The feedback dilemma in medical education: insights from medical residents' perspectives.

BACKGROUND: Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training. METHODS: This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents. RESULTS: The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting. CONCLUSIONS: Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care.

Effectiveness of biosurfactant lipopeptide adhesive mucus paste on the healing process of oral wounds: a randomized controlled trial.

INTRODUCTION: Recurrent aphthous stomatitis is a common lesion of the oral cavity, and many treatments have been introduced by researchers. OBJECTIVE: This study aims to determine the effect of biosurfactant lipopeptide (Acinetobacter baumannii and Pseudomonas aeruginosa) adhesive mucus paste on the healing process of oral wounds. MATERIALS AND METHODS: The studied population included 36 people (age range, 20-41 years). The volunteers had a history of oral ulcers and were randomly assigned to 3 groups: positive control (mouthwash chlorhexidine 0.2%), biosurfactant lipopeptide mucoadhesive (A baumannii and P aeruginosa), and base groups. In this analysis, the 2-paired sample t test, ANOVA, and Kruskal-Wallis test (Wilcoxon signed-rank test) were used. RESULTS: On the second day of treatment, the efficacy index of the positive control group was higher than that of the mucoadhesive and the base groups (P = .04) and there was a significant difference between the mucoadhesive group and the positive control group compared with the base group (P = .001). On the sixth day of treatment, the positive control group was significantly different from the mucoadhesive and base groups in terms of wound size (P < .05). CONCLUSIONS: This study showed that the use of mucoadhesive gel formation containing lipopeptide biosurfactant reduces pain and wound size compared to mucoadhesive without biosurfactant lipopeptide treatment, but it has less effect than routine treatment. Therefore, other studies should be done.

Antibiotics with Antiviral and Anti-Inflammatory Potential Against Covid-19: A Review.

In Covid-19 cases, elderly patients in long-term care facilities, children younger than five years with moderate symptoms, and patients admitted to ICU or with comorbidities are at a high risk of coinfection, as suggested by the evidence. Thus, in these patients, antibiotic therapy based on empirical evidence is necessary. Finding appropriate antimicrobial agents, especially with antiviral and anti-inflammatory properties, is a promising approach to target the virus and its complications, hyper-inflammation, and microorganisms resulting in co-infection. Moreover, indiscriminate use of antibiotics can be accompanied by Clostridioides difficile colitis, the emergence of resistant microorganisms, and adverse drug reactions, particularly kidney damage and QT prolongation. Therefore, rational administration of efficient antibiotics is an important issue. The main objective of the present review is to provide a summary of antibiotics with possible antiviral activity against SARS-CoV-2 and anti-immunomodulatory effects to guide scientists for further research. Besides, the findings can help health professionals in the rational prescription of antibiotics in Covid-19 patients with a high risk of co-infection.

Antidepressants with anti-tumor potential in treating glioblastoma: A narrative review.

Glioblastoma multiforme (GBM) is known as the deadliest form of brain tumor. In addition, its high treatment resistance, heterogeneity, and invasiveness make it one of the most challenging tumors. Depression is a common psychological disorder among patients with cancer, especially GBM. Due to the high occurrence rates of depression in GBM patients and the overlap of molecular and cellular mechanisms involved in the pathogenesis of these diseases, finding antidepressants with antitumor effects could be considered as an affordable strategy for the treatment of GBM. Antidepressants exert their antitumor properties through different mechanisms. According to available evidence in this regard, some of them can eliminate the adverse effects resulting from chemo-radiotherapy in several cancers along with their synergistic effects caused by chemotherapy. Therefore, providing comprehensive insight into this issue would guide scientists and physicians in developing further preclinical studies and clinical trials, in order to evaluate antidepressants' antitumor potential. Considering that no narrative review has been recently published on this issue, specifically on these classes of drugs, we present this article with the purpose of describing the antitumor cellular mechanisms of three classes of antidepressants as follows: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAOIs) in GBM.