Search Results (309)

Background/Objectives: It is essential to explore and disseminate positive deviance strategies that promote resilience, mindfulness, and well-being beyond stress and burnout reduction strategies for residents and physicians who experience high levels of occupational stress. This scoping review maps studies that investigate positive deviance strategies to enhance the well-being of residents and physicians. Methods: A scoping review was conducted by PRISMA guidelines to identify English-language studies on strategies for physician well-being. PubMed, MEDLINE, Embase, and ERIC were searched using terms related to well-being, coping, and medical education. Results: Among the 38 studies included, 17 (44.7%) targeted physicians in graduate medical education (GME), while 19 (50%) focused on continuing medical education (CME). Positive deviance strategies were identified in 26 studies and were most frequently implemented at the microsystem level, such as small group interventions (e.g., coaching, mentoring, and workshops). These strategies addressed individual and organisational factors that contribute to physician well-being and were associated with improvements in life satisfaction, resilience, professional identity, and psychological safety. The review found that positive deviance strategies were often proactive, values-driven, and disseminated organically over time, emphasising the importance of longitudinal engagement and sustained institutional support. Conclusions: This scoping review highlights the growing use of positive deviance strategies, especially at the microsystem level, to promote physician well-being. These approaches emphasise sustainable, values-driven practices and may offer effective, context-sensitive solutions within healthcare systems. Full article

In modern medical education, a robust understanding of statistics is essential for fostering critical thinking, informed clinical decision-making, and effective communication. This paper explores the synergistic value of early and continued statistical education for medical students and residents, particularly in relation to the expanding field of sports supplementation and its impact on athletic performance. Early exposure to statistical principles enhances students’ ability to interpret clinical research, avoid cognitive biases, and engage in evidence-based practice. Continued statistical learning throughout residency further refines these competencies, enabling more sophisticated analysis and application of emerging data. The paper also addresses key challenges in integrating statistics into medical curricula—such as limited curricular space, student disengagement, and resource constraints—and proposes solutions including interactive learning, case-based teaching, and the use of public datasets. A unique emphasis is placed on connecting statistical literacy to the interpretation of research in sports science, particularly regarding the efficacy, safety, and ethical considerations of sports supplements. By linking statistical education to a dynamic and relatable domain like sports performance, educators can not only enrich learning outcomes but also foster lasting interest and competence in quantitative reasoning. This integrated approach holds promise for producing more analytically proficient and clinically capable physicians. Full article

Background/Objectives: Long working hours among pediatricians negatively affect their health and patient safety. In Japan, the Ministry of Health, Labour and Welfare launched the “Work Style Reform for Physicians” in 2024. However, whether these reforms have effectively reduced pediatricians’ working hours remains unclear. We surveyed pediatricians and pediatric residents working in hospital pediatric departments to assess whether the reform has reduced their long working hours. Methods: A questionnaire was distributed to pediatricians in hospitals, collecting data on demographics, working hours, night shifts, and other working conditions. A multivariate logistic regression analysis identified factors associated with working ≥60 and ≥80 h on a weekly basis. Results: Questionnaires were sent to 835 hospitals, with valid responses from 815 pediatricians across 316 hospitals. Among them, 31.7% worked 50–60 h per week, 18.4% worked 60–70 h, 7.7% worked 70–80 h, and 4.9% worked >80 h. Factors associated with working >60 h included being <30 years old and working in a department with five or more physicians. Pediatricians working >80 h were more likely to have a cardiology subspecialty and work in a department with five or more physicians. Conclusions: Although the “Work Style Reform for Physicians” has reduced long working hours among pediatricians, many still experience excessive workloads. Full article

Background/Objectives: Weight loss and its subsequent regain pose significant challenges for those dealing with overweight and obesity. This study explores weight loss strategies among adults in Saudi Arabia and evaluates factors linked to weight regain. Methods: This cross-sectional study focused on adults residing in Jazan, located in southwest Saudi Arabia. Data collection was conducted using a self-administered questionnaire that assessed participants’ demographics, medical history, perceptions of body weight, weight loss methods, and the incidence of weight regain. Logistic regression was used to determine whether there were statistically significant differences related to the occurrence of weight regain. Results: A total of 368 participants reported efforts to lose weight over the past 3 years. The average age of these participants was 32.7 years (standard deviation: 11.3), and the gender distribution was almost equal. The majority of the sample (65%) voiced dissatisfaction with their body weight. Some participants employed a combination of weight loss methods, with exercise, reduced food intake, and intermittent fasting being the most frequently mentioned. The findings also indicate that a minority sought professional help, whether from a physician or a nutritionist. Over 90% claimed to have successfully lost weight at least once during their attempts, but more than half (139 individuals) experienced weight regain following their weight loss efforts. Within the univariate logistic regression, higher odds ratios of weight regain were detected among men, older participants, those living in rural areas, individuals with higher levels of education, employed persons or business owners, those with higher monthly incomes, smokers, khat chewers, and those diagnosed with a chronic condition (p values < 0.05). However, the multivariate logistic regression revealed that only residence, monthly income, smoking status, and being diagnosed with a chronic disease remained statistically significant as predictors of weight regain after adjusting for other variables (p values < 0.05). Conclusions: These findings highlight the significance of incorporating weight regain prevention into body weight management for individuals dealing with overweight and obesity. Further research is needed to evaluate specific dietary, physical activity, and psychological factors that may increase the risk of weight regain in certain participants. Full article

Background: Residency training is a formative and rigorous experience, with burnout rates reported at 76%. Formal peer support groups have shown improvement in burnout among healthcare workers with anxiety and depression. Objective: Implement a peer support program for emergency medicine (EM) residents and characterize utilization of metrics by demographics, burnout rates of participants, and overall session impact. Methods: An IRB-approved, longitudinal, prospective cohort study of 73 EM and EM/Pediatrics residents post-graduate year (PGY) 1–5 from July 2021–June 2022 was performed. Resident peer leaders were trained using a novel curriculum to lead peer support groups. Residents were invited to participate in biweekly sessions, with optional pre- and post-session surveys measuring demographics, burnout, themes discussed, and how they felt after sessions (Patients’ Global Impression of Change scale). Results: There were 134 attendances over 20 sessions, averaging 6 residents per session. Of 73 total residents, 37 (50%) participated at least once. All levels of training were represented, with half being female, 20% underrepresented in medicine, and 14% LGBTQ+. Overall burnout rates were unchanged for first-time attendances (49%, n = 18) vs. recurrent (50%, n = 11). Females had higher burnout at both baseline (60%, n = 15) and recurrent sessions (69%, n = 13). Following sessions, 94% of participants reported feeling immediately better and 100% of leaders felt prepared leading peer support sessions. Conclusions: This study demonstrates that residents utilize peer support, with many returning more than once. Despite stable burnout rates, 94% of participants felt immediately better after the session, suggesting that peer support is a valuable resource for residents actively experiencing burnout. Full article

Antimicrobial resistance (AMR) represents a critical global health threat, with inappropriate antibiotic self-medication (ASM) being a key contributor. China—as the world’s largest antibiotic consumer—faces significant challenges despite regulatory efforts, compounded by limited contemporary data during the COVID-19 pandemic. A nationwide cross-sectional study was conducted using the 2021 China Family Health Index Survey (n = 11,031 participants across 120 cities). Trained investigators administered face-to-face questionnaires assessing ASM practices, decision-making factors, and sociodemographic characteristics. Multivariate logistic regression identified determinants of ASM. Overall, ASM prevalence was 33.7% (n = 3717), with no urban-rural difference (p > 0.05). Physician advice (78.2%), drug safety (67.1%), and efficacy (64.2%) were primary selection criteria; rural residents prioritized drug price and salesperson recommendations more than their urban counterparts (p < 0.01). Key predictors included higher ASM odds among females (OR = 1.30, 95%CI:1.18–1.43), middle-aged adults (46–59 years; OR = 1.20, 95%CI:1.02–1.42), those with health insurance (resident: OR = 1.33; commercial: OR = 1.62), and individuals with drinking histories (OR = 1.20, 95%CI:1.10–1.31). Lower odds were associated with primary education (OR = 0.69, 95%CI:0.58–0.81), unemployment (OR = 0.88, 95%CI:0.79–0.98), and absence of chronic diseases (OR = 0.56, 95%CI:0.47–0.67). One-third of Chinese residents engaged in ASM during the pandemic, driven by intersecting demographic and behavioral factors. Despite converging urban-rural prevalence rates, distinct decision-making drivers necessitate context-specific interventions, including strengthened pharmacy regulation in rural areas, tailored education programs for high-risk groups, and insurance system reforms to disincentivize self-medication. Full article

Background/objectives: Racial and ethnic minority patients are underrepresented in cancer clinical trials (CCTs) and multilevel strategies are required to increase participation. This study describes barriers and facilitators to minority CCT participation alongside feedback on a multilevel intervention (MLI) designed to reduce participation barriers, as posited by the socioecological model (SEM). Methods: Interviews with Moffitt Cancer Center (MCC) physicians, community physicians, patients with cancer, community residents, and clinical research coordinators (CRCs) were conducted from June 2023–February 2024. Verbal responses were analyzed using thematic analysis and categorized into SEM levels. Mean helpfulness scores rating interventions (from 1 (not helpful) to 5 (very helpful)) were summarized. Results: Approximately 50 interviews were completed. Thematic findings confirmed CCT referral and enrollment barriers across all SEM levels. At the community level, MCC patients and community residents felt that community health educators can improve patient experiences and suggested they connect patients to social/financial resources, assist with patient registration, and provide CCT education. While physicians and CRCs reacted positively to all institutional-level tools, the highest scored tool simultaneously addressed CCT referral and enrollment at the institution (e.g., trial identification/referrals) and interpersonal level (communication platform for community and MCC physicians) (mean = 4.27). At the intrapersonal level, patients were enthusiastic about a digital CCT decision aid (mean = 4.53) and suggested its integration into MCC’s patient portal. Conclusions: Results underscore the value of conducting formative research to tailor interventions to target population needs. Our approach can be leveraged by future researchers seeking to evaluate MLIs addressing additional CCT challenges or broader health topics. Full article

The impact of work engagement and burnout on medical activities, physicians’ performance, and quality of care has gained interest over the last decades. However, the effect of demographics, job-related, and organizational variables on burnout and work engagement in young endocrinologists has not been fully investigated. To assess the impact of demographics, job-related, and organizational variables on burnout and work engagement in young endocrinologists who joined the Italian Association of Clinical Endocrinologists. The levels of burnout and work engagement were assessed by the Maslach Burnout Inventory and the Utrecht Work Engagement Scale, respectively, as a part of an online survey of the “Associazione Medici Endocrinologi” addressed to young members (31–40 years). Eighteen MANOVAs were applied to analyze differences in burnout and work engagement based on demographic, job-related, and organizational factors. We collected responses from 160 young endocrinologists, mainly women (80.6%), aged 31–35 years (33.8%) and 36–40 years (66.2%). Most were in a stable relationship with (40%) or without (45%) children. Most of them worked in hospitals or local healthcare districts (35.6%), as independent contractors (31.9%), or as Ph.D. students or residents (25.6%). Multivariate analyses found no statistically significant differences in burnout and work engagement due to demographics (gender, age, and partnership) and job-related variables (type of job and contract). On the other hand, organizational variables (levels of conflict amongst colleagues, more than expected time spent working, and no involvement in team-building activities) were associated with higher emotional exhaustion, lower dedication, and less vigor. The novelty of the study is that both burnout and work engagement can be affected by organizational variables in early-career Italian endocrinologists, highlighting the need for supporting the healthcare system to overcome this gap. Full article

Background and Objective: Despite growing emphasis on quality and safety in healthcare, there remains a limited understanding of how Quality Improvement and Patient Safety (QI/PS) training for health workers has evolved in response to global events like the COVID-19 pandemic and the WHO Global Patient Safety Action Plan. This rapid scoping review aimed to not only identify existing curricula but also uncover trends, innovation gaps, and global inequities in QI/PS education—providing timely insights for reshaping future training strategies. Methods: We searched MEDLINE and Scopus for English-language studies published between January 2020 and April 2024, describing QI and/or PS curricula across graduate, postgraduate, and continuing education levels. All healthcare worker groups were eligible, with no geographic limitations. Two reviewers conducted independent screening and data extraction; a third verified the results. Results: Among 3290 records, 74 curricula met inclusion criteria, with a majority originating from the US (58, 78.4%) and targeting physicians—especially residents and fellows (43/46, 93.5%). Only 27% of curricula were multidisciplinary. While traditional didactic (66.2%) and interactive (73%) approaches remained prevalent, curricula launched after 2020 introduced novel formats such as Massive Open Online Courses and gamification, with long-term programs uniformly leveraging web-based platforms. Common thematic content included Root Cause Analysis, Plan-Do-Study-Act cycles, QI tools, communication skills, and incident reporting. English-language peer-reviewed published literature indicated a marked lack of structured QI/PS training in Europe, Asia, and Africa. Conclusions: This review reveals both an uneven development and fragmentation in global QI/PS training efforts, alongside emerging opportunities catalyzed by digital transformation and pandemic-era innovation. The findings highlight a critical gap: while interest in QI/PS is growing, scalable, inclusive, and evidence-based curricula remain largely concentrated in a few high-income countries. By mapping these disparities and innovations, this review provides actionable direction for advancing more equitable and modern QI/PS education worldwide, whilst showcasing the need to systematically delve into QI/PS training in underrepresented regions. Full article

In agreement with WHO recommendations, the Emilia-Romagna Region, Italy, implemented a population-wide HCV screening program for the treatment of the large asymptomatic infected population. From January 2022, the free-of-charge screening targeted all residents born between 1969 and 1989, prison inmates, and injection drug users. Participants were recruited using phone messages, electronic health record notifications, public advertisement, and direct contact with general practitioners. A single blood sample was collected for anti-HCV IgG testing and, if positive, for reflex HCV–RNA testing. Infected subjects were offered an evidence-based therapeutic pathway. By June 2024, 72.8% of high-risk subjects (n = 19,732), and 36.9% of the general population (n = 488,065) had been screened. A total of 1032 individuals were positive based on the HCV–RNA test, and the detection rate widely differed between the high-risk and the general population (23.8‰ vs. 1.2‰, respectively). Of the infected individuals, 88.1% were seen by a specialist physician, and 74.3% (n = 767) started antiviral therapy. Thanks to multiple recruitment approaches, over one third of the general population participated in HCV screening. The program performance was substantially greater among high-risk individuals compared to the general population. To achieve WHO targets, policymakers might consider expanding the screening to other high-risk subgroups and/or adapting birth cohorts. Full article

As part of the “2nd Training Conference on Heart Failure and Atrial Fibrillation for Residents”, held in Madrid in November 2024, a collaborative initiative was launched to address the most common practical challenges in the management of heart failure (HF) in daily practice. This document is the result of the joint efforts of residents from various hospitals nationwide, in collaboration with senior physicians with extensive HF expertise and members of the Working Group of the Spanish Society of Internal Medicine. Our aim is to provide a useful tool that promotes learning and collaboration among professionals interested in this field. The structure of this document is based on a compilation of the most interesting and challenging questions raised during the conference. Each question is addressed with a concise and practical response, supported by updated references to ensure scientific rigor and facilitate consultation. Full article

Background and Objectives: Medical residency programs play a crucial role in emergency departments (EDs). However, clinical processes may differ between EDs staffed with medical residents and those staffed only by attending physicians. This study aims to compare clinical process times and clinical outcomes between these two types of EDs. Materials and Methods: A retrospective observational study was conducted, analyzing patients aged ≥ 18 years who visited an ED with a medical residency program and an ED staffed only by attending physicians. Time variables, including the time to first physician encounter, first order, CT order, consultation request, consulted specialist arrival, disposition decision, ED length of stay (LOS), and ED dispositions were compared between the two ED settings. Results: A total of 24,942 patients in an ED with a medical residency program and 19,867 patients in an ED staffed only by attending physicians were included in the final analysis. The ED with a medical residency program exhibited significantly longer times in all time variables including time to first physician encounter (7.0 [4.0–12.0] vs. 3.0 [1.0–5.0] min), first order (15.0 [9.0–23.0] vs. 9.0 [5.0–13.0] min), consultation request (95.0 [42.0–146.0] vs. 72.0 [27.0–124.0] min), consulted specialist arrival (156.0 [90.0–238.0] vs. 117.0 [63.0–176.0] min), and disposition decision (134.0 [70.0–208.0] vs. 92.0 [32.0–139.0] min). However, the proportion of discharges, admissions, and deaths were similar between the two EDs. Conclusions: The ED with a medical residency program may contribute to delays in clinical processing times; however, it appears to have no significant impact on clinical outcomes. Full article

Over the past decade, telehealth provision of care has become increasingly common. This shift away from in-person clinics may impact the experience of medical learners and the preceptors who train them. This study aimed to measure and compare obstetrics and gynecology resident physicians’ perceived quality of educational feedback during telemedicine compared to in-person clinical encounters. This prospective observational study recruited residents enrolled in a family planning clinical rotation at an academic residency program. After every in-person and telemedicine clinic session from January 2021 to February 2022, participating residents were sent a link to a 3 min survey via text message. Ordinal regression modeling was used to compare Likert responses between the telehealth and in-person clinical settings. All nine residents enrolled in the clinical rotation chose to participate in this study and responded to 114 of 132 survey prompts (86%). Participants positively rated the feedback they received during all clinic sessions. When comparing the two clinic experiences, there was no statistically significant difference in perceived quality of feedback or satisfaction with feedback. Residents’ perception of educational feedback during telemedicine clinic is at least similar for most measures and superior for contraception counseling when compared to an in-person clinic. Full article

The field of emergency medicine (EM) is a high-stress medical specialty. We aim to comparatively investigate burnout, work addiction, and stress-related growth between EM physicians and EM residents. Our sample consists of 117 EM professionals, 41 physicians and 76 residents, from 5 out of the 12 EM county departments in Romania that run residency programs. Methods: An online survey was sent to 461 EM professionals (170 physicians and 291 residents), with a response rate of 25.4%. The survey comprised two sections: the first focused on sociodemographic and professional data, with the second consisting of six validated assessment instruments: the Oldenburg Burnout Inventory, Dutch Work Addiction Scale—short version, Stress-Related Growth Scale, Responsive Distress Scale, Self-Discipline Scale, and Zuckerman–Kuhlman Personality Questionnaire. Both EM physicians and residents reported moderate to high levels of burnout, disengagement, and exhaustion, but there was no significant difference between them. However, physicians exhibited significantly higher levels of work addiction, excessive work, compulsive work, and stress-related growth. No significant differences were found in compulsive work behaviors. Conclusions: Burnout levels are comparable between EM physicians and residents. However, physicians demonstrate higher work addiction but also higher stress-related growth. Personality variables and sleep duration appear to be more influential in predicting burnout than in work addiction or stress-related growth. Full article

Background: Premature hair graying (PHG) is one of the most prevalent conditions affecting individuals worldwide. It has been recognized as an important cause of low self-esteem, with a significant physical and social impact. This study investigated the factors associated with PHG by comparing medical students and resident physicians to other non-medical majors at Imam Abdulrahman Bin Faisal University (IAU). Methods: This is a comparative cross-sectional study conducted on resident physicians and students from 10 different colleges of IAU, Eastern Province, Saudi Arabia. This study evaluated the characteristics of PHG and its associated risk factors using an online distributed questionnaire. Results: A total of 2644 students and resident physicians were included in this study, with 45.6% coming from medical colleges. The findings show that the premature graying of hair was higher among obese and overweight individuals and those with a combined deficiency of vitamins B12 and vitamin D. Other factors associated with PHG included a family history of PHG, a lack of exercise, smoking, and allergic rhinitis. Gray hair onset before 25 years old was higher among those with high stress levels (95%) than those with moderate (90%) and or mild (86%) stress levels (p = 0.029). Conclusions: In our study, higher stress levels were related to an earlier age of PHG onset, and there was no difference between medical and non-medical students in PHG. Recommendations for future research include randomized clinical trials and larger cohort studies regarding the characteristics of PHG in the Middle East and those with Arabic ethnicity and assessing the medications that induce possible hair repigmentation. Full article