Extracurricular work experience and its association with training and confidence in emergency medicine procedures among medical students: a cross-sectional study from a Norwegian medical school.

OBJECTIVE: Proficiency in basic emergency procedures is important for junior doctors, but the amount of practical exposure may vary. We studied the association between students' extracurricular healthcare-related (ECHR) work experience and self-reported practical training and confidence in selected emergency medicine procedures. STUDY DESIGN: Cross-sectional study. MATERIALS AND METHODS: Medical students and first-year graduates answered a Likert-based questionnaire probing self-reported amount of exposure to ('training amount') and confidence with selected emergency medicine procedures. Participants also reported ECHR work experience, year of study, previous healthcare-related education, military medic training and participation in the local student association for emergency medicine (Tromsø Acute Medicine Students' Association (TAMS)). Differences within variables were analysed with independent samples t-tests, and correlation between training amount and confidence was calculated. Analysis of covariance and mixed models were applied to study associations between training amount and confidence, and work experience (primary outcomes) and the other reported factors (secondary outcomes), respectively. RESULTS: 539 participants responded (70%). Among these, 81% had ECHR work experience. There was a strong correlation (r=0.878) between training amount and confidence. Work experience accounted for 5.9% and 3.5% of the total variance in training amount and confidence (primary outcomes), and respondents with work experience scored significantly higher than respondents without work experience. Year of study, previous education, military medic training and TAMS participation accounted for 49.3%, 8.7%, 6.8% and 23.6%, and 58.5%, 5.1%, 4.7% and 12.3% of the total variance in training amount and confidence, respectively (secondary outcomes). Cohen's D was 0.48 for training amount and 0.32 for confidence level, suggesting medium and weak medium-sized associations with work experience, respectively. CONCLUSION: ECHR work experience is common among medical students and was associated with more training amount and higher confidence in the procedures. Year of study, previous relevant education and TAMS participation, but not military medic training, were also significantly associated with training amount and confidence.

Barriers to body temperature monitoring among prehospital personnel: a qualitative study using the modified nominal group technique.

OBJECTIVES: To identify and explore barriers that healthcare professionals working as prehospital care (PHC) providers at the University Hospital of North Norway experience with temperature monitoring and discover solutions to these problems. STUDY DESIGN: Qualitative study using the modified nominal group technique. MATERIALS AND METHODS: 14 experienced healthcare professionals working in air and ground emergency medical services were invited to the study. Initially, each participant was asked to suggest through email topics of importance regarding barriers to prehospital thermometry. Afterwards, they received a list of all disparate topics and were asked to individually rank them by importance. The top-ranked topics were discussed in a consensus meeting. The meeting was audio-recorded and a transcript was written and then analysed through an inductive thematic analysis. RESULTS: 13 participants accepted the invitation. 63 suggestions were reduced to 24 disparate topics after removal of duplicates. Twelve highly ranked topics were discussed during the consensus meeting. Thematic analysis revealed 47 codes that were grouped together into six overarching themes, of which four described challenges to monitoring and two described potential solutions: equipment dissatisfaction, little focus on patient temperature, fear of iatrogenic complications, thermometry subordinated, more focus on temperature and simplification of thermometry. CONCLUSION: To increase the frequency of temperature measurement on correct indication, we suggest introducing PHC protocols that specify patients and conditions where an accurate temperature measurement should have high priority. Furthermore, there is a profound need for more suitable techniques for temperature monitoring in the prehospital setting.