The successful implementation of Stop the Bleed® in Guatemala.

Pilot: Hematology/Oncology Curriculum for the Internal Medicine and Hematology/Oncology Sub-Internships

The study objective was to determine whether medical students' attendance at a rehabilitation residence for pregnant women with substance-use disorders yielded changes in their attitudes and comfort levels in providing care to this population. This randomized educational trial involved 96 consecutive medical students during their obstetrics and gynecology clerkship. In addition to attending a half-day prenatal clinic designed for women with substance-use disorders, every student was randomly assigned either to attend (Study group) or not to attend (Control group) a rehabilitation residence for pregnant women with substance-use disorders. The primary objective was to measure differences in responses to a confidential 12-question survey addressing comfort levels and attitudes, at the beginning and end of the clerkship. Survey responses revealed improvements in students' comfort levels and attitudes toward pregnant women with substance-use disorders by attending the clinic alone or the clinic and residence. Those who attended the residence reported becoming more comfortable in talking with patients about adverse effects from substance abuse, more understanding of "street" terms, and stronger belief that patients will disclose their substance use to providers. Residents expressed more openly their hardships and barriers while trying to set therapeutic goals. Medical students became more comfortable and insightful about pregnant women with substance-use disorders after attending a rehabilitation residence in addition to a prenatal clinic dedicated to this population.

INTRODUCTION:Education concerning contraceptive use, especially intrauterine devices (IUDs), is often lacking in middle and high school, and sometimes even up to medical school.Compared to oral contraceptive pills or condoms, IUDs have lower failure rates and higher user satisfaction rates but are still less popular.Furthermore, medical school preclinical curriculum often lacks simulation training regarding IUDs, leaving students underprepared in real-life clinical situations.Medical students' knowledge and attitudes towards IUDs is critical for providing safe and effective methods of birth control to the community.Factors such as age, gender, race, marital status, area of residence and education, experience with IUDs, and preferred medical specialty could play an important role in students' pre-existing knowledge and attitudes towards IUD use and safety.We analyzed the impact of a brief educational session and simulated practice with IUD placement on IUD knowledge, attitudes, comfort level, and common misconceptions among medical students. METHODS:We developed an IUD insertion educational clinic for first-and second-year medical students, including a 30 minute lecture, followed by 30 minutes of practice inserting IUDs on uterine models.Uterine models and IUDs were provided by an OB-GYN faculty and Medical Students for Choice (MSFC).Participants completed surveys before and after the clinic assessing demographics, IUD knowledge, attitudes, comfort level, and common misconceptions surrounding IUD insertion and usage.We used Chi-Square and McNemar tests of associations to analyze the impact of IUD clinic on students' knowledge and perceptions. RESULTS:Our survey was completed by 57 medical students before and after the clinic.Majority of the participants were White (71.93%),females (75.44%), unmarried (87.72%), did not have children (100%), lived in urban areas (91.23%), and were from the South region (67.27%).A majority of students or their partners (61.40%) did not have an IUD before.More students from the South region correctly answered about the rate of unintended pregnancies with IUDs (p=0.041)than other regions.The IUD clinic significantly improved students' knowledge regarding recommending an IUD to women under 19 years of age (p=0.024), and someone with chlamydia (p=0.014).Students' attitudes also significantly changed regarding allowing midwives/nurse practitioners to place IUDs (p=0.0003).Our clinic significantly improved students' perceived self-efficacy regarding counseling patients about IUD (p<0.0001) and placing an IUD under faculty supervision (p<0.0001).CONCLUSION: An IUD insertion clinic had a significant impact on improving medical students' knowledge, attitudes, and self-efficacy regarding IUDs.We found that the students' knowledge regarding IUDs varies by region, which could be Impact of an IUD insertion clinic on medical students' knowledge, attitude, and perceived self-efficacy regarding IUDs

This paper examines the theoretical linkage between ICT and advances within a business in a rural community in the North West Province of South Africa. Various aspects are addressed like services and service delivery mechanism, locally adapted content and context, realistic approach to technologies and financial sustainability. A rural community centre in Itsoseng was investigated regarding the above aspects and the results are provided. It became apparent that if these above aspects are not seen as integrated activities within a rural community, success is difficult to achieve. Success in providing human and institutional capacities that harness information and knowledge is imperative.

Training Hospital Personnel in Trauma-Informed Care: Assessing an Interprofessional Workshop With Patients as Teachers.

The Effectiveness of Teaching Emergency Procedural Skills in an Outdoor Environment Using Low-Fidelity Simulation

Patient interactions are fundamental to medical education, influencing the training of medical students and shaping their clinical understanding. Objective: To probe patient perspectives on the presence of medical students during consultations, clinical examinations and surgical procedures, with a focus on identifying gender-based differences in preferences and comfort levels. Methodology: This cross-sectional study was conducted in tertiary care hospitals in Peshawar involving 500 patients from Northwest General Hospital and Research Center and Northwest Teaching Hospital, data collected through a self-structured questionnaire revealed distinct gender disparities. Results: Male participants generally exhibited higher approval and comfort levels with medical student involvement, particularly during consultations, examinations, and surgery. Variations were evident in preferences related to medical history taking, comfort during physical examinations, and willingness to permit students in the operating room. Patients underscored the importance of recognizing gender preferences in medical student interactions. Conclusions: This study emphasized the significance of tailoring medical education practices to address gender-specific variations, ensuring a patient-centered approach and fostering positive healthcare experiences for all.

Rationale: Children with tracheostomies have unique airway risks requiring swift assessment and intervention. While caregivers receive training to provide appropriate care during emergencies, limited exposure to these emergencies makes identifying the necessary interventions challenging. The Children's Wisconsin Tracheostomy and Ventilator Team created the Tracheostomy Emergency and Airway Management (TEAM) Card, a self-guided reference tool for emergency tracheostomy care. This study measured caregivers’ comfort level with the TEAM Card and future use of it. Methods: Through QI methodology, the final prototype of the TEAM Card was created in August 2024. The front of the card is either green (can be intubated from above), or red (cannot be intubated from above). The front also includes sections on key interventions, information on same-size and downsize tracheostomy tubes, and troubleshooting steps to replace a new tracheostomy tube. The back of the card includes CPR steps. Receiving a green or red card was determined via shared decision-making of the otolaryngology and tracheostomy/ventilator teams. Distribution to patients and caregivers began in the outpatient clinic starting in September 2024, where a team member introduced the TEAM Card's sections and function to caregivers. Following this discussion, an anonymous survey was given to each caregiver. Survey questions entailed both quantitative measurements on their comfort level providing airway emergency care (scaled 0-10) and qualitative measurements of their comfort level using the TEAM Card. Quantitative measurements were compared using a two-tailed T-test. Results: 25 patients have received the TEAM Card (20 green, 5 red). Red card diagnoses included subglottic stenosis (n=2), critical airway (n=2), and tracheal agenesis (n=1). Of 29 caregivers surveyed, most were parents (n=26), and a few were home health nurses (n=3). The majority (n=25) had at least 1 year of tracheostomy care experience. Caregivers trended towards increased comfort in airway emergency care after receiving the TEAM Card (Table 1, p-value 0.15), with no decreases noted. All found the card easy to hold, use, and understand, with most (n=27) agreeing it was easy to read. All caregivers would personally use it and recommend it to medical providers. Conclusion: The TEAM Card showed a trend towards increasing caregiver confidence in managing trach-related airway emergencies. This study is ongoing and will continue to collect data from both caregivers and medical providers in the future.

Background: Phantom sensations, such as phantom vibration (PV) and phantom ringing (PR), are perceptual phenomena where individuals feel their smartphone vibrating or ringing when it is not. These sensations are becoming increasingly common in the digital age, particularly among smartphone users. Due to their intensive use of smartphones for academic and social purposes, medical students may be at higher risk of experiencing these sensations. This study aims to assess the prevalence of phantom sensations and explore its relation to smartphone use among medical students in a tertiary care center in Central India. Methods: A cross-sectional study was conducted among 370 medical students from a tertiary care center in Central India. Data were collected using a self-administered questionnaire, which included demographic details, patterns of smartphone use, and experiences of phantom sensations. Smartphone addiction was measured using the smartphone addiction scale-short version (SAS-SV). Descriptive statistics and chi-square tests were used to analyze the data. Results: The prevalence of PR and vibration sensations among the participants was 40% and 39.45% respectively. A significant association was found between smartphone addiction and the occurrence of PR and vibration sensations. Conclusions: Phantom sensations are highly prevalent among medical students, and their frequency is significantly associated with increased smartphone use. Awareness and interventions may be necessary to reduce excessive smartphone use and manage phantom sensations among medical students.

Background: Haemovigilance refers to a systematic framework designed to monitor, record and analyze adverse events associated with the collection, processing and transfusion of blood and blood components. By facilitating early detection of complications, it improves the transfusion safety for both donors and recipients. The effectiveness of haemovigilance depends on active collaboration among healthcare professionals, regulatory bodies and transfusion services. This study was conducted to assess the knowledge, attitude and practice (KAP) of haemovigilance among medical interns and postgraduate students, with the aim of strengthening the awareness and promoting safe transfusion processes.Materials and Methods: A cross-sectional, questionnaire based study was carried out at a tertiary care centre in Kalaburagi, between September to December 2024. The sample comprised of 200 participants who completed a pre-validated self-administered questionnaire covering three domains: knowledge, attitude and practice. Data were analyzed using SPSS software applying descriptive statistics, chi square test with a threshold of p < 0.05.Result: Overall, 60% of participants demonstrated good knowledge of haemovigilance, with post graduates performing significantly better than interns (p =0.00016). A positive attitude towards haemovigilance was expressed by 97.5% of the participants. Postgraduates reported significantly better practice than interns.Conclusion: While knowledge and attitude towards haemovigilance are generally favourable among medical trainees, practical implementation remains inconsistent. Targeted training, institutional support and integration of haemovigilance into routine clinical workflow are necessary to bridge the gap between theoretical understanding and active practice, thereby improving transfusion safety.

High-Risk, Low-Volume: Evaluation of a Reusable Cricothyrotomy Model in Paramedic Difficult Airway Training

The objective of this study was to assess the efficacy and satisfaction of an innovative decision-making capacity curriculum in undergraduate medical education. Authors used Kern's six-step approach for curriculum development to develop a curriculum to teach decision-making capacity assessment. Using a modified Delphi approach, authors also created a communication checklist for decision-making capacity assessment. The educational intervention was implemented for a full academic year, targeting medical students completing their core psychiatry clerkship. Changes in knowledge and comfort level were evaluated through pre- and posttests. Satisfaction was assessed using student feedback. Of the 136 medical students who completed the core psychiatry clerkship, 64 medical students completed both a pretest and posttest. Mean knowledge scores (3.5 vs 6.1, p < 0.001) and comfort level (11% vs 89% comfortable, p < 0.001) significantly improved from pretest to posttest. One hundred and five students provided course feedback, which demonstrated positive ratings of the course. This capacity curriculum led to significant knowledge improvement and increased self-reported comfort with capacity assessment. Health professions educators can adapt this curriculum to promote competency in this important clinical skill. Moreover, educators can use this innovative capacity communication skills checklist for both learning and evaluation.

Introduction Gathering clinical information about the patient in a therapeutic manner is an important interviewing goal, particularly for the psychiatric interview. Psychiatry clerkship students may use this self-learning module (SLM) to prepare for their first supervised psychiatric interview. Alternatively, this module can help first- and second-year students in a behavioral medicine or psychopathology course prepare for a standardized patient interview. Methods This module presents video clips of a psychiatrist conducting a psychiatric interview of a patient with depressive symptoms. Samples of the key components of the interviews, such as the chief complaint, history of present illness, past treatment history, social and developmental history, cognitive exam, and risk assessment are taught using combinations of video clips, interactive diagrams, and selfassessment quizzes. Additionally, basic interview techniques are discussed and illustrated during the interview. Results This SLM has been implemented within the psychiatry clerkship at the University of California Davis, School of Medicine and piloted in the psychiatry clerkships at both Georgia Health Science University and the University of Florida School Of Medicine. This module was piloted by four students and two faculty members. One of the two faculty reported that the SLM could be adapted for first-, second-, and third-year medical students, as well as to behavioral health students. Three out of four students somewhat agreed or strongly agreed that the module: (a) increased their comfort level with performing the psychiatric interview, (b) increased their comfort level with interacting with mentally ill patients, and (c) increased their comfort level of assessing risk of harm. All four students somewhat agreed or strongly agreed that the module increased their comfort level both with applying psychiatric interview techniques in patient interactions and eliciting a symptom history from patients. This SLM was also presented at the 2011 Association of Directors of Medical Student Education in Psychiatry (ADMSEP) Poster Session where we received extensive feedback and won the ADMSEP “2011 Outstanding Education Poster Award.” Discussion Gathering clinical information about the patient in a therapeutic manner is an important interviewing goal, particularly for the psychiatric interview. This resource successfully teaches learners the components of the psychiatric interview.

This study examined differences in nurses' fear of death and level of comfort with patients having a poor prognosis for survival, as a function of the nurses' occupational level, work setting, and level of exposure to such patients. In addition, the relationship among the multidimensional aspects of fear of death and level of comfort with patients' poor prognosis was assessed. The sample included 312 professional and paraprofessional nurses who worked in hospitals and nursing homes. Level of comfort with working with dying patients was found to differ significantly by exposure to such patients and by occupational role. Fear of death for significant others was found to differ significantly by work setting. Finally, a significant inverse relationship was found between comfort working with dying patients and overall fear of death. Suggestions for future research are presented.

To examine the comfort level of medical students beginning their paediatric clerkships, and to identify students' perceived concerns around interacting with children in a medical setting. Prior to beginning required paediatric clerkships, third-year students in two south-eastern US medical schools completed an anonymous, 13-item questionnaire eliciting prior personal experiences with children, as well as comfort levels with selected aspects of paediatric care. Based on 237 responses (76.2% response rate), medical students' total child-related experiences were significantly associated with self-assessed comfort delivering paediatric care. Female students reported more prior experiences than male medical students; however, gender was not associated with comfort working with children. A dose-response curve of experience shows a critical level of two types of experiences for comfort in working with children. Students reported significantly lower levels of comfort in performing a physical exam on a child versus obtaining a child's medical history from a parent/caregiver. Students' child-related experiences were significantly associated with self-assessed comfort delivering paediatric care Medical students with little to no prior experience with children expressed significantly less comfort interacting with children in paediatric clerkships. A diversity of past experiences appeared to be a more meaningful correlate, as opposed to experience in a specific setting or context. Providing some general exposure to children during the preclinical years could instill in students greater comfort approaching their paediatric training.