Micro-computed tomographic analysis of the morphology of maxillary lateral incisors.

OBJECTIVE: This study aimed to investigate the morphology of maxillary lateral incisors (MxLI) using micro-computed tomography (micro-CT). MATERIALS AND METHODS: The root canal configurations (RCC) of maxillary lateral incisors (MxLI) of a mixed Swiss-German population were examined using micro-CT, 3D imaging, and a 4-digit system code indicating the main root canal from coronal to apical thirds and the main foramina number. RESULTS: The most frequently observed RCC of MxLI were 1-1-1/1 (Vertucci I/Ve I, 80.0%), 1-1-2/2 (Ve V, 7.3%), 1-2-1/1 (Ve III, 6.4%), 2-1-1/1 (Ve II, 1.8%), and 1-1-1/2 (1.8%)(n = 110). Three additional RCC were observed less frequently (0.9%). The MxLI showed one physiological foramen in 89.1%, two in 9.1%, and seldom three (1.8%). Most accessory canals were identified in the apical third of a root (20.0%), and no accessory canals in 72.7% of the samples. CONCLUSIONS: Detailed information on the internal morphology of MxLI of a Swiss-German population is given. The most frequently observed RCC of MxLI is 1-1-1/1 (Ve I). However, accessory canals may occur in all apical thirds, and 20% of all teeth investigated showed a challenging RCC for clinical treatment. CLINICAL RELEVANCE: This study offers clinicians comprehensive data on MxLI morphology, emphasizing the significance of understanding varied RCC and accessory canal presence for improving root canal treatment outcomes. Over 25% of teeth exhibited complex RCC or accessory canals, influencing decisions during root canal treatment.

Enhancing dental education: integrating online learning in complete denture rehabilitation.

This study investigated the integration of online learning into complete denture rehabilitation (CDR) training for dental interns, highlighting its impact on their education and readiness for clinical practice. Given that CDR poses significant challenges due to its technical complexity and profound influence on patient well-being, online learning has emerged as a strategic educational tool to enhance interns' knowledge and skills. This research included the administration of a comprehensive questionnaire to 63 dental interns to assess their backgrounds, experiences with online learning, and attitudes toward its application in CDR education. The results revealed strong engagement with online learning, with a majority valuing its flexibility, accessibility, and capacity to facilitate self-paced, individualized learning. Despite the enthusiasm for online modalities, the results identified notable gaps in interns' confidence in and preparedness for performing CDR, highlighting the need for targeted improvements in online curriculum development. By emphasizing the essential role of innovative teaching methods, including virtual reality (VR), this study underscores the need for a balanced educational approach that combines traditional and digital platforms. This strategy aims to prepare future dental professionals for the complexities of modern clinical environments, ensuring that they are well equipped to meet the diverse needs of the edentulous population.

Nursing experience and leadership skills among staff nurses and intern nursing students in Saudi Arabia: a mixed methods study.

BACKGROUND: Nurse leaders have a crucial impact in healthcare settings. Hospitals require qualified nurses with leadership skills to provide healthy work environments and enhance the outcomes related to staff nurses and patients. This study aimed to investigate the effect of nursing experience on leadership skills among staff nurses and intern nursing students. METHODS: A mixed methods design was applied (quantitative survey design for quantitative part and open-ended questions for qualitative part). Convenience sampling of staff nurses and intern nursing students in Saudi Arabia was applied. There were148 participants who completed the survey of the quantitative part, and 50 of them completed the qualitative part. Participants completed the Leadership Practice Inventory Questionnaire. SPSS v26 was used to analyze quantitative part, and thematic analysis was used to analyze qualitative part. RESULTS: This study found a significance difference among participating groups regarding to the years of experience (F = 5.05, p = 0.00). Three themes were found for the qualitative part which were strategies to enhance leadership skills, factors affecting leadership skills, and obstacles facing participants related to leadership skills. The qualitative data also revealed that participants found that clinical supervision and education ways to enhance the leadership skills, while work pressure, work environment and communication were obstacles of developing their leadership skills. CONCLUSION: Leadership skills are considered as a significant component of the function of qualified nurses and should be viewed as central to intern nursing students' learning development. Moreover, leadership skills are essential for the patient and organization outcomes. Nursing colleges and educators play an important role in enhancing to leadership skills as well as experience. Nurse leaders can create healthy care environments that have high quality and safety for patients. Management systems in healthcare organizations must motivate and support clinical leaders who can recognize both individual and clinical requirements and address current issues in their field.

A closer look: obsessive-compulsive symptoms among intern nurses amidst COVID-19 pandemic.

BACKGROUND: The distinctive circumstances and socio-cultural context in Egypt make it crucial to explore the psychological well-being of intern nurses amid the COVID-19 pandemic, with a specific focus on obsessive-compulsive symptoms. This study aimed to investigate the influence of fear of COVID-19 on obsessive-compulsive symptoms among intern nurses. METHODS: A cross-sectional survey involving 375 randomly recruited intern nurses was conducted. Data collected included the Fear of COVID-19 Scale and the Short Version of the Arabic Obsessive-Compulsive Scale. RESULTS: A significant relationship was found between the fear of COVID-19 and the severity of obsessive-compulsive symptoms among the participants (r = 0.472, p = 0.000). A stepwise regression analysis indicated that the fear of COVID-19, living in urban regions, frequency of COVID-19 infection, and increased number of infected family members may contribute to the severity of Obsessive-Compulsive Symptoms with adjusted R2 value = 27.5%. CONCLUSION: The findings suggest that the COVID-19 pandemic has had significant psychological impacts on newly qualified nurses during their internship training period, including the manifestation of mental health symptoms such as Obsessive-Compulsive Symptoms. It was observed that urban residents, intern nurses with recurrent COVID-19 infections, and those with more infected family members exhibited a higher severity of OCS. These findings underscore the need for further research to investigate additional factors that may influence OCS severity.

The role of Empathy in the relationship between emotional support and caring behavior towards patients among intern nursing students.

BACKGROUND: The empathic relationship between nursing students and patients allows them to understand and address caring behavior for patients. Appropriate emotional support equips them to overcome the complexities and difficulties inherent in patient care. This support cultivates resilience and self-awareness, enabling students to manage their emotions effectively and establish meaningful connections and caring with their patients. OBJECTIVES: To investigate the role of empathy in the association between emotional support and caring behavior toward patients among intern nursing students at Alexandria and Damanhur University. SUBJECTS: The study subjects were 200 intern nursing students in their internship years of 2022-2023, randomly selected from an equal sample size from Alexandria and Damanhur University, Egypt. TOOLS: A questionnaire of social information& academics from students, the Toronto Empathy Questionnaire, the Caring Dimension Inventory, and the Multidimensional Scale of Perceived Social Support are used to collect participants' data. RESULTS: Empathy was associated with caring behavior and emotional support among nursing students (P < 0.001), and higher levels of empathy indicated increased levels of caring behavior and emotional support. The caring behavior significantly increased when intern nursing students received more emotional support and among those who were not working in private hospitals (p < 0.001,&p = 0.023 respectively). Empathy acts as a mediating role in the relationship between emotional support and caring behavior. IMPLICATIONS: Implementing strategies to assist interns in navigating challenges and promoting a culture of support can facilitate the cultivation of caring behaviors. Shedding light on the interconnectedness of empathy, emotional support, and caring behavior can inform the design of interventions to strengthen empathy as a pathway to improving patient outcomes. CONCLUSION: Empathy is a mediating factor in the relationship between emotional support and caring behavior. This suggests that interventions promoting empathy may serve as a pathway to enhancing caring behavior among nursing students and strategies for improving patient care outcomes by strengthening empathy skills among healthcare professionals.

Association between Presenteeism, Associated Factors, and Outcomes among Intern Physicians in Public Hospitals during the COVID-19 Pandemic: A Cross-Sectional Study.

Background and Objectives: Presenteeism, when employees continue to work despite being sick, may have increased among intern physicians during the COVID-19 pandemic due to the necessity of performing unfamiliar tasks. This study aimed to investigate the prevalence of presenteeism among intern physicians (IPs) in Thailand, its associated factors, and outcomes. Material and Methods: A total of 254 IPs participated in this cross-sectional study conducted from June to July 2022. Participants completed a nationwide online questionnaire including demographics, financial status, underlying diseases, hospital location and affiliation, department, resource problems, manpower shortage, workload intensity, presenteeism, and its outcomes. IPs were recruited via various social media platforms. Statistical analysis was performed using multivariable zero-inflated Poisson regression and multivariable linear regression. Results: The average age of IPs was 25.5 years (SD 1.9), and 57.5% were female. The majority of IPs reported dealing with resource problems (74.8%), insufficient manpower (94.9%), and intense workload (83.5%). Presenteeism was prevalent among 63.8% of IPs, with the most common of the diseases being allergic rhinitis (31.3%). IPs with underlying diseases had an increased rate of presenteeism (adjusted odds ratio (aOR) 2.50, 95% confidence interval (CI) 1.33-4.55). IPs working in community hospitals during their rotations exhibited a lower rate of presenteeism (aOR 0.39, 95% CI 0.16-0.94) compared to other departments within general or regional hospitals. The IPs frequently exposed to insufficient manpower had an increased rate of presenteeism (aOR 4.35, 95% CI 1.02-20.00) compared to those not exposed. Additionally, IPs with presenteeism had more exhaustion (ß 1.40, 95% CI 0.33 to 2.46), lower perceived well-being (ß -0.65, 95% CI -1.26 to -0.03), and job satisfaction (ß -0.33, 95% CI -0.63 to -0.03). Conclusions: During COVID-19, intern physicians in Thailand often exhibit presenteeism due to physical conditions, resource scarcity, and personnel shortages, impacting exhaustion, well-being, and job satisfaction. Recommendations include assessing healthcare workforces, allocating resources more effectively, enforcing policies to promote responsible use of sick leave, and implementing sick leave systems.

[Analysis of latent potential profiles and influencing factors of intern nursing students' professional identity in Shandong Province].

Objective: To explore the current situation of professional identity of intern nursing students in Shandong Province, to analyze the potential characteristics of different categories of intern nursing students' professional identity, and to provide reference for formulating relevant intervention programs. Methods: From September to October 2023, using convenient cluster sampling, selected nursing students from different regions of Shandong Province colleges and universities as the research objects, a total of 1298 questionnaires were released and recovered, with 1221 valid questionnaires, and the effective recovery rate of questionnaires was 94.07%. General demographic data was collected, and information on nursing students' professional identity was investigated with the Nursing Students' Professional Identity Questionnaire, the Work Readiness Scale, and the Feedback Seeking Behavior Scale. Latent potential profiles of nursing students' sense of professional identity were analyzed by Mplus 8.3 software, and the best-fitting model was selected by the test of fitness and difference. The χ(2) test was used for comparison between groups of count data, analysis of variance (ANOVA) was used for comparison between groups of measure data, and the effects of each factor on different potential profiles were analyzed by multivariate logistic analysis. Results: A total of 1221 intern nursing students were 984 (80.6%) females and 237 (19.4%) males, aged (21.12±2.96) years old, with a total score of (64.23±14.99) for nursing students' professional identity. Nursing students' professional identity was divided into 3 categories: 98 (8.0%) in the low identity group, 624 (51.4%) in the medium identity group, and 496 (40.6%) in the high identity group. The gender, region, age, work readiness scores and feedback seeking behavior scores of nursing students in different categories were different, and the differences were statistically significant (P<0.05). Compared with the high identity group, the nursing students in the low identity group were more likely to be included in the high identity group (OR=0.390, 0.167, P=0.005, 0.006) with higher work readiness and better feedback seeking behavior. Compared with the high identity group, the higher work readiness and non-Jinan areas of the medium identity group were more likely to be included in the high identity group (OR=0.597, 1.470, P=0.011, 0.012). Compared with the medium identity group, the more feedback seeking behaviors of the low identity group were more likely to be included in the medium identity group (OR=10.411, P<0.001) . Conclusion: The level of professional identity of intern nursing students can be classified into 3 categories, and nursing administrators can improve work readiness and increase feedback seeking behaviors according to the potential characteristics of the different types to enhance the professional identity of nursing students.

Analytical performance specifications and quality assurance of point-of-care testing in primary healthcare.

Point-of-care testing (POCT) is the fastest-growing segment of laboratory medicine. This review focuses on the essential aspects of setting analytical performance specifications (APS) and performing quality assurance for POCT in primary healthcare. In-vitro diagnostic medical devices for POCT are typically small and easy to operate. Users often have little to no laboratory experience and may not necessarily see the value of conducting quality assurance on their devices. Therefore, training, guidance, and motivation should be integral parts of the total quality management system, as they are vital for managing errors and ensuring reliable results. It is common to believe that the analytical quality of POCT should be comparable to that of laboratory testing, and as a result, APS should be the same. This paper challenges this concept. The APS for POCT can often be less stringent compared to those used in a central laboratory because the requester is closer to both the analytical and clinical situation. Point-of-care instruments should be selected based on clinical needs, the required analytical quality and user-friendliness in the intended usage setting.Quality assurance should include both internal quality control (IQC) and external quality assessment (EQA). It is recommended that IQC protocols should be dependent on the complexity of the POCT device. A scoring system to determine how frequent IQC should be analyzed in primary healthcare on different types of POCT devices has been suggested. The main challenge in EQA for POCT involves using suitable control materials that reflect instrument performance on patient samples. Obtaining commutable control materials for POCT is difficult since the matrix often is whole blood. An essential aspect of EQA for POCT is that feedback reports should be easily interpretable. Users should receive advice from the EQA organizer regarding the root causes of deviating results. Quality assurance for POCT is not an easy task and presents numerous challenges. However, there is evidence that quality assurance improves the quality of POCT measurements and, consequently, can enhance patient outcomes.

Impact of virtual group-based acceptance and commitment therapy on social adjustment and work-family conflict among intern nurses: a randomized control trial.

BACKGROUND: An action-oriented approach such as acceptance and commitment therapy may help reduce the fusion of conflicting ideas, empower new intern nurses to act according to their values, and maximize their psychological flexibility. OBJECTIVE: To evaluate the impact of a virtual group-based acceptance and commitment therapy intervention on intern nurses' social adjustment and work-family conflict. DESIGN: A parallel, single-blind randomized control trial on intern nurses (n = 70) was randomly allocated to either a six-session online acceptance or commitment therapy intervention (n = 35) or a waiting list control group (n = 35), with each session lasting 90 min. MEASURES: The work-related acceptance and action questionnaire, the social adjustment scale-self report, and the work-family conflict scale before, after, and one month after the intervention. RESULTS: The psychological flexibility mean score of the study group was significantly higher than that of the control group (43.11 vs. 34.15, p < .001) immediately after the intervention, and this effect was sustained one month after the intervention (41.88 vs. 33.21, p < .001) with a more significant effect size (F = 128.457, p < .001, η2 = 0.791). The social adjustment mean score of the study group had significantly improved in all four subscales, with statistically significant differences (p < .001). One month after the intervention, the study group had significantly higher scores than the control group in total score, with statistically significant differences (p < .001) and large effect sizes (η2 = 0.932). Work-family conflict mean score of the study group was decreased immediately after the intervention, with statistically significant differences (p < .001). One month after the intervention, the study group had significantly lower scores than the control group in all three subscales of the WFCS, with statistically significant differences (p < .001) and large effect sizes (η2 = 0.943). CONCLUSION: Our findings proved that the virtual group-based ACT intervention effectively improved psychological flexibility and social adjustment, reducing work-family conflict among intern nurses. These findings suggest that the virtual group-based ACT intervention can be a practical approach to improving intern nurses' mental health and well-being, which could affect their job performance and overall quality of life. TRIAL REGISTRATION: The study was registered retrospectively as a randomized clinical trial on 10/2/2023, reference number; NCT05721339 .

The Boot Camp Model in Urology: Preparing PGY1 Urology Interns for Practice.

PURPOSE OF REVIEW: The purpose of this review is to highlight literature regarding resident boot camps published across surgical specialties with a focus on urology. Herein, we discuss different boot camp iterations, their results, and the integration of simulation into their curriculum. We review program elements such as curriculum, course length, and efficacy as well as areas for continued investigation. RECENT FINDINGS: The field of urology has grown in both the breadth of knowledge and the complexity of procedures. With urology now being an integrated surgical subspecialty, interns often start on the urology service despite limited experience navigating this unique specialty. The boot camp model is one method by which interns and junior residents participate in consolidated training programs to best prepare them for a patient-facing role and the day-to-day demands of residency. Urology programs, both in the USA and abroad, have begun integrating boot camps into their training programs with positive results. Urology boot camps can be a valuable part of training programs for interns to quickly establish medical knowledge, skills, and efficiency. Boot camps should be easily accessible, have sufficient support from institutions, and provide effective training through various methods such as didactics and simulation.

How do foundation year and internship experience shape doctors' career intentions and decisions? A meta-ethnography.

PURPOSE: Foundation years or internships are an important period for junior doctors to apply their knowledge and gain clinical competency. Experiences gained during the foundation years or internships are likely to inform newly qualified doctors' opinions about how they want to continue their career. We aimed to understand how medical doctors' internship experiences influence their career intention/decision. METHODS: We conducted qualitative evidence synthesis using meta-ethnography. We searched six electronic bibliographic databases for papers published between 2000-2020 and included papers exploring how foundation years or internship experiences shape doctors' career intention/decisions, including in relation to migration, public/private/dual practice preference, rural/urban preference, and specialty choice. We used the GRADE-CERQual framework to rate confidence in review findings. RESULTS: We examined 23 papers out of 6085 citations screened. We abstracted three high-level inter-related themes across 14 conceptual categories: (1) Deciding the personal best fit both clinically and in general (which option is 'more me'?) through hands-on and real-life experiences (2) Exploring, experiencing and witnessing workplace norms; and (3) Worrying about the future in terms of job market policies, future training and professional development opportunities. Confidence in findings varied but was rated high in 8 conceptual categories. CONCLUSIONS: Our meta-ethnographic review revealed a range of ways in which internship experience shapes medical doctors' career intentions/decisions allowing us to produce a broad conceptual model of this phenomenon. The results highlight the importance of ensuring sufficient, positive and inspiring clinical exposure, improving workplace environment, relationship and culture, refraining from undermining specific specialities and communicating contractual and job market policies early on to young doctors, in order to attract doctors to less popular specialties or work locations where they are most needed. We propose our conceptual model should be further tested in new research across a range of contexts.

Mediating effect of resilience between social support and compassion fatigue among intern nursing and midwifery students during COVID-19: a cross-sectional study.

AIMS: To examine the mediating effect of resilience between social support and compassion fatigue among intern nursing and midwifery students during COVID-19. BACKGROUND: Compassion fatigue has become exceedingly common among intern nursing and midwifery students, especially during the COVID-19 pandemic. Social support and resilience can help intern nursing and midwifery students control their negative emotions, reduce compassion fatigue, and increase their well-being. However, the mediating effect of resilience between social support and compassion fatigue remains unclear. DESIGN: A multicentre cross-sectional survey. METHODS: A total of 307 intern nursing and midwifery students were recruited from November 2020 to February 2021 in tertiary grade A hospitals in China. Structural equation modelling was applied to analyse the mediating effects of resilience between social support and compassion fatigue. The Social Support Rating Scale, the 10-item Connor-Davidson Resilience Scale, and the Chinese version of the Compassion Fatigue Short Scale were used to collect data. The hypothetical path model was tested by using IBM SPSS version 26.0 and AMOS version 26.0 software. RESULTS: Intern nursing and midwifery students had moderate compassion fatigue. Social support positively affected resilience (ß = 0.514, p < 0.01). Social support negatively affected compassion fatigue (ß = - 0.310, p < 0.01), while resilience negatively affected compassion fatigue (ß = - 0.283, p < 0.01). Resilience played a mediating role between social support and compassion fatigue. CONCLUSION: Social support can directly affect the compassion fatigue of intern nursing and midwifery students during COVID-19 and indirectly through resilience. Stronger resilience can reduce compassion fatigue. Accordingly, resilience-based interventions should be developed to reduce compassion fatigue.

Prevalence and characteristics of needlestick injuries among dental interns during their first-year clinical training: an observational study.

BACKGROUND: Dental interns are vulnerable to needlestick injuries (NSI). The objectives of this study were to examine the prevalence and characteristics of NSI exposures among dental interns during their first-year clinical training, assess risk factors, and evaluate reporting behaviours. METHODS: An online survey was conducted among dental interns of Class 2011-2017 at Peking University School and Hospital of Stomatology (PKUSS), China. The self-administrated questionnaire consisted of information on demographic profiles, NSI characteristics, and reporting practices. The outcomes were presented by descriptive statistics. A multivariate regression analysis was performed to assess NSI sources using a forward step-wise approach. RESULTS: A total of 407 dental interns completed the survey (response rate 91.9%, 407/443), and 23.8% sustained at least one NSI. The mean number of NSIs per intern was 0.28 during the first clinical year. More occupation exposures occurred from October to December, between 13:00-15:00. Syringe needles were the most frequent sources, followed by dental burs, suture needles, and ultrasonic chips. The risk of peer-inflicted NSIs in the department of Paediatric Dentistry was 12.1 times higher than that in Oral Surgery (OR 12.1, 95% CI: 1.4-101.4). Appropriately 64.9% NSIs occurred when chairside assistants were absent. Compared to working alone, the risk of peer-inflicted NSIs was 32.3 times higher when providing chairside assistance (OR 32.3, 95% CI: 7.2-145.4). The left-hand index finger was the most commonly injured site. About 71.4% of exposures were reported in paperwork. CONCLUSIONS: Dental interns are susceptible to NSIs during their first-year clinical training. Extra attention should be paid to syringe needles, dental burs, suture needles, and ultrasonic chips. The lack of chairside assistance is hazardous regarding NSIs. The training of chairside assistance of the first-year dental interns should be enhanced. First-year dental interns are required to increase their awareness of ignored behaviors related to NSI exposures.

Comparison of physicians' and dentists' incident reports in open data from the Japan Council for Quality Health Care: a mixed-method study.

BACKGROUND: Patient safety is associated with patient outcomes. However, there is insufficient evidence of patient safety in the dental field. This study aimed to compare incidents reported by dentists and physicians, compare the type of errors made by them, and identify how dentists prevent dental errors. METHODS: A mixed-methods study was conducted using open data from the Japan Council for Quality Health Care database. A total of 6071 incident reports submitted for the period 2016-2020 were analyzed; the number of dentists' incident reports was 144, and the number of physicians' incident reports was 5927. RESULTS: The percentage of dental intern reporters was higher than that of medical intern reporters (dentists: n = 12, 8.3%; physicians: n = 180, 3.0%; p = 0.002). The percentage of reports by dentists was greater than that by physicians: wrong part of body treated (dentists: n = 26, 18.1%; physicians: n = 120, 2.0%; p < 0.001), leaving foreign matter in the body (dentists: n = 15, 10.4%; physicians: n = 182, 3.1%; p < 0.001), and accidental ingestion (dentists: n = 8, 5.6%; physicians: n = 8, 0.1%; p < 0.001), and aspiration of foreign body (dentists: n = 5, 3.4%; physicians: n = 33, 0.6%; p = 0.002). The percentage of each type of prevention method utilized was as follows: software 27.8% (n = 292), hardware (e.g., developing a new system) 2.1% (n = 22), environment (e.g., coordinating the activities of staff) 4.2% (n = 44), liveware (e.g., reviewing procedure, double checking, evaluating judgement calls made) 51.6% (n = 542), and liveware-liveware (e.g., developing adequate treatment plans, conducting appropriate postoperative evaluations, selecting appropriate equipment and adequately trained medical staff) 14.3% (n = 150). CONCLUSION: Hardware and software and environment components accounted for a small percentage of the errors made, while the components of liveware and liveware-liveware errors were larger. Human error cannot be prevented by individual efforts alone; thus, a systematic and holistic approach needs to be developed by the medical community.

Comparison of Attempts Needed for Veterinary Students to Reach Proficiency in a Basic and Advanced Robotic Simulator Task.

Surgical training of students is one of the most difficult aspects of veterinary medical education. Competing interests of house officers, owner's wishes, and ethical concerns have led to increasing use of inanimate models for basic surgical skills training. Robotic simulators have benefits for psychomotor training but have not been previously investigated in veterinary medicine. Understanding the necessary practice time for new training devices is important when determining their potential value. The aim of this study was to compare the number of attempts needed for veterinary students to reach proficiency in both a basic and advanced robotic simulator task, and to assess the predictive nature of performance variables. Each student performed a basic and advanced tasks on the Mimic dV-Trainer™ until proficiency was reached. Students required a median of eight attempts (95% CI = 7-8, range: 6-11) to reach proficiency for the basic task versus 22 attempts (95% CI = 20-26, range: 11-62) for the advanced task. The median time required to complete training for the basic and advanced task was 13.5 minutes (range: 8-24 minutes) and 26.5 minutes (range: 11-82 minutes) respectively. The difference in task attempts supports the training protocol and confirms proficiency can be attained in a short period of time. The number of attempts to reach proficiency correlated with specific performance variables which can be used by educators to aid in training students on a robotic simulator. Continued investigations on robotic simulators should be performed to investigate their use in improving psychomotor skills in veterinary students.

Pre-Treatment and Post-Treatment Dental Anxiety in Patients Visiting Intern Dental Clinic.

Background and Objectives: This study aimed to assess the dental anxiety of patients using the modified dental anxiety scale (MDAS) questionnaire along with examining the possible relationship between dental anxiety and sociodemographic factors. Materials and Methods: The MDAS questionnaire was used to assess the anxiety level of the patients which included a total of five questions and five options to respond to each question. MDAS questionnaire was filled out by all the patients before the dental treatment. After finishing the treatment, all the patients were given a post-treatment questionnaire to assess their anxiety levels after treatment. Descriptive statistics were performed for measuring the frequency of responses. Mann-Whitney U test was used to compare the anxiety between the gender. The chi-square test was used to identify the distribution of pre-treatment with gender and post-treatment questionnaire with gender and treatment modalities. Linear regression was used to identify the association between clinical variables and different levels of anxiety. Results: A total of 115 patients including 59 males and 56 females with a mean age of 35 ± 11.34 years were included in the current study. Female patients were significantly more anxious about dental treatment compared to male patients. Linear regression showed that age and gender have a significant association with the pre-treatment anxiety level; however, types of treatment is not associated with the MDAS. Anxiety levels decreased for the majority of the patients after the treatment and types of treatment did not show any differences with the post-treatment anxiety level. Conclusions: Age and gender play an important role in dental anxiety; however, types of treatment are not associated with pre-treatment and post-treatment dental anxiety.

[Health of technical intern trainees: One-year qualitative longitudinal study after arrival in Japan].

Objective　This study aimed to qualitatively analyze changes in the health status and factors affecting technical intern trainees over time during their first year in Japan and examined the necessary support for healthy living.Methods　The study targeted sixteen technical intern trainees who had been living in Japan for almost four months. The study was conducted quarterly in a year, using semi-structured interviews to measure physical and mental health conditions, injury or illness, subjective symptoms, and training and daily life conditions. Dietary content was assessed using photographs taken by participants. Health-check results were collected when available. Data were classified into the six components of the International Classification of Functioning, Disability and Health (ICF), and further qualitative data were analyzed inductively for health-affecting factors using qualitative longitudinal analysis.Results　The types and timing of illnesses, injuries, subjective symptoms, and health-affecting factors varied. Stress and concerns were experienced by more than 56.3% of each study's participants and more than 44.4% had the possibility of a mood or anxiety disorder. The participants with heavy labor had musculoskeletal disorders in the first half of the study period. The health-check results were in Japanese and some participants did not fully understand them. Fifteen categories were extracted as health-affecting factors:《sleeping conditions》,《joy of independence and anxiety》,《decreased vitality and fatigue》,《undertaking the training》,《communication skills and efforts to learn Japanese》,《efforts for self-health care》,《adaptation to Japanese lifestyle》,《leisure and interaction with Japanese people》,《religious activities》,《training environment》,《living environment》,《support from friends, family and workplace》,《natural environment and economic trends》,《saving-oriented lifestyle》, and《motive for coming to Japan and self-evaluation after one year》.Conclusion　The technical intern trainees experienced various physical and psychological symptoms. Support in maintaining and promoting positive aspects of health-affecting factors and removing negative aspects is important for the health of trainees. In addition, it is important to support the improvement of the health literacy of trainees by offering information on exercise facilities and medical institutions providing health-check services in multiple languages, and improving means of communications through cooperation with related organizations and the use of regular channels by trainees. Furthermore, involving healthcare professionals in "regional councils" is necessary.

["Junior Doctor" in Plastic Surgery, a new status. Evaluation of the practices after one semester of application of the reform]. / Docteur Junior en chirurgie plastique, un nouveau statut. Évaluation des pratiques après un semestre d'application de la réforme.

INTRODUCTION: The reform of the third cycle of medical studies in 2017 led to the creation of the status of "Junior Doctor", corresponding to the consolidation phase and allowing increasing autonomy and supervision from the intern. In plastic surgery, this status appeared for the first time in November 2021 in French hospitals; it lasts two years and succeeds the first four years of internship. MATERIAL AND METHODS: We sent a self-questionnaire by email in May 2022 to the 21 French Junior Doctors. This was interested in their training ground, formation program, consultation activity, operating program, integration into the on-call list, the existence of half-days of availability, and their general opinion on this reform and its implementation. RESULTS: We collected 20 questionnaires with a sex ratio of twelve men for eight women. The majority of respondents worked in a university hospital (85 %). 45 % had their consultations, 60 % had their own operating sessions under general anesthesia, and 35 % under local anesthesia. Only 25 % of them considered this reform to be a step forward in terms of training. CONCLUSION: The introduction of the status of Junior Doctor is contrasted within the various hospitals. Despite the progressive and supervised autonomy provided by this reform, it is generally perceived neutrally or negatively by Junior Doctors. The establishment of own consultations and operating sessions stands out as a key positive element allowing better application of the reform.

Simulation-based holistic education in physiotherapy interns to increase empathy toward older adults and individuals with disabilities.

BACKGROUND: The proportion of older adults and individuals with disabilities in the general population increases each year. Thus, clinical clerkships designed for physiotherapy interns should provide more than simply knowledge and skills. For such interns to be able to handle the requirements of their future jobs, clerkships must enable them to develop empathy and positive attitudes toward patients. This study investigated the effect of simulation-based, holistic health-care education on physiotherapy interns' empathy, attitudes, and knowledge.  METHODS: A parallel-group design. Thirty physiotherapy interns from a medical institution were enrolled as participants, with experimental and control groups each comprising 15 participants. Both groups received standard clinical training. However, the experimental group received an additional 3.5 h of simulation-based holistic health-care education. The Jefferson Scale of Empathy, Kogan's Attitudes Toward Old People Scale, the Attitudes Towards the Elderly Scale, the Knowledge About Aging Scale, Knowledge of the Situation of Older People Scale, Perceptions of Working with Older People Scale, and Care Willingness Scale were used in a pretest and posttest. RESULTS: After the intervention period, we observed substantial between-group differences of 6.4 points on the Jefferson Scale of Empathy (p = 0.001), 7.7 points on Kogan's Attitudes Toward Old People Scale (p = 0.002), 3.5 points on the Attitudes Toward the Elderly Scale (p = 0.002), 2.5 points on Knowledge About Aging (p = 0.055), 4.5 points on the Knowledge of the Situation of Older People Scale (p < 0.001), and 2.1 points on Perceptions of Working with Older People Scale (p = 0.046). CONCLUSION: Simulation-based, holistic health-care education can significantly improve the empathy, knowledge, and attitudes of physiotherapy interns.

NICU Nurse Residents: Evidence-Based Practice Projects.

As conventional nursing programs prepare students to provide safe, competent care for the typical adult medical/surgical patient, it is necessary for new graduate nurses to apply for nurse residency programs for on-to-job intensive training for a unique specialty such as surgery, pediatrics, or neonatal intensive care.1-3 Although not the norm for all nurse residency programs, some require residents to complete an evidence-based practice (EBP) project.4 EBP projects are a newer, very valuable component of residency programs that facilitate practice change and positively impact unit goals and metrics. When EBP projects become an expectation of a new nurse residency program, both the unit and the resident benefit in numerous ways. With EBP project process and expectation changes, just like within EBP in general, constant reevaluation is necessary to further improve the experience and outcomes for all stakeholders involved.