Search Results (2,175)

Background/Objectives: Effective airway management during pediatric cardiopulmonary resuscitation (CPR) is crucial but technically challenging, especially during continuous chest compressions. While direct laryngoscopy with Macintosh (MAC) or Miller (MIL) blades remains the standard, optical devices such as the VieScope (VSL) may enhance performance under dynamic resuscitation conditions. This study compared first-pass success and intubation time, as well as procedural difficulty and glottic visualization, of MAC, MIL, and VSL during simulated pediatric cardiopulmonary resuscitation. Methods: This prospective, randomized crossover simulation study involved 53 medical students. Participants performed endotracheal intubation on a high-fidelity manikin simulating a 5-year-old pediatric patient using MAC, MIL, and the Bebé VieScope laryngoscope. Each technique was evaluated in two scenarios: with and without continuous chest compressions. Results: Without chest compressions, first-pass success (FPS) and intubation time varied significantly between techniques. VSL achieved the highest FPS (100%; p = 0.032) and the shortest intubation time (27.9 ± 9.2 s; p = 0.040), performing faster than MIL and achieving higher FPS than MAC. Visualization quality, ease of intubation, and optimization maneuvers were similar across techniques. During continuous chest compressions, all outcomes differed significantly. FPS increased from MAC to MIL and VSL (p = 0.001), with MAC showing the lowest success rate. VSL showed the shortest intubation time (35.9 ± 13.0 s; p < 0.001), better glottic visualization, easier intubation, and fewer optimization maneuvers, followed by MIL. Conclusions: In this simulated pediatric cardiac arrest model, the VieScope laryngoscope demonstrated superior overall performance, especially during uninterrupted chest compressions. Optical tubular laryngoscopy may therefore provide clinically relevant benefits in pediatric resuscitation where maintaining high-quality chest compressions is crucial. Given the manikin-based design of this study, confirmation of these findings in clinical pediatric cardiac arrest settings will require further prospective clinical investigation. Full article

Ultrasound-guided femoral vascular access (UFVA) is a crucial step in cardiovascular intervention, yet training models remain costly, anatomically limited, or insufficiently durable. This research aimed to develop and evaluate a reusable, self-healing vascularised leg phantom in collaboration with clinicians. This bifurcating vascular model was cast in Plastisol using a customisable silicone mould design. The material exhibited a Shore OO hardness of 18.0 ± 2.2, a speed of sound of 1454 ± 15 m/s, an acoustic attenuation of 1.66 ± 0.02 × 106 kg/m²s, and healed 18G needle lesions within 3 h. Training capabilities were evaluated in a workshop involving 18 medical students: FVA times improved by more than 60% after 5 min of free practice. Qualitative feedback was collected from 31 medical educators via a seven-question Likert survey, with most reporting they would adopt the phantom for teaching. Phantoms cost £7.87 for materials, yet educators valued the models at £100–£500, underscoring its perceived utility. Compared to commercial alternatives, this in-house production approach reduced costs by 10–60 times, achieving comparable durability and anatomical fidelity. This study establishes a scalable, ultra-low-cost method for producing anatomically realistic, self-healing vascular phantoms, validated for effective skill acquisition in both educational and research settings. Full article

The use of interpreter services is an important component of medical care. It is critical for medical students to practice this during training. It is known that simulation and role play provide important opportunities for students to practice skills. This scoping review maps the experience that medical students around the world have practicing with interpreter services in a simulated environment. We searched within three major databases (PubMed, ERIC, and SCOPUS) using a wide range of search terms for publications from the past 15 years. This scoping review was conducted according to PRISMA-ScR guidelines. Of the 1341 studies initially obtained from search terms, 22 were ultimately found to meet inclusion criteria. There is variability in curricula offered including when in medical school, what other specialties are involved, and how the education is conveyed. Most publications lacked longitudinal follow-up and assessment of learner competence was limited. Review articles, a prevalence study, and proof of concept studies also serve to demonstrate the breadth of publications on this subject. This is an area of important consideration within medical education today. Many studies highlight the relative scarcity of formal programs as well as a lack of consistency. Where programs do exist, the importance of including simulation is highlighted. Full article

Background/Objectives: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders globally, significantly impacting quality of life across diverse populations. Despite its association with middle-aged and older populations, evidence indicates that LBP is increasingly prevalent among younger age groups. Health science students are considered a potential risk factor for LBP; however, longitudinal studies are scarce. This study aims to determine the risk factors for LBP among health science students over a 2-year follow-up. Methods: One hundred ninety-seven of the third-class health science students (Nursing, Physiotherapy, Medical laboratory science, and Emergency Medical services) were contacted in June 2024. A self-administered modified version of the Standardized Nordic Questionnaire, and data about sedentary and physical activity behavior, as well as 1-month LBP (lasting at least 12 h and numeric rating scale > 5) and stress scores, were recorded. Results: A total of 172/197 (87.3%) respondents completed the questionnaire at the end of the 2-year follow-up. The mean age was 25 ± 3.5 (years) and body mass index (BMI) value 23.5 ± 4.3 (kg/m²). About 49% (n = 84) and 20% (n = 34) of the participants had 1-month LBP and functional disability, respectively. No significant association was found between health science programs and the presence of 1-month LBP (χ² = 0.55, p > 0.05). The logistic regression analyses found that males (OR = 0.269, p = 0.005) and a history of pain frequency (OR = 3.377, p = 0.001) had a significant association with LBP over time. Conclusions: This prospective study shows a high prevalence of 1-month LBP (48.8%) among health science students at Zefat Academic College. LBP was significantly related to sex (female) and pain frequency, but not to health science students. We believe that implementing ergonomic and educational strategies is recommended for this population. Full article

Background/Objectives: Kidney donation remains a critical component of addressing end-stage renal disease. This study examines differences in awareness, willingness to donate, and concerns related to kidney donation among medical and non-medical university students. By comparing these groups within the context of Croatia’s presumed-consent system for organ donation, the study provides insights into how educational backgrounds shape attitudes in a setting with high transplantation rates but limited data on young adults. Methods: A cross-sectional observational study targeted at medical and non-medical university students in Croatia. Data were collected from 640 participants via a self-administered, close-ended, structured questionnaire with 33 items divided across three sections. Responses were analyzed using IBM SPSS Statistics program (v. 30.0), to identify significant differences. Due to the cross-sectional design, causal relationships could not be inferred. Results: Overall, 190 students (28.7%) reported willingness to donate a kidney during their lifetime, which was more common among medical students (N = 59; 39.0%) than non-medical students (N = 131; 26.8%). Collectively, willingness to donate postmortem was high in both groups (N = 527; 82.3%), as was willingness in a brain-dead state (N = 448; 70.0%). Medical and non-medical students mostly cited perceived health risks as a concern and concerns related to surgical complications. Regarding information sources, 33.2% of students reported inadequate knowledge of kidney donation, with social media and internet searches cited more frequently than healthcare professionals. Conclusions: Our findings indicate that medical and non-medical students exhibit distinct gaps in knowledge, risk perception and willingness toward kidney donation. Within Croatia’s presumed-consent framework, these findings highlight the importance of targeted educational strategies to support informed decision-making among future generations. Full article

Background: Simulation-based training may offer a useful approach to support skill acquisition in neurointerventional stroke treatment without exposing patients to procedural risks. As the global demand for thrombectomy rises, training strategies that ensure procedural competence while addressing workforce constraints are increasingly important. With this pilot study, we aim to generate a hypothesis as to whether additional exposure of trainees to mechanical thrombectomy could benefit from simulator training on top of the standard training carried out on flow models. This study was designed as an exploratory pilot investigation and was not able to provide inferential or confirmatory statistical conclusions. Methods: Six novice participants (advanced clinical-year medical students with completed anatomical and preclinical training, but without previous exposure to catheter-based interventions) performed two neurointerventional tasks, vascular access and mechanical thrombectomy (MTE), on flow models. After a baseline assessment, three participants received standard model-based training (control group), and three received additional simulator training using a high-fidelity angiography simulator (Mentice VIST G5). Performance was reassessed after four weeks using technical and clinical surrogate metrics, which were ranked and descriptively analyzed. Results: No relevant differences were observed between groups for the vascular access task. In contrast, the simulator group demonstrated a trend toward improved performance in the MTE task, with greater gains in efficiency, autonomy, and procedural safety. Conclusions: Our findings indicate a possible benefit of even brief simulator exposure for skill acquisition for complex endovascular procedures such as MTE. While conventional training may suffice for basic skills, simulation may be particularly helpful in supporting learning in more advanced tasks. Full article

Transitioning from theoretical learning to practical application remains a significant challenge for students in medical and veterinary science education, particularly in the context of medical imaging and ultrasound interpretation. Traditional lecture-based methods offer limited support for developing the spatial reasoning and technical skills required for ultrasound pregnancy diagnosis. This study evaluates the effectiveness of an interactive mixed reality (MR) training tool, Ewe Scan, delivered through the Apple Vision Pro, compared to traditional lecture-based instruction. Forty-two undergraduate students were randomly assigned to either a lecture-trained or MR-trained group and assessed immediately after training and again after six weeks. Results showed that MR-trained students significantly outperformed their lecture-trained peers in both immediate comprehension and retention over time, particularly in ultrasound interpretation skills. The MR-trained group also reported higher levels of engagement, confidence, and satisfaction with their training experience. These findings suggest that MR-based learning enhances educational outcomes by improving spatial understanding, increasing active engagement, and supporting knowledge retention. Integrating MR simulations into ultrasound education offers a scalable, ethical, and effective alternative to traditional training methods, contributing to advancements in medical imagery education. Full article

Support Vector Machines (SVMs) are widely used in critical decision-making applications, such as precision agriculture, due to their strong theoretical foundations and their ability to construct an optimal separating hyperplane in high-dimensional spaces. However, the effectiveness of SVMs is highly dependent on the efficiency of the optimization algorithm used to solve their underlying dual problem, which is often complex and constrained. Classical solvers, such as Sequential Minimal Optimization (SMO) and Stochastic Gradient Descent (SGD), present inherent limitations: SMO ensures numerical stability but lacks scalability and is sensitive to heuristics, while SGD scales well but suffers from unstable convergence and limited suitability for nonlinear kernels. To address these challenges, this study proposes a novel hybrid optimization framework based on Open Competency Optimization and Particle Swarm Optimization (OCO–PSO) to enhance the training of SVMs. The proposed approach combines the global exploration capability of PSO with the adaptive competency-based learning mechanism of OCO, enabling efficient exploration of the solution space, avoidance of local minima, and strict enforcement of dual constraints on the Lagrange multipliers. Across multiple datasets spanning medical (diabetes), agricultural yield, signal processing (sonar and ionosphere), and imbalanced synthetic data, the proposed OCO-PSO–SVM consistently outperforms classical SVM solvers (SMO and SGD) as well as widely used classifiers, including decision trees and random forests, in terms of accuracy, macro-F1-score, Matthews correlation coefficient (MCC), and ROC-AUC. On the Ionosphere dataset, OCO-PSO achieves an accuracy of $95.71\%$, an F1-score of $0.954$, and an MCC of $0.908$, matching the accuracy of random forest while offering superior interpretability through its kernel-based structure. In addition, the proposed method yields a sparser model with only 66 support vectors compared to 71 for standard SVC (a reduction of approximately $7\%$), while strictly satisfying the dual constraints with a near-zero violation of $1.3\times {10}^{-3}$. Notably, the optimal hyperparameters identified by OCO-PSO ($\mathrm{C}=2$, $\gamma \approx 0.062$) differ substantially from those obtained via Bayesian optimization for SVC ($\mathrm{C}=10$, $\gamma \approx 0.012$), indicating that the proposed approach explores alternative yet equally effective regions of the hypothesis space. The statistical significance and robustness of these improvements are confirmed through extensive validation using 1000 bootstrap replications, paired Student’s t-tests, Wilcoxon signed-rank tests, and Holm–Bonferroni correction. These results demonstrate that the proposed metaheuristic hybrid optimization framework constitutes a reliable, interpretable, and scalable alternative for training SVMs in complex and high-dimensional classification tasks. Full article

Background: Eating disorders (EDs) are important mental illnesses that are often associated with depression and anxiety, leading to significant negative consequences. However, research on this topic in Saudi Arabia remains limited. This study aims to examine the risk of EDs among male and female medical students at King Saud University (KSU) and assess their risk factors and association with anxiety and depression. Methods: A cross-sectional study involving 425 participants was conducted, using a convenience sampling method. The study tools consisted of a questionnaire developed by the research team, the Eating Attitudes Test-26 (EAT-26), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 scale (GAD-7). Results: Almost half (49.6%) were classified as high risk for EDs. Obesity was much higher among high-risk students than low-risk students (p < 0.001). Anxiety and depression were greater among high-risk students than low-risk ones. A higher body mass index (BMI) and depression greatly increased the risk of EDs (p < 0.001). Conclusions: The findings support the notion that medical students have a significant likelihood of developing EDs, especially if they have a high BMI and are depressed. The results show the importance of early identification and offering appropriate interventions to this vulnerable group. Full article

Effective communication is essential for professional practice, yet medical curricula rarely incorporate systematic, performance-based training. The Sell Yourself!—Presentation Techniques course was developed to address this gap through a two-day, practice-oriented program integrating rhetorical training, evolutionary psychology, and structured peer feedback. We examined anonymized institutional evaluations from 450 medical students using descriptive statistics and combined inductive–deductive thematic and content coding to gauge the perceived educational utility of the course. The course received a mean satisfaction rating of 9.6/10, with approximately 74% of students assigning the maximum score. Inductive analysis identified interactivity (143 mentions), practical usefulness (76), feedback and improvement (75), positive atmosphere (51), instructor quality (47), and multimedia examples (37) as key strengths, while critiques primarily concerned breaks and scheduling (62), course length and intensity (59), and smaller concerns regarding feedback processes, content structure, and technical issues. Deductive coding indicated perceived improvements across five predefined dimensions: increased confidence, rhetorical fluency, feedback quality, peer recognition, and cultural inclusivity. Structured rhetorical training appears to be well received by learners and may provide a feasible model for embedding communication competence in medical education. These findings also offer a transferable template for integrating performance-based communication training into other programs. However, conclusions are limited by reliance on self-reported perceptions and the absence of a control group or direct assessment of applied communication outcomes. Full article

Background: Cigarette smoking remains one of the most important preventable causes of respiratory morbidity, exerting detrimental effects even in young adults. Medical students represent a particularly relevant population, as the lifestyle habits they adopt during their training years may influence both their personal health and professional credibility. Methods: We conducted a cross-sectional analysis of 264 medical students from the University of Medicine, Pharmacology, Science and Technology of Târgu-Mures, aged 18–30 years, stratified according to smoking status, type of tobacco product used, and lifestyle characteristics (athletic vs. sedentary). Standardized spirometry was performed to assess FVC, FEV₁, FEV₁/FVC ratio, PEF, and small airway flow parameters (MEF₂₅, MEF₅₀, MEF₇₅). Statistical comparisons between groups were performed using t-tests, Mann–Whitney U tests, chi-square tests, and correlation analyses, with p < 0.05 considered statistically significant. Results: Smokers demonstrated significantly lower values for FEV₁, PEF, and MEF parameters compared with non-smokers, confirming early functional impairment of both large and small airways. Within the smoking group, users of e-cigarettes or heated tobacco products exhibited more favorable FEV₁ and small airway flow values than conventional cigarette smokers. However, differences in FVC were less pronounced. Significantly, athletes consistently outperformed their sedentary peers across all respiratory parameters, regardless of smoking status, with markedly higher FEV₁, FVC, and MEF values and a lower prevalence of obstructive patterns. Cumulative smoking exposure (pack-years) was inversely associated with small airway function, whereas higher levels of physical activity were independently linked to a pronounced protective effect. Conclusions: Even in early adulthood, smoking is related to measurable declines in lung function, particularly affecting small airway dynamics. Although alternative products may appear less harmful than conventional cigarettes, they cannot be considered risk-free. Conversely, regular physical activity demonstrated a protective association in the case–control analysis, attenuating functional decline and supporting the preservation of long-term respiratory health. These findings underscore the importance of integrated prevention strategies in medical universities, combining smoking cessation initiatives with the systematic promotion of physical activity to safeguard the health of future physicians and reinforce their role as credible health advocates. Full article

Medical students experience fluctuations in their motivation, influenced by various factors, including curricular rigor, mental health, and institutional factors. Based on Self-Determination Theory (SDT) and the Four Pillars of Academic Engagement (HPEE), this study, conducted at a private Mexican university, examined motivational variation according to academic year, curricular impact, gender differences, and its relationship with mental health. Methods: A quantitative, cross-sectional, descriptive study was conducted using qualitative tools for contextualization (n = 1326). Mann–Whitney U tests, Kruskal–Wallis tests, logistic regression, and psychological network analysis were performed. Results: Motivation showed cross-sectional variation: high in preclinical years 1 and 2, decreasing in clinical years 3 and 4 (p < 0.001), and rebounding in year 6. The reformed curriculum (elective subjects, student-centered active learning) resulted in greater motivation (OR = 10.68, p < 0.001). Women tended to have slightly higher motivation (p = 0.050), higher grade point averages (p < 0.001), but also greater stress (p < 0.001). Network analysis revealed that intrinsic achievement (centrality = 1.11) and curiosity about knowledge (predictability = 84.5%) are the main drivers, while demotivation was linked to the later years. The qualitative part of the study showed altruism/curiosity as the main motivators; mistreatment/workload (demotivators). Conclusions: Motivation is context-sensitive, peaks in the preclinical stage, and recovers with autonomy but is vulnerable during clinical immersion. Autonomy in course selection, active student-centered pedagogies, and gender-sensitive support foster sustained participation. The centrality of intrinsic factors in the network highlights that achievement motivation and knowledge are general and independent motivators. Qualitative data reveal systemic barriers. Stage-specific interventions, such as mentoring, student support programs, and reporting mistreatment, can be crucial for strengthening resilience and performance. Longitudinal and multi-institutional studies are needed to validate the causality and generalizability of this study. Full article

Background: Self-harm is a growing public health concern and the strongest predictor of suicide in young people (YP). The “Supporting Adolescents with Self-Harm” (SASH) intervention was developed with YP with lived experience and expert clinicians. It involves rapid follow-up after ED attendance and up to six intervention sessions. The intervention has three components: Therapeutic Assessment (TA) of self-harm; an enhanced safety plan (SP); and Solution-Focused Brief Therapy (SFBT). Depending on the YP’s preference, carers can join sessions. Carers can also receive two individual sessions. The clinical and cost-effectiveness of SASH is being evaluated in a randomised controlled trial across nine emergency departments in three NHS Trusts in London, England. A total of 154 YP were recruited between May 2023 and March 2025 and randomised on a 1:1 ratio to SASH alongside Treatment As Usual (TAU) or TAU. A logic model describes the SASH inputs, activities, mechanisms, outcomes and longer-term impacts. The aim of this paper is to (1) illustrate how TA, SP, and SFBT were implemented in practice by presenting intervention materials and session recordings for four YP cases and one carer case and (2) explore how the case study materials/recordings reflect the intervention mechanisms in the SASH logic model. Methods: Each case focused on a different component of the intervention. Intervention materials (TA self-harm diagram and completed SP) and recorded SFBT sessions with four YP and one carer were analysed using a descriptive case study approach. The TA diagram and SP were extracted from medical records. Audio/video recordings of intervention sessions were identified. Recordings of intervention sessions and qualitative interviews were transcribed. Quotes from qualitative interviews with the same participants were included where relevant. Results: Across the four YP cases, some core themes emerged. The role of friendships for young people, particularly at school, was important in both negative and positive ways. Experiencing difficulties with friends at school led to feelings of sadness and stress, which could become overwhelming, leading to thoughts of self-harm (“I just need to hurt myself”), triggering self-harm behaviour. YP described mood changes and signs that they were becoming stressed, which improved their self-awareness and understanding of the link between their feelings and self-harm behaviour. They reflected on what kept them feeling calm and overcoming their fear of burdening others by sharing how they were feeling, as this helped them not to self-harm. They also described difficult feelings stemming from a need to please everyone or needing validation from others. Overcoming these feelings led to less social anxiety and more confidence. This made it easier to go to school and to be more social with friends/student peers, which in turn improved their mood. Conclusions: These case studies demonstrate how YP improved their self-awareness and understanding of the link between feelings and self-harm behaviour and identified personal strategies for managing difficult feelings and situations. The carer case study demonstrates how sessions with carers can facilitate carers better supporting their YP’s mental health. Supporting YP and carers in this way has the potential to reduce the risk of future self-harm. Full article

This pre–post study aimed to determine whether interprofessional education (IPE) combining online and in-person instruction enhanced medical students’ empathy. The IPE program was conducted during the academic years 2022 and 2023 for medical (n = 240) and other healthcare students. Subjects discussed a case scenario involving a patient with chronic myeloid leukemia, sharing their ideas within their team and with other teams. The medical students’ empathy was assessed before and after the IPE program using the Japanese version of the Jefferson Scale of Empathy for Health Professions Students (JSE-HPS). Medical students provided written responses to the question, “What do you think is necessary for the care of patients with cancer, besides medical skills and knowledge?” Empathy-related terms were identified using frequency and co-occurrence analyses. The frequencies before and after the IPE were compared. The median JSE-HPS score rose from 98.0 to 114.0 (p < 0.001, Wilcoxon signed-rank test). The frequency of words categorized as demonstrating empathy increased from 37.9% to 52.9% after the IPE (p < 0.01, chi-square test). Our hybrid IPE program enhanced medical students’ empathy, which was supported by both quantitative and qualitative methods. Full article

Background: Pathology education requires innovative experimental teaching approaches to enhance clinical competency. This study evaluated the integration of special staining techniques into pathology curricula to improve diagnostic confidence and practical skills. Methods: The reform involved 227 medical students, incorporating acid-fast, PAS, GMS, Congo red, and other special stains into laboratory sessions. Diagnostic confidence was surveyed, and theoretical and practical exam scores were compared with 180 students from a previous grade. Statistical analysis was performed using GraphPad Prism 7.0. Results: Practical exam scores significantly improved (86.0 ± 17.2 vs. 82.2 ± 18.9, p < 0.001), while theoretical scores remained unchanged. Diagnostic confidence strongly correlated with morphological recognition, particularly for acid-fast and fungal stains. Student feedback noted challenges such as staining artifacts. Conclusion: Integrating special staining enhances practical skills and diagnostic confidence, effectively bridging basic and clinical training. Expanding such modules is recommended to advance competency-based medical education. Full article