Ability Of Trainees Research Articles

Implementation of an Optimized Preoperative Checklist for Endoscopic Sinus Surgery Within a Multiinstitutional Resident Education Curriculum.

Preoperative review of computed tomography (CT) imaging assists with endoscopic sinus surgery (ESS) planning, where trainees may benefit from a systematic approach. We have previously developed an optimized preoperative checklist for sinus CT imaging using an iterative modified Delphi method. In this study, we assess the utility of an optimized preoperative checklist for residents performing ESS. Resident sinus CT scan education consisted of a preintervention questionnaire, an 18-min video outlining the optimized preoperative checklist, and a delayed postintervention questionnaire; these were distributed via Qualtrics to otolaryngology residents across 5 training programs in the NY metro area. The preintervention questionnaire contained 25 survey questions and a 225-point quiz on sinus CT anatomy; the delayed postintervention questionnaire contained the same 25 survey questions and a second, distinct 225-point quiz. In total, 74 residents completed the preintervention questionnaire, 47 completed the postintervention questionnaire, and 36 completed both. Among residents completing both questionnaires, the average preintervention quiz score was 136.8 ± 24.0 and the average postintervention quiz score was 156.0 ± 23.5 (P < .001). Resident habitual utilization of a systematic preoperative CT imaging checklist increased significantly from 21.6% to 72.9% as a result of the curriculum intervention. We find that an educational program centered on an iteratively optimized preoperative checklist for ESS improves the ability of trainees to identify critical sinus CT structures. Further integration of checklists and educational curricula may enhance rhinology education efforts and improve surgical anatomy competency.

Framing our Expectations: Variability in Entrustable Professional Activity Assessments

To determine the ability of surgical trainees and faculty to correctly interpret entrustability of a resident learner in a modeled patient care scenario. Prospective study utilizing a web-based survey including 4 previously-recorded short videos of resident learners targeted to specific levels of the American Board of Surgery's (ABS) Entrustment Scale. Respondents were asked to choose the entrustment level that best corresponded to their observations of the learner in the video. Responses were subcategorized by low and high entrustment. Online, utilizing the Qualtrics survey platform. Survey targeting US surgical trainees and surgical faculty via email and social media. We received 31 complete responses and 2 responses which completed > 1 video assessment question without demographic information (n = 33). Respondents included 10 trainees (32%) and 21 attending surgeons (68%). Neither faculty nor trainees readily identified the targeted entrustment level for Question 1 (preoperative care of a patient with acute appendicitis with high entrustment, 36% correct), though evaluations of the remaining questions (2 through 4) demonstrated more accuracy (70, 84, and 75% correct, respectively). Faculty were more readily able than trainees to identify low entrustment (level Limited Participation) in intraoperative inguinal hernia repair (95% vs 60%, p = 0.03). After subcategorization to high and low entrustment, both residents and faculty were able to accurately identify entrustment 95% overall. Both trainees and attending surgeons were able to identify high- and low-performing residents on short video demonstrations using the ABS EPA entrustment scale. This provides additional evidence in support of the need for frequent observations of EPAs to account for the variability in raters' perceptions in addition to complexity of clinical scenarios. Frame-of-reference training via a video-based platform may also be beneficial for both residents and faculty as an ongoing EPA implementation strategy.

Independent Curriculum Implementation Training for Students of the Elementary School Teacher Education Study Program at SDN 3 Baubau

Changing the curriculum is something that must be done by a country along with the times. Curriculum changes in Indonesia have been made several times. The results of the latest curriculum changes have resulted in the Independent Curriculum. Curriculum changes are expected to have a significant positive impact on learning and outcomes. However, curriculum changes also provide flexibility to teachers who carry out learning in the classroom. Students of the Teacher Education Study Program of the University of Muhammadiyah Buton as prospective teachers need to be equipped with experience before they become teachers. This training activity aims to provide experience to participants implementing the independent curriculum. The activity was attended by 12 students as training participants. In general, this training activity is carried out in three stages: the presentation of material, training, and evaluation of results. The presentation of the material uses the lecture and question and answer method, the practice uses the tutoring method, and the evaluation of the results uses the observation method. The evaluation results showed that the average ability of participants to compile learning tools was 88.44%, the average ability to carry out learning reached 90.56, and the personality of participants reached 92.88. Based on the analysis of the results of the discussion, it was concluded that this training activity has had a very satisfactory impact on the ability of trainees in the implementation of the independent curriculum in elementary schools.

Filling the gap in competency-based training for medical oncology with supervised online patient counseling: A qualitative study.

9036 Background: The Higher School of Oncology (HSO) is a collaborative US-Russian postgraduate program that improves learning outcomes for young oncologists. Many HSO medical oncology (MO) residents/graduates are also engaged in online supervised patient counseling, known as ‘Just Ask.’ We aimed to explore the educational role of ‘Just Ask’ in shaping the competency-based learning outcomes of MO graduates, who have recently begun independent clinical practice. Methods: This qualitative study included 10 HSO alumni (2019-2023) who practice MO in Russia. All participants were current or prior ‘Just Ask’ consultants. Anonymous, online semi-structured in-depth interviews were conducted to explore interviewees reflection on competencies obtained at HSO and ‘Just Ask.’ The interview guide included 42 open-ended questions based on the American Accreditation Council for Graduate Medical Education (ACGME) list of competencies for MO physicians. All interviews were recorded and transcribed. Inductive-deductive coding with code categorization was followed by thematic analysis. Themes were mapped against the ACGME competencies. Results: Interviews, with a median duration of 69 (IQR: 54-80) minutes,involved participants with 0.5-3 years of practice. Six (60%) interviewees worked in hospitals, while 2 (20%) were in outpatient and another 2 (20%) were in mixed settings. We identified 85 codes and categorized them into 10 educational experience themes. Interviewees attributed learning an evidence-based approach, basic oncology knowledge, and patient communication skills through the HSO curriculum. Themes associated with learning from online counseling included integration into real-world practice, specific types of expertise (rare tumors), and advanced communication (explaining differences in management, written communication), which are less covered by HSO. This activity enhanced skills in patient navigation, advocacy, and the ability to detect care not supported by evidence. Safe-space learning provided by ‘Just Ask’ was a unique theme reflecting the ability of trainees to hone skills in a secure and resource-enriched environment with easy access to mentoring. The association of the selected 'Just Ask'-related themes with ACGME competencies is presented in the table. Conclusions: Supervised online counseling has emerged as a valuable educational tool aimed at supplementing competencies insufficiently covered by medical oncology postgraduate curriculum. [Table: see text]

Re-evaluating the Need for Routine Maximal Aerobic Capacity Testing within Fighter Pilots.

INTRODUCTION: There is a current belief in aviation suggesting that aerobic training may reduce G-tolerance due to potential negative impacts on arterial pressure response. Studies indicate that increasing maximal aerobic capacity (<mml:math id="ie1" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂ max) through aerobic training does not hinder G-tolerance. Moreover, sustained centrifuge training programs revealed no instances where excessive aerobic exercise compromised a trainee's ability to complete target profiles. The purpose of this review article is to examine the current research in the hope of establishing the need for routine <mml:math id="ie2" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing in air force pilot protocols.METHODS: A systematic search of electronic databases including Google Scholar, PubMed, the Aerospace Medical Association, and Military Medicine was conducted. Keywords related to "human performance," "Air Force fighter pilots," "aerobic function," and "maximal aerobic capacity" were used in various combinations. Articles addressing exercise physiology, G-tolerance, physical training, and fighter pilot maneuvers related to human performance were considered. No primary data collection involving human subjects was conducted; therefore, ethical approval was not required.RESULTS: The <mml:math id="ie3" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max test provides essential information regarding a pilot's ability to handle increased Gz-load. It assists in predicting G-induced loss of consciousness by assessing anti-G straining maneuver performance and heart rate variables during increased G-load.DISCUSSION: <mml:math id="ie4" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing guides tailored exercise plans, optimizes cardiovascular health, and disproves the notion that aerobic training hampers G-tolerance. Its inclusion in air force protocols could boost readiness, reduce health risks, and refine training for fighter pilots' safety and performance. This evidence-backed approach supports integrating <mml:math id="ie5" display="inline"><mml:mrow><mml:mover><mml:mtext>V</mml:mtext><mml:mo>˙</mml:mo></mml:mover></mml:mrow></mml:math>o₂-max testing for insights into fitness, risks, and tailored exercise.Zeigler Z, Acevedo AM. Re-evaluating the need for routine maximal aerobic capacity testing within fighter pilots. Aerosp Med Hum Perform. 2024; 95(5):273-277.

Supporting self-regulated-learning in colonoscopy training—A comparison cohort trial

AimThis study aimed to demonstrate that using a self-regulated learning (SRL) approach can improve colonoscopy performance skills. BackgroundColonoscopy is the gold standard for detecting colorectal cancer and removing its precursors: polyps. Acquiring proficiency in colonoscopy is challenging, requiring completion of several hundred procedures. SRL seems to be beneficial to help trainees acquire competencies in regulating their future learning processes and enhance the outcomes of current learning situations. SRL is a learner-centred approach that refers to a trainee's ability to understand and control their learning environment, including cognitions, motivations and emotions. The key abilities include self- and situational awareness, task analysis, and strategic planning. This study is the first to use an SRL approach for workplace-based colonoscopy training. MethodsIn this comparison cohort trial, participants used two SRL supports: a self-review of videotaped performance, and an online learning platform with procedural and conceptual knowledge about colonoscopy. In the control cohort, participants performed patient-based colonoscopy as usual in their departments. Improvement was monitored via three video-based ratings (study start, end of the study period, and follow-up) using the Gastrointestinal Endoscopy Competency Assessment Tool (GiECAT). Outcomes were analysed using two-way analysis of variance with repeated measurements. ResultsThis study recruited 21 participants (12, intervention cohort; nine, control cohort); 58 videos were recorded. The intraclass correlation coefficient was 0.88 (95% CI 0.61–0.98; p < 0.001). The global rating scale (GRS) and checklist (CL) in GiECAT were analysed separately. No statistically significant main effects of cohort (GRS: F(1,16) = 2.84, p = 0.11; CL: F(1,16) = 1.06, p = 0.32), test (GRS: F(2,32) = 2.56, p = 0.09; CL: F(2,32) = 0.76, p = 0.48), or interactions between cohort and test were observed (GRS: F(2,32) = 1.16, p = 0.33; CL: F(2,32) = 1.01, p = 0.37). ConclusionsSRL in patient-based colonoscopy is feasible; however, no clear effect on performance scores was observed.

Exploring the Impact of Firefighter Trainee Fitness on Academy Graduation or Release.

Lockie, RG, Orr, RM, Montes, F, and Dawes, JJ. A research note exploring the impact of firefighter trainee fitness on academy graduation or release. J Strength Cond Res 38(5): 999-1003, 2024-This study investigated the impact of fitness test performance on firefighter trainee ability to graduate an academy using ordinal logistic generalized linear models. Retrospective analysis was conducted on trainee data ( N = 686) from one fire department who completed an occupational physical ability test (OPAT) that included the following: Illinois agility test (IAT); push-ups; pull-ups; leg tucks; maximal aerobic capacity (V̇ o2 max); backward overhead 4.54-kg medicine ball throw (BOMBT); 10-repetition maximum deadlift; and 91.44-m farmer's carry. Data were recorded in raw and scaled scores based on internal scoring (tests scored from 0 to 100; maximum total OPAT score of 800). Trainees were split into graduated ( n = 576) or released ( n = 110) groups. Data were analyzed through ordinal logistic generalized linear models ( p < 0.05). Raw and scaled scores were investigated separately, with odds ratios (OR) and confidence intervals (CI) produced. Regarding raw scores, there was a difference in the odds of graduating relative to the IAT (OR = 1.357; CI = 1.047-1.760; p = 0.021), BOMBT (OR = 0.744; CI = 0.628-0.882; p < 0.001), and V̇ o2 max (OR = 0.907; CI = 0.862-0.954; p < 0.001). For scaled scores, there was a difference in the odds of graduating relative to the points attained for the BOMBT (OR = 0.985; CI = 0.972-0.999; p = 0.032), deadlift (OR = 0.982; CI = 0.968-0.995; p = 0.008), and total OPAT (OR = 0.994; CI = 0.988-1.000; p = 0.047). Change-of-direction speed (IAT), total-body power (BOMBT), aerobic fitness (V̇ o2 max), lower-body strength (deadlift), and overall fitness (total OPAT points) impacted the odds of trainee fire academy graduation. The IAT presented as the largest impacting variable where, for every unit increase in time (i.e., a slower IAT), there was 1.36 greater chance of a trainee being released from the academy.

Pelatihan Bahasa Inggris “Tenses” Bagi Siswa Sekolah Minggu HKBP Getsemane Medan Labuhan

Mastery of English is a must for everyone around the world. Likewise in Indonesia, mastering English will provide great benefits for future studies and careers. However, students still experience obstacles in learning and practicing English either in the school environment or in the community because English is a foreign language for the Indonesian people, which is not used as an official or everyday language. Therefore, the PKM activities of the Faculty of Languages ​​and Arts, HKBP Nommensen University try to provide solutions to students and the community to improve their ability to master English. By focusing on English 'tenses' training for Sunday school students at the HKBP Getsemane church, Martubung Medan. The training participants were 20 elementary and middle school students who were Sunday school children and church teenagers. The training lasted for two weeks with three meetings each week, starting from 16-28 October 2023. After the training was carried out, the results of the training in the form of trainee test scores showed significant progress in the trainee's ability to understand and practice English tenses, both written and verbal. From the observations it was also found that the training participants were very enthusiastic and interested in learning English using the methods used in class.

Learner engagement regulation of dual-user training based on deep reinforcement learning

AbstractThe dual-user training system is essential for fostering motor skill learning, particularly in complex operations. However, the challenge lies in the optimal tradeoff between trainee ability and engagement level. To address this problem, we propose an intelligent agent that coordinates trainees’ control authority during real task engagement to ensure task safety during training. Our approach avoids the need for manually set control authority by expert supervision. At the same time, it does not rely on pre-modeling the trainee’s skill development. The intelligent agent uses a deep reinforcement learning (DRL) algorithm based on trainee performance to adjust adaptive engagement during the training process. Our investigation aims to provide reasonable engagement for trainees to improve their skills while ensuring task safety. Our results demonstrate that this system can seek the policy to maximize trainee participation while guaranteeing task safety.

Validation of a training system for laparoscopic longitudinal suturing in lesion.

A training system that allows the trainee to perform laparoscopic suturing in a realistic environment and measures the force applied to the tissue would be invaluable. This study aims to establish the construct and content validity of the training system we developedfor the objective assessment of surgeons' skills. Ten novices, 6 residents, and 6 experts performed the suturing and knot-tying task using the training system. Ten force-related parameters were used to analyse the system's construct validity. Experts were invited to evaluate the content validity with questionnaires. Eight parameters showed significant differences between the three groups. The construct validity results demonstrated that the system could distinguish the tissue handling ability of operators. The experts agreed that the system had excellent content validity with an average score of 4.71/5. The training system is likely valid for surgical training. It can realistically simulate surgical scenarios and evaluate the tissue handling ability of trainees.

Operative dictations in surgical trainees: an underutilized educational resource?

Accurate operative notes are imperative to patient care and are used for communication, billing, quality assurance, and medical-legal conflicts. However, operative note quality often varies and many lack critical details. Unfortunately, no standardized training exists in operative dictations for surgical trainees. This pilot study sought to determine resident ability to dictate a comprehensive operative note and to determine a need for a formal operative dictation curriculum. Thirty-eight surgical residents between post-graduate years (PGY) one to four participated in a ventral hernia repair simulation. One senior (PGY3/4) resident coached two junior residents (PGY1/2). Residents completed an informal needs assessment regarding operative dictations. Post-simulation, residents completed an operative dictation. Notes were graded using a modified validated rubric. Thirty-five residents completed the needs assessment, and 38 residents submitted an operative note. Eighty-two percent of this group have completed ≤ 25 operative dictations in training and 77% have received minimal feedback on operative dictations. Out of 33 total points, mean overall score was 18.9 ± 5.4 (Junior resident: 17.9 ± 5.4; Senior resident: 20.9 ± 4.8) Total mean scores did not significantly differ between junior and senior residents (p = 0.10). Senior and junior residents scored similarly on the procedural details component (p = 0.29). Senior residents scored higher on relevant patient history and operative note headers (p = 0.04). Standard surgical training may not provide enough teaching and feedback to residents on operative note dictations. A formal residency training curriculum may bolster trainee ability to learn the components of an effective operative note.

Aseptic tibial loosening: Radiographic identification remains a diagnostic dilemma

IntroductionAseptic tibial loosening following total knee arthroplasty (TKA) can be challenging to diagnose radiographically. Surgeons often face the clinical scenario of determining implant fixation in patients that do not have serial radiographs and only subtle radiographic features of loosening. Therefore, the purpose of our study was to determine how accurately attendings and trainees are at identifying aseptic tibial loosening. MethodsTwo cohorts of patients were identified for this study. Cohort one consisted of twenty patients with aseptic tibial loosening. Cohort two consisted of twenty patients with well-fixed pain-free total knee replacements at one-year follow-up. Surgeons were then given a clinical scenario that all patients are returning with pain at follow-up. The surgeon then reviewed each patient's radiographs and determined whether the tibial component was loose or well-fixed. ResultsOverall, surgeons were significantly more likely to correctly identify well-fixed implants than loose implants (p<0.001). There were no significant differences in the surgeon's vs. trainee's ability to diagnose implant fixation (p = 0.926). However, the percentage of correctly identified loose implants was significantly higher for trainees compared to surgeons (p = 0.023). For surgeons, the proportion of correctly identified well-fixed implants was significantly higher than the proportion of correctly identified loose implants (p<0.001). ConclusionAseptic tibial loosening following primary total knee arthroplasty remains a diagnostic dilemma. Surgeons were significantly less likely to identify implant loosening than trainees. Improving diagnostic accuracy in this patient population is critical to avoid delaying surgery in patients with implant loosening and avoiding unnecessary surgery in patients with well-fixed implants.

Script concordance testing in genetic counseling training: Apilot study.

Clinical reasoning is a complex skill that represents a trainee's ability to use their professional knowledge and skills to assess and solve the problems that arise in clinical practice. As an integral tenet of the genetic counseling process, clinical reasoning skills underlie many of the Practice-Based Competencies (2019) across a variety of domains. Despite the long-lasting recognition of the importance of this complex skill in the training of genetic counselors, clinical reasoning has traditionally been difficult to assess in a standardized way in healthcare education. Script concordance testing is a standardized method of assessing clinical reasoning skills in ambiguous clinical situations. The tool has been used to successfully measure the clinical reasoning skills of trainees in various healthcare training programs and has never been used in a genetic counseling training program. We conducted a pilot study to assess the utility of script concordance testing in the field of genetic counseling as an objective measure of clinical reasoning in trainees. The script concordance test was constructed for the field of genetic counseling and administered to 22 second year genetic counseling students in the Joan H. Marks Graduate Program in Human Genetics at Sarah Lawrence College. Twelve genetic counselors served on a panel to provide expert clinical reasoning responses and a scoring grid was developed using the aggregate scores method. The utility of the tool was measured using Cronbach's alpha coefficient, and scores of students and the panel were compared using Hedge's g. Results revealed statistically significant differences between the scores of panelists and students and good reliability. This study shows that script concordance testing can be used to measure clinical reasoning skills in genetic counseling trainees in a way that is reliable, standardized, and easy to use, thereby allowing programs to better assess the clinical reasoning skills of trainees prior to graduation.

Importance of clinical parameters for cultivation of critical care thinking by online teaching of critical care medicine

BackgroundThe teaching of critical care medicine is a very important task, especially during the COVID-19 pandemic. The understanding of critical care parameters is the foundation and core, which is conducive to the formation of clinical thinking. This study is to evaluate the training effect of teaching of critical care parameters based on an online platform, and explore the teaching methods of critical care medicine that can help to cultivate trainees’ clinical thinking and practical ability.MethodsQuestionnaires were released before and after the training through the official new media platform “Yisheng” application (APP) of China Medical Tribune involving 1109 participants. The trainees who filled in the questionnaire in APP and received training were randomly selected as the investigated population. Statistical description and analysis were carried out using SPSS 20.0 and Excel 2020.ResultsThe trainees were mainly attending physicians in tertiary hospitals and above. Among all critical care parameters, trainees paid more attention to critical hemodynamics, respiratory mechanics, severity of illness scoring systems, critical ultrasound, and critical hemofiltration. The degree of satisfaction with the courses was high, especially the course of critical hemodynamics was scored the highest. The trainees believed that the course contents were of great help to clinical work. However, no significant difference was found in the trainees’ understanding or cognition of the connotation of the parameters before and after the training.ConclusionTeaching of critical care parameters based on an online platform is conducive to improving and consolidating the clinical care ability of trainees. However, it is still necessary to strengthen the cultivation of clinical thinking in critical care. In the future, the integration of theory with practice must be strengthened in clinical practice, ultimately achieving the homogeneous diagnosis and treatment of patients with critical illness.

Multidisciplinary High-Risk Obstetrical Simulation Improves Periviability Counseling [ID: 1366577

INTRODUCTION: The objective of this study was to determine the feasibility and effectiveness of multidisciplinary simulation in the development of skills required for high-risk periviability counseling. METHODS: Trainees were recruited from the University of Minnesota to participate in a faculty-observed standardized high-risk periviability patient simulation. The simulation was unique in that multiple specialties collaborated in the evaluation, counseling, and management of their patient. Trainees completed presimulation and postsimulation knowledge and comfort self-assessment surveys to evaluate skill improvement and merit of the study. Evaluations were also performed by faculty and simulated patients. An IRB waiver was obtained. RESULTS: Of the 18 participants, there were 6 neonatal intensive care unit fellows, 2 maternal–fetal medicine fellows, and 10 senior ob-gyn residents. Presimulation and postsimulation Likert surveys with scale 1–5, showed improvement in the ability of trainees to elicit patient values and tailor their conversations (pre-mean 2.84, SD 0.67; post-mean 3.39, SD 0.59), use patient-centered language (pre-mean 3.37, SD 0.74; post-mean 3.89, SD 0.57), ally with patients (pre-mean 3.37, SD 0.93; post-mean 3.94, SD 0.52), provide difficult medical information (pre-mean 3.32, SD 1.03; post-mean 3.67, SD 0.58), discuss medical uncertainty (pre-mean 3.11, SD 0.79; post-mean 3.50, SD 0.60), and understand their own implicit biases (pre-mean 3.26, SD 0.71; post-mean 3.50, SD 0.60). Trainees also reported an increased use of hopeful language that did not focus on statistical outcomes (pre-mean 3.00, SD 0.65; post-mean 3.33, SD 0.47) and discussion of multiple management options, including comfort cares (pre-mean 2.05, SD 1.05; post-mean 2.94, SD 0.85). The post surveys also reflected that trainees felt the simulation was useful, provided a safe environment to practice counseling (mean 4.83, SD 0.37), and better prepared them for future high-risk obstetrical scenarios (mean 4.83, SD 0.37). CONCLUSION: Multidisciplinary high-risk obstetrical simulation offers a unique opportunity for trainees to receive structured training and improve their ability to collaboratively counsel in rare high-risk obstetrical scenarios.

Are Plastic Surgery Trainees Accurate Assessors of Their Own Microsurgical Skill?

Microsurgery is a technically demanding surgical discipline with a steep learning curve. Trainees have faced several difficulties due to less hands-on theater time and pandemic-related limits on access to technical training. To overcome this, trainees engaged in self-directed training, which requires an accurate self-assessment of skill. This study aimed to assess the ability of trainees to accurately self-assess their performance while performing a simulated microvascular anastomosis. Novice and specialist plastic surgery trainees performed a simulated microvascular anastomosis on a high-fidelity chicken femoral vessel model. Each participant objectively rated the quality of their anastomosis using the Anastomosis Lapse Index (ALI). Two expert microsurgeons subsequently blindly rated each anastomosis. To determine the accuracy of self-evaluation, self-scores and expert-scores were compared using a Wilcoxon signed-rank test. Twenty-seven surgical trainees completed the simulation, with a mean time to completion (TTC) of 40.3 minutes (range 14.2-106.0 minutes). For the entire cohort, the median ALI self-score was 4 (range 3-10), while the median ALI expert-score was 5.5 (range 2.5-9.5). There was a significant difference between the ALI self-score and the expert-score (p<0.001). When grouped by experience level, there was no significant difference between self-score and expert-score within the specialist group, while there was a significant difference within the novice group (p=0.001). These findings suggest that specialist trainees are accurate assessors of their own microsurgical skills, but novice trainees tend to overestimate their technical skills. While novice trainees can engage in independent self-directed microsurgical training, they should seek expert feedback to ensure targeted training.

The Completion of a PGY-1 Neurology Bootcamp Leads to Increased Trainee Knowledge and Confidence in Neurologic Emergencies Management and Procedural Skills (P2-2.001)

<h3>Objective:</h3> To evaluate the impact of an end-of-the-year, post-graduate year 1 (PGY-1) simulation-based neurology bootcamp on trainee knowledge, self-confidence, and skill independence regarding acute neurologic emergencies management and bedside procedural skills. <h3>Background:</h3> The post-graduate year 2 (PGY-2) neurology resident is often the first line of triage for evaluation of acute neurologic deterioration on the inpatient neurology service, requiring autonomy and responsibility. We implemented and evaluated a bootcamp prior to this critical training period. <h3>Design/Methods:</h3> In this prospective cohort study, 14 rising PGY-2 neurology residents attended a two-day bootcamp with a simulation-based curriculum led by neurology faculty practicing cerebrovascular, critical care, and inpatient neurology medicine. Pre- and postbootcamp, trainees completed multiple-choice knowledge assessments and via Likert scales, self-reported confidence in managing neurologic emergencies. Faculty observed and rated trainee ability to independently perform five neurologic procedures (lumbar puncture, external ventricular drain [EVD] management, botulinum toxin injection for migraine, digital fundoscopy, and pupillometry), with residents additionally reporting their own perceived degree of independence. <h3>Results:</h3> Proportion of trainees demonstrating independence per faculty rating significantly increased for all five procedural skills post-bootcamp (for all, p &lt; .05). Trainee self-reported independence of EVD management, pupillometry, and fundoscopy skills also increased postbootcamp (for all, p &lt; .05), with &lt; 25% of trainees reporting total independence pre-bootcamp to 50%, 86%, and 79% post-bootcamp, respectively. Knowledge assessment scores increased from a pre-bootcamp mean of 54% of questions correct to mean 70% correct (p = 0.002), driven by increases in vascular neurologic emergency and procedural knowledge. On a 5-point Likert scale, trainee self-reported confidence in emergency management increased from median 2.5 (a little confident) to median 4 (fairly confident) (p &lt; .001) <h3>Conclusions:</h3> A simulation-based, two-day bootcamp with focus on acute cerebrovascular neurologic emergencies and neurologic procedural skills showed significant improvements in trainee knowledge along with faculty-observed and self-reported confidence and independence. <b>Disclosure:</b> An immediate family member of Dr. Swetlik has received personal compensation for serving as an employee of Pfizer. Dr. Buletko has nothing to disclose. Dr. Marquardt has nothing to disclose. Dr. Higgins has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Organon. Ms. Hassett has nothing to disclose.

Counselor educators’ views on cognitively complex trainees: A Q method study

AbstractOur Q method exploration of counselor educators’ perspectives of minimally acceptable cognitive complexity (CC) in trainees at the end of internship yielded two factors: Trainee's Conceptual Integration Ability and Trainee's Ability to Apply Integrated Knowledge. Implications for teaching, supervision, and research pertinent to assessment of and enhancement of CC conclude.

Professional teaching competence: key point of developing pupils’creativity

The article points out the results of the research of a competent professional education specialist activity aimed at developing creative abilities of trainees. In the modern multilingual education system great importance is attached to teaching a foreign language, increasing students’ interest and motivating language learning. Through the use of active teaching methods that develop creativity, it is possible to activate students and create a harmonious learning environment. The authors analyzed the concepts of competence, creativity and conducted a survey on the use of innovative and creative teaching methods by teachers. The survey involved 100 respondents: school teachers, graduate students, teachers of educational centers. More than 77% of respondents believe that it is necessary to use a creative approach in teaching foreign languages; more than 86.3% of respondents consider it is necessary to use critical thinking methods to increase the effectiveness of teaching foreign languages and develop creativity. It is crucial to prepare a creative environment for teaching foreign languages according to 86% of respondents. Respondents stated out methods as the most useful of specific methods: 73.3% chose "picture gallery", of which 57.8% chose "quality line" and 53.3% chose the "mind mapping" option. In the final part of the survey, several methods were proposed to obtain information about the extent to which teachers use critical thinking techniques. Keywords:educational process, development of creative abilities, creativity, competency, pupils &nbsp

Providing Structured Real-Time Feedback on Postdischarge Outcomes Using Electronic Health Record Data.

Most trainees do not receive information about postdischarge outcomes, despite the importance of external feedback for accurate self-assessment and improvement in discharge planning skills. We aimed to design an intervention to foster reflection and self-assessment by trainees regarding how they can improve transitions of care with minimal investment of program resources. We developed a low-resource session delivered near the end of an internal medicine inpatient rotation. Faculty, medical students, and internal medicine residents reviewed and reacted to postdischarge outcomes of their patients, explored understanding of the reasons for these outcomes, and developed goals for future practice. The intervention required minimal resources given that it was conducted during scheduled teaching time, did not require additional staff, and used already available data. Forty internal medicine resident and medical student participants completed pre- and postintervention surveys that evaluated their understanding of causes for poor patient outcomes, sense of responsibility for postdischarge outcomes, degree of self-reflection, and goals for future practice. Trainee understanding of the causes for poor patient outcomes was significantly different in several areas after completing the session. Trainees were less likely to believe that their responsibility for patients ends at the time of discharge, indicating an increase in sense of responsibility for postdischarge outcomes. After the session, 52.6% of trainees planned to change their approach to discharge planning, and 57.1% of attending physicians planned to change their approach to discharge planning with trainees. Through free-text responses, trainees noted that the intervention facilitated reflection and discussion about discharge planning and led to the development of goals to adopt specific behaviors for future practice. Meaningful information about postdischarge outcomes from the electronic health record can be used to provide feedback to trainees in a brief, low-resource session during an inpatient rotation. This feedback significantly affects trainee sense of responsibility for and understanding of postdischarge outcomes, which may lead to improved trainee ability to orchestrate transitions of care.