Perception of Plagiarism Among Medical Postgraduate Students: An Observational Study.

Introduction Plagiarism is appropriating another person's ideas, words, results, or processes without giving appropriate credit and usually claiming them to be one's own. Thus, plagiarism is a dishonest act of fraud or cheating. Objectives The objective of this study is to assess the perception of plagiarism among medical postgraduate (PG) students. Materials & Methods: An educational observational study was conducted among second-year PG students about the perception of plagiarism by using pre-test and post-test questionnaires after an orientation session on plagiarism and data analysis before the start of dissertation analysis. Questions included were on awareness and attitude towards plagiarism.  Results A survey involving 91 PG students assessed their understanding of plagiarism. Remarkably, the majority (97.7%) demonstrated awareness of plagiarism, yet only 18.6% had authored a published article. It was discovered that about 30% of the students had resorted to plagiarism at some point during their academic pursuits. Approximately 70.9% of the PG students were acquainted with the University's plagiarism policy. The survey highlighted a notable enhancement in plagiarism awareness among PG students, with their attitudes toward plagiarism evolving after participating in the session. Conclusion Plagiarism can be avoided by implementing rigorous guidelines, ensuring strict policy adherence, and providing comprehensive training before commencing work. Training, retraining, and strict institute policies will help increase awareness about plagiarism and reduce the percentage of plagiarism in scientific writing.

Predictors of Success in Obtaining Post-Graduate Residency or Fellowship.

OBJECTIVE: As more pharmacy students are pursuing post-graduate training, colleges of pharmacy are investigating ways to predict success in matching for residency or fellowship. While data have been published about characteristics predictive of matching, we sought to study student scores, rotation types, and rotation evaluations as predictors of success. METHODS: Data was collected from students in the graduating classes of 2021, 2022, and 2023. Students were surveyed as to participation in mock interviews, numbers of programs to which they applied, and number of interviews received. In addition, data was collected on imposter phenomenon, grit, perceived stress, anxiety, grade point average (GPA), types of patient care rotations, and preceptor evaluations. RESULTS: Overall, 295 students were included, with 69 unsuccessful and 226 successful students. Successful students were more likely to have lower PSS-10 scores in the final three semesters of school, a higher GPA, more elective patient care rotations, and preceptors who answered yes to "would you hire this student" after graduation. In the multivariate logistic regression analysis, final GPA and preceptors answering yes to "would you hire this student" were independent predictors of success in obtaining a post-graduate position. CONCLUSION: As colleges of pharmacy prepare students for post-graduate residencies or fellowships, in addition to GPA, stress levels during the final three semesters of pharmacy school may be areas on which to focus. Since the willingness of a preceptor to hire a student after graduation was a predictor of success in securing a post-graduate position, this should be explored in future research.

Nationwide Survey to Characterize and Compare the Research Experiences of American Society of Health-System Pharmacists-Accredited Postgraduate Year One Pharmacy Residency Programs.

Background: Many Postgraduate Year One (PGY1) Pharmacy residencies provide research training however, details of this training are not well described. Publication rates have been utilized to assess residency research learning experiences. Higher publication rates have been reported by programs that have implemented a structured research learning experience. Objective: The primary objective was to identify differences in the research learning experiences for American Society of Health-System Pharmacists (ASHP) accredited PGY1 Pharmacy residencies with reported resident publication rates of ≥20% vs <20%. Methods: This survey was distributed to PGY1 Pharmacy residency program directors (RPDs). Seven sections were analyzed to identify research learning experience differences between programs with reported publication rates of ≥20% vs <20%: (1) program characteristics/research outcomes; (2) involved individuals; (3) requirements; (4) learning experience structure; (5) educational methods; (6) formal education; (7) barriers/RPD perceptions. Variables with P < 0.05 on logistic regression were considered statistically significant. Results: The survey response rate was 31.3% (308/984). Significant positive predictors for reported publication rates of ≥20% were: involved individuals: research director/coordinator, individuals trained in statistics, non-pharmacy medical staff; requirements: Collaborative Institutional Training Initiative training, research seminars/training courses, research manuscript; learning experience structure: research committee; educational methods: didactic residency-led lectures/courses, formal workshops, self-taught online modules; and formal education: manuscript preparation. Conclusion: This study suggests there are differences in the research learning experiences at PGY1 Pharmacy residencies with reported resident publications rates of ≥20% vs <20%. We encourage PGY1 Pharmacy residency programs to consider implementing elements associated with reported resident publication rates of ≥20%.

Are healing abutments being reused in periodontics residency programs in the United States? A survey-based study.

PURPOSE: Recent studies indicate that reusing healing abutments (HAs) may pose a risk of biomaterial cross contamination among patients. The intent is to investigate whether postgraduate periodontics residency programs in the United States are reusing dental implant HAs and determine if there is a standardization in the decontamination and sterilization protocol of used HAs. METHODS: An electronic survey consisting of-seven multiple choice and/or short answer questions pertaining to the re-use of HAs among postdoctoral periodontics programs was sent to program directors of 57 accredited dental schools in the United States via an online survey system (Qualtrics). Three follow-up remainder emails were sent to programs that did not respond after over a 6-month period. Data were analyzed using descriptive statistics. RESULTS: Of the 57 postdoctoral periodontics program directors contacted, only 14 responded with three programs (3/14, 21%) reported reusing HAs. Approximately, 46% stated their residents place dental implants in two stages, while ∼54% stated they used a one-stage protocol indicating varied time exposure of HA to the oral cavity. Even in a two-stage protocol, the extended time HA remained in situ varied from 4 weeks to 6 months. Each program reusing HAs employed a distinct decontamination approach highlighting a notable lack of standardization in practices. CONCLUSION: The findings from our study suggest that a minority of residency programs in the United States are reusing HAs. However, the limited number of responses leaves uncertainty regarding whether our findings underestimate the prevalence of this practice and accurately reflect the reality. Among those re-using HAs, there seems to be a lack of standardization in their decontamination, potentially leading to cross-contamination of residual biomaterial among patients.

Impact of Basic Course in Biomedical Research (BCBR) on Medical Teachers and Postgraduate Students Across India: A Cross-Sectional Survey-Based Study.

Introduction Despite world-class medical facilities and clinical expertise in India, various challenges have hampered biomedical research, including limited funding, overburdened healthcare professionals, and inadequate research infrastructure. The National Medical Commission (NMC) has recognized the need to enhance research capabilities in the medical community and mandated the Basic Course in Biomedical Research (BCBR). This study evaluates the impact of BCBR on medical teachers and postgraduate students across India. Methods A cross-sectional survey-based study was conducted among 245 participants who completed BCBR, out of 1,187 who were sent the questionnaire. A structured questionnaire collected data on demographics, motivations for taking the course, knowledge and skills improvement, and research output. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 29.0 (Released 2022; IBM Corp., Armonk, NY, USA). Results Participants included diverse age groups, with motivations ranging from regulatory compliance to a genuine desire for research knowledge. The majority scored over 70% in the course, indicating substantial knowledge improvement. BCBR positively influenced research output with increased research proposal submissions, publications, and improved thesis mentoring. The analysis showed that participants' designations and branches of study significantly affected course performance, while gender did not. The study revealed a strong correlation between pre-course and post-course performance across various research topics. Conclusion BCBR, mandated by the NMC, not only fulfills regulatory requirements but also promotes a research culture in India's medical community.

Assessment of psychiatrists' preparedness in managing disaster-related psychiatric disorders: a survey in Taiwan from post-graduate medical education perspective.

Background: Disaster-related psychiatric disorders (DRPD) present a significant challenge to mental health professionals, yet there is a notable lack of emphasis on the preparedness of psychiatrists in managing these conditions within post-graduate medical education. Methods: This study utilized a questionnaire to collect data from psychiatrists, focusing on their prior involvement in managing DRPD, perceived competence, medication preferences, and factors influencing their experiences in handling such disorders. Analysis included distribution and ranking of variables, alongside cross-analysis examining associations between demographic factors (age, gender, hospital levels, years of practice, board certification) and treatment experiences, as well as readiness for in-hospital or outside-hospital mobilization in DRPD management. Results: One hundred and three Taiwanese psychiatrists participated in the study, with the majority reporting involvement in managing DRPD (71.8%), particularly in post-traumatic stress disorder (PTSD) and depression. Antidepressants, specifically serotonin selective reuptake inhibitors, were commonly preferred for DRPD treatment, including PTSD and depression. Psychiatrists aged over 40, with more than 10 years of practice, and hold the board-certified status, showed greater experiences for outside- or inside- the hospital mobilization in DRPD management. Conclusion: Findings suggest that within post-graduate medical education, Taiwanese psychiatrists demonstrate significant experience, willingness, and capacity to effectively manage DRPD. However, there is a need to integrate comprehensive training on disaster psychiatry into post-graduate psychiatric education programs to further enhance preparedness and optimize outcomes in managing these challenging conditions.

Midwifery practice in Mongolia: Policy implications for accelerating care delivery transformation.

Midwives can play a significant role in reducing maternal and neonatal mortality rates as well as in improving maternal and perinatal health outcomes in low- and middle-income countries such as Mongolia. However, the shortage of midwives in Mongolia is severe. Despite the evidence indicating numerous challenges associated with substandard midwifery education and practice in Mongolia, there is a need for policy recommendations to accelerate the improvement of midwifery care delivery in the country. Therefore, we identified three main topics as key issues in Mongolian midwifery care: 1) the current training and service delivery in midwifery; 2) the potential for the development of the midwifery role; and 3) content requirements for the postgraduate certificate in midwifery. The World Health Organization report made forty recommendations to enhance the midwife's role to professional status. However, the absence of senior nursing/midwifery leadership in the Ministry of Health in Mongolia has hindered the implementation of the recommendations. To strengthen midwifery at a national level, it is imperative to make multilevel investments in supporting educators and clinical practitioners to ensure the delivery of high-quality midwifery care. This article represents an initial in-depth exploration of issues in Mongolian midwifery practice, with the aim of providing suggestions for practical avenues for enhancing midwifery care in Mongolia.

Encouraging medical students to become surgeons? Impact of psychological and surgical factors on career choice at medical school.

Aim: Training decisions are viewed as a problem by the majority of medical students.In the present study we compared sociodemographic and psychological characteristics of students who are interested in surgical training to those who preferred a non-surgical specialty. Furthermore, we examined whether students who wish to be trained as surgeons performed better than their non-surgical counterparts in a course designed to acquire skills in minimally invasive surgery. Method: From October 2020 to January 2021 we performed a cross-sectional survey among 116 medical students prior to their year of practical training at Christian-Albrechts University in Kiel. Based on their intended field of specialization, the students were divided into a non-surgical and a surgical group. Sociodemographic and psychological characteristics such as self-efficacy expectations, resilience and stress perception were evaluated and compared between groups. Simultaneously, we compared their surgical performance in two laparoscopic exercises and their self-assessment as surgeons. Statistical differences between the training groups were determined by the Mann-Whitney U test or Pearson's Chi square test. Results: Ninety-two students participated in the study, of whom 64.1% intended to train in a non-surgical specialty and 35.9% in a surgical specialty. Students who wished to be trained as surgeons had higher general self-efficacy expectations (p<0.001) and greater resilience (p=0.009). However, on comparison they had a lower stress level (p=0.047). The inter-group comparison of training results and self-assessment as surgeons revealed no unequivocal differences in surgical performance. Conclusion: Interest in surgical specialties is correlated, among other factors, with the strength of psychological skills such as general self-efficacy expectations, resilience and stress perception. Early attention to these psychological resources in academic training might assist medical students in future career choices.

The Ottawa resident observation form for nurses (O-RON): evaluation of an assessment tool's psychometric properties in different specialties.

BACKGROUND: Workplace-based assessment (WBA) used in post-graduate medical education relies on physician supervisors' feedback. However, in a training environment where supervisors are unavailable to assess certain aspects of a resident's performance, nurses are well-positioned to do so. The Ottawa Resident Observation Form for Nurses (O-RON) was developed to capture nurses' assessment of trainee performance and results have demonstrated strong evidence for validity in Orthopedic Surgery. However, different clinical settings may impact a tool's performance. This project studied the use of the O-RON in three different specialties at the University of Ottawa. METHODS: O-RON forms were distributed on Internal Medicine, General Surgery, and Obstetrical wards at the University of Ottawa over nine months. Validity evidence related to quantitative data was collected. Exit interviews with nurse managers were performed and content was thematically analyzed. RESULTS: 179 O-RONs were completed on 30 residents. With four forms per resident, the ORON's reliability was 0.82. Global judgement response and frequency of concerns was correlated (r = 0.627, P < 0.001). CONCLUSIONS: Consistent with the original study, the findings demonstrated strong evidence for validity. However, the number of forms collected was less than expected. Exit interviews identified factors impacting form completion, which included clinical workloads and interprofessional dynamics.

Unveiling the paradoxes of implementing post graduate competency based medical education programs.

PURPOSE: Competency-based medical education (CBME) has gained prominence as an innovative model for post-graduate medical education, yet its implementation poses significant challenges, especially with regard to its sustainability. Drawing on paradox theory, we suggest that revealing the paradoxes underlying these challenges may contribute to our understanding of post graduate competency-based medical education (PGCBME) implementation processes and serve as a first-step in enhancing better implementation. Thus, the purpose of the current study is to identify the paradoxes associated with PGCBME implementation. METHOD: A qualitative study was conducted, as part of a larger action research, using in-depth semi-structured interviews with fellows and educators in eight Neonatal wards. RESULTS: Analysis revealed that the PGCBME program examined in this study involves three different levels of standardization, each serving as one side of paradoxical tensions; (1) a paradox between the need for standardized assessment tools and for free-flow flexible assessment tools, (2) a paradox between the need for a standardized implementation process across all wards and the need for unique implementation protocols in each ward; and 3) a paradox between the need for a standardized meaning of competency proficiency and the need for flexible and personal competency achievement indicators. CONCLUSIONS: Implementing PGCBME programs involves many challenges, some of which are paradoxical, i.e. two contradictory challenges in which solving one challenge exacerbates another. Revealing these paradoxes is important in navigating them successfully.

Diagnosing and Discussing Sexual Abuse: A Scoping Review on Training Methods for Health Care Professionals.

Purpose: Sexual abuse is a health issue with many consequences. Recognizing and discussing past sexual abuse has proven to be challenging for health care professionals. To improve overall quality of health care for sexual abuse victims, health care professionals need to be properly trained. The aim of this paper is to provide an overview of training methods for health care professionals and to report on their effectiveness. Methods: A scoping review was conducted. A broad search was executed in six databases in December 2022. Study selection was performed by two independent reviewers, followed by quality assessment and data extraction. Results: After screening of titles and abstracts and later full-text assessment for quality appraisal, seven articles were selected, consisting mostly of non-randomized trials, performed among a total of 1299 health care professionals. All studies were assessed to be of moderate to poor quality. The participants attended training courses with a wide variety of durations, settings, formats and methods. The outcomes showed improvements in self-perceived or measured knowledge, skills and confidence to discuss sexual violence. Changes in clinical practice were scarcely investigated. Training courses were most effective when a mix of didactic passive methods, such as lectures and videos, and active participatory strategies, such as discussions and roleplay, were applied. Timely iteration to reinforce retention of gained knowledge and skills also contributed to effectiveness. Participants most enjoyed incorporating opportunities for receiving feedback in small settings and sharing personal experiences. Conclusion: This scoping review summarizes on how to effectively train health care professionals. Flaws and difficulties in measuring the effectiveness of training courses were discussed. Recognition and discussion of past sexual abuse by health care providers can be effectively trained using an alternating mix of multiple active and passive training methods with room for feedback and personal experiences.

Evaluation of the creation of podcasts for instructional delivery in a post-graduate training elective course.

OBJECTIVES: To describe the creation of podcasts for instructional delivery and evaluate strengths and areas for improvement in a post-graduate training (PGT) elective course. METHODS: After creating a podcast series, students in the PGT elective from Spring 2021 to Fall 2022 listened to the series then completed a reflection based on five open-ended questions that provoked their thoughts and feelings about use of podcasts as a method of delivering information and teaching. Responses were downloaded and a content analysis was performed. Each investigator analyzed responses from all reflections to identify major themes and subthemes. Letter of intent assignment and overall course grades were compared to assess if podcasts affected student learning. RESULTS: Ninety-one students provided reflections about the use of podcasts in the PGT elective course, which revealed three major themes with 13 subthemes, including perception of guests, learner experience, and show and episode production. Students appreciated the various perspectives, authenticity, relatability, and diversity of the guest speakers; the learning environment was described as flexible, relatable, positive, and a safe space; the podcast design was noted to be informative, organized, and easily accessible. Areas for improvement included more interaction with guests and more visuals. Letter of intent assignment and overall course grades were similar before and after podcast implementation. CONCLUSION: The use of podcasts as an educational tool in a PGT elective course had a variety of characteristics that students preferred to traditional lecture-style classes.

The Autonomous Post Graduate Medical Education Board (PGMEB) of National Medical Commission (NMC): Minimum Standard of Requirements for Postgraduate Courses-2023 (PGMSR-2023) - Impact on Family Medicine/ Family Physician Vocational Training for Indian Medical Graduates.

The National Medical Commission (NMC) of India has issued new guideline for post graduate medical courses in India on 15th January 2024. These Guidelines may be called the "Minimum Standard of Requirements for Postgraduate Courses-2023 (PGMSR-2023)". These guidelines will come into force with immediate effect. Unfortunately, Family Medicine specialty has been entirely excluded from this document, despite clear mandate in the National Medical Commission Act 2019. Previously, the Undergraduate Medical Education Board of NMC did not include the Family Medicine as a mandatory department for training at MBBC Course. In the absence of a specific policy on medical education, a careful planning is required for number of post graduate residency positions across India depending upon population coverage and morbidity patterns. So, far during past three decades the increase in the number of post graduate residency posts/ seats have been random. There has been no clear-cut policy by the government or by the regulator itself. There appears to be no mapping for specialty need across geographical territories and population density in the background of the morbidity pattern. Under section 24(1)(c) of the National Medical Commission Act 2019 The Under-Graduate Medical Education Board shall perform the following functions, namely: - (c) develop competency-based dynamic curriculum for addressing the needs of primary health services, community medicine and family medicine to ensure healthcare in such areas, in accordance with the provisions of the regulations made under this Act; Under section 25. (1)(j) National Medical Commission Act 2019 The Post-Graduate Medical Education Board shall perform the following functions, namely: - (j) promote and facilitate postgraduate courses in family medicine. Under section 57. (1) The Commission may, after previous publication, by notification, make regulations consistent with this Act and the rules made thereunder to carry out the provisions of this Act. (2), and without prejudice to the generality of the preceding power, (p) the curriculum for primary medicine, community medicine, and family medicine under clause (c) of sub-section (1) of section 24. It is to be noted that Family Medicine is a community-based clinical discipline, all parameters for the graduate Family Medicine department, training, and faculty eligibility have been kept as per other hospitalist disciplines. It is the mandate of the Post Graduate Board of NMC to promote the PG program in Family Medicine. Suggestions articulated in this paper may be worthy of consideration of the esteemed members of National Medical Commission.

Using cultural historical activity theory to understand how post-graduate residents perform discharge planning at a medical center in Taiwan.

BACKGROUND: Despite the importance of discharge planning in physicians' education, currently in most countries, no identical training is provided. Difficulties in promoting physician discharge planning education in Taiwan are still noted. This study aims to find the physicians' role of discharge planning training in educating post graduate year residents (PGY) in Taiwan. MATERIALS AND METHODS: We took advantage of government and hospital policies that promote the discharge planning program to teach and implement it, beginning with PGY residents by incorporating it into their training program. We recruited 30 PGY residents who were attending their three-month general internal medicine training from 2018 to 2019. They were interviewed at the end of the program using cultural-historical activity theory (CHAT). Qualitative research methods were used to further understand how discharge planning and care was implemented. RESULTS: Trainees initially believed that they did not have any role in discharge planning. Using the cycle of expansive learning, we found that the role of physicians in discharge planning was unclear. There were still some inconsistencies in the teaching and implementation of the discharge planning program for PGY residents that needed to be resolved, but this study also let participants learn through practice to improve their identification of discharge planning. CONCLUSIONS: This study analyzed the impact of a discharge planning program for PGY physicians in Taiwan. It showed that the program affected physicians' practice and medical education, although some contradictions remain.

Education pathways for graduate entry registered nurses to transition to advanced practice roles: A realist review.

OBJECTIVE: Explore potential education and clinical pathways for nurses entering the profession through a Graduate Entry Nursing programme to transition to advanced practice roles. DESIGN: Realist review. REVIEW METHODS: A two stage process included 1) a systematic search of the following electronic databases EMCARE, MEDLINE, CINAHL, ERIC, and Scopus for published peer reviewed literature reporting academic pathways for graduates of graduate entry nursing programmes to progress to advanced nursing roles, and 2) consultation with key education programme stakeholders of graduate entry nursing programmes across Australasia, who undertook an inductive interpretive approach using realist logic to determine what works, for whom, and in what circumstances. RESULTS: Twelve published articles that explored advanced practice academic pathways for graduate entry nursing graduates were synthesised in terms of context, mechanisms, and outcomes. Data were then interpreted as to what works, for whom, in what context, and why, to develop new understandings of opportunities for advanced practice pathways for these students. No specific tailored academic pathway for graduate entry nursing graduates to progress to advanced practice was identified. Important relationships were identified between financial imperatives, political drivers, and registration requirements. CONCLUSIONS: Transformative strategies for new education pathways were identified as necessary to inspire innovation in nurturing graduate entry nurse graduates to progress to advanced practice roles. Effective collaboration and consultation within and across agencies and organisations are needed to both develop and implement accessible, expedient, and equitable programmes to enable this capable cohort to contribute to the health workforce.

Differences in the resident encounter of disruptive behavior by gender.

This study aimed to investigate the prevalence of gender-based differences in disruptive behaviors (DBs) among trainee physicians to shed light on the extent and nature of the problem. Using a national cross-sectional design, data were collected through a web-based, self-administered questionnaire administered to post-graduate first-year (PGY1) and second-year (PGY2) residents participating in the General Medicine Intermittent Examination (GM-ITE). A total of 5,403 participants, representing a response rate of 71.9%, were included in the study. Of these, approximately 35% of residents reported encounters with DBs in the past year. A gender-based comparison revealed that 38.4% of male residents faced DBs from physicians, compared to 27.6% of their female counterparts (p < 0.001). Conversely, a higher proportion of male residents (35.8%) experienced DBs from nurses than did female residents (32.9%; p = 0.037). After adjusting for factors such as hospital size, hospital type, urban location, age, and PGY, male residents exhibited an increased likelihood of experiencing DB from both physicians (adjusted OR 1.59, 95% CI 1.40-1.81) and nurses (adjusted OR 1.17, 95% CI 1.03-1.32) relative to women. Moreover, the study provides valuable insight into the prevalence of various types of DBs experienced by trainee physicians, including disrespectful behavior, exclusion from patient discussions, and reprimands. Understanding and addressing the gender-based differences in DBs among trainee physicians is crucial for improving the educational environment and promoting respectful behavior in healthcare settings. These findings highlight the need for targeted interventions based on gender to mitigate the negative impact of DBs on patient care and the well-being of medical residents.

Post-graduate educational environment of two parallel programs in Pediatric Medicine.

Objective: To compare the trainees' perception of the Educational Environment (EE) of the two parallel post-graduate training programs (MD & FCPS) in Pediatric Medicine. Methods: This quantitative cross-sectional study was carried out by Department of Medical Education UOL and Department of Pediatric Medicine KEMU from February to December 2021. Data about the perception of EE was collected from the Pediatric Medicine trainees by purposive sampling using the 40 items PHEEM inventory. The inventory has three perception domains: role autonomy, teaching, and social support. In addition, to mean scores, the inventory also gives interpretation according to the score ranges. The FCPS and MD trainees of both genders and all years of training across the institutions of Punjab were approached using Google Forms. SPSS (v 23.0) was used for descriptive and analytic statistics. Results: A total of 327 trainees' responses were included-188 (57.5%) FCPS and 139 (42.5%) MD trainees. The mean overall score was 92±19.7 for FCSP and 93.88±21.5 for MD trainees (p-value 0.41). The interpretation of the overall score was "more positive than negative but room for improvement" in 67.3%. For the subscales of role autonomy, teaching, and social support, the perception was positive by 71%, 80%, and 45% of trainees, respectively. Except for three individual items, the mean scores of the subscales and the individual items were not statistically different between the two groups. Conclusion: The Pediatric Medicine trainees' perception of the educational environment in the FCPS and MD groups was comparable overall and in all three domains. Individual item analysis showed almost similar areas for improvement in both programs.

Attitudes of primary care physicians towards antimicrobial stewardship and the impact of a multi-part training course - a pilot study.

Background: A plethora of antimicrobial stewardship (AMS) programs has been initiated during the past years, focusing on hospital settings. Primary-care physicians have seldom been addressed, although the majority of antibiotic prescriptions are issued for outpatients. We sought to investigate attitudes of primary-care physicians and the impact of a customized training course. Methods: Primary-care physicians in southwest Germany were invited to a multi-part training course on AMS in the primary-care setting. Participants were asked to answer a questionnaire about their attitude and factors that hinder them from implementing AMS or enable them to perform AMS. In addition, a knowledge assessment exam at the beginning and end of the training was conducted on selected infectious diseases/syndromes. Results: In total, 36 primary-care physicians participated in the training course. The predominant age group was 51-60 years old (36%; 13/36). The majority, 23/35 (66%), indicated never having had AMS training, while 22/35 (63%) acknowledged partly implementing AMS activities in their daily routine. The primary barrier was lack of expertise, while the main motives were reducing antimicrobial resistance and optimizing patient care. The provision of guidelines was regarded as more important than feedback on their prescription behavior. Exam performance improved from the initial to the final exam on all topics. Conclusion: Customized AMS training courses are a feasible and potentially complimentary tool to address antibiotic misuse in the primary-care setting.

Rheumatology nurses' perceptions of undertaking a postgraduate education programme: A phenomenological study.

BACKGROUND: The expansion of the role of the rheumatology nurse specialist led to the instigation, in 1999, of the first Masters programme in rheumatology nursing, with the aim of supporting clinical advancement with evidence-based practice. This study explored the experience of rheumatology nurses undertaking postgraduate study at Masters level. OBJECTIVES: (1) To explore the perceptions and experiences of clinical nurse specialists undertaking a Masters programme in Rheumatology Nursing, including perceptions of impact. (2) To identify future educational needs. METHODS: Ten rheumatology nurses who had completed a Masters degree in rheumatology nursing participated in a semi-structured video link or telephone interview conducted between 17th March 2021-17th May 2021. Interpretive phenomenological analysis was undertaken by two researchers and two public contributors. RESULTS: Four themes were identified: (i) Increased confidence and the development of new clinical skills. (ii) The perceived impact on the organisation; (iii) Benefits of face-to-face learning; and (iv) Continuing evolution of the rheumatology nurse specialist role. Participants reported increased confidence in clinical skills and felt that their learning had benefited their employing organisation. However, lack of time and insufficient managerial support could impede the implementation of new skills. Learning examination techniques, engagement in learning and peer support were seen as advantages of face-to-face learning. Future educational needs focused on diagnostic and prescribing skills. CONCLUSIONS: Participant learners perceived that completing a face-to-face Masters in rheumatology increased confidence in delivering new clinical skills and fostered peer networks, whilst also benefiting their employing organisations. There is a need for organisational support to apply learning to the clinical setting.