An Interactive, Case-Based Workshop on the Patient Experience for Internal Medicine Residents.

Introduction: The technological revolution has narrowed the information gap between physician and patient. This has led to an evolution in medicine from paternalistic to patient-centric, with health care systems now prioritizing patient experience to achieve higher satisfaction scores. Therefore, it is imperative to start early in educating trainees on how to best address the holistic needs of the patient while also delivering high-quality care. Methods: We implemented a 1-hour workshop that was repeated weekly over 8 weeks to capture all internal medicine residents in our program. During the workshop, we reviewed the historical evolution of patient care from paternalistic to patient-centered, presented the Hospital Consumer Assessment of Healthcare Providers and Systems survey questions, and discussed evidence-based strategies for physicians to improve their patients' experience utilizing four case-based scenarios. Results: Over the 8-week period, a total of 195 residents participated in the workshop. One hundred thirty-nine residents (71%) completed the pre- and postsession survey. Results demonstrated significant knowledge improvement (p < .001) in all of the topics discussed. Additionally, the majority of residents felt the workshop would be useful in their clinical practice and found the clinical scenarios useful. Discussion: Given the evolution towards patient-centered care, it is important to take a proactive approach in providing residents with the tools to best address their patients' needs. Early understanding of patient satisfaction surveys and the impacts they have on hospital metrics can help trainees in their careers as practicing physicians.

Integrating Evidence-Based Screening, Brief Intervention, and Referral to Treatment Into a Family Nurse Practitioner Program.

PROBLEM STATEMENT: Substance use disorder (SUD)-and more specifically opioid use disorder-is a national epidemic. With the increasing amounts of people suffering from SUD, all healthcare professionals should be educated to identify substance abuse, provide a brief intervention, and refer patients for treatment when indicated. PURPOSE: The purpose of this project is to integrate the SBIRT into the curriculum of a graduate-level family nurse practitioner (FNP) program in southeastern Pennsylvania and to determine if educating FNP students on the SBIRT process increases their knowledge of SUDs and their treatment and increases their motivation to work with patients with SUD. MEASUREMENTS: The measurements used were as follows: shortened Alcohol and Alcohol Problems Perception Questionnaire (S-AAPPQ), shortened Drug and Drug Problems Perception Questionnaire (S-DDPPQ), a 10-question knowledge test, and demographic data. RESULTS: All subscales of the S-DDPPQ, the S-AAPPQ, and the knowledge test showed a statistically significant change from the pretest score means and to posttest means. This evidence-based practice project supports the integration of SBIRT education into FNP programs to increase their ability to identify and treat individuals with SUDs.

Integrative nursing in the Brazilian northeast: introduction, potential, and challenges.

OBJECTIVE: to describe the introduction, potential, and challenges experienced by nurses in the provision of Integrative and Complementary Health Practices in the northeast f Brazil. METHOD: A qualitative study conducted from June to December 2022 with 15 northeastern nurses qualified in Integrative and Complementary Practices. The data were produced through individual online interviews and submitted to content analysis. RESULTS: 15 nurses participated, and 23 integrative practices were cited, with a predominance of auriculotherapy, greater introduction in primary care and private nursing offices, highlighting labor and personal benefits. Their potential includes technical qualification for the practice and interest in continuing education. The hospital-centric view of professionals, the low diffusion on the theme in teaching, as well as the difficulty in pricing procedures and in developing clinical reasoning in other medical rationalities were cited as the main challenges. CONCLUSION: Despite the challenges still faced, northeastern nurses are offering integrative practices to complement user care.

Contemporary Training in American Critical Care Cardiology: Minnesota Critical Care Cardiology Education Summit: JACC Scientific Expert Panel.

This consensus statement emerges from collaborative efforts among leading figures in critical care cardiology throughout the United States, who met to share their collective expertise on issues faced by those active in or pursuing contemporary critical care cardiology education. The panel applied fundamentals of adult education and curriculum design, reviewed requisite training necessary to provide high-quality care to critically ill patients with cardiac pathology, and devoted attention to a purposeful approach emphasizing diversity, equity, and inclusion in developing this nascent field. The resulting paper offers a comprehensive guide for current trainees, with insights about the present landscape of critical care cardiology while highlighting issues that need to be addressed for continued advancement. By delineating future directions with careful consideration and intentionality, this Expert Panel aims to facilitate the continued growth and maturation of critical care cardiology education and practice.

Learning curves of novice residents on cataract surgery simulator: the E3CAPS pedagogic study.

INTRODUCTION: Training novice ophthalmology residents on the EyeSi® simulator increases cataract surgery safety. However, there is no consensus regarding how much training residents should perform before their first time on patients. We evaluated the French national training program through the analysis of the learning curves of novice residents. METHODS: This prospective multicentric pedagogic study was conducted with French novice residents. Each resident completed the recommended four two-hour training sessions and performed a standardized assessment simulating standard cataract surgery before the first session (A0), at the end of the first (A1), second (A2), third (A3) and fourth (A4) sessions. For each surgical step of each attempt, the following data were collected: score, odometer, completion time, posterior capsular rupture and cumulative energy delivered (ultrasounds) during phacoemulsification. A performance threshold was set at a score of 80/100 for each surgical step, 400/500 for the overall procedure. Only descriptive statistics were employed. RESULTS: Sixteen newly nominated ophthalmology residents were included. Median score progressively increased from 95 [IQR 53; 147]) at A0 to 425 [IQR 411; 451] at A4. Despite a significant progression, the "emulsification" step had the lowest A4 scores 86 [IQR 60; 94] without reduction in completion time, odometer or ultrasounds delivered. The rate of posterior capsular rupture decreased linearly from 75% at A0 to 13% at A4 during "emulsification" and from 69 to 0% during "irrigation and aspiration". At A4, only 25% [8; 53] of residents had > 80 at each step and only 75% [47; 92] had > 400/500 overall. CONCLUSION: A training program consisting of four two-hour sessions on the EyeSi simulator over four consecutive days effectively enhances the surgical skills of novice ophthalmology residents. Undergoing more training sessions may improve scores and decrease the incidence of surgical complications, particularly at the emulsification step of cataract surgery. The learning curves presented here can reassure residents who are progressing normally and help identify those who need a further personalized training program.  TRIAL REGISTRATION: ClinicalTrials registration number: NCT05722080 (first submitted 22/12/2022, first posted 10/02/2023).

The requirements of providing health education for rural people through electronic methods: the experiences and perspectives of community health workers.

BACKGROUND: Reliance solely on traditional approaches in health education is no longer considered sufficient, and electronic/digital education can be a complementary approach. Implementing electronic methods in health education requires identifying the requirements from the perspective of the service providers. Therefore, this study aimed to elucidate the experiences and perspectives of community health workers (Behvarzan) regarding the requirements for providing health education for rural people through electronic/digital means. METHODS: This descriptive qualitative study was conducted in 2022 at Alborz University of Medical Sciences. Data were collected through semi-structured interviews with 14 Behvarzan from Health Houses (HH) in Karaj City. The data were analyzed using the inductive Elo & Kyngas approach and conventional content analysis facilitated with MAXQDA software. RESULTS: After analyzing the results, we extracted 139 open codes, and by merging them for more precise coding and to facilitate the research process, we formed three main themes and ten subthemes. The themes included Technology (technical infrastructure, content production, content delivery methods, and content delivery channels), Facilities and equipment (communication equipment and electronic content repositories), and Stakeholders (training of providers, motivating providers, persuading learners and target groups, and reference groups). CONCLUSION: From the perspective of rural healthcare workers, the implementation of electronic education requires necessary technology, equipment, facilities, processes, and content should be pursued and provided through specialized working groups, extending from the Ministry of Health and Medical Education to local HHs. These resources should be available to the healthcare workers and their target populations. Concurrently, educational programs and incentives should be defined and offered at the university level and within health networks for rural healthcare workers and their populations.

Undergraduate dental sleep medicine teaching at German university dental schools - a questionnaire-based survey.

PURPOSE: Diagnosing and treating obstructive sleep apnea (OSA) requires fundamental understanding of sleep medicine, including training and clinical experience. So far, dental sleep medicine (DSM) has not yet become a mandatory part of dental education in Germany. This questionnaire-based survey for both lecturers and students aimed to evaluate DSM education among undergraduate students. METHODS: A structured questionnaire was sent to the managing directors and student councils of all 30 German university dental schools. The questionnaire contained 13 questions on teaching quantity and content, lecturers' knowledge, and future interest in DSM. For each university dental school, only one questionnaire should be completed by the student council and the managing director. A scoring system assessed lecturers' knowledge based on clinical experience and qualifications. Descriptive data and correlation coefficients were calculated (P < 0.05). RESULTS: The responses of 24 lecturers (80%) and 28 students (93.3%) could be evaluated. DSM was reported to be included in the curriculum by 14 lecturers (58.3%) and 4 students (14.3%). Mean teaching hours per semester were 1.4 ± 1.4 h (lecturers) and 0.2 ± 0.6 h (students) accordingly. Greater knowledge of lecturers in DSM was positively correlated with the inclusion of DSM in the curriculum (P = 0.022) and with the number of teaching hours per semester (P = 0.001). CONCLUSION: Postgraduate education and incorporating DSM knowledge into undergraduate education ("Teach the Teacher") seems to play a key role in fundamentally training future dentists in this field.

The efficacy of simulation-based learning versus non-simulation-based learning in endocrinology education: a systematic review and meta-analysis.

BACKGROUND: Simulation-Based Learning (SBL) is increasingly adopted in medical education across various specialties, employing realistic simulations to significantly enhance learning experiences. However, a comprehensive evaluation of its effectiveness specifically in endocrinology has not yet been conducted. The study aims to systematically review and meta-analyze the impact of SBL versus Non-Simulation-Based Learning (NSBL) on knowledge acquisition, skills, satisfaction, and interest in learning among endocrinology trainees. METHODS: This systematic review and meta-analysis adhered to the PRISMA guidelines, searching PubMed, Web of Science, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang Data, Weipu, and Chinese Biomedical Database (CBM) until March 2024. We included randomized controlled trials comparing SBL to NSBL in endocrinology education. The quality evaluation relied on the Cochrane risk-of-bias assessment tool. The main results included evaluations from both theoretical and practical assessments. Additional measures consisted of assessing satisfaction and interest in learning. RESULTS: We identified 22 studies suitable for systematic review and 21 for meta-analysis, involving a total of 2517 participants. SBL greatly enhanced theoretical knowledge [standardized mean difference (SMD) = 1.00, 95% confidence interval (CI): 0.68-1.32, P < 0.00001, I2 = 89%] and practical skills (SMD = 1.56, 95% CI: 1.11-2.01, P < 0.00001, I2 = 93%) compared to NSBL. Additionally, SBL was associated with higher satisfaction and greater interest in learning. No significant publication bias was detected, and sensitivity analysis confirmed the stability of these findings. CONCLUSIONS: SBL significantly enhances knowledge, skills, satisfaction, and interest in learning within endocrinology education compared to NSBL. These findings support the integration of high-quality SBL into endocrinology curricula to improve educational outcomes. Future research should explore the lasting effects of SBL on knowledge retention and clinical practice, as well as to evaluate its cost-effectiveness and compatibility with various educational tools in diverse settings.

Understanding the role of a general education course Oral Science in establishing oral health knowledge and behaviors among undergraduate students from different majors: a questionnaire-based study.

BACKGROUND: The general education course, Oral Science, has been offered by Guanghua School of Stomatology, Sun Yat-sen University for many years in order to improve students' knowledge of oral health. Information about the oral health knowledge, status, and behaviors among undergraduates who had taken Oral Science was collected to evaluate the impact of this course, and to provide a basis for further improvement of the course teaching quality. METHODS: Undergraduates taking Oral Science as an elective course were selected as the research subjects. The research time is the second semester of the 2022 academic year, from February 2023 to June 2023. Undergraduates who had not taken the course served as the control group. To investigate the oral health knowledge, status, and behaviors among undergraduate students who have taken the general education course of Oral Science, course students and non-course students were asked to fill out the same questionnaire at both the beginning and end of semester. The answer scores and accuracy of these two groups were compared and analyzed. Before and after the first lesson, and at the end of the semester, course students were asked to fill out the same oral knowledge questionnaire. Another questionnaire was released in week 10 to collect the data of the course students' oral health status and behaviors. The control group completed the same oral knowledge questionnaire at the beginning and end of the semester, respectively. SPSS 20.0 statistical software was used to analyze the data. Statistical significance level was set at 0.05 for all tests. RESULTS: At the beginning of the semester, there was no significant difference in the accuracy of the 16 questions nor the scores between two groups (P > 0.05). After one semester of learning, the accuracy of the 16 questions answered by the course students at the end of the semester was significantly higher (P < 0.05), as well as the score of the course students. CONCLUSION: The general education course of Oral Science can significantly improve undergraduates' general knowledge of dentistry and effectively improve their oral hygiene behavior.

Presentation skills teaching in anaesthesia.

Presentation is a communication method to convey information within a specific time, involving judgment, decision-making and critical thinking. Incorporation of teaching- learning-assessment of presentation skills is essential in medical curriculum because medical education involves presentations such as case reports, seminar, and conferences. The presentation skills equip 'the future doctors' to be at par with the ever-advancing world of technology, artificial intelligence and globalisation. The presentations should involve effective constructive feedback to enhance the effectiveness of presentation skills in medical curriculum.

Improving Endoscopy Nursing Staff's Patient Management Through the Implementation of an Education Initiative.

Endoscopic procedure areas have high-volume, fast-paced work environments. This practice requires a diverse range of knowledge and skills that are continuously changing with the evolution of high-acuity procedures and the shift toward routine use of anesthesia services. Endoscopy nursing staff have recently shown higher levels of stress and emotional exhaustion than their colleagues in similar practice settings. Patient management and recovery from anesthesia are identified by this group of nurses as a perceived stressor with high priority for improvement in competencies. Standardized education in collaboration with anesthesia services regarding these topics does not exist. As an improvement initiative, a standardized education guide was developed and implemented in an urban endoscopy unit situated within a Level 1 trauma center to improve nursing staff's patient management, knowledge, and readiness. Nursing knowledge was evaluated before and after the delivery of an educational presentation. Results demonstrated a substantial improvement in nursing knowledge and preparedness for complex procedures and high-acuity patients. Implementation of a similar standardized endoscopy nursing education guide has the potential to positively impact endoscopy nursing staff's knowledge and preparedness related to complex endoscopy patient care delivery, possibly relieving a source of stress for endoscopy staff and improving patient safety.

Development and Implementation of an Evidenced-Based Practice (EBP) Educational Program for a Multidisciplinary Rehabilitation Department.

OBJECTIVE: Describe the development and implementation of an evidence-based practice (EBP) training program for occupational and physical therapists in a large pediatric hospital. CONTEXT: EBP is valued, but a known knowledge-to-practice gap between academic training and clinical practice limits routine use. This gap was addressed through an academic-clinical partnership to develop an EBP training program. RESULTS: Sixty-one therapists completed the program. Therapists demonstrated improved EBP skills, knowledge, and confidence following training and a positive trend in change score for clinical outcomes and decision-making scores was noted. CONCLUSION: Academic-clinical partnerships have a unique and valuable role to support professional EBP knowledge and skill development. Stakeholder support and engagement supported program development, execution, and meaningful outcomes. IMPACT STATEMENT: The knowledge-to-practice gap for EBP is a challenge to regular EBP use. The described program addressed this challenge and improved therapists' knowledge, skills, and confidence. It provides a model for professional development.

The Transformative Care Continuum: implementing an accelerated pathway that addresses the new roles of the family medicine physician.

BACKGROUND: The Transformative Care Continuum (TCC) emerged in 2018 at Ohio University's Heritage College of Osteopathic Medicine, combining a three-year medical education track with a three-year family medicine residency. TCC aligns evolving family physician roles through the Kern model, AMA's Master Adaptive Learner model, Health Systems Science Training, and Kirkpatrick's evaluation model. METHODS: The TCC curriculum emphasizes intensive coaching, clinical encounter video evaluation, reflection, and case-log review. It fosters longitudinal clinical integration, community engagement, and a dynamic learning atmosphere. Students receive rigorous patient-centered communication training and engage in residency-based quality improvement projects, targeting care gap closure and community health in an accelerated 3-year program. OUTCOMES: Assessment of TCC graduates demonstrates advanced team communication, leadership, and project management skills, with entrustable professional activities (EPA) scores meeting or surpassing those of traditional program graduates. Projects led by students have yielded notable clinical enhancements, national recognition, and significant philanthropic funding for non-medical determinants of health. Finally, there is an overall increase in scholarly activity and leadership roles within the residency programs that have engaged these students. DISCUSSION: Lessons reveal intrinsic challenges and heightened academic demands for students and residency programs. Additional educational support for students may be necessary, though costly. Limitations in residency slots and faculty availability as student educators potentially hinder scalability. Ongoing faculty training, cultural support, and early integration of digital systems for curriculum management and evaluation are vital for success. Obtaining patient satisfaction, health outcomes, and program measures remains challenging due to privacy concerns and approval processes between institutions. CONCLUSION: Programs like TCC effectively prepare students for family physician leadership and change management roles through tailored learning, longitudinal experiences, health systems training, and addressing critiques of traditional medical education. Continuous feedback and robust communication strategies are essential for program improvement, fostering well-prepared family physicians committed to health system enhancement.

Facilitating positive emotions in people with challenges by combining conventional occupational training and a novel farming program: a feasibility study.

OBJECTIVE: Japan has a system of occupational therapy programs known as self-reliance training (training for daily living), which helps people with various disabilities lead more meaningful lives. Recently, it has been shown that green care farms are beneficial for dementia care and that agricultural and horticultural work has a positive impact on people with intellectual disabilities and mental disorders. This study examined the health-improving effects of farm activities and developed an attractive program for adolescents with developmental and intellectual disabilities who use independent training facilities. The program comprised agricultural and horticultural activities such as vegetable cultivation and management, flower planting, and flower arrangement. RESULTS: No significant differences were observed in any of the measures for positive mood before and after the usual program (UP). However, anger-hostility and depression-dejection improved significantly after the farm program (FP) (p < .05). Self-efficacy improved significantly after both UP and FP (p < .10). Free responses were obtained from UP (131 responses) and FP (126 responses) participants; thematic analysis of FP participants' statements revealed that positive comments included "confidence in accomplishing tasks," "anticipation and joy of growing plants," and "motivation for gardening activities."

The background and experience of neuroscience teachers in Australian universities: A cross-sectional survey.

Neuroscience is an academic discipline taught within a broad range of university degrees and programs. The expertise and experience of neuroscience teaching staff contribute to the student's learning experience and knowledge acquisition. We undertook a survey to characterize the neuroscience teaching workforce and practices in Australian universities, and to investigate access to and deficiencies in neuroscience teaching resources and training. Two hundred neuroscience teaching staff completed our anonymous online survey. The responses indicated that neuroscience is primarily being delivered by highly qualified (86% with doctoral degrees, 27% with formal qualifications in tertiary teaching), research-active (45% were recently primary supervisors of research students) teaching academics with secure employment (77% in full-time continuing positions). There were more females (61.5%) than males (38.5%) in the sample and most respondents taught neuroscience to students enrolled in a range of degrees/programs. Most survey respondents could access an anatomy laboratory for teaching (87%) but access to specialised online resources, such as augmented reality presentations, customised game-based learning approaches, and/or online brain atlases, was limited. Most survey respondents reported they would benefit from increased access to neuroscience teaching resources and/or peer-tested teaching materials (80%), an informal network of Australian neuroscience teaching peers (64%), and/or training workshops on neuroscience teaching (59%). Approximately half of survey respondents supported the creation of national guidelines for neuroscience teaching curricula. The survey results identify specific gaps in teacher training and resources and inform the development of strategies to support tertiary teachers of neuroscience and student learning.

Assessment of ChatGPT-4 in Family Medicine Board Examinations Using Advanced AI Learning and Analytical Methods: Observational Study.

Background: This research explores the capabilities of ChatGPT-4 in passing the American Board of Family Medicine (ABFM) Certification Examination. Addressing a gap in existing literature, where earlier artificial intelligence (AI) models showed limitations in medical board examinations, this study evaluates the enhanced features and potential of ChatGPT-4, especially in document analysis and information synthesis. Objective: The primary goal is to assess whether ChatGPT-4, when provided with extensive preparation resources and when using sophisticated data analysis, can achieve a score equal to or above the passing threshold for the Family Medicine Board Examinations. Methods: In this study, ChatGPT-4 was embedded in a specialized subenvironment, "AI Family Medicine Board Exam Taker," designed to closely mimic the conditions of the ABFM Certification Examination. This subenvironment enabled the AI to access and analyze a range of relevant study materials, including a primary medical textbook and supplementary web-based resources. The AI was presented with a series of ABFM-type examination questions, reflecting the breadth and complexity typical of the examination. Emphasis was placed on assessing the AI's ability to interpret and respond to these questions accurately, leveraging its advanced data processing and analysis capabilities within this controlled subenvironment. Results: In our study, ChatGPT-4's performance was quantitatively assessed on 300 practice ABFM examination questions. The AI achieved a correct response rate of 88.67% (95% CI 85.08%-92.25%) for the Custom Robot version and 87.33% (95% CI 83.57%-91.10%) for the Regular version. Statistical analysis, including the McNemar test (P=.45), indicated no significant difference in accuracy between the 2 versions. In addition, the chi-square test for error-type distribution (P=.32) revealed no significant variation in the pattern of errors across versions. These results highlight ChatGPT-4's capacity for high-level performance and consistency in responding to complex medical examination questions under controlled conditions. Conclusions: The study demonstrates that ChatGPT-4, particularly when equipped with specialized preparation and when operating in a tailored subenvironment, shows promising potential in handling the intricacies of medical board examinations. While its performance is comparable with the expected standards for passing the ABFM Certification Examination, further enhancements in AI technology and tailored training methods could push these capabilities to new heights. This exploration opens avenues for integrating AI tools such as ChatGPT-4 in medical education and assessment, emphasizing the importance of continuous advancement and specialized training in medical applications of AI.

Multiple Addictions and Psychoeducation: What Standardisation Is Possible in Liaison Psychiatry?

BACKGROUND: In liaison psychiatry, issues related to multiple substance use disorders are encountered, but systematic assessment and treatment protocols are lacking. The implementation of psychoeducation groups with earlier access could be one solution, but it raises the question of how to systematically approach psychoeducation for multiple substance use disorders. SUBJECT AND METHOD: Based on a narrative review of multiple substance use disorders in liaison psychiatry and the proposed treatments, we aimed to identify the possible systematisation of standardised psychoeducation. RESULTS: The triadic model of interoception-impulsivity-addiction emerged as a general approach to addressing addiction issues and could serve as a foundation for the standardisation of psychoeducation. CONCLUSION: Prospective studies on the impact of systematised brief psychoeducational interventions on multiple substance use disorders in the patient treatment plan are to be developed.