Pub Date : 2024-03-18DOI: 10.1101/2024.03.17.24304448
Briana Christophers, Briana Macedo, Jessica Weng, Michael C Granovetter, Rachit Kumar, Chynna Smith, Olaf S Andersen, Catharine Boothroyd
Introduction: Physician-scientists are uniquely positioned to contribute translational research that will impact patient care and our understanding of disease. Having a diverse cadre of physician-scientists is critical to ensuring that the biomedical research enterprise explores the breadth of problems affecting the nation's health. The National Institutes of Health has identified diversity, including educational background, to be important for the biomedical workforce. In 2020, less than ten percent of MD-PhD program matriculants were the first in their families to pursue higher education (first-generation) despite the majority of the US population having less than a Bachelor's degree. Little is known about the specific challenges that first-generation students face, which makes it challenging to address this gap in matriculation. Methods: This qualitative study used a phenomenological approach to examine the experiences of first-generation individuals, from the applicant stage to the early-career stage. We conducted semi-structured interviews with 41 participants and analyzed responses in accordance with a networked ecological systems theory. Results: The interviews revealed that first-generation individuals put together a patchwork of support. Whereas many MD-PhD trainees struggle at some point in their training, first-generation individuals tend to lack a support system that may provide proactive advice and prepare them for milestones. Interviews shared a common sentiment of isolation due to both a lack of social capital within medicine and academia, as well as a growing disconnect from their families and community. Discussion: Key interventions that would support first-generation students include greater access to high-quality information about the pathway, tailored mentorship throughout training, and more financial resources at the application stage. Trainees and early career physician-scientists seek more flexibility, opportunities for finding community, financial guidance and options, and mentorship around building their careers.
导言：医生科学家在转化研究方面具有得天独厚的优势，他们的研究将对病人护理和我们对疾病的认识产生影响。拥有一支多元化的医生科学家队伍，对于确保生物医学研究事业探索影响国家健康的广泛问题至关重要。美国国立卫生研究院（National Institutes of Health）认为，包括教育背景在内的多样性对生物医学人才队伍非常重要。2020 年，尽管美国大多数人口的学士学位都不到，但只有不到 10% 的医学博士预科生是家庭中第一个接受高等教育的人（第一代）。人们对第一代学生所面临的具体挑战知之甚少，这使得解决预科生的这一差距问题具有挑战性。研究方法这项定性研究采用现象学的方法来考察第一代学生从申请阶段到职业生涯初期的经历。我们对 41 名参与者进行了半结构化访谈，并根据网络生态系统论分析了他们的回答。结果显示访谈结果显示，第一代个体获得的支持是拼凑而成的。许多医学博士受训者在培训的某个阶段都会遇到困难，而第一代受训者往往缺乏一个可以提供积极建议并让他们为里程碑做好准备的支持系统。由于在医学界和学术界缺乏社会资本，以及与家庭和社区的联系日益脱节，受访者普遍感到孤立无援。讨论：支持第一代学生的主要干预措施包括：提供更多有关医学途径的高质量信息、在整个培训期间提供量身定制的指导以及在申请阶段提供更多的财政资源。受训人员和早期职业医生科学家需要更多的灵活性、寻找社区的机会、财务指导和选择，以及围绕其职业生涯的指导。
{"title":"Pathways and barriers to becoming physician-scientists for first-generation individuals","authors":"Briana Christophers, Briana Macedo, Jessica Weng, Michael C Granovetter, Rachit Kumar, Chynna Smith, Olaf S Andersen, Catharine Boothroyd","doi":"10.1101/2024.03.17.24304448","DOIUrl":"https://doi.org/10.1101/2024.03.17.24304448","url":null,"abstract":"Introduction: Physician-scientists are uniquely positioned to contribute translational research that will impact patient care and our understanding of disease. Having a diverse cadre of physician-scientists is critical to ensuring that the biomedical research enterprise explores the breadth of problems affecting the nation's health. The National Institutes of Health has identified diversity, including educational background, to be important for the biomedical workforce. In 2020, less than ten percent of MD-PhD program matriculants were the first in their families to pursue higher education (first-generation) despite the majority of the US population having less than a Bachelor's degree. Little is known about the specific challenges that first-generation students face, which makes it challenging to address this gap in matriculation. Methods: This qualitative study used a phenomenological approach to examine the experiences of first-generation individuals, from the applicant stage to the early-career stage. We conducted semi-structured interviews with 41 participants and analyzed responses in accordance with a networked ecological systems theory. Results: The interviews revealed that first-generation individuals put together a patchwork of support. Whereas many MD-PhD trainees struggle at some point in their training, first-generation individuals tend to lack a support system that may provide proactive advice and prepare them for milestones. Interviews shared a common sentiment of isolation due to both a lack of social capital within medicine and academia, as well as a growing disconnect from their families and community. Discussion: Key interventions that would support first-generation students include greater access to high-quality information about the pathway, tailored mentorship throughout training, and more financial resources at the application stage. Trainees and early career physician-scientists seek more flexibility, opportunities for finding community, financial guidance and options, and mentorship around building their careers.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140166581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-18DOI: 10.1101/2024.03.17.24304430
Ibrahem Hanafi, Marah Alsalkini, Kheder Kheder, Maarouf Gorra Al Nafouri, Ahmad Rami Rahmeh, Rami Sabouni
Objectives Medical research in Syria faced significant limitations due to inadequate human and financial resources, exacerbated by the ongoing war. Until recently, the curriculum did not incorporate sufficient training on research skills. Consequently, extracurricular workshops were initiated or utilized nationwide to acquire research-related expertise, aiming to bolster research output. This study aims to characterize and evaluate these training endeavors concerning research-related knowledge, attitudes, barriers, as well as research productivity. Methods This case-control study encompassed all training initiatives in Syria from 2011 to 2020, both on-site and online. Participants consisted of early career healthcare professionals affiliated with all Syrian universities and were recruited into four equal groups based on the quantity of research projects they undertook and published. Our participants reported and assessed individual extracurricular workshops regarding their gained knowledge, attitudes, and practical skills. These initiatives were compared to curricular training and practical peer-led support regarding these outcomes. Results The study included 53 on-site and 30 online workshops, displaying diverse distributions and features. Attendance of extracurricular workshops correlated with participants' knowledge, attitudes, and research productivity (p<0.001). The most effective interventions were massive open online courses and workshops lasting over 12 hours. Extracurricular workshops and peer-led support has comparable effectiveness and associated with higher knowledge, attitudes, and practical skills of their beneficiaries in comparison to curricular training (adjusted p<0.05). Lastly, peer trainers in these workshops exhibited more publications and higher levels of knowledge and attitude than the rest of the sample (adjusted p<0.05). Conclusions Overall, extracurricular interventions and peer support demonstrated their superiority over curricular training. Despite the varied nature of these workshops and the absence of institutional organization, these approaches exhibited significant potential in enhancing research-related knowledge, promoting positive attitudes, and augmenting research productivity in resource-constrained settings such as Syria.
{"title":"Analyzing the efficacy of a decade-long endeavor: extracurricular medical research training amidst the turmoil of Syria","authors":"Ibrahem Hanafi, Marah Alsalkini, Kheder Kheder, Maarouf Gorra Al Nafouri, Ahmad Rami Rahmeh, Rami Sabouni","doi":"10.1101/2024.03.17.24304430","DOIUrl":"https://doi.org/10.1101/2024.03.17.24304430","url":null,"abstract":"Objectives Medical research in Syria faced significant limitations due to inadequate human and financial resources, exacerbated by the ongoing war. Until recently, the curriculum did not incorporate sufficient training on research skills. Consequently, extracurricular workshops were initiated or utilized nationwide to acquire research-related expertise, aiming to bolster research output. This study aims to characterize and evaluate these training endeavors concerning research-related knowledge, attitudes, barriers, as well as research productivity. Methods This case-control study encompassed all training initiatives in Syria from 2011 to 2020, both on-site and online. Participants consisted of early career healthcare professionals affiliated with all Syrian universities and were recruited into four equal groups based on the quantity of research projects they undertook and published. Our participants reported and assessed individual extracurricular workshops regarding their gained knowledge, attitudes, and practical skills. These initiatives were compared to curricular training and practical peer-led support regarding these outcomes. Results The study included 53 on-site and 30 online workshops, displaying diverse distributions and features. Attendance of extracurricular workshops correlated with participants' knowledge, attitudes, and research productivity (p<0.001). The most effective interventions were massive open online courses and workshops lasting over 12 hours. Extracurricular workshops and peer-led support has comparable effectiveness and associated with higher knowledge, attitudes, and practical skills of their beneficiaries in comparison to curricular training (adjusted p<0.05). Lastly, peer trainers in these workshops exhibited more publications and higher levels of knowledge and attitude than the rest of the sample (adjusted p<0.05). Conclusions Overall, extracurricular interventions and peer support demonstrated their superiority over curricular training. Despite the varied nature of these workshops and the absence of institutional organization, these approaches exhibited significant potential in enhancing research-related knowledge, promoting positive attitudes, and augmenting research productivity in resource-constrained settings such as Syria.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140166711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-15DOI: 10.1101/2024.03.13.24304232
Catherine A Lippi, Holly D Gaff, Alexis L White, Sadie Jane Ryan
Background: Tick-borne diseases are a growing public health threat in the United States. Despite the prevalence and rising burden of tick-borne diseases, there are major gaps in baseline knowledge and surveillance efforts for tick vectors, even among vector control districts and public health agencies. To address this issue, an online tick training course (OTTC) was developed through the Southeastern Center of Excellence in Vector-Borne Diseases (SECOEVBD) to provide a comprehensive knowledge base on ticks, tick-borne diseases, and their management. Methods: The OTTC consisted of training modules covering topics including tick biology, tick identification, tick-borne diseases, and public health, personal tick safety, and tick surveillance. The course was largely promoted to vector control specialists and public health employees throughout the Southeastern US. We collected assessment and survey data on participants to gauge learning outcomes, perceptions of the utility of knowledge gained, and barriers and facilitators to applying the knowledge in the field. Results: The OTTC was successful in increasing participants' baseline knowledge across all course subject areas, with the average score on assessment increasing from 62.6% (pre-course) to 86.7% (post-course). More than half of participants (63.6%) indicated that they would definitely use information from the course in their work. Barriers to using information identified in the delayed assessment included lack of opportunities to apply skills (18.5%) and the need for additional specialized training beyond what the OTTC currently offers (18.5%), while the main facilitator (70.4%) for applying knowledge was having opportunities at work, such as an existing tick surveillance program. Conclusions: Overall, this OTTC demonstrated capacity to improve knowledge in a necessary and underserved public health field, and more than half of participants use or plan to use the information in their work. The geographic reach of this online resource was much larger than simply for the Southeastern region for which it was designed, suggesting a much broader need for this resource. Understanding the utility and penetrance of training programs such as these is important for refining materials and assessing optimal targets for training.
{"title":"Assessing the value and knowledge gains from an online tick identification and tick-borne disease management course for the Southeastern United States.","authors":"Catherine A Lippi, Holly D Gaff, Alexis L White, Sadie Jane Ryan","doi":"10.1101/2024.03.13.24304232","DOIUrl":"https://doi.org/10.1101/2024.03.13.24304232","url":null,"abstract":"Background: Tick-borne diseases are a growing public health threat in the United States. Despite the prevalence and rising burden of tick-borne diseases, there are major gaps in baseline knowledge and surveillance efforts for tick vectors, even among vector control districts and public health agencies. To address this issue, an online tick training course (OTTC) was developed through the Southeastern Center of Excellence in Vector-Borne Diseases (SECOEVBD) to provide a comprehensive knowledge base on ticks, tick-borne diseases, and their management. Methods: The OTTC consisted of training modules covering topics including tick biology, tick identification, tick-borne diseases, and public health, personal tick safety, and tick surveillance. The course was largely promoted to vector control specialists and public health employees throughout the Southeastern US. We collected assessment and survey data on participants to gauge learning outcomes, perceptions of the utility of knowledge gained, and barriers and facilitators to applying the knowledge in the field. Results: The OTTC was successful in increasing participants' baseline knowledge across all course subject areas, with the average score on assessment increasing from 62.6% (pre-course) to 86.7% (post-course). More than half of participants (63.6%) indicated that they would definitely use information from the course in their work. Barriers to using information identified in the delayed assessment included lack of opportunities to apply skills (18.5%) and the need for additional specialized training beyond what the OTTC currently offers (18.5%), while the main facilitator (70.4%) for applying knowledge was having opportunities at work, such as an existing tick surveillance program.\u0000Conclusions: Overall, this OTTC demonstrated capacity to improve knowledge in a necessary and underserved public health field, and more than half of participants use or plan to use the information in their work. The geographic reach of this online resource was much larger than simply for the Southeastern region for which it was designed, suggesting a much broader need for this resource. Understanding the utility and penetrance of training programs such as these is important for refining materials and assessing optimal targets for training.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140155734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-13DOI: 10.1101/2024.03.11.24303739
Paulina Stehlik, Caitlyn Withers, Rachel Bourke, Adrian Barnett, Caitlin Brandenburg, Christy Noble, Alexandra Bannach-Brown, Gerben Keijzers, Ian A Scott, Paul Glasziou, Emma Veysey, Sharon Mickan, Mark Morgan, Hitesh Joshi, Kirsty Forrest, Thomas Campbell, David Henry
Objective: To explore medical trainees experiences and views concerning college-mandated research projects. Setting: Online survey (Apr-Dec 2021) of current and recent past trainees of Australian and New Zealand colleges recruited through 11 principal colleges and snowballing. Participants: Current trainee or completed training in the past 5 years. Main outcome measures: We asked participants: whether they were required to conduct research as part of their college training, how they conducted their research, and their research activity after training. Respondents were invited to submit project reports for reporting and methodological quality evaluation. Data were analysed descriptively. Results: Of the 372 respondents, 313 (86%) were required to complete one or more projects. Of the 177 who had completed their project (representing 267 projects), 76 provided information on 92 studies, with 34 reports submitted for evaluation. Most respondents developed their own research questions, study design and protocol, and conducted research in their own time, with 56% (38/68) stating they had the skills to complete their project. Most project teams consisted of their own medical specialty followed by statisticians, but seldom others. 44% (30/68) were satisfied with their research experience, and 53% (36/67) supported mandatory projects. Half (87/174) felt research was important for career development, 72% (44/61) considered initiating research post-training, and 54% (33/61) participated in it. Commonly expressed themes were time-burden of conducting projects, production of research waste, and the importance of research for skills development. Of the 34 submitted reports, 75% were published and 82% had a clear research question. Only three had a low risk of bias. Conclusion: Majority of respondents conducted projects, but few shared details or reports. Despite valuing their research experiences and seeing clinical relevance, time conflicts and research waste were common concerns. Colleges should focus on enhanced research methods training and creating trainee research collaboratives. Protocol registration: https://doi.org/10.17605/OSF.IO/BNGZK
{"title":"A cross sectional survey of Australian and New Zealand specialist trainees research experiences and outputs.","authors":"Paulina Stehlik, Caitlyn Withers, Rachel Bourke, Adrian Barnett, Caitlin Brandenburg, Christy Noble, Alexandra Bannach-Brown, Gerben Keijzers, Ian A Scott, Paul Glasziou, Emma Veysey, Sharon Mickan, Mark Morgan, Hitesh Joshi, Kirsty Forrest, Thomas Campbell, David Henry","doi":"10.1101/2024.03.11.24303739","DOIUrl":"https://doi.org/10.1101/2024.03.11.24303739","url":null,"abstract":"Objective: To explore medical trainees experiences and views concerning college-mandated research projects. Setting: Online survey (Apr-Dec 2021) of current and recent past trainees of Australian and New Zealand colleges recruited through 11 principal colleges and snowballing.\u0000Participants: Current trainee or completed training in the past 5 years. Main outcome measures: We asked participants: whether they were required to conduct research as part of their college training, how they conducted their research, and their research activity after training. Respondents were invited to submit project reports for reporting and methodological quality evaluation. Data were analysed descriptively. Results: Of the 372 respondents, 313 (86%) were required to complete one or more projects. Of the 177 who had completed their project (representing 267 projects), 76 provided information on 92 studies, with 34 reports submitted for evaluation. Most respondents developed their own research questions, study design and protocol, and conducted research in their own time, with 56% (38/68) stating they had the skills to complete their project. Most project teams consisted of their own medical specialty followed by statisticians, but seldom others. 44% (30/68) were satisfied with their research experience, and 53% (36/67) supported mandatory projects. Half (87/174) felt research was important for career development, 72% (44/61) considered initiating research post-training, and 54% (33/61) participated in it. Commonly expressed themes were time-burden of conducting projects, production of research waste, and the importance of research for skills development. Of the 34 submitted reports, 75% were published and 82% had a clear research question. Only three had a low risk of bias. Conclusion: Majority of respondents conducted projects, but few shared details or reports. Despite valuing their research experiences and seeing clinical relevance, time conflicts and research waste were common concerns. Colleges should focus on enhanced research methods training and creating trainee research collaboratives. Protocol registration: https://doi.org/10.17605/OSF.IO/BNGZK","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140128600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.1101/2024.03.04.24303753
Perola Nakandakari Sugimoto, GABRIELA BUNO GOUVEA, igor Salles, Heráclito B Carvalho, Priscila Aikawa, Liana Maria Torres de Araújo Azi, Luiz Fernando da Silva, MARIANGELA MACCHIONE, Federico Semeraro, Andrew Lockey, Robert Greif, Maria J Carvalho Carmona, Bernd W. Bottiger, Naomi Kondo Nakagawa
Education in basic life support is widely proposed to increase survival and quality of life in out-of-hospital sudden cardiac arrest. We aimed to assess knowledge, skills, and attitudes regarding acute myocardial infarction and sudden cardiac arrest among university students of all fields of knowledge. Methods: The local Ethical Research Committee approved this cross-sectional study. An electronic survey "KIDS SAVE LIVES BRAZIL" was sent to 58,862 students of 82 disciplines in three universities, aged ≥ 18 years. The survey covered three categories: knowledge, skills, and attitude. Each category was graded between 0 and 10 points (the highest). Results: Among university students, 4,803 undergraduates (8.2 %) answered the survey and were divided into three groups of disciplines: medicine (219, ~21.7 years, 38% male), other-health-care (n=1,058; ~22.9 years; 36% male), and nonhealth-care (n=3,526; ~22.9 years; 35% male). All three groups showed significant differences between them (p<0.001). The nonhealth-care compared with medicine and the other-health-care group showed, respectively, the lowest (p<0.001) median scores (25-75%) in knowledge [4.0 (0.0-9.3), 4.0 (4.0-8.0), and 4.0 (4.0-4.7)], skills [2.4 (1.2-3.3), 6.4 (4.0-8.3), 4.0 (2.4-6.2], and attitude [5.9 (5.9-6.8), 7.3 (5.9-7.3), and 7.3 (5.9-7.3)]. Conclusion: University students have the willingness to help victims suffering from acute myocardial infarction or sudden cardiac arrest. However, nonhealth-care students markedly lack the knowledge and skills to perform cardiopulmonary resuscitation and automated external defibrillation. Our findings reveal a stark difference in basic life support competencies between students in health-care-related fields and those in nonhealthy-care fields, emphasizing the need for universal basic life support training.
{"title":"Targeting students of nonhealth academic fields for basic life support: they need to know why, what and how to do CPR","authors":"Perola Nakandakari Sugimoto, GABRIELA BUNO GOUVEA, igor Salles, Heráclito B Carvalho, Priscila Aikawa, Liana Maria Torres de Araújo Azi, Luiz Fernando da Silva, MARIANGELA MACCHIONE, Federico Semeraro, Andrew Lockey, Robert Greif, Maria J Carvalho Carmona, Bernd W. Bottiger, Naomi Kondo Nakagawa","doi":"10.1101/2024.03.04.24303753","DOIUrl":"https://doi.org/10.1101/2024.03.04.24303753","url":null,"abstract":"Education in basic life support is widely proposed to increase survival and quality of life in out-of-hospital sudden cardiac arrest. We aimed to assess knowledge, skills, and attitudes regarding acute myocardial infarction and sudden cardiac arrest among university students of all fields of knowledge. Methods: The local Ethical Research Committee approved this cross-sectional study. An electronic survey \"KIDS SAVE LIVES BRAZIL\" was sent to 58,862 students of 82 disciplines in three universities, aged ≥ 18 years. The survey covered three categories: knowledge, skills, and attitude. Each category was graded between 0 and 10 points (the highest). Results: Among university students, 4,803 undergraduates (8.2 %) answered the survey and were divided into three groups of disciplines: medicine (219, ~21.7 years, 38% male), other-health-care (n=1,058; ~22.9 years; 36% male), and nonhealth-care (n=3,526; ~22.9 years; 35% male). All three groups showed significant differences between them (p<0.001). The nonhealth-care compared with medicine and the other-health-care group showed, respectively, the lowest (p<0.001) median scores (25-75%) in knowledge [4.0 (0.0-9.3), 4.0 (4.0-8.0), and 4.0 (4.0-4.7)], skills [2.4 (1.2-3.3), 6.4 (4.0-8.3), 4.0 (2.4-6.2], and attitude [5.9 (5.9-6.8), 7.3 (5.9-7.3), and 7.3 (5.9-7.3)]. Conclusion: University students have the willingness to help victims suffering from acute myocardial infarction or sudden cardiac arrest. However, nonhealth-care students markedly lack the knowledge and skills to perform cardiopulmonary resuscitation and automated external defibrillation. Our findings reveal a stark difference in basic life support competencies between students in health-care-related fields and those in nonhealthy-care fields, emphasizing the need for universal basic life support training.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140053802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.1101/2024.03.01.24303412
Katelin C. Jackson, Kayla A Miller, Samantha M Hill, Stephanie S Johnson, Laila A Reimanis, Eric T Lofgren
Objectives: This study aimed to explore the use of medical dramas to train observers when in-person observations or patient contact in clinical settings is impossible. The study also assessed the media's portrayal of the medical profession and compared time use patterns in medical dramas to previous hospital observational studies. Design: Activity-pattern observational study using Work Observation by Activity Timing software. Setting: The hospital, ICU, and community settings of medical television shows. Participants: The first and last season of the main cast of three medical dramas; Grey's Anatomy, Scrubs, and ER. Main outcome measures: Inter-rater reliability scores were used to assess how well medical dramas can be used as a training tool for observers. Proportions of time spent on daily medical tasks were compared to other in-person hospital studies. Results: Grey's Anatomy and Scrubs had excellent Intraclass Correlation Coefficients (ICC) scores for a general medical setting, with Grey's Anatomy ICC scores for Season 1 0.99 (0.97 to 1.0), and Season 16 0.98 (0.90 to 1.0) and Scrubs ICC scores of 0.91 (0.65 to 0.98) for Season 1 and 0.91 (0.55, 0.99) for Season 8. In contrast, ER had an acceptable ICC score of 0.89 (0.59 to 0.98) for Season 1 and 0.81 (0.35 to 0.96) for Season 15 and might be more suitable for studies exploring activity patterns in the Emergency Department. All had p-values of <0.001. Conclusions: Medical dramas can serve as training tools when clinical observation is limited or impossible, and our methods reflect these shows' ease of use and flexibility. Additionally, medical dramas can be selected for their similarity to in-person studies. Still, one should be mindful that inaccuracies in the representation of clinical activity patterns are present. However, using medical dramas to train research staff in direct observation is a feasible and reliable method.
{"title":"Charting is Never Exciting: Measuring Physician Time Use in Medical Dramas","authors":"Katelin C. Jackson, Kayla A Miller, Samantha M Hill, Stephanie S Johnson, Laila A Reimanis, Eric T Lofgren","doi":"10.1101/2024.03.01.24303412","DOIUrl":"https://doi.org/10.1101/2024.03.01.24303412","url":null,"abstract":"Objectives: This study aimed to explore the use of medical dramas to train observers when in-person observations or patient contact in clinical settings is impossible. The study also assessed the media's portrayal of the medical profession and compared time use patterns in medical dramas to previous hospital observational studies. Design: Activity-pattern observational study using Work Observation by Activity Timing software. Setting: The hospital, ICU, and community settings of medical television shows. Participants: The first and last season of the main cast of three medical dramas; Grey's Anatomy, Scrubs, and ER. Main outcome measures: Inter-rater reliability scores were used to assess how well medical dramas can be used as a training tool for observers. Proportions of time spent on daily medical tasks were compared to other in-person hospital studies. Results: Grey's Anatomy and Scrubs had excellent Intraclass Correlation Coefficients (ICC) scores for a general medical setting, with Grey's Anatomy ICC scores for Season 1 0.99 (0.97 to 1.0), and Season 16 0.98 (0.90 to 1.0) and Scrubs ICC scores of 0.91 (0.65 to 0.98) for Season 1 and 0.91 (0.55, 0.99) for Season 8. In contrast, ER had an acceptable ICC score of 0.89 (0.59 to 0.98) for Season 1 and 0.81 (0.35 to 0.96) for Season 15 and might be more suitable for studies exploring activity patterns in the Emergency Department. All had p-values of <0.001. Conclusions: Medical dramas can serve as training tools when clinical observation is limited or impossible, and our methods reflect these shows' ease of use and flexibility. Additionally, medical dramas can be selected for their similarity to in-person studies. Still, one should be mindful that inaccuracies in the representation of clinical activity patterns are present. However, using medical dramas to train research staff in direct observation is a feasible and reliable method.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"30 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140053658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Creating clinical vignettes requires considerable effort. Recent developments in generative artificial intelligence (AI) for natural language processing have been remarkable and may allow for the easy and immediate creation of diverse clinical vignettes. Objective In this study, we evaluated the medical accuracy and grammatical correctness of AI-generated clinical vignettes in Japanese and verified their usefulness. Methods Clinical vignettes in Japanese were created using the generative AI model GPT-4-0613. The input prompts for the clinical vignettes specified the following seven elements: 1) age, 2) sex, 3) chief complaint and time course since onset, 4) physical findings, 5) examination results, 6) diagnosis, and 7) treatment course. The list of diseases integrated into the vignettes was based on 202 cases considered in the management of diseases and symptoms in Japan's Primary Care Physicians Training Program. The clinical vignettes were evaluated for medical and Japanese-language accuracy by three physicians using a five-point scale. A total score of 13 points or above was defined as 'sufficiently beneficial and immediately usable with minor revisions,' a score between 10 and 12 points was defined as 'partly insufficient and in need of modifications,' and a score of 9 points or below was defined as 'insufficient.' Results Regarding medical accuracy, of the 202 clinical vignettes, 118 scored 13 points or above, 78 scored between 10 and 12 points, and 6 scored 9 points or below. Regarding Japanese-language accuracy, 142 vignettes scored 13 points or above, 56 scored between 10 and 12 points, and 4 scored 9 points or below. Overall, 97% (196/202) of vignettes available with some modifications. Conclusions Overall, 97% of the clinical vignettes proved practically useful, based on confirmation and revision by Japanese medical physicians. Given the significant effort required by physicians to create vignettes without AI assistance, the use of GPT is expected to greatly optimize this process.
{"title":"Can AI-generated clinical vignettes in Japanese be used medically and linguistically?","authors":"Yasutaka Yanagita, Daiki Yokokawa, Shun Uchida, Yu Li, Takanori Uehara, Masatomi Ikusaka","doi":"10.1101/2024.02.28.24303173","DOIUrl":"https://doi.org/10.1101/2024.02.28.24303173","url":null,"abstract":"Background\u0000Creating clinical vignettes requires considerable effort. Recent developments in generative artificial intelligence (AI) for natural language processing have been remarkable and may allow for the easy and immediate creation of diverse clinical vignettes. Objective\u0000In this study, we evaluated the medical accuracy and grammatical correctness of AI-generated clinical vignettes in Japanese and verified their usefulness.\u0000Methods\u0000Clinical vignettes in Japanese were created using the generative AI model GPT-4-0613. The input prompts for the clinical vignettes specified the following seven elements: 1) age, 2) sex, 3) chief complaint and time course since onset, 4) physical findings, 5) examination results, 6) diagnosis, and 7) treatment course. The list of diseases integrated into the vignettes was based on 202 cases considered in the management of diseases and symptoms in Japan's Primary Care Physicians Training Program. The clinical vignettes were evaluated for medical and Japanese-language accuracy by three physicians using a five-point scale. A total score of 13 points or above was defined as 'sufficiently beneficial and immediately usable with minor revisions,' a score between 10 and 12 points was defined as 'partly insufficient and in need of modifications,' and a score of 9 points or below was defined as 'insufficient.'\u0000Results\u0000Regarding medical accuracy, of the 202 clinical vignettes, 118 scored 13 points or above, 78 scored between 10 and 12 points, and 6 scored 9 points or below. Regarding Japanese-language accuracy, 142 vignettes scored 13 points or above, 56 scored between 10 and 12 points, and 4 scored 9 points or below. Overall, 97% (196/202) of vignettes available with some modifications.\u0000Conclusions\u0000Overall, 97% of the clinical vignettes proved practically useful, based on confirmation and revision by Japanese medical physicians. Given the significant effort required by physicians to create vignettes without AI assistance, the use of GPT is expected to greatly optimize this process.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140016920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-29DOI: 10.1101/2024.02.28.24303514
Adalberto Campo-Arias, John Carlos Pedrozo-Pupo, Carmen Cecilia Caballero-Dominguez
Background and purpose: A new version of the Sleep Hygiene Index (SHI-10) has recently been introduced, and the psychometric performance in other populations is unknown. This study aimed to determine the dimensionality, internal consistency, and nomological validity of the SHI-10 among medical students at a Colombian university. Methods: A psychometric study was designed to determine indicators of validity (construct and nomological) and reliability (internal consistency) in which 309 medical students between 18 and 39 years (M=20.83, SD=2.68) and 54.69% were female. Construct validity (dimensionality) was tested through confirmatory factor analysis, internal consistency with Cronbach's alpha and McDonald's omega coefficients, and nomological validity through correlations with the Athens Insomnia Scale, Epworth Somnolence Scale, Generalized Anxiety Disorder (GAD)-7) and Patient Health Questionnaire (PHQ-9). Results: The four-dimensional structure of the SHI-10 showed adequate indicators of goodness of fit (Satorra-Bentler's chi-square of 43.30 [df of 29, p=.04], chi-square/df of 1.49, RMSEA of .04 [90%CI .01-.06], CFI of .97, TLI of .96 and SRMR .04). The four dimensions of the SHI-10 showed values less than .70 and limited nomological validity (most Pearson correlations were less than .30). Conclusions: The SHI-10 shows a four-dimensional structure of SHI-10; however, the four dimensions of the SHI-10 present low internal consistency and limited nomological validity. More studies are needed to show the psychometric performance of the SHI-10.
{"title":"Sleep Hygiene Index: Dimensionality, internal consistency, and nomological validity among Colombian medical students","authors":"Adalberto Campo-Arias, John Carlos Pedrozo-Pupo, Carmen Cecilia Caballero-Dominguez","doi":"10.1101/2024.02.28.24303514","DOIUrl":"https://doi.org/10.1101/2024.02.28.24303514","url":null,"abstract":"Background and purpose: A new version of the Sleep Hygiene Index (SHI-10) has recently been introduced, and the psychometric performance in other populations is unknown. This study aimed to determine the dimensionality, internal consistency, and nomological validity of the SHI-10 among medical students at a Colombian university. Methods: A psychometric study was designed to determine indicators of validity (construct and nomological) and reliability (internal consistency) in which 309 medical students between 18 and 39 years (M=20.83, SD=2.68) and 54.69% were female. Construct validity (dimensionality) was tested through confirmatory factor analysis, internal consistency with Cronbach's alpha and McDonald's omega coefficients, and nomological validity through correlations with the Athens Insomnia Scale, Epworth Somnolence Scale, Generalized Anxiety Disorder (GAD)-7) and Patient Health Questionnaire (PHQ-9). Results: The four-dimensional structure of the SHI-10 showed adequate indicators of goodness of fit (Satorra-Bentler's chi-square of 43.30 [df of 29, p=.04], chi-square/df of 1.49, RMSEA of .04 [90%CI .01-.06], CFI of .97, TLI of .96 and SRMR .04). The four dimensions of the SHI-10 showed values less than .70 and limited nomological validity (most Pearson correlations were less than .30). Conclusions: The SHI-10 shows a four-dimensional structure of SHI-10; however, the four dimensions of the SHI-10 present low internal consistency and limited nomological validity. More studies are needed to show the psychometric performance of the SHI-10.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140001916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malaria is a global health burden with a projection of 247 million cases in 2021 in 84 countries known to be malaria-endemic. The majority of the cases are expected to occur in WHO African Region countries inclusive of Nigeria where the disease is a public health concern particularly in the northern regions. This study aimed to evaluate the effectiveness of a one-day malaria microscopy training program for laboratory professionals in Kano, Nigeria, and to assess the impact of the training on their proficiency in detecting malaria parasites. A total of 56 medical laboratory professionals from both public and private healthcare facilities participated in the training, which was based on the WHO basic microscopy learners guide. The training included theoretical and practical components, focusing on blood film preparation, staining techniques, and identification of Plasmodium species. Participants' knowledge was assessed before and after the training using a pre-test and post-test survey, and their proficiency in malaria diagnosis was evaluated through the examination of a panel of stained blood slides. The sensitivity and specificity of the participants in detecting malaria parasites were determined as 66% and 34% respectively, indicating moderate sensitivity but very low specificity. A significant improvement in participants' knowledge of malaria detection was observed post-training, with private facilities showing a median knowledge score increase from 47.5% to 65.0%, and public facilities from 55.0% to 70.0%. However, the overall agreement between participant readers and an expert reader, measured by the kappa coefficient, was zero, suggesting no agreement beyond chance. The study highlighted the need for enhanced training and standardization in malaria microscopy to improve diagnostic accuracy. Despite the moderate increase in knowledge and sensitivity post-training, the low specificity and agreement underscore the importance of ongoing education and quality assurance measures in malaria diagnosis, especially in high-prevalence settings like Kano.
{"title":"Assessing the performance of Laboratory professionals following a day of malaria microscopy training in Kano, Nigeria","authors":"Oluwaseunayo Deborah Ayando, Nirmal Ravi, Obinnaya Okoronkwo","doi":"10.1101/2024.02.23.24303252","DOIUrl":"https://doi.org/10.1101/2024.02.23.24303252","url":null,"abstract":"Malaria is a global health burden with a projection of 247 million cases in 2021 in 84 countries known to be malaria-endemic. The majority of the cases are expected to occur in WHO African Region countries inclusive of Nigeria where the disease is a public health concern particularly in the northern regions. This study aimed to evaluate the effectiveness of a one-day malaria microscopy training program for laboratory professionals in Kano, Nigeria, and to assess the impact of the training on their proficiency in detecting malaria parasites. A total of 56 medical laboratory professionals from both public and private healthcare facilities participated in the training, which was based on the WHO basic microscopy learners guide. The training included theoretical and practical components, focusing on blood film preparation, staining techniques, and identification of Plasmodium species. Participants' knowledge was assessed before and after the training using a pre-test and post-test survey, and their proficiency in malaria diagnosis was evaluated through the examination of a panel of stained blood slides. The sensitivity and specificity of the participants in detecting malaria parasites were determined as 66% and 34% respectively, indicating moderate sensitivity but very low specificity. A significant improvement in participants' knowledge of malaria detection was observed post-training, with private facilities showing a median knowledge score increase from 47.5% to 65.0%, and public facilities from 55.0% to 70.0%. However, the overall agreement between participant readers and an expert reader, measured by the kappa coefficient, was zero, suggesting no agreement beyond chance. The study highlighted the need for enhanced training and standardization in malaria microscopy to improve diagnostic accuracy. Despite the moderate increase in knowledge and sensitivity post-training, the low specificity and agreement underscore the importance of ongoing education and quality assurance measures in malaria diagnosis, especially in high-prevalence settings like Kano.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139979354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-18DOI: 10.1101/2024.02.16.24302932
Alberto Rubio-López, Rodrigo García Carmona, Laura Zarandieta Román, Alejandro Rubio Navas, Ángel González Pinto, Pablo Cardinal-Fernández
Background The CoBaTrICE program (Competency Based Training Program in Intensive Care Medicine) has been instrumental in standardizing intensive care training across Europe. Among the various procedures taught, pericardiocentesis is notably challenging due to its high-risk nature. This study aims to compare the efficacy and stress levels induced by two simulation models for pericardiocentesis training: a traditional 3D-printed mannequin and a virtual reality (VR) model. Methods A pilot, before and after study was conducted with last-year medical students. Participants were trained using both a 3D-printed mannequin and a VR model. Learning outcomes were assessed using a questionnaire modeled after the Objective Structured Clinical Examination (OSCE). Stress levels were measured through Heart Rate Variability (HRV) analysis, supplemented by the Biosignal plux system for real-time biometric data collection. Results Thirty-six students participated, with no significant differences in learning outcomes between the two models, except in parameters requiring fine motor skills. Stress levels, as measured by HRV, showed no statistically significant differences between the two simulations models. Conclusion The study suggests that VR model is as effective as 3D printed for pericardiocentesis training. Take Home Message The study demonstrates that virtual reality (VR) and traditional 3D-printed mannequins are equally effective for training medical students in pericardiocentesis, with no significant difference in learning outcomes or induced stress levels. This suggests that VR could be a viable, resource-efficient alternative in intensive care medicine training, particularly for high-risk procedures. Tweet Study finds VR as effective as 3D mannequins for pericardiocentesis training in med students, offering equal learning and stress levels. #MedEd #VRinMedicine
背景 CoBaTrICE 计划（重症监护医学能力培训计划）在规范欧洲重症监护培训方面发挥了重要作用。在各种教学程序中，心包穿刺术因其高风险性质而具有显著的挑战性。本研究旨在比较两种模拟模型在心包穿刺术培训中的效果和引起的压力水平：一种是传统的 3D 打印人体模型，另一种是虚拟现实（VR）模型。方法 对上一年级的医学生进行了一项试验性的前后对比研究。参与者同时使用 3D 打印人体模型和 VR 模型接受培训。学习成果通过仿照客观结构化临床考试（OSCE）的问卷进行评估。压力水平通过心率变异性（HRV）分析进行测量，并辅以 Biosignal plux 系统进行实时生物计量数据收集。结果 36 名学生参加了考试，除了需要精细动作技能的参数外，两种模式的学习效果没有明显差异。通过心率变异测量的压力水平在两种模拟模型之间没有明显的统计学差异。结论 研究表明，在心包穿刺术培训中，VR 模型与 3D 打印模型同样有效。带回家的信息 该研究表明，虚拟现实（VR）和传统的 3D 打印人体模型对医科学生的心包穿刺术培训同样有效，在学习效果或诱导压力水平方面没有明显差异。这表明，在重症监护医学培训中，VR可能是一种可行的、节约资源的替代方法，尤其是在高风险手术中。Tweet 研究发现 VR 与 3D 人体模型对医学生心包穿刺术培训同样有效，学习效果和压力水平相当。#医学教育 #VRinMedicine
{"title":"Biometric analysis of induced stress and learning during the performance of pericardiocentesis in a virtual reality simulated scenario: a before and after study","authors":"Alberto Rubio-López, Rodrigo García Carmona, Laura Zarandieta Román, Alejandro Rubio Navas, Ángel González Pinto, Pablo Cardinal-Fernández","doi":"10.1101/2024.02.16.24302932","DOIUrl":"https://doi.org/10.1101/2024.02.16.24302932","url":null,"abstract":"Background The CoBaTrICE program (Competency Based Training Program in Intensive Care Medicine) has been instrumental in standardizing intensive care training across Europe. Among the various procedures taught, pericardiocentesis is notably challenging due to its high-risk nature. This study aims to compare the efficacy and stress levels induced by two simulation models for pericardiocentesis training: a traditional 3D-printed mannequin and a virtual reality (VR) model. Methods A pilot, before and after study was conducted with last-year medical students. Participants were trained using both a 3D-printed mannequin and a VR model. Learning outcomes were assessed using a questionnaire modeled after the Objective Structured Clinical Examination (OSCE). Stress levels were measured through Heart Rate Variability (HRV) analysis, supplemented by the Biosignal plux system for real-time biometric data collection. Results Thirty-six students participated, with no significant differences in learning outcomes between the two models, except in parameters requiring fine motor skills. Stress levels, as measured by HRV, showed no statistically significant differences between the two simulations models. Conclusion The study suggests that VR model is as effective as 3D printed for pericardiocentesis training. Take Home Message The study demonstrates that virtual reality (VR) and traditional 3D-printed mannequins are equally effective for training medical students in pericardiocentesis, with no significant difference in learning outcomes or induced stress levels. This suggests that VR could be a viable, resource-efficient alternative in intensive care medicine training, particularly for high-risk procedures. Tweet Study finds VR as effective as 3D mannequins for pericardiocentesis training in med students, offering equal learning and stress levels. #MedEd #VRinMedicine","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"737 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139902754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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