A Hypothesis-Driven, Near-Peer Physical Diagnosis Module on Streptococcal Pharyngitis Within the Pediatrics Clerkship.

Introduction: In busy clinical settings, there is limited time to teach physical examination (PE) and procedural skills, particularly when the traditional head-to-toe PE approach is time-consuming. Near-peer teaching of a more efficient approach, the hypothesis-driven PE (HDPE), increases students' learning opportunities. We developed a near-peer HDPE module to improve medical student confidence, knowledge, and skills for diagnosing and managing streptococcal pharyngitis. Methods: During this 1-hour module, residents taught the diagnostic approach for a patient with sore throat and facilitated small groups for practicing PE and throat swab skills. We assessed students using pre- and postmodule surveys including Likert-scale confidence scores (1 = not at all confident, 5= extremely confident), multiple-choice knowledge questions, and a skills rubric. A control group was surveyed at clerkship conclusion. Results: Of the 71 pediatric clerkship students who participated, 69 (97%) completed premodule surveys and 65 (91%) completed skills assessments. Twenty-eight (39%) completed postmodule surveys and skill assessments. After participation, students' survey responses and rubrics indicated significant increase in confidence (Mdn pre = 2 [IQR = 1,2], Mdn post = 4 [IQR = 4,5]; p < .001), knowledge (M pre = 40%, M post = 77%; p < .001), and skills (M pre = 5.3, M post = 7.5; p < .01). Participating students also had significantly higher confidence (p < .005) and knowledge (p < 0.01) compared to the control group. Discussion: This near-peer HDPE module improved students' knowledge, confidence, and skills related to streptococcal pharyngitis diagnosis and management and achieved compliance for a required clerkship skill.

The perceived long-term impact of peer teaching in the skills lab. A descriptive interview study.

Teaching is an essential skill for future doctors. Peer-assisted learning (PAL)-where students take up a teaching role at an early stage of their training-is widely used in medical curricula. No studies have explored the long-term perceived impact of peer teaching. Therefore, we aimed to determine how former peer teachers reflected on PAL and its perceived long-term impact. In this longitudinal descriptive study, we conducted 42 semi-structured interviews with 11 former peer teachers at the University of Antwerp. Five of them were interviewed 6 months after PAL; 6 of them 9 years after PAL. This latter group was also interviewed during PAL in a previous study. We conducted secondary analyses of previously collected interviews, consistently comparing the findings with new data gathered from the current interviews. Using realist thematic analysis, topic summary themes were generated. Former peer teachers reflected on their PAL experience with a lot of satisfaction. Those meanwhile working as residents are still passionate about teaching. Peer teachers experienced a gain in clinical examination- and professional skills in the long-term, facilitating a smoother transition to their internship. Our findings suggest that PAL selects diverse but committed students. The longitudinal data demonstrate how PAL initiates or stimulates different skills in diverse students, including public speaking, teaching, time management, and self-efficacy in specific clinical skills. Regarding the chicken-and-egg question, our study encompasses both longitudinal cases illustrating the pre-existing skill theory and cases demonstrating how achieved competences were induced by PAL. Former peer teachers experienced long-term benefits of PAL, which eased their transition into the internship. PAL has the potential to ignite a lasting passion for teaching, providing diverse and unique learning opportunities not only for the most talented and 'pre-selected' medical students but also for a range of dedicated future clinicians.

Low-Cost, Scalable Simulations in Obstetric Trauma and Resuscitative Hysterotomy for Emergency Medicine Residents.

Introduction: Simulation-based learning is essential for health care providers to prepare for rare obstetric emergencies, such as severe trauma and maternal cardiac arrest. These situations demand rapid and prompt actions, often testing the skill of emergency physicians. Resuscitative hysterotomy (RH), a critical procedure in maternal cardiac arrest, requires technical expertise, coordination, and anatomical knowledge. The high cost of commercial trainers and complex existing models restricts accessibility. This resource introduces a low-cost anatomically accurate RH task trainer and assesses its effectiveness in improving skills and confidence among trainee emergency physicians. Methods: A 20-minute-long case scenario depicted the resuscitation of a pregnant trauma patient with tension pneumothorax and uterine rupture, culminating in maternal cardiac arrest necessitating RH. Residents performed RH on the task trainer under faculty guidance. Feedback followed the Pendleton model, and an online questionnaire gauged the residents' experiences. Results: Thirty emergency medicine residents participated in the simulation. The questionnaire revealed positive responses, confirming the session's relevance and enhancement of clinical skills and confidence. Discussion: Our results underscore the RH task trainer's critical role in improving residents' skills and confidence during obstetric trauma simulations. Its realism and effectiveness were notably well received. Future refinements aim to augment fidelity while preserving affordability and integrating regular reinforcement sessions. This innovative educational approach equips health care professionals to respond adeptly to rare and challenging obstetric emergencies, ultimately elevating outcomes for mothers and infants during critical situations.

Can written prompts help medical residents to accurately monitor their own communication skills and those of others?

In healthcare, effective communication in complex situations such as end of life conversations is critical for delivering high quality care. Whether residents learn from communication training with actors depends on whether they are able to select appropriate information or 'predictive cues' from that learning situation that accurately reflect their or their peers' performance and whether they use those cues for ensuing judgement. This study aimed to explore whether prompts can help medical residents improving use of predictive cues and judgement of communication skills. First and third year Kenyan residents (N = 41) from 8 different specialties were randomly assigned to one of two experimental groups during a mock OSCE assessing advanced communication skills. Residents in the intervention arm received paper predictive cue prompts while residents in the control arm received paper regular prompts for self-judgement. In a pre- and post- test, residents' use of predictive cues and the appropriateness of peer-judgements were evaluated against a pre-rated video of another resident. The intervention improved both the use of predictive cues in self-judgement and peer-judgement. Ensuing accuracy of peer-judgements in the pre- to post-test only partly improved: no effect from the intervention was found on overall appropriateness of judgements. However, when analyzing participants' completeness of judgements over the various themes within the consultation, a reduction in inappropriate judgments scores was seen in the intervention group. In conclusion, predictive cue prompts can help learners to concentrate on relevant cues when evaluating communication skills and partly improve monitoring accuracy. Future research should focus on offering prompts more frequently to evaluate whether this increases the effect on monitoring accuracy in communication skills.

Lived Experiences and Perceptions of Autistic Young Adults Participating in Employment Readiness Skills Training.

This study aimed to examine the experiences and perceptions of participants engaged in an employment readiness program, Employment Preparation And Skills Support (EPASS), which is a manualized group-based training program designed to improve employment readiness among autistic young adults. A qualitative descriptive design was utilized to generate thick descriptions through semi-structured interviews with 22 transition-age autistic individuals (Mage = 20; 6 females; 16 males). Thematic analysis was employed to understand the experiences and career outcomes of transition-age autistic individuals pre- and post-participation in the EPASS program. Five main themes were identified: (1) More Negative Than Positive Employment-related Experiences; (2) Insight about Training Needs despite Hesitation to Participate; (3) Improved Perception and Confidence of Employment readiness through Experiential Learning; (4) Emerging Career Goals and Plans in Future Application of Knowledge and Skills; and (5) Learning Preference for More Interactive and Practice Experience. Participants reported a better understanding of job preparation skills, work-related social skills and interview etiquette. They also reported that what they learned in EPASS helped them improve their skills and confidence in obtaining and maintaining employment. Overall, participants expressed satisfaction with participating in EPASS and anticipated potential long-term impacts on their employability. This study sheds light on the training needs for transition-age autistic individuals and informs future employment readiness program development. Future studies should focus on collaborating with stakeholders to address training gaps and support needs that foster improved employment outcomes for this population.

Public safety personnel's perceptions of mental health training: an assessment of the Emotional Resilience Skills Training.

Public safety personnel (PSP) work experiences necessitate diverse and frequent exposures to potentially psychologically traumatic events (PPTEs) and other occupational stressors, which may explain the higher prevalence of mental health disorders and suicidal ideation among PSP relative to the general population. Consequently, PSP require emotional coping skills and evidence-informed mental health training to navigate arduous situations. The Emotional Resilience Skills Training (ERST) is a pilot 13-week mental health training program led by a peer and based on the robustly evidenced Unified Protocol for the Transdiagnostic Treatment of Mental Disorders. The study assessed whether PSP: perceived the ERST as improving their mental health or their management of stressors; applied the associated knowledge and skills; and would recommend ESRT to other PSP. Data were collected using a self-report survey and focus groups. A total of 197 PSP (58% male) completed a self-report survey and 72 PSP (33% female) participated in a sector-specific focus group to assess the ERST. The results indicate that PSP perceived ERST as helpful when applied. Almost all participants would recommend the training to other PSP. PSP expressed the ongoing need for mental health skills and knowledge, but also identified mental health training gaps during early-career training and stages.

The Efficacy of Prospective Memory and Metacognitive Skills Training in Improving the Cognitive Skills and the Quality of Life of Elderly Persons With Dementia.

Introduction Elderly people may experience a deterioration in cognitive function as part of natural aging, which impacts their ability to function independently. Dementia is often experienced by the elderly; their cognitive and memory deficits can limit independence and productivity. Metacognitive skills training can facilitate self-awareness and strategy use and may improve cognitive skills.  Aims and objectives  The article aimed to evaluate the effectiveness of prospective memory and metacognitive skills training in improving cognitive skills and quality of life for elderly persons with dementia.  Methods This was a quasi-experimental study that took place in Chennai city, India. Based on the criteria, a total of fifty (n = 50) elderly participants were selected and divided into control (n = 25) and experimental (n = 25) groups. The control group underwent conventional occupational therapy, whereas the experimental group underwent prospective memory and metacognitive skills training (PM and MST) over 36 sessions (three times/week, for 12 weeks). Outcome measures used were the mini mental status examination (MMSE) and quality of life - Alzheimer's disease (QOL-AD). Data were analyzed using the Mann-Whitney U test and Wilcoxon signed-rank test.  Results The results revealed that there were statistically significant (p-value < 0.05) differences between control and experimental groups. When compared to the control group, the experimental group had greater significant improvement in cognitive skills (MMSE, the control group's mean score was 20.94 and the experimental group's mean score was 30.94, p-value = 0.026), and quality of life (QOL-AD, the control group's mean score was 13.54 and the experimental group's mean score was 37.46, p-value = 0.000) after the implementation of a 12-week therapy program.  Conclusion This study concludes that PM and MST can be used as an effective intervention as it improves cognitive skills and quality of life among elderly persons with dementia.

Teaching trainees to implement functional communication training with multiple schedules: An evaluation of training effects and durability.

We evaluated the effects of behavioral skills training on improving participant implementation of functional communication training with multiple schedules when working with a confederate. Behavioral skills training produced mastery-level responding for all six participants who required training, providing the first empirically supported training for this functional communication training approach. Next, we assessed durability during training challenges with (a) procedural changes to the original protocol, (b) a novel confederate with different discriminative stimuli and reinforcers, and (c) relapsed confederate destructive behavior. Training effects degraded at least once for all participants and in 62% of training challenges, although continuing to expose the participant to the challenging situations or providing postsession booster training resolved the degradation in most cases. We discuss these findings in relation to their clinical implications and directions for future research.

Effectiveness of a structured life skills training program among Indian nursing students.

Nursing education programs increasingly emphasize the importance of life skills alongside clinical competencies to prepare students for the multifaceted demands of modern healthcare. However, there remains a gap in understanding the most effective strategies for integrating life skills into nursing curricula. Therefore, it is of interest to evaluate the impact of a structured life skills training program on first-year B.Sc. Nursing students' proficiency in selected life skills in Tamil Nadu, India. A true experimental pretest-posttest design was employed, with 257 first-year B.Sc. Nursing students from six selected colleges in Trichy district, Tamil Nadu, participating. The intervention, an eight-week Life Skills Training Program, was delivered to the experimental group, while the control group received no intervention. Data were collected using a self-administered questionnaire comprising socio-demographic variables and the Life Skills Assessment Scale. Statistical analysis included chi-square tests, one-way ANOVA repeated measures, and correlation analysis. Significant differences were observed between the experimental and control groups in various life skills, including self-awareness, empathy, interpersonal relationships, and creative thinking (p < 0.001). Age, place of stay, number of friends, hobbies, reason for choosing nursing, and interest in the course showed significant associations with pretest life skills scores (p < 0.05). Positive correlations were found between certain life skills, emphasizing their interconnectedness (p < 0.05). The structured life skills training program demonstrated effectiveness in enhancing the life skills proficiency of first-year B.Sc. Nursing students. The study underscores the importance of integrating life skills development into nursing education curricula to better prepare students for the complexities of patient care. Tailored interventions based on individual characteristics may further optimize outcomes. Future research should explore longitudinal effects and additional factors influencing life skills development among nursing students.

Skills on wheels: caregiver perspectives on the design and long-term impact of a pediatric wheelchair Skills training program.

Manual wheelchair skills training programs are novel developments, particularly in the United States. As perceived by the caregivers of participants, this study aimed to examine the long-term impact of the Skills on Wheels program on participants' occupational engagement and quality of life at home, at school, and in the community. Secondly, this study investigated the caregivers' perspectives of the program design of Skills on Wheels. This was a qualitative inquiry based upon thematic analyses of semi-structured interviews after participation in a pediatric wheelchair skills training program. The study participants were 9 caregivers whose children participated in this program over the 2021 and 2022 implementation years. Caregivers were given a 10-question semi-structured interview. The five overarching topics included program impact: (i) occupational engagement, (ii) program impact: quality of life factors, (iii) program resources/design, (iv) novelty/importance of program/wheelchair skills training, and (v) desired continued wheelchair skills practice in the future. Results provided tangible feedback to integrate into program design and supported the Skills on Wheels program's positive value as it relates to impact on quality of life and occupational engagement for participants.

Wheelchair skills training programs are important for children with disabilities to fill in service gaps related to community mobility.When developing community programs in general, it is necessary to gain the understanding of the impact on caregivers of children with disabilities.This paper provides insight into how a pediatric wheelchair skills training program is viewed by the caregivers of participating children.Therapists and researchers can see the caregiver impact of programs or training such as that described in this study.

Patient autonomy and shared decision-making in the context of clinical trial participation.

AIMS: This study aimed to explore how incorporating shared decision-making (SDM) can address recruitment challenges in clinical trials. Specifically, it examines how SDM can align the trial process with patient preferences, enhance patient autonomy and increase active patient participation. Additionally, it identifies potential conflicts between SDM and certain clinical trial aspects, such as randomization or blinding, and proposes solutions to mitigate these issues. MATERIALS AND METHODS: We conducted a comprehensive review of existing literature on patient recruitment challenges in clinical trials and the role of SDM in addressing these challenges. We analysed case studies and trial reports to identify common obstacles and assess the effectiveness of SDM in improving patient accrual. Additionally, we evaluated three proposed solutions: adequate trial design, communication skill training and patient decision aids. RESULTS: Our review indicates that incorporating SDM can significantly enhance patient recruitment by promoting patient autonomy and engagement. SDM encourages physicians to adopt a more open and informative approach, which aligns the trial process with patient preferences and reduces psychological barriers such as fear and mental stress. However, implementing SDM can conflict with elements such as randomization and blinding, potentially complicating trial design and execution. DISCUSSION: The desire for patient autonomy and active engagement through SDM may clash with traditional clinical trial methodologies. To address these conflicts, we propose three solutions: redesigning trials to better accommodate SDM principles, providing communication skill training for physicians and developing patient decision aids. By focussing on patient wishes and emotions, these solutions can integrate SDM into clinical trials effectively. CONCLUSION: Shared decision-making provides a framework that can promote patient recruitment and trial participation by enhancing patient autonomy and engagement. With proper implementation of trial design modifications, communication skill training and patient decision aids, SDM can support rather than hinder clinical trial execution, ultimately contributing to the advancement of evidence-based medicine.

Integrating international Chinese visualization teaching and vocational skills training: leveraging attention-connectionist temporal classification models.

The teaching of Chinese as a second language has become increasingly crucial for promoting cross-cultural exchange and mutual learning worldwide. However, traditional approaches to international Chinese language teaching have limitations that hinder their effectiveness, such as outdated teaching materials, lack of qualified instructors, and limited access to learning facilities. To overcome these challenges, it is imperative to develop intelligent and visually engaging methods for teaching international Chinese language learners. In this article, we propose leveraging speech recognition technology within artificial intelligence to create an oral assistance platform that provides visualized pinyin-formatted feedback to learners. Additionally, this system can identify accent errors and provide vocational skills training to improve learners' communication abilities. To achieve this, we propose the Attention-Connectionist Temporal Classification (CTC) model, which utilizes a specific temporal convolutional neural network to capture the location information necessary for accurate speech recognition. Our experimental results demonstrate that this model outperforms similar approaches, with significant reductions in error rates for both validation and test sets, compared with the original Attention model, Claim, Evidence, Reasoning (CER) is reduced by 0.67%. Overall, our proposed approach has significant potential for enhancing the efficiency and effectiveness of vocational skills training for international Chinese language learners.

A study on the impact of open source metaverse immersive teaching method on emergency skills training for medical undergraduate students.

BACKGROUND: In recent years, the traditional simulation-based medical teaching approach has faced challenges in meeting the requirements of practical emergency medicine education. This study utilized open-source tools and software to develop immersive panoramic videos using virtual reality technology for emergency medical teaching. It aims to investigate the efficacy of this novel teaching methodology. This transformation shifted the focus from physical simulation to virtual simulation in medical education, establishing a metaverse for emergency medical teaching. METHODS: In accordance with the curriculum guidelines, the instructors produced panoramic videos demonstrating procedures such as spinal injury management, humeral fracture with abdominal wall intestinal tube prolapse, head and chest composite injuries, cardiopulmonary resuscitation, and tracheal intubation. Using Unity software, a virtual training application for bronchoscopy was developed and integrated into the PICO4 VR all-in-one device to create a metaverse teaching environment. Fourth-year medical undergraduate students were allocated into either an experimental group (n = 26) or a control group (n = 30) based on student IDs. The experimental group received instruction through the metaverse immersive teaching method, while the control group followed the traditional simulation-based medical teaching approach. Both groups participated in theoretical and practical lessons as usual. Subsequently, all students underwent a four-station Objective Structured Clinical Examination (OSCE) to assess the effectiveness of the teaching methods based on their performance. Additionally, students in the experimental group provided subjective evaluations to assess their acceptance of the new teaching approach. RESULTS: Before the training commenced, there were no significant statistical differences in the first aid test scores between the experimental and control groups. Following the training, the experimental group outperformed the control group in the four-station OSCE examination, with all P-values being less than 0.05. The satisfaction rate among the experimental group regarding the new teaching method reached 88.46%, reflecting levels of satisfaction and extreme satisfaction. CONCLUSION: The open-source metaverse immersive teaching method has demonstrated a positive impact on enhancing the emergency skills of medical undergraduate students, with a high level of acceptance among students. In comparison to traditional simulated medical teaching methods, this approach requires less time and space, incurring lower costs, and is deemed worthy of wider adoption.

Educating Hematology-Oncology Fellows About How to Communicate with Patients About Clinical Trials: A Needs Assessment.

Objectives: Only 5-8% of adults with cancer participate in cancer clinical trials (CCTs), with even lower rates among underrepresented groups. Improving oncologists' communication skills may enhance the frequency and quality of their discussions with patients about CCTs, consequently increasing participation. However, little is known about interest in or presence of CCT-related communication training during Hematology-Oncology (Hem-Onc) fellowships. This study aimed to describe, from the perspective of Hem-Onc fellowship program directors (PDs): (1) the current landscape of CCT education for Hem-Onc fellows; (2) the acceptability and feasibility of implementing a CCT communication skills workshop for Hem-Onc fellows. Methods: We used an explanatory sequential mixed-methods approach. PDs were surveyed and interviewed about their graduate medical education (GME) programs' current CCT curriculum, training challenges, fellows' CCT knowledge and CCT communication skills, and preferences for a CCT communication workshop. Results: PDs were surveyed (n = 40) and interviewed (n = 12). PDs reported that their institutions prioritize CCT accrual (M = 4.58, SD = .78; 1-5 scale, 5 = "Strongly Agree") and clinical research training (M = 4.20, SD = .85). CCT skills that programs least often addressed were how to (1) discuss CCTs with newly diagnosed patients, (2) talk to patients about CCTs when none are available, and (3) help patients find CCTs at other institutions. PDs were interested in a CCT communication workshop for fellows ("yes" = 67.5%, "maybe" = 32.5%) and said training would be feasible (M = 4.28, SD = .78) and useful (M = 4.47, SD = .78). Qualitative results described programs' current approaches to CCT education and insights about developing and implementing CCT communication training. Conclusions: There is a clear need to improve CCT communication skills training in Hem-Onc fellowship programs and to implement and scale such training to increase CCT participation, especially among diverse patient populations. Furthermore, Hem-Onc GME PDs view such training as feasible and useful.

"Bring your worst": Residents' perspectives on video review of challenging patient communication as a learning tool.

Objective: To investigate residents' experiences recording and receiving feedback on a challenging video of a patient encounter. Methods: We used a qualitative design with first year residents who took part in a mandatory communication skills course in which all participants were asked to bring a challenging video of a patient encounter. The methods consisted of brief reflection texts and focus groups related to their perspectives on the use of challenging videos. Results: 106 residents wrote brief reflection texts, and 13 residents participated in four focus groups. Residents mainly expressed positive experiences with the challenging video exercise. Residents reported that the pressure to perform was felt to be less than on previous teaching sessions because the focus was on choosing an encounter which was less than perfect. They also reported that they appreciated the opportunity to see that other doctors were not performing optimally. Conclusion: The use of challenging videos as a teaching method for communication skills was experienced as encouraging by residents and facilitated enhanced learning. Innovation: We recommend adding more focus on challenging situations in video review. This could support learning by providing what our participants found to be a less daunting learning environment.

Behavioral skills training produces acquisition and generalization of run-blocking skills of high school football players.

Behavioral skills training (BST) has been used to improve football players' performance in one prior study, but limited data were collected on how the skill generalized from the training environment to the natural environment. The purpose of this study was to further evaluate the effects of BST in enhancing football players' performance while also evaluating the generalization of a skill taught in a training environment (i.e., practice) to the natural environment (i.e., game-simulated scrimmage). This study included five high school offensive line football players and recorded their run-blocking skills in the training context and a game context in baseline and following BST. The results showed that BST improved performance in the training environment, with run-blocking skills slightly generalizing from the training environment to game-simulated scrimmages. When BST was conducted in the natural environment, it further improved the participants' run-blocking skills.

Web-Based Coping Skills Training and Coach Support for Women Living With a Partner With an Alcohol Use Disorder: Randomized Controlled Trial.

BACKGROUND: Individuals living with a partner with an alcohol use disorder (AUD) can experience significant psychological distress and use health care more than those without a partner with an AUD. However, the prevailing treatment system's focus on the partner and personal barriers limit these individuals from getting help for themselves. Preliminary work on a self-directed, web-based coping skills training program, Stop Spinning My Wheels (SSMW), shows promise in broadening available treatments for this population. In this study, we conducted a robust evaluation of SSMW primary outcomes. OBJECTIVE: The study aims to test whether women with a partner with an AUD assigned to SSMW experienced a greater reduction in negative affect (depression and anger) (1) than a usual web care (UWC) control and (2) with brief phone coach support (SSMW+coach) rather than without (SSMW only) and (3) whether baseline negative affect moderated treatment effects. METHODS: Women (mean age 45.7, SD 10.8 years; Black: 17/456, 3.7%; White: 408/456, 89.5%) were randomized to SSMW only, SSMW+coach, or UWC. Depression (Beck Depression Inventory-II) and anger (State-Trait Anger Expression Inventory 2-State Anger) were assessed at baseline, 12-week posttest, and 6- and 12-month follow-ups. RESULTS: Participants in all conditions decreased in depression from baseline to posttest and from baseline to follow-up; SSMW-only and SSMW+coach participants decreased in anger, but UWC participants did not. Compared to UWC participants, SSMW-only participants experienced greater anger reduction (P=.03), and SSMW+coach participants experienced a greater reduction in depression (P<.001) from baseline to posttest. However, from baseline to follow-up, only a greater, but not statistically significant (P=.052), reduction in anger occurred in SSMW+coach compared to UWC. Although the SSMW conditions did not differ from each other in negative affect outcomes (P=.06-.57), SSMW+coach had higher program engagement and satisfaction (all P<.004). Baseline negative affect did not moderate effects, although remission from baseline clinically relevant depressive symptoms (Beck Depression Inventory≥14) was higher in SSMW only (33/67, 49%; odds ratio 2.13, 95% CI 1.05-4.30; P=.03) and SSMW+coach (46/74, 62%; odds ratio 3.60, 95% CI 1.79-7.23; P<.001) than in UWC (21/67, 31%); remission rates did not differ between the SSMW conditions (P=.12). CONCLUSIONS: The results partially supported the hypotheses. The SSMW conditions had earlier effects than UWC, but positive change in UWC mitigated the hypothesized long-term SSMW-UWC differences. The results highlight the importance of incorporating active controls in web-based clinical trials. Although SSMW+coach showed benefits over SSMW only on engagement and satisfaction measures and in the number needed to treat (5.6 for SSMW only; 3.2 for SSMW+coach), the SSMW conditions were comparable and superior to UWC on depressive symptom remission levels. Overall, SSMW with or without a coach can reduce clinically meaningful distress and add to available treatment options for this large, underserved group. TRIAL REGISTRATION: ClinicalTrials.gov NCT02984241; https://www.clinicaltrials.gov/study/NCT02984241.

Empathic communication skills training to reduce lung cancer stigma: Study protocol of a cluster randomized control trial.

BACKGROUND: Prior research demonstrates that nearly all (95 %) people with lung cancer (PwLC) report stigma, and approximately half (48 %) PwLC experience stigma during clinical encounters with oncology care providers (OCPs). When stigma is experienced in a medical context, it can have undesirable consequences including patients' delaying and underreporting of symptoms, misreporting of smoking behavior, and avoiding help-seeking such as psychosocial support and cessation counseling. Multi-level interventions are needed to prevent and mitigate lung cancer stigma. One promising intervention for reducing patient perception and experience of stigma is to train OCPs in responding empathically to patient emotions and promoting empathic communication within clinical encounters. METHODS: This paper describes the study protocol for a cluster randomized trial comparing Usual Care (waitlist control group) with Empathic Communication Skills (ECS) training (intervention group). For this study, we will recruit 16 community oncology practice sites, 9-11 OCPs per site, and 6 PwLCs per OCP. RESULTS: The goal of this trial is to investigate the effect of the ECS training on (a) OCP primary outcomes (communication and empathic skill uptake) and secondary outcomes (ECS training appraisal - relevance, novelty, clarity; self-efficacy, attitude towards communication with patients); and (b) patient-reported primary outcomes (lung cancer stigma), and secondary outcomes (perceived clinician empathy, satisfaction with OCP communication, psychological distress, social isolation, and appraisal of care). CONCLUSION: Findings from this trial will advance understanding of the effectiveness of the ECS training intervention and inform future provider-level training interventions that may reduce lung cancer stigma and improve cancer care delivery. CLINICALTRIALS: govIdentifier: NCT05456841.

A Multidisciplinary Curriculum to Standardize Chest Procedures Training for Trainees in General Surgery, Emergency Medicine, and Critical Care.

Introduction: Critical care, emergency medicine, and surgical trainees frequently perform surgical and Seldinger-technique tube thoracostomy, thoracentesis, and thoracic ultrasound. However, approaches to teaching these skills are highly heterogeneous. Over 10 years, we have developed a standardized, multidisciplinary curriculum to teach these procedures. Methods: Emergency medicine residents, surgical residents, and critical care fellows, all in the first year of their respective programs, underwent training in surgical and Seldinger chest tube placement and securement, thoracentesis, and thoracic ultrasound. The curriculum included preworkshop instructional videos and 45-minute in-person practice stations (3.5 hours total). Sessions were co-led by faculty from emergency medicine, thoracic surgery, and pulmonary/critical care who performed real-time formative assessment with standardized procedural steps. Postcourse surveys assessed learners' confidence before versus after the workshop in each procedure, learners' evaluations of faculty by station and specialty, and the workshop overall. Results: One hundred twenty-three trainees completed course evaluations, demonstrating stable and positive responses from learners of different backgrounds taught by a multidisciplinary group of instructors, as well as statistically significant improvement in learner confidence in each procedure. Over time, we have made incremental changes to our curriculum based on feedback from instructors and learners. Discussion: We have developed a unique curriculum designed, revised, and taught by a multidisciplinary faculty over many years to teach a unified approach to the performance of common chest procedures to surgical, emergency medicine, and critical care trainees. Our curriculum can be readily adapted to the needs of institutions that desire a standardized, multidisciplinary approach to thoracic procedural education.

The Role of Interprofessional Education in Optimizing Laparoscopic Skills Training: A Randomized Controlled Trial.

Background: This investigation evaluates the utility and benefits of integrating interprofessional education (IPE) into laparoscopic training, aiming to enrich medical education and skill acquisition methodologies. Methods: The study randomly allocated 36 participants of a 2023 laparoscopic training course into experimental and control groups, each comprising 18 individuals. The control group underwent traditional theory and practical training, whereas the experimental group additionally engaged in interdisciplinary instruction with nursing educators and participated in simulated laparoscopic surgery exercises. The effectiveness of this interdisciplinary approach was assessed by comparing laparoscopic theory and simulation performance, Objective Structured Assessment of Technical Skills (OSATS) scores in animal-based training, and course satisfaction between the groups. Moreover, the impact on interdisciplinary collaborative competencies was measured through pre- and post-training self-evaluations using the Interprofessional Collaborative Competency Attainment Survey (ICCAS) in the experimental group. Results: The experimental group demonstrated superior performance in laparoscopic theory and simulation, as well as higher OSATS scores, compared with the control group. Satisfaction ratings regarding the skills practice mode, effects, and instructional quality were also significantly better in the experimental group (P < .05, P < .01). Furthermore, participants in the experimental group reported significant pre-to-post training enhancements in interprofessional communication, team collaboration, role perception, conflict management, and learning and feedback marked by statistically significant differences (P < .05, P < .01). Conclusion: The introduction of an IPE framework significantly boosts laparoscopic training efficiency and promotes team collaboration awareness. This model effectively bridges gaps between disciplines, illustrating substantial applicative value and expansion potential within medical education and skill training arenas.