills and expanding their knowledge base. The disadvantages of this article include only a theoretical approach to the formation of concepts and tasks for an intelligent medical system, and a review of existing systems.

Prevalência e fatores preditores do ‘Fear of Missing Out’ entre acadêmicos de Medicina durante a pandemia da Covid-19

ABSTRACT Introduction: The indiscriminate use of social networks is closely related to social anxiety, including Fear of Missing Out (FoMO), an expression in English that means the “fear of being left out”. This phenomenon is defined as a lasting apprehension that others may be having rewarding experiences from which the user is absent, and FoMO can be intensified in specific situations, such as during the Covid-19 pandemic. Objective: This study aimed to evaluate the prevalence and predictive factors of Fear Of Missing Out among medical students from a federal public university in the Legal Amazon during the Covid-19 pandemic. Method: This is an analytical study, with a cross-sectional design and a quantitative approach. The data were obtained through an online questionnaire, made available to study participants through Google forms®, which addressed sociodemographic, economic, academic characteristics, lifestyle habits and health status. To assess FoMO, the Fear of Missing Out Scale was applied. For the statistical analysis, multivariate analysis was performed, and the crude and adjusted prevalence ratios (PR) and the 95% confidence interval (95%CI) were calculated, with the significance level of 5% (p&lt;0.05) being adopted for the final adjusted model. Results: 185 students participated in the study, with 42.2% of respondents having FoMO during the Covid-19 pandemic. The predictive factors of FoMO included residing in student housing [PR 1.66 (95%CI 1.03 - 2.54); p = 0.037] and presence of symptoms of depression during the Covid-19 pandemic [PR 2.03 (95%CI 1.27 - 3.25); p = 0.003]. Conclusion: The prevalence of FoMO among medical students from the assessed institution was high, and sociodemographic factors and health status remained associated with the investigated outcome. These findings indicate the need to implement emotional support strategies and promote the health and well-being of medical students, contributing to a more holistic and healthy approach in the training of future medical professionals, especially in public universities.

Investigation and Countermeasure Research on the Current Situation and Countermeasures of Medical Professional Master Training under the Integrated Training Mode of &amp;amp;#8220;Two-Track Integration&amp;amp;#8221;

Investigation and Countermeasure Research on the Current Situation and Countermeasures of Medical Professional Master Training under the Integrated Training Mode of &amp;amp;#8220;Two-Track Integration&amp;amp;#8221;

Construction of Low-Cost Simulators for Training in Minimally Invasive Breast Procedures.

The aim of this work was to describe a technique for building low-cost simulators for training in minimally invasive breast procedures guided by ultrasound (US) and stereotactic mammography (MMG), focusing mainly on training medical professionals studying related areas. Low-cost phantoms were developed using organic structures that mimic breast tissue, such as chicken breast and eggplant, and materials that simulate breast lesions. A step-by-step description of the preparation and use of these simulators was made, enabling the reproducibility of the technique by the physicians in training themselves. The low-cost phantoms showed a high degree of echogenic and radiological similarity with human breast tissue, allowing adequate training in minimally invasive procedures. It was possible to build low-cost phantoms that allow training in US- and stereotactic MMG-guided minimally invasive breast procedures.

Critical Thinking: A Program Review of Doctor of Audiology Students.

Critical thinking is a crucial component of health care, and its importance has been recognized in training medical professionals. This study reports critical thinking skills for entering doctor of audiology (AuD) students and the trajectory of the change in critical thinking skills measured 2 times over a period of 3 years. This longitudinal, descriptive, and exploratory design was implemented for programmatic review. Critical thinking skills were measured using the Health Sciences Reasoning Test (HSRT; Insight Assessment) upon entering the program and compared to measurements during the final month of academic coursework. Descriptive statistics, exploratory analyses of the HSRT scores among cohorts, the relationship of the HSRT to the graduate record examinations (GREs), and changes in the HSRT over time using a repeated measures multivariate analysis of variance were conducted. There were no significant differences in critical thinking skills between any of the cohort years. There was a significant correlation between the GRE verbal scores and OVERALL HSRT. Improvements in critical thinking skills were found between the time the students entered the graduate program and their final academic semester. Greater gains were reported for students who initially scored below the 50th percentile on the OVERALL HSRT. This program review showed improvement in the critical thinking skills of AuD students during their academic training program. Information regarding critical thinking skills may be useful for programs to monitor students' clinical thinking skills and possibly include clinical and didactical activities to promote critical thinking skills.

HELPING KOREAN AMERICAN OLDER ADULTS THROUGH EDUCATION, RESOURCES, AND VOLUNTEERING: A CASE STUDY OF SOMANG SOCIETY

Abstract Many community organizations serving Korean Americans lack culturally or linguistically tailored services for end-of-life care. Subsequently, Korean American older adults often lack understanding of end-of-life care, particularly advance care planning and hospice. Somang Society is a nonprofit organization serving Korean American older adults and their family caregivers with a mission to promote healthy aging, dignity in later life, and a meaningful death. This study details how Somang Society utilizes education, resources, and volunteer programs to increase the awareness of end-of-life issues among Korean American older adults. The organization provides two distinct community education and volunteer trainings regarding (1) end-of-life care planning program and (2) older adults living with dementia and their family caregivers. They provide community education and volunteer trainings in Korean and expect the volunteers to educate others in the community about the importance of healthy aging, dementia, and advanced care planning. As a result, 15,717 Korean American seniors have filed a living will and advance healthcare directives as of February 2023. In addition, Somang Society emphasizes the importance of whole-body donation for training medical students and healthcare professionals. As a result, 2,134 Korean American seniors have donated or registered for the UCI Willed Body Program through Somang Society since 2008. To further disseminate their programming, the organization actively uses social media to educate Korean Americans on these issues. Their YouTube channel analytics indicate the viewers’ positive responses and the potential impact technology usage can have for sharing education with this hard-to-reach population.

Impact of Psychiatric Internship on Medical Graduates: Quasi Experimental Study

Background: Physical health is incomplete without mental health; despite this fact Psychiatric teaching and training of medical health professionals is an undermined area especially in developing countries like Pakistan. This study is aimed to determine the impact of knowledge, attitude and perception towards Psychiatry and also possible change in the career choice of medical graduates (house job interns) of public sector hospital of Karachi after doing internship in Psychiatry Methods: This Quasi experimental study was conducted in 40 medical graduates house job interns who were doing 12 weeks internship in Psychiatry department of Dow Medical College &amp; Dr Ruth K.M.Pfau Civil Hospital Karachi from April 2020 to March 2021 on quarterly basis. A Self synthesized pretested questionnaire was employed twice at pre internship and post internship levels and two semi structured questions were also administered to qualitatively compare their responses. SPSS-19 was applied to&#x0D; statistically analyze the result and paired sample t-test was used to compare both pre and post internship scores Results: There was found statistically significant impact of psychiatric internship on medical graduates (preinternship; M=52.2, SD=10.8 and post internship M=60.6, SD=8.3); t(39)=-4.6,p=