Barriers to Choosing Pediatrics as a Specialty: Insights From a Cross-Sectional Analysis.

BACKGROUND: The pediatric field in South Korea is experiencing a significant workforce crisis due to a sharp decline in pediatricians, exacerbated by a decrease in pediatric residents and a series of distressing incidents in pediatric healthcare institutions. No prior studies have explored the waning interest in pediatrics among South Korea's medical students and interns, which our research seeks to address during a pediatric workforce decline. This study aimed to investigate the declining interest in pediatrics among medical students and interns in South Korea amidst decreasing birth rates. We conducted a comprehensive survey to identify the factors deterring young medical professionals from pursuing a career in pediatrics. METHODS: In this cross-sectional study, in December 2023 we surveyed medical students and interns at Jeonbuk National University and Hospital using a 40-item electronically distributed questionnaire tailored to assess the factors influencing specialty choice, focusing on pediatrics. The participants were divided into the pre-clinical and clinical groups, allowing for analysis across educational stages. The survey covered demographics, perceptions of pediatrics, attitudes toward medical errors, and awareness of critical issues; it included a range of question types to ensure detailed and nuanced data collection. RESULTS: Our findings revealed a clear decrease in interest in pediatrics as medical students progressed through their education, with 86.69% displaying negative views. Although a sense of mission and emotional satisfaction from patient interactions were highlighted as positive influences, they were significantly countered by worries related to declining pediatric populations, legal challenges, and interactions with patient guardians. Additionally, 95.84% of the participants recognized the critical role of vital pediatric departments; however, litigation risks and psychological burdens substantially affected their willingness to specialize in these areas. The analysis also showed an increasing awareness of pediatric incidents as students advanced through their education; however, this did not directly correlate with their choice of specialty (P = 0.090). CONCLUSION: The results emphasize the necessity for targeted interventions to alleviate concerns and improve the attractiveness of pediatrics. These efforts are essential to counteract the declining interest and ensure a sustainable pediatric workforce for the future.

The effects of clinical learning environment and career adaptability on resilience: A mediating analysis based on a survey of nursing interns.

BACKGROUND: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. AIMS: To evaluate the resilience level of Chinese nursing interns and explore the effects of factors affecting resilience early in their careers, focusing on the mediating roles of career adaptability between clinical learning environment and resilience. METHODS: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment Scale for Nurse and the Career Adapt-Abilities Scale. Structural equation modelling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped confidence intervals. RESULTS: The nursing interns showed a moderately high level of resilience [M (SD) = 70.15 (19.90)]. Gender, scholastic attainment, scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns' resilience. Male interns with good academic performance showed higher levels of resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (ß = 0.62, 0.18, respectively, p < .01). Career adaptability was also positively affected by the clinical learning environment (ß = 0.36, p < .01), and mediated the effect of clinical learning environment on resilience (ß = 0.22, p < .01). CONCLUSION: Clinical learning environment can positively affect the resilience level of nursing interns. Career adaptability can affect resilience directly and also play a mediating role between clinical learning environment and resilience. Thus, promotion of career adaptability and clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for female nursing interns with low academic performance.

Tangible impact of patient communication modules on medical students and interns.

Attitude, ethics, and communication are key attributes in the doctor-patient relationship and to strengthen these qualities, the National Medical Commission, the body that regulates medical education and medical professionals in India introduced a course called Attitudes, Ethics and Communication (AETCOM) in the undergraduate medical curriculum. The objective of this study was to ascertain the perceptible qualitative influence of the modules in communication in the AETCOM course and to obtain feedback on its implementation. In this cross-sectional study, the attitude of medical students in all stages of training including internship was first explored using a Communication Skills Attitude Scale. Out of 27 modules in AETCOM course, five modules named foundations of communication deal with communication, and they are taught from the first to final professional years of training. After introducing communication modules in AETCOM for all professional years, feedback was collected from interns who had completed training in all modules. The interns provided feedback with a validated scale and two focused group discussions. Additionally, feedback from faculty involved in teaching AETCOM was analyzed. There was a significant increase in the positive attitude scores in the final year and internship compared to the first year. Eighty percent of the interns agreed that communication modules in AETCOM were useful and that they equipped them with the communication skills required for actual practice during their internship. Faculty agreed that these modules motivated the students to acquire communication skills. However, faculty also felt that these modules alone may not be sufficient to learn communication skills.NEW & NOTEWORTHY In the current study, we have assessed the attitude of medical students toward learning communication skills in all stages of their training. The novelty of our study is that communication modules were formally introduced for the first time into the medical curriculum and feedback was obtained from a cohort of interns who completed training in all modules in communication from AETCOM. The feedback from faculty and students provided us with concepts to improvise these modules.

Introduction of a bleepless intern on-call era.

BACKGROUND: The current bleep communication system between nurses and interns on-call in most Irish hospitals has been linked with interruption in patient care, disruption to workflow, inefficiency, increased burden and stress to the on-call health staff. A new electronic system was introduced in a University Hospital to replace and eliminate bleep usage during on-call hours. METHODS: An Intern on-call task electronic template was generated using Microsoft Excel Spreadsheet. This electronic system enabled users to review and respond to requests placed by nursing healthcare staff. This project initially underwent a trial process in three wards for a period of two weeks in June 2023. Interns and nurses were asked to fill a survey before and after introduction of the system. The project was implemented across all wards in August 2023 and a secondary survey was obtained. In addition, the spreadsheets were analysed retrospectively. RESULTS: During the trial, twenty-six interns and twenty nurses were surveyed before and after implementation of the electronic system. Interns satisfaction rate was 73% and stress was reported to be reduced by 65%. Notably, 57% of interns reported a reduction in workload and the number of bleeps was reported to be as <10 by 42%. Nurses reported a decrease in the number of bleeps they needed to send overall by 65% and by 55% for repeated jobs. Workload was reported to be increased by 15% by nurses. However, exactly half of the nurses were unhappy with the new system and stress levels were unchanged. CONCLUSION: This project has shown promising results, efficient and clear communication was noted with an overall positive feedback and satisfaction rate by doctors. However, as evident, from a nursing perspective further work is needed to further progress into a system that can benefit both parties involved.

Relationships of the adversity quotient subtypes of nursing interns with depression, coping styles, positive psychological capital, and professional adaptability: a cross-sectional study.

BACKGROUND: Nursing interns encounter numerous professional pressures during clinical practice. Assessing adversity quotient levels and understanding the influencing factors are crucial for supporting students' seamless transition to professional nurses. PURPOSE: This study examined the adversity quotient subtypes of nursing interns and explored the relationships between adversity quotient and depression, coping styles, positive psychological capital, and professional adaptability. METHODS: This study employed a cross-sectional research design, involving a survey of 287 nursing interns in five general hospitals in Shanghai, China. Latent profile analysis was conducted to explore the subtypes of adversity quotient with the four domains as input variables. Multinomial logistic regression models and multiple correspondence analysis were used for subsequent data analysis. RESULTS: The average adversity quotient score of the nursing interns was 116.63 ± 32.22. A three-profile solution was obtained based on the latent profile analysis results. Three distinct subtypes emerged: a high-adversity quotient subtype (n = 50, 17.4%), a medium-adversity quotient subtype (n = 189, 65.9%), and a relatively low-adversity quotient subtype (n = 48, 16.7%). Multinomial logistic regression revealed that nursing interns in the high-adversity quotient subtype tended to be male, and had higher scores for positive psychological capital, negative coping style, and professional adaptability (p < 0.05). CONCLUSION: Most of the nursing interns were in the medium adversity quotient subtype. Gender, positive psychological capital, negative coping style and professional adaptability were all significantly related to the adversity quotient. Boosting the positive psychological capital of nursing interns is an effective way to improve the adversity quotient.

Assessment of the competency of learner-centered teaching of clinical preceptor using the augmented Stanford Faculty Development Program Questionnaire (SFDPQ): a cross sectional comparative study.

BACKGROUND: Education is an important part of the work of most doctors. Clinical preceptors act as role models and supervisors. Preceptors' quality of supervision strongly influences the learning quality of clinical interns (Bartlett et al. BMC Med Educ 20:165, 2020). To ensure a consistent approach to every preceptorship experience, the competency of clinical preceptors should be assessed to ensure that the desired outcomes are achieved. This study aims to evaluate clinical preceptors' competency in learner-centered teaching, to provide constructive feedback to develop the preceptors' competency and improve supervisory skills and internship quality at Kunming Medical University (KMU) in Kunming of China. METHODS: This is a cross-sectional study with a quantitative self-administered online questionnaire. The convenience sampling technique was employed. In the undergraduate internship stage of KMU, clinical preceptors (N = 340) and interns (N = 487) were invited to use the augmented Stanford Faculty Development Program questionnaire (SFDPQ) (Stalmeijer et al. Med Teach 30:e272-e277, 2008), to (self-) assess the preceptor's competency of learner-centered teaching on a five-point scale (1 = strongly disagree, 5 = strongly agree). RESULTS: Two hundred twenty-eight preceptors and two hundred thirty-six interns completed the questionnaire correctly. Overall, the assessment was positive, but the preceptors' self-assessment significantly higher than the interns' (p < 0.00). The overall mean of each category of preceptors' self-assessment was greater than 4.5, with no difference based on educational qualification. Male preceptors scored significantly higher in two categories than female preceptors. Preceptors under 30 years of age with less than 5 years of teaching experience rated "Teacher's knowledge and attitude" lower than those over 40 years of age with more than 5 years of experience (p < 0.05). There were statistically significant differences in the four categories across disciplines (p < 0.05). Undergraduate interns rated "Teachers' knowledge" as the highest category and "Learning climate" as the lowest, and interns of different genders are evaluated without distinction in all categories of SFDPQ. CONCLUSIONS: Employing the augmented SFDPQ to evaluate learner-centered teaching competency of clinical preceptors, offers potentially useful information for delivering constructive feedback. Combining self-evaluations with learner evaluation data can contribute to exploring preceptor competency development framework to guide them in targeted learner-centered teaching skill and acquisition and improvement, finally improving the overall quality of internships.

Developing bullying prevention guidelines for nurse interns' and its effects on their assertiveness.

BACKGROUND: Bullying is a serious problem that has short and long term negative consequences for nurse interns. Bullying prevention guidelines have a great impact on reducing the incidence of bullying among nurse interns. AIM: The present study aimed to evaluate the effect of developing bullying prevention guidelines on nurse interns' assertiveness levels. METHODS: A methodological study design was used to conduct the study at Ain Shams University Hospitals in Cairo Governorate, Egypt. The study subjects consisted of all nurse interns enrolled in the 2022-2023 internship year and their number 121 nurse interns. The data were collected using four tools: the Bullying Knowledge Questionnaire, the Negative Act Questionnaire Revised (NAQ-R), the Individual Bullying Behaviors in Clinical Practice Survey, and the Assertiveness Inventory. RESULTS: The scores for total bullying knowledge and assertiveness after the implementation of the prevention guidelines were significantly increased (91.4% and 86.3%, respectively) among those who were exposed to bullying than among those with pretest scores of (34.7% and 11.8% respectively) (P < 0.001). CONCLUSION: Bullying prevention guidelines significantly reduced nurse interns bullying and improved their assertiveness. The study recommended the dissemination and generalization of the developed bullying prevention guidelines in different training settings.

Psychological capital educational program and its effect on nurse interns' innovative behavior.

BACKGROUND: Nurse interns' capacity for innovative behavior is a key component of healthcare settings because of increasing demands and complexities. Thus, it is important to find strategies that promote their innovative behavior. The development of psychological capital (PsyCap) improves positive behaviors and attitudes, such as engagement, motivation, and satisfaction, in the work environment. Therefore, this study aimed to assess the effect of a PsyCap educational program on nurse interns' innovative behavior. METHODS: A quasi-experimental design was used in this study. This study was executed at Fayoum University hospitals. The study participants comprised all the available nurse interns (n = 223) registered in the internship year (2022-2023) in the aforementioned settings. The data were gathered using three instruments, namely, the PsyCap Knowledge Questionnaire, the PsyCap Questionnaire, and the Innovative Behavior Inventory. RESULTS: The nurse interns' mean scores regarding total knowledge about PsyCap, total perception of PsyCap, and total perception of innovative behavior significantly improved through the posttest phase (41.27 ± 9.31, 92.22 ± 6.26, 91.31 ± 9.06, respectively) and the follow-up phase (37.83 ± 8.83, 89.96 ± 6.31, 88.89 ± 8.33) in comparison with the pretest phase (14.39 ± 5.83, 69.04 ± 8.13, 60.55 ± 7.15). CONCLUSION: The PsyCap educational program was effective and beneficial for improving the nurse interns' perceptions of innovative behavior. Therefore, PsyCap interventions should be implemented in hospitals through professional development programs and orientation programs.

Transition shock among nursing interns and its relationship with patient safety attitudes, professional identity and climate of caring: a cross-sectional study.

BACKGROUND: Nursing interns often experience lots of challenges during their clinical nursing internships, which can adversely affect career decisions and result in a squandering of nursing education resources. Patient safety attitudes, professional identity and climate of caring may affect nursing interns' clinical experience. However, more evidence is requested to validate these relationships for nursing educators to develop effective education programs and facilitate interns' successful transition. METHODS: This was a cross-sectional study, which used a convenience sampling method to recruit 387 nursing interns during December 2022 to April 2023 in university affiliated hospital in Hunan province, China. Data were collected using standardized scales. Spearman correlation and multiple regression analysis were employed to examine the relationship between transition shock, patient safety attitudes, professional identity, and climate of caring. RESULTS: Nursing interns experienced transition shock at a moderate level and the highest levels of transition shock in response to overwhelming practicum workloads, with the second being related to the conflict between theory and practice. Transition shock was negatively correlated with patient safety attitudes, professional identity and climate of caring among nursing interns. CONCLUSIONS: Nursing managers and educators need to value the transition shock experienced by nursing interns. Our study suggests that developing a strong sense of professional identity and a positive attitude toward patient safety can be effective in reducing the level of transition shock among nursing interns. In addition, a caring climate within the nursing unit can significantly enhance the overall experience of nursing interns. This can be achieved by enhancing the support of clinical mentors, providing patient safety-focused education, and facilitating team communication among nurses.

Utilizing Local Professional Association Chapters as Pathways for Leadership Development.

In 2019, there was no entity specifically dedicated to health promotion and education practitioners in Connecticut or New England. This made it difficult for health promotion practitioners and students to network, collaborate, and engage in professional development. The purpose of this article is to share our experiences developing the new Connecticut Chapter of the Society for Public Health Education (CT SOPHE), including how we leveraged student interns during the first two years to promote organizational growth. To build our membership, it was important to determine who would be interested in joining CT SOPHE and so we focused on three groups: the current workforce/professionals, future workforce/students, and future leaders/interns. Over the course of these two years, three interns were recruited to help with creating a needs assessment (MPH student) and program development (two BS students); the organization was established by an MPH student as her internship project. Three former interns share how their experience working with the CT SOPHE board has helped them develop crucial leadership skills early in their careers. Embedding student interns into the framework and operations of CT SOPHE demonstrates an intentional and strategic commitment to the sustainability of both the organization and the workforce.

Mediating effect of moral sensitivity and professional identity between moral courage and compassion fatigue among nursing interns: a cross-sectional study.

BACKGROUND: Compassion fatigue in nursing interns contributes to career indecision and worsens the nursing shortage. While work environment and psychological factors are well-studied, the ethical dimension remains unexplored. Understanding these mechanisms, particularly the role of moral courage, is essential for designing interventions to combat compassion fatigue and address the workforce crisis. This study investigates the influence of moral courage on compassion fatigue among Chinese nursing interns, focusing on the mediating roles of moral sensitivity and professional identity. METHODS: A quantitative, cross-sectional study was conducted in accordance with the STROBE guidelines. We used the convenience sampling method to recruit 467 nursing interns from four public junior colleges in Hunan Province, China in February, 2024. Data were collected using Compassion Fatigue Short Scale, Moral Courage Scale, Revised Moral Sensitivity Questionnaire, and Professional Identity Scale. Data analyses were conducted using SPSS 22.0 and Amos 21.0. RESULTS: The modified model exhibited a good fit (χ2/df = 3.437, AGFI = 0.928, IFI = 0.984, TLI = 0.976, CFI = 0.984, NFI = 0.977, RMSEA = 0.072). Moral sensitivity positively influenced both moral courage and professional identity, while professional identity negatively impacted compassion fatigue. Importantly, the effect of moral courage on compassion fatigue was entirely mediated by moral sensitivity and professional identity (ß = -0.114, P = 0.001). CONCLUSION: This study suggests that moral courage in nursing interns mitigates compassion fatigue through the combined mediating effects of moral sensitivity and professional identity. Ethics education programs fostering moral courage, moral sensitivity, and professional values in nursing students could be crucial in alleviating compassion fatigue.

Relationship between emotional intelligence and academic support perception among nursing interns: The moderating role of bullying behaviors in nursing education.

AIM: This study aims to investigate the status of academic support perception among nursing interns and explore the correlation between academic support perception, emotional intelligence, and bullying behaviors in nursing education, especially the moderating role of bullying behavior on the relationship between emotional intelligence and academic support perception. BACKGROUND: Academic support perception is closely related to the nursing interns' mental health and academic performance. To some extent, it can reflect nursing interns' satisfaction and happiness during their internship, affecting their motivation to continue their studies. However, little is known about the nursing interns' academic support perception in China. METHODS: A total of 1020 nursing interns participated in this study. A sociodemographic information questionnaire, Bullying Behaviors in Nursing Education Scale, Wong and Law's Emotional Intelligence Scale, and Academic Support in the Practicum Scale were used to collect data. FINDINGS: Bullying behaviors and emotional intelligence were significantly associated with nursing interns' academic support perception. In addition, bullying behaviors in nursing education moderated the association between emotional intelligence and academic support perception. DISCUSSION: Nursing interns who possess high emotional intelligence and experience less bullying in nursing education tend to perceive higher academic support in clinical practice. The positive effects of emotional intelligence on nursing interns' academic support perceptions are contingent on the level of bullying behavior experienced in nursing education. Less bullying behaviors in nursing education enhance the impact of emotional intelligence on academic support perception. CONCLUSION AND IMPLICATIONS FOR NURSING: Strategies should be created to promote emotional intelligence and decrease bullying behaviors in nursing education to improve the perception of academic support among nursing interns.

Using machine learning with intensive longitudinal data to predict depression and suicidal ideation among medical interns over time.

BACKGROUND: Use of intensive longitudinal methods (e.g. ecological momentary assessment, passive sensing) and machine learning (ML) models to predict risk for depression and suicide has increased in recent years. However, these studies often vary considerably in length, ML methods used, and sources of data. The present study examined predictive accuracy for depression and suicidal ideation (SI) as a function of time, comparing different combinations of ML methods and data sources. METHODS: Participants were 2459 first-year training physicians (55.1% female; 52.5% White) who were provided with Fitbit wearable devices and assessed daily for mood. Linear [elastic net regression (ENR)] and non-linear (random forest) ML algorithms were used to predict depression and SI at the first-quarter follow-up assessment, using two sets of variables (daily mood features only, daily mood features + passive-sensing features). To assess accuracy over time, models were estimated iteratively for each of the first 92 days of internship, using data available up to that point in time. RESULTS: ENRs using only the daily mood features generally had the best accuracy for predicting mental health outcomes, and predictive accuracy within 1 standard error of the full 92 day models was attained by weeks 7-8. Depression at 92 days could be predicted accurately (area under the curve >0.70) after only 14 days of data collection. CONCLUSIONS: Simpler ML methods may outperform more complex methods until passive-sensing features become better specified. For intensive longitudinal studies, there may be limited predictive value in collecting data for more than 2 months.

Emotional intelligence as a mediator between spiritual care-giving competency and core competencies in Chinese nursing interns: a cross-sectional study.

BACKGROUND: The development of nursing interns' fundamental competencies should be a top focus because they represent an essential reserve for nursing professionals. The objective of this study is to investigate the relationship between spiritual care-giving competency (SCG) and nursing core competencies (NCC) among Chinese nursing interns, adopting a competency-based education (CBE) perspective, additionally, the study aims to examine how emotional intelligence (EI) serves as a mediator in this relationship. METHODS: A nationwide online survey was completed by 1811 Chinese nursing interns at vocational colleges between June and July 2022 as part of a multi-site, cross-sectional, web-based study. Participants completed a demographic questionnaire and competencies inventory for the registered nurse questionnaire (CIRN), the Chinese version of the spiritual care-giving scale questionnaire (C-SCGS), and the Chinese version of the Wong and Law EI scale questionnaire (WLEIS-C). Means, standard deviations, t-tests, one-way ANOVA analysis, and Pearson's production correlation coefficients were calculated using IBM SPSS25.0 software. Mediated effect tests and studies utilizing the process plug-in SPSS developed by Hayes. RESULTS: The NCCs of college nursing interns were related to whether working as student leaders, whether have a better self-learning evaluation level, whether a college nursing intern with good interpersonal relationship, and whether they intend to engage in the nursing profession in the future. The scores of NCC, EI, and SCG were (156.43±23.14), (61.55±9.10), and (167.64±20.52) respectively. There were positive correlations among SCG (r = 0.402), EI (r = 0.506), and NCC. The partial mediating effect of EI between SCG and NCC was 0.127, accounting for 36.29% of the total results. CONCLUSION: The average levels of Chinese college nursing interns' NCC and SCG were at a moderate level. EI is mediating between SCG and NCC in Chinese nursing interns. This new perspective shows that developing and improving SCG and EI may improve NCC. We suggest modifying the nurse curriculum and instruction to strengthen NCC and integrating SCG and EI management into the nursing curriculum.

Application of flipped classroom based on CDIO concept combined with mini-CEX evaluation model in the clinical teaching of orthopedic nursing.

BACKGROUND: After the COVID-19 epidemic, the state has paid more attention to the clinical teaching function of affiliated hospitals of colleges and universities. Strengthening the integration of medicine and education and improving the quality and effect of clinical practice teaching are critical challenges facing medical education. The difficulty of orthopedic teaching lies in the characteristics of a wide variety of diseases, strong professionalism, and relatively abstract characteristics, which affect the initiative, enthusiasm, and learning effect of nursing students. In this study, a flipped classroom teaching plan based on the CDIO (conceive-design-implement-operate) concept was constructed and practiced in the orthopedic nursing student training course to improve the effect of practical teaching, and it is convenient for teachers to implement more effective and targeted teaching in the flipped classroom of nursing education and even medical education in the future. METHODS: Fifty undergraduate nursing students who practiced in the Orthopedics Department of a tertiary hospital in June 2017 were enrolled in the control group, while 50 undergraduate nursing students who practiced in the same department in June 2018 were enrolled in the intervention group. The intervention group adopted the flipped classroom teaching mode of the CDIO concept, whereas the control group adopted the traditional teaching mode. After finishing the department practice task, the students in the two groups completed the evaluation of theory, operation skills, independent learning ability, and critical thinking ability. They completed the evaluation of clinical practice ability in eight dimensions, including four processes of nursing procedures, humanistic care ability, and evaluation of clinical teaching quality for two groups of teachers. RESULTS: After teaching, the clinical practice ability, critical thinking ability, autonomous learning ability, theoretical and operational performance, and evaluation of clinical teaching quality in the intervention group were significantly higher than those in the control group (all p < 0.05). CONCLUSION: The CDIO-based teaching mode can stimulate the independent learning ability and critical thinking ability of nursing interns, promote the organic combination of theory and practice, improve their ability to comprehensively use theoretical knowledge to analyze and solve practical problems, and improve teaching effectiveness.

Sociodemographic factors associated with knowledge and attitudes of Peruvian dental interns about dental shade selection.

BACKGROUND: The dentist should have a thorough knowledge of the science, protocols and procedures for dental shade selection in order to mimic dental tissue with restorative materials, respecting the individual needs and attitudes of each patient and providing them with a pleasant and esthetically acceptable appearance. The present study evaluated the knowledge and attitudes of dental interns from two Peruvian universities about dental shade selection and its relationship with sociodemographic factors. METHODS: The present cross-sectional and analytical study was carried out on Peruvian dental interns from the Universidad Nacional Federico Villarreal and the Universidad Privada de San Juan Bautista during May to June 2022. Two validated questionnaires on knowledge and attitudes about dental shade selection were used. A Poisson regression model with robust variance using the adjusted prevalence ratio (APR) was used to assess the influence of the variables: age group, sex, place of origin and type of university, considering a significance level of p<0.05. RESULTS: The results showed that 40.8% (95% CI: 34.0% - 47.6%) of the interns presented unfavorable attitudes while 90.1% (95% CI: 86.0% - 94.2%) presented insufficient knowledge. It was also found that dental interns under 29 years of age were 32% less likely to have unfavorable attitudes (APR = 0.68, 95% CI 0.48 - 0.96) and 11% more likely to have insufficient knowledge (APR = 1.11, 95% CI 1.01 - 1.24) about tooth shade selection compared to dental interns aged 29 years and older. Finally, women were 55% more likely to have unfavorable attitudes about tooth shade selection compared to men (APR = 1.55; 95% CI: 1.08 - 2.22). CONCLUSION: The majority of dental interns presented insufficient knowledge and less than half had unfavorable attitudes about dental shade selection. In addition, being a student under 29 years of age was a risk factor for presenting insufficient knowledge and at the same time constituted a protective factor for presenting unfavorable attitudes. Likewise, being a female student was a risk factor for presenting unfavorable attitudes about dental shade selection.

Unpopular medical specialties: exploring the concept that "the customer knows best".

BACKGROUND: Healthcare systems often face shortages of certain medical specialists due to lack of interest among medical students. We questioned a common "one solution fits all" approach to this problem which involves monetary incentives to lure students to these specialties. Instead, we used the marketing principle the "consumer knows best" to explore ways of elucidating the reasons and proposing solutions for such shortages. METHODS: A convenience sample of Israeli 6th-year medical students and interns completed questionnaires to determine why they thought three specialties (geriatrics, anesthesiology, emergency medicine) were unpopular and their ideas on increasing their appeal. RESULTS: 119 6th-year students and 84 interns completed questionnaires. Geriatrics was reported having a problematic patient population; not being interesting and challenging; and not considered prestigious by colleagues and the populace. This contrasts with emergency medicine which, although considered prestigious, has difficult working conditions both during and after residency accompanied by much pressure at work. Although, improvements in lifestyle and remuneration were thought by students and interns as possibly making these specialties more attractive, reducing the pressure at work and decreasing on-call obligations were designated by the students/interns as ways to increase emergency medicine's and anesthesiology's appeal. Half the students replied that anesthesiology would be more appealing if work was in shifts (< 16 h), while 60% replied so for emergency medicine and only 18% for geriatrics. 90% of students reported that control over lifestyle would make emergency medicine more attractive while 55% and 48% replied positively for anesthesiology and geriatrics, respectively. CONCLUSIONS: Using the concept "consumer knows best" provided additional insight into the specialty selection process. Students/interns have specialty-specific opinions as to why some specialties are unpopular. Their ideas about attracting more students to these specialties were also specialty-dependent, i.e. "one solution does not fit all". These observations render problematic a single solution aimed at ameliorating the workforce shortages of multiple specialties. Instead, these results advocate a differential approach wherein the lack of appeal of each unpopular specialty is analyzed individually and the students'/interns' (the "consumers") ideas sought resulting in solutions tailored to address each specialty's lack of attractiveness. TRIAL REGISTRATION: None.

A study of empathy levels among nursing interns: a cross-sectional study.

BACKGROUND: Empathy is one of the therapeutic communication techniques used to help the client feel better. However, there are a few studies have investigated level of empathy among enrollers at nursing colleges. The aim was to examine the level of self-reported empathy among nursing interns. METHODS: The study was a descriptive, cross-sectional in nature. A total of 135 nursing interns fill in the Interpersonal Reactivity Index from August to October 2022. Data was analyzed through the SPSS program. An independent -sample t-test and one way- ANOVA was used to explore differences in the degree of empathy with respect to academic and sociodemographic factors. RESULTS: The results of this study showed that nursing interns showed a mean level of empathy of 67.46 (SD = 18.86). This result indicated that the nursing interns have moderate levels of empathy overall. There was statistical significant difference in the mean level of subscales of perspective-taking and empathic concern between males and females. Additionally, nursing interns who are less than 23 years old scored high in the subscale of perspective-taking. Married nursing interns and who preferred nursing as a profession scored higher in the subscale of empathic concern than unmarried ones and who did not preferred nursing as a profession. CONCLUSION: Perspective taking incresed with younger male nursing interns, this reflects high cognitive flexibility with younger age nursing interns. Morover, the empathic concern incresed with male married nuring interns who preferred nursing as a profession. This implies that they should engage in continuous reflection and educational activities as part of their clinical training as nursing interns in order to improve their empathic attitudes.

Psychometric evaluation of nursing interns' consciousness of rights scale in clinical practice.

OBJECTIVE: The purpose of this study was to translate the Awareness of Rights Scale into Chinese and test its psychometric properties among nursing students in clinical practice. METHODS: The original English scale was translated, synthesized, and back-translated according to the Brislin translation model: the translated scale was cross-culturally adapted through expert correspondence and pretesting to form the Chinese version of the scale; a convenience sampling method was used to survey 486 nursing interns in Liaoning, Guangdong, and Anhui regions to assess the reliability and validity of the scale. RESULTS: The Chinese version of the scale consists of 14 items in three dimensions. The Cronbach's alpha value of the scale was 0.916 and the range of Cronbach's alpha coefficients of subscale was 0.768 to 0.894. The discounted half reliability was 0.867 and the retest reliability was 0.901. The scale content validity index (S-CVI) was 0.963. A total of three common factors were extracted for the exploratory factor analysis. The confirmatory factor analysis indices fit well (χ2/df = 1.092, RMSEA = 0.014, CFI = 0.998, IFI = 0.998. TLI = 0.997), and the model fit was good. CONCLUSION: The Chinese version of the scale has good reliability and validity in the nursing intern population and can be used to assess nursing interns' awareness of their rights in clinical practice in mainland China.

Correlations between moral courage, moral sensitivity, and ethical decision-making by nurse interns: a cross-sectional study.

BACKGROUND: Clinical decision-making involves ethical issues that become more and more complex. Nurse interns must be more skilled in making rational and timely decisions when facing ethical dilemmas. The contributing factors and their relationships that challenge ethical decision-making among nurse interns must be fully understood, as this level of knowledge can support the development of strategies and interventions that improve the ethical decision-making ability of nurse interns. OBJECTIVE: This study examined the relationships between moral courage, moral sensitivity, and ethical decision-making by nurse interns. In addition, we investigated whether moral sensitivity mediates the relationship between moral courage and ethical decision-making. DESIGN: A descriptive cross-sectional study using an online questionnaire. SETTING: The study sampled nurse interns from Class iii Grade A general hospitals in Sichuan Province, China. PARTICIPANTS: A convenience sampling method was used to select 1334 nurse interns from March 2022 to May 2022. METHODS: A general information questionnaire, the Nurses' Moral Courage Scale (NMCS), the Chinese Moral Sensitivity Questionnaire (MSQ), and the Judgement About Nursing Decision (JAND) were used for data collection. Data was processed and analysed using SPSS 26.0 and Amos 28.0. Data analysis included descriptive statistics, Pearson correlation analysis, and structural equation modelling. RESULTS: Moral courage was found to be positively correlated with ethical decision-making (P < 0.01). Moral sensitivity was also positively correlated with ethical decision-making (P < 0.01) and had a mediating effect on the relationship between moral courage and ethical decision-making (P < 0.01). CONCLUSIONS: The moral courage and moral sensitivity of nurse interns are positively correlated with ethical decision-making ability. Moral sensitivity significantly mediates the relationship between moral courage and ethical decision-making ability. The knowledge gained from this study can inform educational strategies and interventions in supporting the development of nurse interns' ethical decision-making ability.