Search Results (99)

Background/Objectives: Effective teamwork is crucial for minimizing human error in healthcare settings. Medical teams, typically composed of physicians and nurses, supported by auxiliary professionals, achieve better outcomes when they possess strong collaborative competencies. High-quality teamwork is associated with fewer adverse events and complications and lower mortality rates. Based on this background, the objective of this study is to analyze the perception of non-technical skills and immediate learning outcomes in interprofessional simulation settings based on E-CRM items. Methods: A cross-sectional observational study was conducted involving participants from the official postgraduate Medicine and Nursing programs at the Catholic University of Murcia (UCAM) during the 2024–2025 academic year. Four interprofessional E-CRM simulation sessions were planned, involving randomly assigned groups with proportional representation of medical and nursing students. Teams worked consistently throughout the training and participated in clinical scenarios observed via video transmission by their peers. Post-scenario debriefings followed INACSL guidelines and employed the PEARLS method. Results: Findings indicate that 48.3% of participants had no difficulty identifying the team leader, while 51.7% reported minor difficulty. Role assignment posed moderate-to-high difficulty for 24.1% of respondents. Communication, situation awareness, and early help-seeking were generally managed with ease, though mobilizing resources remained a challenge for 27.5% of participants. Conclusions: This study supports the value of interprofessional education in developing essential competencies for handling urgent, emergency, and high-complexity clinical situations. Strengthening interdisciplinary collaboration contributes to safer, more effective patient care. Full article

Background: Medication adherence is essential for managing chronic conditions, while non-adherence remains a widespread issue, leading to poorer health outcomes and higher healthcare costs. This study aimed to identify key adherence barriers, explore their relationship with patient satisfaction, and assess their impact on overall well-being among ambulatory patients in Albania. Methods: A cross-sectional study was conducted in three public urban health centers in Vlora, Albania, between November 2024 and January 2025. A total of 80 ambulatory patients were recruited using convenience sampling. Data were collected through face-to-face interviews using validated questionnaires, including the Adherence Barriers Questionnaire (ABQ), the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), and the Patient Health Questionnaire (PHQ-9) for depression screening. Results: The study included 80 ambulatory patients (mean age 66.7 years; 48.7% female), predominantly diagnosed with diabetes (42.5%) and rheumatic diseases (36.3%). All participants reported at least one adherence barrier, with 92.5% experiencing multiple barriers. The most common were financial burden (91.3%) and fear of side effects (77.5%). A significant positive correlation was found between adherence barriers and depression severity (ρ = 0.518, p < 0.0001), while patient satisfaction did not significantly influence adherence barriers (ρ = −0.217, p = 0.053) or depression severity (ρ = −0.004, p = 0.969). Multiple regression analysis showed that higher depression severity (p = 0.0049) was significantly associated with greater adherence barriers, while postgraduate education was associated with fewer barriers (p = 0.0175). Conclusions: Financial burden, fear of side effects, and psychological distress are key barriers to adherence among Albanian ambulatory patients. Although there are limitations inherent to the cross-sectional design and modest sample size, our findings highlight the potential benefit of routine mental health screening, targeted financial support, and improved patient education on medication management within primary care. These insights may help inform future research and interventions aimed at enhancing adherence and overall well-being. Patient satisfaction did not significantly impact adherence or depression. Targeted interventions focusing on financial support, mental health care, and patient education are needed to improve adherence and patient well-being. These findings underscore the need for integrated mental health and adherence support strategies within routine primary care services. Full article

Background: The effective use of electronic health records (EHRs) is an essential clinical skill, but medical schools have traditionally provided limited systematic teaching on the topic. Inefficient use of EHRs results in delays in diagnosis, fragmented care, and clinician burnout. This study investigates the impact on medical students’ confidence, efficiency, and proficiency in extracting clinically pertinent information from patient records following an organised EHR teaching programme. Methods: This observational cohort involved 60 final-year medical students from three London medical schools. Participants received a structured three-phase intervention involving an introductory workshop, case-based hands-on practice, and guided reflection on EHR navigation habits. Pre- and post-intervention testing involved mixed-method surveys, simulated case tasks, and faculty-assessed data retrieval exercises to measure changes in students’ confidence, efficiency, and ability to synthesise patient information. Quantitative data were analysed using paired t-tests, while qualitative reflections were theme-analysed to identify shifts in clinical reasoning. Results: All 60 students successfully finished the intervention and assessments. Pre-intervention, only 28% students reported feeling confident in using EHRs effectively, with a confidence rating of 3.0. Post-intervention, 87% reported confidence with a rating of 4.5 (p < 0.01). Efficiency in the recovery of critical patient information improved from 3.2 to 4.6 (p < 0.01). Students also demonstrated enhanced awareness regarding system-related issues, such as information overload and fragmented documentation, and provided recommendations on enhancing data synthesis for clinical decision making. Conclusions: This study emphasises the value of structured EHR instruction in enhancing the confidence and proficiency of medical students in using electronic records. The integration of structured EHR education to medical curricula can better prepare future physicians in managing information overload, improve diagnostic accuracy, and enhance the quality of patient care. Future research should explore the long-term impact of structured EHR training on clinical performance, diagnostic accuracy, and patient outcomes during real-world clinical placements and postgraduate training. Full article

Background: The Museum for Anatomy and Pathology at the Radboud University (The Netherlands) has created a permanent teratological exhibition, which is enhanced with augmented reality (AR) modalities. This exhibition serves various (post)graduate educational purposes and is open to the general public. However, data on visitors’ views and experiences regarding the teratological collection and AR models are currently lacking. Methods: To address this, a qualitative study was conducted to explore visitors’ opinions and experiences. One-on-one in-depth interviews were conducted using a predefined topic list, with audio recordings transcribed verbatim. Thematic analysis was applied to the twenty-six interview transcripts. Results: The findings indicate that publicly displaying teratological specimens alongside AR modalities is valued and positively received by both (bio)medical students and laypeople alike. AR enhances understanding of dysmorphology and provides a more interactive and engaging learning experience for complex topics. Conclusion: The use of AR within a teratological exposition holds tremendous educational potential and improves public awareness and acceptance of developmental anomalies. Moreover, it provides a unique opportunity to reflect on both historical and contemporary bioethical issues. Full article

This case report explores the experience of a newly diagnosed type 2 diabetes (T2DM) patient transitioning from passive non-adherence to active adherence over a two-month period following hospital discharge. During this two-month period, he participated in four exploratory, non-interventional research interviews investigating his medication adherence, beliefs, and self-management strategies. His feedback on these research interviews highlighted the role of key communication strategies—such as patient partnership, non-judgmental communication, and interprofessional active listening—in fostering self-reflection and behavioural change. While these techniques are well-documented, there remains an urgent need to translate them into routine practice by integrating behavioural science and interprofessional collaboration into healthcare pregraduate and postgraduate education in order to increase awareness and skills in clinical environments. Full article

A major aspect of transition of care is the patient handover, during which miscommunication can significantly cause medical error and harm in patient care. Few medical schools in the U.S. offer formalized instructions on patient handovers, with most medical students learning from interns and residents through unstructured teaching. The aim of this study was to assess the effectiveness of a patient handover curriculum we developed for fourth-year medical students to increase their confidence and skills. Graduating fourth-year medical students (N = 98) enrolled in a two-week Transition to Residency (TTR) course attended an interactive session on patient handovers. During this session, students were presented with the I-PASS (illness severity, patient summary, action items, situation awareness and contingency planning, synthesis by receiver) mnemonic, went over case vignettes, and practiced giving and receiving handovers with a partner using the I-PASS template. At the end of TTR, students participated in an OSCE (Objective Structured Clinical Exam) activity that consisted of two standardized patient cases on blood transfusion and informed consent. Overall, our students did well with including important information in their Patient Summary (P: Case Scenario 1 Mean Score 56%; Case Scenario 2 Mean Score: 68%) and Action List (A: Case Scenario 2 Mean Score; 78%; Case Scenario 2 Mean Score: 87%) in their simulated patient case scenario. Pre-and-post survey results also indicated a significant improvement on student level of confidence (agreed or strongly agreed) in giving a patient handover (Pre: 53.1%; Post: 93.6%, p < 0.001), in receiving a patient handover (Pre: 58.2%; Post: 92.5%, p < 0.001), and in knowing what pertinent information to include in a patient handover (Pre: 62.2%; Post: 89.4%, p < 0.001). This study underscores the importance of systematic and repeated patient handover education throughout medical school training. Full article

There has been an exponential increase in the utility of mixed-reality (MR) software as a tool for medical education and training due to its immersive and interactive capabilities. Whilst it has been progressively used in surgical training or in simulation training, there is a significant lack of using it to train the “trainers”. In this single-centre prospective study, MR technology was used to deliver a dedicated 2-h tutorial in surgical training to two cohorts of postgraduate students attending a course on clinical research and education. The Microsoft HoloLens 2 was used to run mixed-reality software capable of rendering CT scan images of a normal brain, an MRI of a large meningioma, an abdominal–pelvic CT scan, and a 3D-printed cranioplasty scan. The participants were then asked to complete a post-usage questionnaire in an anonymous manner. Fourteen participants attended the teaching session and completed the post-usage questionnaire. Scores obtained on the User Experience Questionnaire (UEQ) revealed that MR technology is rated “Excellent” on quality aspects for Attractiveness, Stimulation and Novelty. This prospective study provides insight into incorporating MR in training the trainers, allowing them to be equipped with the technology to imparting education to the next generation across various disciplines. Full article

Background/Objectives: The field of paediatric bioethics addresses ethical issues in paediatric care, where parental authority often guides medical decisions, but children’s preferences should also be considered. Promoting ethical awareness among minors can help them understand complex issues. This study aimed to analyse how sociodemographic, educational, and experiential factors shape adult perspectives on paediatric bioethical issues, particularly concerning pain and death. Methods: A questionnaire was developed to collect adult views of bioethical issues. The online questionnaire was disseminated via e-mail or WhatsApp. It started with an initial group of known individuals and then expanded hierarchically to include contacts of friends. Participants completed an online questionnaire, and data were analysed using SPSS version 22.0 for Windows. Clustering analysis identified two distinct groups. Results: This research focused on Italian adults (N = 889) aged 18 and over. Cluster 1, predominantly female (78.3%) and more highly educated (38.6% with postgraduate degrees), exhibited greater experience with paediatric bioethical issues (81.1%). This group favoured a collaborative approach, supporting shared training among adults (92.3%) and advocating for gradually addressing bioethical issues during childhood (84.3%). Cluster 2, with a higher proportion of males (31.5%) and parents (75.1%), showed lower educational levels (3.0% with middle school education) and less experience with bioethical concerns (93.5%). This group preferred a reactive, situation-specific approach to these issues. Conclusions: This study showed two distinct adult profiles regarding how they approach paediatric bioethics. The first group adopts a preventive and collaborative strategy, while the second group is more reactive and situation-driven. These findings can guide the development of tailored educational programmes to improve discussions about sensitive topics such as pain, incurability, and death in paediatric care. Full article

Background: Diversity of gender representation in surgery is known to positively influence patient outcomes and predict career trajectories for female trainees. This study aims to identify the current and recent past state of gender diversity amongst trainees entering Canadian surgical residency programs. Methods: Data were sourced from the Canadian Post-M.D. Education Registry (CAPER) and the Canadian Resident Matching Service (CaRMs) for ten surgical specialties. CAPER data include PGY-1 trainees in all surgical specialties for the academic years 2012–2013 to 2021–2022. CaRMs provided data of total applicants and matched applicants for Canadian Medical Graduates (CMGs) in the match years 2013–2022. Results: From 2012–2022, there were 4011 PGY-1 surgical residents across Canada (50.4% female, 49.6% male). The surgical specialties with the most female representation were obstetrics/gynecology (82.1–91.9%), general surgery (40.2–70.7%), and plastic surgery (33.3–55.6%). The surgical specialties with the least female representation were neurosurgery (18.7–35.3%), urology (11.8–42%), and orthopedic surgery (17.5–38.5%). The number of female applicants to surgical programs has increased since 2013 and outnumbers male applicants each subsequent year. The match rate to surgical programs for female applicants has varied by year, with the highest being 63.9% in 2014 and the lowest in 2018 at 48.8%. Conclusions: Our study shows promising trends that reflect increased representation of female trainees. However, while the number of female trainees in general surgery and obstetrics/gynecology programs matches and even exceeds Canadian demographic proportions, this is not true for most other surgical specialties. This calls for continued efforts to improve and retain gender equity across surgical specialties in Canada. Full article

Background: The misuse of antibiotics in both humans and food-producing animals poses significant risks to human health and contributes to the rise of antibiotic resistance. Raising public awareness is crucial to managing antibiotic resistance, particularly among university students, as they represent a future force in tackling this global issue. Methods: A cross-sectional study was conducted from July 2022 to May 2024 in seven cities in Southern and Central China to assess university students’ knowledge, attitude, and practice regarding antibiotic use in humans and food-producing animals. Binary logistic regression was used to identify associated factors. Results: A total of 6357 students from 72 universities participated. Less than half of the students answered the knowledge items appropriately. Only 21.47% to 29.98% had a proper understanding of basic antibiotic concepts and their use in humans and food-producing animals. Respectively, 21.49% and 28.50% students paid attention to antibiotic content in food from food-producing animals and refused to buy food containing antibiotics. Factors associated with higher knowledge, attitude, and practice total scores included being male, being of older age, having a postgraduate education, majoring in the medical science discipline, studying at a double-first-class university, having a higher family monthly income, having parents in the medical area, and using antibiotics in the past year (p < 0.001). Conclusions: Given students’ insufficient knowledge—particularly in identifying antibiotics and understanding their functions—and inappropriate practices related to purchasing food from food-producing animals, targeted education programs are suggested. These programs should address the fundamental concepts of antibiotic use in both humans and food-producing animals while providing practical guidance on individual behaviors to help mitigate antibiotic resistance. Full article

Background: The frozen elephant trunk method combines the implantation of a Dacron prosthesis with a self-expanding stent graft, which allows for complex repairs of the aortic arch and thoracic aorta in one procedure. Despite the advantages of hybrid treatment for aortic arch aneurysms, in Poland, only a few such surgeries are performed annually compared to in Western countries. The aim of this study was to demonstrate the 8-year outcomes of treatment at the center where the Aortic Team operates, which is one of the centers in Poland with the most extensive experience in hybrid FET treatment. Methods: Patients who underwent frozen elephant trunk surgery for chronic and acute pathologies of the aortic arch and thoracic aorta between March 2016 and March 2024 were comprehensively analyzed retrospectively. Frozen elephant trunk procedures were performed under three consecutive clinical conditions: acute aortic dissection, chronic aortic dissection and redo surgery. Results: A total of 40 patients (median age: 60 years (53–66), 67.5% male) were admitted to our hospital and underwent an FET procedure. The median Euroscore II was 25.9% and the 30-day mortality was 7.5%. The 1-year and 5-year mortalities were the same, equal to 15%, with mortality cases observed only in the first and second groups of consecutive patients during the first two months of follow-up. Spinal cord injury was observed in 2.5% of patients. Conclusions: The FET technique can be successfully used to treat aortic aneurysms with optimal results and low complication rates. The surgery length, including the cardiopulmonary bypass and aortic cross-clamp times, decreased significantly with increasing experience. Full article

About 14% of adolescents experience mental illnesses globally. The rate increased after the COVID-19 pandemic. This study aimed to estimate the prevalence of COVID-related major mental illnesses (depression and anxiety) and their predictors among adolescents. This community-based cross-sectional study was conducted among 350 adolescents aged 10–19 years, recruited from rural communities in West Bengal, India. The study areas included 27 subcenters in the Budge Budge II Block, which comprised 191,709 population and 45,333 households. Data were collected from randomly selected households by trained research assistants through house-to-house interviews. Pretested standardized questionnaires, Patient Health Questionnaire (PHQ) for depression, Generalized Anxiety Disorder (GAD) for anxiety, and a demographic questionnaire were used for data collection. The prevalence of anxiety was 35.7% (125 out of 350), and the prevalence of depression was 30.0% (105 out of 350). Females had significantly higher scores of anxiety (6.67 ± 4.76 vs. 3.42 ± 3.17, respectively, p < 0.001) and depression (5.51 ± 4.99 vs. 3.26 ± 3.86, respectively, p < 0.001) compared to males. Adolescents who had COVID-19 cases or deaths in the family had significantly higher scores of anxiety and depression compared to those who did not have these events. In multivariate analysis, the statistically significant predictors of anxiety were COVID-19 death in the family, COVID-19 cases in the family, female gender, and a lower income group (p < 0.001 for all). For depression, the significant predictors included COVID-19 death in the family, COVID-19 cases in the family, female gender, a lower income group, and a higher age group in adolescents (p < 0.001 for all). Based on the study results, we recommend that immediate attention is needed for adolescents’ mental health support and coping with stresses following COVID-19. Full article

Large language models (LLMs) are trained using large datasets and may be applied to language-based tasks. Studies have demonstrated their ability to perform and pass postgraduate medical examinations, and with the increasingly sophisticated deep learning algorithms and incorporation of image-analysis capabilities, they may also be applied to the Specialty Certificate Examination (SCE) in Dermatology. The Dermatology SCE sample questions were used to assess the performance of five freely available and high-performance LLMs. The LLMs’ performances were recorded by comparing their output on multiple-choice questions against the sample answers. One hundred questions, four of which included photographs, were entered into the LLMs. The responses were recorded and analysed, with the pass mark set at 77%. The accuracies for Claude-3.5 Sonnet, Copilot, Gemini, ChatGPT-4o, and Perplexity were 87, 88, 75, 90, and 87, respectively (p = 0.023). The LLMs were generally capable of interpreting and providing reasoned responses to clinical scenarios and clinical data. This continues to demonstrate the potential of LLMs in both medical education and clinical settings. Full article

Antibiotics like colistin can save patients infected with carbapenem-resistant Pseudomonas aeruginosa. However, patients can succumb to such infections even if they undergo colistin therapy. This prompted us to investigate the probable antimicrobial resistance mechanisms and virulence determinants involved in colistin- and carbapenem-resistant P. aeruginosa (CCRPA). Of the 448 P. aeruginosa clinical strains, 19 isolates were resistant to both colistin and carbapenem. Carbapenemases and efflux pump encoding genes were assessed by multiplex PCR and qPCR, respectively. blaVIM was detected among six CCRPA isolates and blaIMP in one strain. The expression levels of pmrA and phoP, as well as pmrB genes and their association with colistin resistance, were assessed by qPCR and semi-quantitate PCR, respectively. pmrA and phoP genes were significantly enhanced in three and nine CCRPA isolates, respectively. We also phenotypically evaluated biofilms, pyocyanin, and alginate production among CCRPA strains. Alginate production was observed in 15 isolates, followed by biofilm (n = 8) and pyocyanin (n = 5). Our results highlighted the coexistence of colistin and carbapenem resistance and biofilm formation among clinical isolates of CCRPA. Further studies are required to trace the source and the origin of colistin and carbapenem resistance in this specific environment. Full article

Over the last decade, initiatives like the Choosing Wisely campaign have promoted the practice of evidence-based, cost-conscious care. However, education surrounding value in medicine has been largely restricted to graduate-level medical education or post-clerkship undergraduate medical education. Here, we present a mixed-methods study evaluating pre-clerkship medical student engagement with and response to new value-based curricular initiatives to assess whether high-value care (HVC) can be introduced successfully earlier in training. Initiatives were introduced into the pre-clerkship clinical curriculum without major alterations to the established curricular structure. These comprised an annual event devoted to self-reflecting on HVC observed in prior and current clinical experiences and subsequent small-group facilitated discussion. Engagement with and response to these initiatives were analyzed for two whole-class cohorts using an abductive, progressive focusing approach complementing quantitative survey data. Baseline familiarity with HVC and post-event response to the annual event was higher and more positive, respectively, among responders from the Class of 2025 compared with those from the Class of 2024. Analysis of reflection essays revealed the emergence of five primary themes differentiating the two class years: (1) understanding HVC, (2) addressing barriers to HVC, (3) medical waste and underserved communities, (4) patient–physician relationship and value, and (5) self-reflection. Evaluation of thematic patterns in light of survey response data suggests that early clinical exposure combined with intentional self-reflection could promote engagement with HVC topics in a way that shapes students’ foundational understanding of the practice of medicine. Full article