Optimizing simulated interviews and feedback to maximize medical students' self-efficacy in real time.

BACKGROUND: Self-efficacy is crucial in improving medical students' communication skills. This study aims to clarify where medical students' self-efficacy is greatest following an interview with a simulated patient and subsequent feedback. METHODS: A total of 162 medical students (109 men, 53 women) in their fourth or fifth year at a university in Japan participated in this study. The degree of self-efficacy in medical interviewing was measured before and after a medical interview with a simulated patient, and after the subsequent feedback session. RESULTS: ANOVA analysis revealed that self-efficacy for medical interviews was higher after both the interview and the feedback session than before the interview. Among all three time points, self-efficacy was highest after the feedback session. CONCLUSIONS: Feedback following a simulated interview with a simulated patient is important to improve the self-efficacy of medical students when learning medical interviewing skills.

Comparison of student self-assessment and teacher assessment of medical interview performance during bedside learning.

Accurate and efficient self-assessment is a critical skill for medical students to develop as part of their professional development. Along with clinical training reform at Fukushima Medical University, rubric-based student self-assessment and teacher assessment of students' performance using our proposed assessment tool, which includes several aspects of clinical skills and abilities, was initiated to improve the clinical clerkship process. To investigate how students identified their weaknesses and strengths, we analyzed the results of 119 fourth-year medical students' self-assessment and corresponding teacher assessment. Our study revealed substantial consistency between student self-assessment and teacher assessment, despite some overestimation and underestimation in student self-assessments. Students who incorrectly assess themselves require a variety of feedback to increase their self-efficacy and self-confidence, as well as to identify their weaknesses.

A Wearable Thermometry for Core Body Temperature Measurement and Its Experimental Verification.

A wearable thermometry for core body temperature (CBT) measurement has both healthcare and clinical applications. On the basis of the mechanism of bioheat transfer, we earlier designed and improved a wearable thermometry using the dual-heat-flux method for CBT measurement. In this study, this thermometry is examined experimentally. We studied a fast-changing CBT measurement (FCCM, 55 min, 12 subjects) inside a thermostatic chamber and performed long-term monitoring of CBT (LTM, 24 h, six subjects). When compared with a reference, the CoreTemp CM-210 by Terumo, FCCM shows 0.07 °C average difference and a 95% CI of [-0.27, 0.12] °C. LTM shows no significant difference in parameters for the inference of circadian rhythm. The FCCM and LTM both simulated scenarios in which this thermometry could be used for intensive monitoring and daily healthcare, respectively. The results suggest that because of its convenient design, this thermometry may be an ideal choice for conventional CBT measurements.

A Chair-Based Unobtrusive Cuffless Blood Pressure Monitoring System Based on Pulse Arrival Time.

In this paper, we present an unobtrusive cuffless blood pressure (BP) monitoring system based on pulse arrival time (PAT) for facilitating long-term home BP monitoring. The proposed system consists of an electrocardiograph (ECG), a photoplethysmograph (PPG), and a control circuit with a Bluetooth module, all of which are mounted on a common armchair to measure ECG and PPG signals from users while sitting on the armchair in order to calculate continuous PAT. Considering the good linear correlation of systolic BP (SBP) and the nonlinear correlation of diastolic BP (DBP) with PAT, a new BP estimation method was proposed. Ten subjects underwent BP monitoring experiments involving stationary sitting on a chair, lying on a bed, and pedaling using an ergometer in order to assess the accuracy of the estimated BP. A cuff-type BP monitor was used as reference in the experiments. Results showed that the mean difference of the estimated SBP and DBP was within 0.2 ± 5.8 mmHg ( p < 0.00001) and 0.4 ± 5.7 mmHg ( p < 0.00001), respectively, and the mean absolute difference of the estimated SBP and DBP were 4.4 and 4.6 mmHg, respectively, compared to references. Additionally, five subjects participated in data collections consisting of sitting on a chair twice a day for one month. Compared to the reference, the difference did not obviously increase along with time, even though individualized calibration was executed only once at the beginning. These results suggest that the proposed system has quite the potential for long-term home BP monitoring.

A chair for cuffless real-time estimation of systolic blood pressure based on pulse transit time.

This study presents an unobtrusive cuffless blood pressure (BP) monitoring system for estimating beat-by-beat systolic blood pressure (SBP) in real-time based on pulse transit time (PTT). The system mainly includes an electrocardiograph with three conductive textile electrodes, a pulse monitor with a LED and a photodetector, a control circuit with a Bluetooth module, and a battery, all of which are mounted on a common armchair to measure ECG and photoplethysmography (PPG) signals from users during sitting on the armchair. The measured ECG and PPG data are transmitted to the software terminal installed on a tablet PC and are further derived to obtain a series of PTT for estimating beat-by-beat BP using Chen's method. We had 9 healthy subjects undergo the BP monitoring experiments of still sitting on a chair for 3 minutes, lying on a bed for 10 minutes, and pedaling using ergometer for 11 minutes in order to assess the accuracy of the estimated BP. A Finometer and a cuff-type BP meter were used as references in the experiments. Preliminary results showed that the mean error and mean absolute difference (MAD) of estimated BP were within -0.5 ± 5.3 mmHg and 4.1 ± 3.4 mmHg, respectively, compared to references. The result suggests that the proposed BP estimation system has the potential for long-term home BP monitoring.

Automatic home care system for monitoring HR/RR during sleep.

This paper described an automatic home care system for monitoring HR/RR during sleep. Pressure signal is measured with a completely unconstrained pressure sensor beneath a pillow; then the signal is digitalized and the data are transmitted to a remote server using TCP/IP via a netbox. The data are processed and analyzed with a wavelet-based algorithm to obtain the heart rate and respiration rhythm during sleep. Through analyzing 180 days' data obtained from a female subject, it was found that this system can be used for daily monitoring heart rate and respiration rhythm during sleep and evaluating the quality of sleep at home.