Clinical competency:perceptions of nursing interns and clinical mentors

Objective:To assess the clinical competency of nursing interns and the perception of clinical nurse mentors toward student nurses'clinical competency.Methods:A study was carried out among 104 nursing interns and 26 clinical nurse mentors using the purposive sampling technique.A self-repor ted perception scale was used to collect the data.Results:In general,most nursing interns perceived themselves as clinically competent during the internship.The clinical nurse mentors too repor ted that the current internship is helping the nursing interns in becoming competent.Conclusions:Frequent clinical evaluation,buddy system,provision of stipends,good leadership,and coordination between the academic institute and hospital are repor ted as the critical motivating factors for improving the clinical competency of student interns.

Progress in the Application of Reflective Education on Undergraduate Nursing Interns

Objective:To explore the implementation methods and effects of reflective education,and to provide references for the development of reflective education in Chinese nursing schools.Methods:Relevant literature was searched from China National Knowledge Infrastructure,Wanfang Database,Wipro Chinese Science and Technology Journal Database,and PubMed Database,and the included studies were analyzed descriptively.Results:The implementation of reflective education included work-site education,group discussion,video teaching,self-reflection,and expert lectures;the interventions mainly included study groups,role-playing,individual instruction,peer cooperation,demonstration and observation,field simulation,and video presentations.The implementation of reflective education can improve the sense of professional identity and professional competence of nursing interns,and reduce nursing errors and adverse events.Conclusion:Currently,nurses in China lack self-awareness and critical thinking skills,it is recommended that reflective education be incorporated into the teaching content of undergraduate nursing students during their internship in order to promote the development of professionalism and humanistic caring skills of nursing students.

Exploring the Role of Narrative Medicine in the Cultivation of Humanistic Spirit among Respiratory Medicine Interns

Objective:To explore the role of narrative medicine in cultivating the humanistic spirit of respiratory medicine interns.Methods:Thirty interns were selected,all of whom were received by the respiratory department of our hospital from September 2023 to June 2024 and underwent narrative medicine teaching.Scores on narrative medicine knowledge,empathy ability,humanistic care ability,and teaching recognition were compared before and after the internship.Results:Compared to before the internship,the interns’scores on narrative medicine knowledge were significantly higher after the internship,as were their empathy and humanistic care scores(P<0.05).Among the 30 interns,25 expressed interest in narrative medicine,and 29 were willing to continue with the narrative medicine teaching model.Conclusion:The application of narrative medicine in respiratory medicine internship teaching is highly effective.It cultivates the humanistic spirit of interns,improves their empathy and humanistic care abilities,and is worthy of wider implementation.

Simulation Training for Laparoscopic Surgery Can Improve Minimally Invasive Surgical Techniques for Interns and Probationers

Objective: The clinical clerkship and practice stage plays a pivotal role in the transition of medical students from theoretical knowledge to practical application, bridging the gap between classroom learning and real-life clinical experience. In order to improve the teaching quality of interns and probationers, we try to let them practice the skills of laparoscopic surgery in the early stage, and summed up a set of evaluation methods that can be widely used in medical education. Methods: From September 2019 to December 2019, a total of 54 interns and 72 trainees were selected as research objects. They were assigned to training sessions and their proficiency was assessed before and after the training. The change in proficiency is compared to determine whether the training course is valuable. Results: Before the operation training, the interns scores were BP 17.3 3.1, CC 17.9 3.4, KT 16.4 3.4, LS 16.7 3.3. The results of probationers were BP 16.9 2.7, CC 16.8 2.8, KT 15.2 1.6, and LS 14.8 2.2. After completing the operations training, the results of interns were BP 21.1 1.9, CC 20.6 2.7, KT 19.6 3.0, and LS 20.9 1.4. The probationers scores were BP 19.3 3.2, CC 19.6 3.5, KT 19.6 2.6, and LS 20.0 2.4. After the operation training, the performance of the intern group was better than that before the training (P < 0.05). The same is true of the probationer group. The time-consuming intern examinations were BP 147.9 38.5 s, CC 123.2 28.7 s, KT 82.6 24.1 s and LS 162.5 31.1 s. The examination time of probationers were BP 179.9 46.4 s, CC 132.1 24.3 s, KT 109.3 27.5 s and LS 210.0 58.8 s. Conclusion: Simulation training for laparoscopic surgery can improve minimally invasive surgical techniques for interns and probationers.

Research and Application of Bedside Rhetorical Teaching Method in Teaching Nursing Interns

Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July 2022 to May 2023 were randomly divided into two groups,32 cases in the control group and 32 cases in the intervention group.The control group was given conventional teaching methods,and the intervention group was given the bedside rhetorical teaching method on the basis of the conventional teaching.The differences in the methods of teaching between the two groups were compared after the end of the internship,and there was a statistically significant difference with P<0.05.Results:The scores of the interns in the intervention group were significantly better than those of the control group in theoretical knowledge,communication skills,and case analysis items(P<0.05).Conclusion:The bedside rhetorical teaching method transforms classroom education into bedside teaching,which enables the interns to apply the theoretical knowledge to clinical practice,and has a higher improvement in the three aspects of disease knowledge,communication skills,and case analysis,cultivates the interns’comprehensive clinical skills,and lays a good foundation for the future entry into the nursing field.

Professional identity, wellness, and future hope among nurse interns in Egypt

Objective:Since nursing is a performance-based profession,clinical learning environments play an important role in the acquisition of professional abilities and train nursing students to enter the nursing profession and become a registered nurse.The study aimed to investigate the relations among professional identity,wellness,and future hope in nurse interns.Methods:A cross-sectional,analytic,descriptive,correlational study design was used to test these relations in the study where 210 nurse interns’students were selected using a convenience sampling from Zagazig University hospitals and Suez Canal University hospitals in Egypt.The questionnaires consisted of 4 parts,namely demographic characteristics,Professional Identity Scale for Nursing Students(PISNS),Holistic Health and Wellness Survey,and Hope scale.Results:Less than half of the study sample had chosen nursing specialty by own will(43.8%),while slightly more than half of them had a"very good"graduation level,and had no nursing role model.The lowest mean professional identity score was for independence in career choice while the highest was for social modeling.The repor ted physical wellness mean-score was the least,while social wellness was the highest.Professional identity,wellness,and future hope scores differed significantly based on nurse interns’personal characteristics.There were statistically significant,positive,weak-to-moderate correlations among the scores of professional identity,wellness,and future hope;however,the"choice of nursing study by own will"was a statistically significant independent positive predictor of the scores of professional identity,wellness,and future hope.Conclusions:Nurse interns’professional identity,wellness,and future hope were positively inter-correlated.However,nurse interns’wellness was the lowest,and it should be fostered as it was the main predictor for future hope.The internship programs should be modulated to improve nurse interns’professional identity,par ticularly regarding independence,and should foster their well-being in the clinical environment.

Knowledge,attitude and anxiety pertaining to basic life support and medical emergencies among dental interns in Mangalore City,India

BACKGROUND: This cross-sectional study aimed to assess the knowledge, attitude and anxiety pertaining to basic life support(BLS) and medical emergencies among interns in dental colleges of Mangalore city, Karnataka, India.METHODS: The study subjects comprised of interns who volunteered from the four dental colleges. The knowledge and attitude of interns were assessed using a 30-item questionnaire prepared based on the Basic Life Support Manual from American Heart Association and the anxiety of interns pertaining to BLS and medical emergencies were assessed using a State-Trait Anxiety Inventory(STAI) Questionnaire. Chi-square test was performed on SPSS 21.0(IBM Statistics, 2012) to determine statistically signifi cant differences(P<0.05) between assessed knowledge and anxiety.RESULTS: Out of 183 interns, 39.89% had below average knowledge. A total of 123(67.21%) reported unavailability of professional training. The majority(180, 98.36%) felt the urgent need of training in basic life support procedures. Assessment of stress showed a total of 27.1% participants to be above highstress level. Comparison of assessed knowledge and stress was found to be insignifi cant(P=0.983).CONCLUSION: There was an evident lack of knowledge pertaining to the management of medical emergencies among the interns. As oral health care providers moving out to the society, a focus should be placed on the training of dental interns with respect to Basic Life Support procedures.

Practical Experience in Home Care of Nursing Interns: A Qualitative Research

Purpose: To explore practical experience in home care of nursing interns. Methods: The phenomenological method for qualitative research was to interview 15 nursing interns in a semi-structured way, and then the collected data were analyzed and summarized by using the Colaizzi analysis method. Results: Interviewing results showed that there were five recurring themes, including: 1) personalized care;2) health education;3) humanistic care;4) solid professional foundation and sense of responsibility;5) expanded vision. Conclusion: Through home care practice, nursing interns deepened their cognitions of nursing connotation, stimulated their love for nursing and motivation of continuous learning, and improved their sense of identity to nursing career. In general, the practice of home care had a positive impact on nursing interns.

Research on the Stress Management Strategies of Hotel Interns:A Case Study of Hotel Z in Foshan

In this study,by the combination of quantitative and qualitative research,the number of valid questionnaires was 217.The results show that there was a positive correlation between stress sources and stress response,and the four stress sources of own ability and quality,interpersonal relationship and communication,role requirements,work environment and atmosphere had a significant predictive effect on work pressure response;different personality characteristics had significant differences in the effect of work stress.

Hospitality and Tourism International Internships and Perceived Employability

This paper investigates the experiences of UK undergraduate students who have undertaken a one year paid internship abroad within the hotel sector by using a phenomenological approach.Semi-structured interviews were conducted with 25 final year undergraduate students.The findings shed light on the alignment of key elements of the constructs of positive psychological capital and cosmopolitan human capital,along with strong self-belief in employability as a consequence of the experience.A theoretical model of international experience and positive psych-social development is postulated and contributes to improved practice in internship and employability mentoring and policy decision-making with respect to current internationalisation and employability agendas in the UK’s higher education system.

Application of the “Six-Step Teaching Method” in the Nursing Teaching of Obstetric Interns

Objective: The “six-step teaching method” is a teaching method, which is summarized based on practical experience. This study aimed to explore the effect of “six-step teaching method” in clinical teaching of obstetrics. Methods: A quasi-experimental study design was used, 30 nursing students who entered obstetrics practice from March 2022 to July 2022 were selected as the control group according to the order of time, and traditional teaching methods were adopted. From August to December 2022, 30 interns were selected as the experimental group, and the “six-step teaching method” was adopted. After 8 weeks of clinical practice, the assessment results and teaching effect satisfaction of the two groups were compared. Results: The scores of obstetrical specialty in the experimental group were higher than those in the control group, and the difference was statistically significant (P < 0.05);The evaluation of teaching methods, teaching quality, classroom atmosphere and individual observation ability, clinical thinking ability and nurse-patient communication ability of the experimental group were higher than those of the control group, and the differences were statistically significant (P Conclusion: “six-step teaching method” can effectively master the professional knowledge of obstetrics, stimulate the clinical thinking ability of interns, and improve the teaching effect and satisfaction. .

Study on the Effectiveness of the Application of Perineal Wound Model in Teaching Midwife Interns

Objective:To discuss and analyze the effectiveness of the application of perineal wound model in teaching midwife interns.Methods:The research subjects in this study were 40 midwife interns who enrolled in our hospital from January 2020 to December 2022,which were divided into a control group(consisted of 20 interns,taught with the conventional method)and a research group(consisted of 20 participants,taught with the perineal wound model)using the random number table method.The outcomes of these two groups were compared.Results:The examination results of the research group were better than control group(P<0.05);the interns of the research group were more satisfied towards the teaching method compared to the control group(P<0.05).Conclusion:Applying the perineal wound model in teaching midwife interns could effectively improve their examination achievements and teaching satisfaction,which brings a significant clinical value.

Internal hernia as a rare cause of small bowel obstruction:An insight from 13 years of experience

BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.

Assessing healthcare workers’knowledge and confidence in the diagnosis,management and prevention of Monkeypox

BACKGROUND Monkeypox(Mpox),is a disease of global public health concern,as it does not affect only countries in western and central Africa.AIM To assess Burundi healthcare workers(HCWs)s’level of knowledge and confidence in the diagnosis and management of Mpox.METHODS We conducted a cross-sectional study via an online survey designed mainly from the World Health Organization course distributed among Burundi HCWs from June-July 2023.The questionnaire comprises 8 socioprofessional-related questions,22 questions about Mpox disease knowledge,and 3 questions to assess confidence in Mpox diagnosis and management.The data were analyzed via SPSS software version 25.0.A P value<0.05 was considered to indicate statistical significance.RESULTS The study sample comprised 471 HCWs who were mainly medical doctors(63.9%)and nurses(30.1%).None of the 22 questions concerning Mpox knowledge had at least 50%correct responses.A very low number of HCWs(17.4%)knew that Mpox has a vaccine.The confidence level to diagnose(21.20%),treat(18.00%)or prevent(23.30%)Mpox was low among HCWs.The confidence level in the diagnosis of Mpox was associated with the HCWs’age(P value=0.009),sex(P value<0.001),work experience(P value=0.002),and residence(P value<0.001).The confidence level to treat Mpox was significantly associated with the HCWs’age(P value=0.050),sex(P value<0.001),education(P value=0.033)and occupation(P value=0.005).The confidence level to prevent Mpox was associated with the HCWs’education(P value<0.001),work experience(P value=0.002),residence(P value<0.001)and type of work institution(P value=0.003).CONCLUSION This study revealed that HCWs have the lowest level of knowledge regarding Mpox and a lack of confidence in the ability to diagnose,treat or prevent it.There is an urgent need to organize continuing medical education programs on Mpox epidemiology and preparedness for Burundi HCWs.We encourage future researchers to assess potential hesitancy toward Mpox vaccination and its associated factors.

Novel Methodologies for Preventing Crack Propagation in Steel Gas Pipelines Considering the Temperature Effect

Using the software ANSYS-19.2/Explicit Dynamics,this study performedfinite-element modeling of the large-diameter steel pipeline cross-section for the Beineu-Bozoy-Shymkent gas pipeline with a non-through straight crack,strengthened by steel wire wrapping.The effects of the thread tensile force of the steel winding in the form of single rings at the crack edges and the wires with different winding diameters and pitches were also studied.The results showed that the strengthening was preferably executed at a minimum value of the thread tensile force,which was 6.4%more effective than that at its maximum value.The analysis of the influence of the winding dia-meters showed that the equivalent stresses increased by 32%from the beginning of the crack growth until the wire broke.The increment in winding diameter decelerated the disclosure of the edge crack and reduced its length by 8.2%.The analysis of the influence of the winding pitch showed that decreasing the distance between the winding turns also led to a 33.6%reduction in the length of the straight crack and a 7.9%reduction in the maximum stres-ses on the strengthened pipeline cross-section.The analysis of the temperature effect on the pipeline material,within a range from-40℃ to+50℃,resulted in a crack length change of up to 5.8%.As the temperature dropped,the crack length decreased.Within such a temperature range,the maximum stresses were observed along the cen-tral area of the crack,which were equal to 413 MPa at+50℃ and 440 MPa at-40℃.The results also showed that the presence of the steel winding in the pipeline significantly reduced the length of crack propagation up to 8.4 times,depending on the temperature effect and design parameters of prestressing.This work integrated the existing methods for crack localization along steel gas pipelines.

Effect of external and internal cues on core muscle activation during the Sahrmann five-level core stability test

BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex.Preparatory cues and images can be used to increase the activation of these muscles.To attain optimal movement patterns,it will be necessary to determine what cueing will give the most effective results for core stability.AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.METHODS Total 68 participants(21.83±3.47 years)were randomly allocated to an external(n=35)or internal cue group(n=33).Participants performed the Sahrmann fivelevel core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue.External cue group received a pressure biofeedback unit(PBU),and the internal cue group received an audio cue.A Delsys Trigno^(TM)surface electromyography unit was used for muscle activation from the rectus abdominis,external oblique,and transverse abdominis/internal oblique muscles.RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation(P=0.001);however,there was no significant difference between cue types(internal or external)(P=0.130).CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.

Effectiveness of a Structured Orientation Program for Medical Interns in Increasing the Awareness of Informed Consent

Background:Informed consent has medicolegal implications and is imperative in presentday medical practice.Aims and Objectives:The objectives of this study were to estimate the awareness regarding informed consent in interns and to determine the effectiveness of sessions in interns’orientation programs about informed consent.Materials and Methods:Pretest-Posttest study was conducted with a validated questionnaire distributed through Google Forms to interns attending the orientation program at our institute.Responses were recorded on the Likert scale(−2 to+2).Paired t-test was used to compare the mean pretest and posttest scores.The number of interns with a positive score(+1,+2)for every question in pretest and posttest were also compared.Results:One hundred and seventyone out of 232 interns who attended the program submitted both pretest and posttest responses.In the pretest,12 interns scored<50%and 46 interns scored more than 75%.A significant increase in posttest responses was seen in the mean score(P<0.001)and questions related to consent in research,radiological investigations,regarding the need for consent in the additional nonlifesaving procedure.There was an increase in the number of interns having a positive score(+1,+2)for all the questions in posttest as compared to pretest,but a statistically significant increase was seen in questions related to consent in ultrasound and need for consent in the additional nonlifesaving procedure.Conclusion:A wellstructured interns’orientation program is effective in improving awareness regarding consent.Certain gaps in knowledge regarding various aspects of consent need to be emphasized.

Mechanism of internal thermal runaway propagation in blade batteries

Blade batteries are extensively used in electric vehicles,but unavoidable thermal runaway is an inherent threat to their safe use.This study experimentally investigated the mechanism underlying thermal runaway propagation within a blade battery by using a nail to trigger thermal runaway and thermocouples to track its propagation inside a cell.The results showed that the internal thermal runaway could propagate for up to 272 s,which is comparable to that of a traditional battery module.The velocity of the thermal runaway propagation fluctuated between 1 and 8 mm s^(-1),depending on both the electrolyte content and high-temperature gas diffusion.In the early stages of thermal runaway,the electrolyte participated in the reaction,which intensified the thermal runaway and accelerated its propagation.As the battery temperature increased,the electrolyte evaporated,which attenuated the acceleration effect.Gas diffusion affected thermal runaway propagation through both heat transfer and mass transfer.The experimental results indicated that gas diffusion accelerated the velocity of thermal runaway propagation by 36.84%.We used a 1D mathematical model and confirmed that convective heat transfer induced by gas diffusion increased the velocity of thermal runaway propagation by 5.46%-17.06%.Finally,the temperature rate curve was analyzed,and a three-stage mechanism for internal thermal runaway propagation was proposed.In Stage I,convective heat transfer from electrolyte evaporation locally increased the temperature to 100℃.In Stage II,solid heat transfer locally increases the temperature to trigger thermal runaway.In StageⅢ,thermal runaway sharply increases the local temperature.The proposed mechanism sheds light on the internal thermal runaway propagation of blade batteries and offers valuable insights into safety considerations for future design.

Endoscopic polidocanol foam sclerobanding for the treatment of grade Ⅱ-Ⅲ internal hemorrhoids:A prospective,multi-center,randomized study

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain.AIM To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL.METHODS This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL group.All patients were followed-up for 12 months.Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile range.RESULTS One hundred and ninety-five patients were enrolled,with 98 in the EFSB group.HSS was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of follow-up.The prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours post-procedure.The median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

Selective internal radiation therapy segmentectomy:A new minimally invasive curative option for primary liver malignancies?

Transarterial radioembolization or selective internal radiation therapy(SIRT)has emerged as a minimally invasive approach for the treatment of tumors.This percutaneous technique involves the local,intra-arterial delivery of radioactive microspheres directly into the tumor.Historically employed as a palliative measure for liver malignancies,SIRT has gained traction over the past decade as a potential curative option,mirroring the increasing role of radiation segmentectomy.The latest update of the BCLC hepatocellular carcinoma guidelines recognizes SIRT as an effective treatment modality comparable to other local ablative methods,particularly well-suited for patients where surgical resection or ablation is not feasible.Radiation segmentectomy is a more selective approach,aiming to deliver high-dose radiation to one to three specific hepatic segments,while minimizing damage to surrounding healthy tissue.Future research efforts in radiation segmentectomy should prioritize optimizing radiation dosimetry and refining the technique for super-selective administration of radiospheres within the designated hepatic segments.