Introducing the Principles of Tendon Transfer for Surgical Trainees to Improve Anatomical Knowledge

This article reviewed the principles and outcomes of tendon transfer procedures described in the literature to restore function following injuries delivered in a workshop as a way of improving basic science and anatomical knowledge in surgical trainees preparing for surgical examinations. Post intervention surveys showed an improvement in trainees’ familiarity with musculoskeletal anatomy and engagement in learning with improved readiness for surgical examinations.

Intraocular lens exchange or explantation post cataract surgery

AIM:To report incidence,indications,and visual outcomes of intraocular lens(IOL)exchange/explantation surgery.METHODS:Retrospective analysis of 60 eyes requiring IOL exchange/explantation surgery between 1^(st) January 2017 and 31^(st) December 2022.The overall outcomes as well as comparison between the trainee versus experienced surgeons were analyzed.RESULTS:Out of 39778 cataract surgeries(with no preexisting ocular co-morbidities)during a six-year period(2017-2022),60(0.15%)needed IOL exchange/explantation.Surgeons-under-training performed 36/60 cases(60%)while 24/60(40%)were by experienced surgeons.The commonest indication was subluxated IOL in 26(43.3%),followed by dislocated IOL in 20(33.3%),postoperative refractive surprise in 7(11.6%),IOL induced uveitis in five and broken haptic in two eyes.Twenty-four(40%)eyes had intraoperative complications during primary surgery.Posterior chamber IOL(PCIOL)was the commonest secondary IOL in 21(35%)eyes,scleral fixated in 20(31.6%),anterior chamber IOL(ACIOL)in 13(21.6%),iris fixated IOL in three(5%)and three eyes(5%)were left aphakic.The mean time between primary and secondary surgery was 168d(168±338.8).Best corrected visual acuity(BCVA)of>20/60 was obtained in 43 eyes(71.66%),20/80-20/200 in 14(23.33%),20/250 in two and hand movements in one.No statistically significant difference in visual outcome was noted at post-op one month between trainees versus experienced surgeons(UCVA 0.45±0.29 vs 0.53±0.32,P=0.20,BCVA 0.34±0.25 vs 0.37±0.26,P=0.69).CONCLUSION:IOL subluxation as the commonest indication and posterior capsular rupture is the commonest intraoperative risk factor.This complication can be effectively addressed with selection of the appropriate secondary IOL achieving good visual outcomes in over 70% of patients.

Perspectives and Experiences of Education Stakeholders: A Quantitative Study on the Adoption of Artificial Intelligence in Executive Training Using Structural Equation Modeling

The recent increase in the use of artificial intelligence has led to fundamental changes in the development of training and teaching methods for executive education. However, the success of artificial intelligence in regional centers for teaching and training professions will depend on the acceptance of this technology by young executive trainees. This article discusses the potential benefits of adopting AI in executive training institutions in Morocco, specifically focusing on CRMEF Casablanca Settat. Based on the Unified Theory of Acceptance and Use of Technology (UTAUT) (Venkatesh et al., 2003), this study proposes a model to identify the factors influencing the acceptance of artificial intelligence in regional centers for teaching professions and training in Morocco. To achieve this, a structural equation modeling approach was used to quantitatively describe the impact of each factor on AI adoption, utilizing data collected from 173 young executive trainees. The results indicate that perceived ease of use, perceived usefulness, trainer influence, and personal innovativeness influence the intention to use artificial intelligence. Our research provides managers of CRMEFs with a set of practical recommendations to enhance the implementation conditions of an artificial intelligence system. It aims to understand which factors should be considered in designing an artificial intelligence system within regional centers for teaching professions and training (CRMEFs).

Exertional heat stroke in a young military trainee:is it preventable?

Background: Heat stroke is a life-threatening condition with exertional heat stroke occurring frequently among soldiers and athletes. Because of its common occurrence, many military trainees practice preventive measures prior to any activity requiring severe exertion. Although it is said to be common in practice, different presentations of heat stroke are scarcely described in literature.Case Presentation: We describe a case of an exertional heat stroke in a 23-year-old male Sinhalese soldier who developed early changes of renal failure, liver failure and rhabdomyolysis. The patient initially presented with convulsions, delirium and loss of consciousness to an outside health care facility before being transferred to our institution.Conclusion: It is clear that heat stroke does occur in military trainees while preventive strategies are being practiced. It is important for those who provide healthcare to soldiers to provide proper advice on how to identify impending heat stroke prior to any exercises resulting in severe physical exertion. Further, treating physicians should educate all military trainees about preventive strategies.

Difficult-to-Treat-Depression—Perceptions of GPs and GP Trainees

Introduction: GPs are often the first contact point for mental health concerns. Training to qualify as a GP involves completing a three-to-four year program. Among other things, the training program may include a six-hour mental health training workshop. The study’s purpose was to compare GPs’ and Trainees’ perceptions of difficult-to-treat-depression (DTTD). Methods: Using a semi-structured interview schedule comprising six questions, 10 GPs and six Trainees participated in focus groups or telephone interview. To understand participants’ perspectives, data were analyzed using the Framework Method. Findings: Trainees were less clear than GPs about the meaning of DTTD and other diagnostic terms. GPs’ diagnosis included querying diagnosis and treatment options. Trainees’ experience was limited but they raised barriers including non-response to various treatment trials. Both groups identified management difficulties including: doctor shopping, suicide risk, patients not being well informed;with management difficulties exacerbated by limited access/referring to health professionals, cost and/or unavailability of bulk billing. While some GPs and Trainees had heard of an illness management model or chronic illness model, few used a model. Most reported limited referring to psychiatrists, mainly because of cost and/or limited availability. GPs were more likely to refer to other health professionals and use pharmacological and complementary therapies. Both groups discussed the impact of external factors including cultural factors, patient compliance, treatment failure, and the importance of the relationship between the patient and the professional. Trainees were more likely to stress the importance local clinical guidelines. Discussion and Conclusion: Despite the small size and limited nature, this research provides insight into some of the similarities and differences of GPs’ and Trainees’ experiences and understanding of DTTD. This may have implications for training providers, clinical supervisors and Trainees, and suggests that enhancement in the role of mental health training may be relevant.

Preliminary study of associative stigma among trainee psychiatrists in Flanders, Belgium

AIM: To study the degree of stigmatization among trainee psychiatrists, individual characteristics potentially leading to higher associative stigma, and coping mechanisms.METHODS: Two hundred and seven trainee psychiatrists in Flanders(Belgium), all member of the Flemish Association of Trainee Psychiatrists, were approached to participate in the survey. A non-demanding questionnaire that was specifically designed for the purpose of the study was sent by mail. The questionnaire consisted of three parts, each emphasizing a different aspect of associative stigma: devaluing and humiliating interactions, the focus on stigma during medical train-ing, and identification with negative stereotypes in the media. Answers were scored on a Likert scale ranging from 0 to 3. The results were analyzed using SPSS Version 18.0. RESULTS: The response rate of the study was 75.1%. The internal consistency of the questionnaire was good, with a Cronbach's α of 0.71. Seventy-five percent of all trainee psychiatrists confirmed hearing denigrating or humiliating remarks about the psychiatric profession more than once. Additionally, more than half of them had had remarks about the incompetence of psychiatrists directed at them. Only 1.3% remembered having stigma as a topic during their psychiatric training. Trainees who had been in training for a longer period of time had experienced a significantly higher level of stigmatization than trainees with fewer years of experience(mean total stigma scores of 16.93 ± SD 7.8 vs 14.45 ± SD 6.1, t =-2.179 and P < 0.05). In addition, senior trainees effectively kept quiet about their profession significantly more often than their junior colleagues(mean item score 0.44 ± SD 0.82 vs 0.13 ± SD 0.48, t = 2.874, P < 0.01). Comparable results were found in trainees working in adult psychiatry as were found in those working in child or youth psychiatry(mean item score 0.38 ± SD 0.77 vs 0.15 ± SD 0.53, t =-2.153, P < 0.05). Biologically oriented trainees were more inclined to give preventive explanations about their profession, which can be seen as a coping mechanism used to deal with this stigma(mean item score 2.05 ± SD 1.05 vs 1.34 ± SD 1.1, t =-3.403, P < 0.01).CONCLUSION: Associative stigma in trainee psychiatrists is underestimated. More attention should be paid to this potentially harmful phenomenon in training.

Effectiveness and safety of a laparoscopic training system combined with modified reconstruction techniques for total laparoscopic distal gastrectomy

BACKGROUND Total laparoscopic distal gastrectomy(TLDG)is increasing due to some advantages over open surgery,which has generated interest in gastrointestinal surgeons.However,TLDG is technically demanding especially for lymphadenectomy and gastrointestinal reconstruction.During the course of training,trainee surgeons have less chances to perform open gastrectomy compared with that of senior surgeons.AIM To evaluate an appropriate,efficient and safe laparoscopic training procedures suitable for trainee surgeons.METHODS Ninety-two consecutive patients with gastric cancer who underwent TLDG plus Billroth I reconstruction using an augmented rectangle technique and involving trainees were reviewed.The trainees were taught a laparoscopic view of surgical anatomy,standard operative procedures and practiced essential laparoscopic skills.The TLDG procedure was divided into regional lymph node dissections and gastrointestinal reconstruction for analyzing trainee skills.Early surgical outcomes were compared between trainees and trainers to clarify the feasibility and safety of TLDG performed by trainees.Learning curves were used to assess the utility of our training system.RESULTS Five trainees performed a total of 52 TLDGs(56.5%),while 40 TLDGs were conducted by two trainers(43.5%).Except for depth of invasion and pathologic stage,there were no differences in clinicopathological characteristics.Trainers performed more D2 gastrectomies than trainees.The total operation time was significantly longer in the trainee group.The time spent during the lesser curvature lymph node dissection and the Billroth I reconstruction were similar between the two groups.No difference was found in postoperative complications between the two groups.The learning curve of the trainees plateaued after five TLDG cases.CONCLUSION Preparing trainees with a laparoscopic view of surgical anatomy,standard operative procedures and practice in essential laparoscopic skills enabled trainees to perform TLDG safely and feasibly.

Educational Value of Doctor Trainee Employments (“Student Doctor”) —A Questionnaire Study

Background: In Sweden, medical students can work as employed doctor trainees under supervision during medical school breaks. The aim of the present study was to evaluate the educational value of such employments, as well as to compare university and non-university positions. Method: A questionnaire was administered to all employed doctor trainees at Sahlgrenska University Hospital, Gothenburg, in 2003-2004 (n = 67) plus all students in last term medical school 2005 who had had such a position inside or outside this university hospital (n = 43). The questionnaire included questions on trainee position/s, as well as statements regarding the educational value. Result: 75 unique individuals returned a filled-in questionnaire (response rate: 78%). The respondents experienced the positions as valuable concerning gain in professional confidence (mean ± standard deviation: 3.9 ± 1.1;1 = total disagreement to 5 = total agreement) and independence (3.9 ± 1.1), subsequent learning in medical school (4.3 ± 0.9), and future professional work (4.2 ± 1.0). The gain in professional confidence and independence was greater for those who had worked in a non-university hospital (n = 17) than in a university hospital (n = 29): 4.4 ± 0.6 vs. 3.6 ± 3.6, P = 0.011;4.3 ± 0.7 vs. 3.6 ± 1.1, P = 0.038. Conclusion: Employment as a doctor trainee seems to facilitate subsequent learning in medical school and enhance professional progress;the latter is particularly prominent in non-university hospitals.

Malaysian Teacher Trainees＇ Competencies of Accessing, Evaluating, and Applying Information Ethically in Research Process

The case study attempts to discover with certainty the competency of accessing, evaluating and applying information in research process acquired by undergraduate trainees of Malaysian Teacher Education Institute in the northern region of Peninsula Malaysia. Considered as highly important skills that trainee teachers have to acquire a comprehensive understanding of information literacy to pursue a research. Yet, it is a pivotal fact indicated by recent researchers that most future teachers often enter teaching without the necessary information literacy skills and knowledge in research process. The scope of study is based on full-time final year undergraduate trainee teachers for the Educational Degree Programme doing their school based action research in the states of Kedah, Perlis, and Penang. The study analyzes problems and issues faced by these trainee teachers tied up to information literacy competency in doing research process. The study investigates trainees＇ competencies of accessing, evaluating, and applying information ethically in their research process. The findings hope to give insights to stake holders on the ways to move forward in terms of needs, process and outcomes in accordance with the Malaysian National Information Literacy Agenda.

Evidencing Personal &Professional Development, Perspective of a Surgical Trainee

Introduction: The author strongly believes that there is a continuous need for personal and professional development in order to keep and improve an individual career path way. It is also imperative to provide evidence of these acquired skills and attributes. According to General medical council, it is a responsibility of every doctor to be competent and up to date. This should be achieved by regularly taking part in activities that maintain and further develop competence and performance. This in turn ensures safety and care to patients [1]. Methodology: The author has had excellent opportunities in his career to participate in diverse personal and professional development programmes. It was important to participate in these programmes to achieve career progression. He would like to share three recent activities from his curriculum vitae which resulted in his significant personal and professional development. The author also had his revalidation last year and found to be fit to practice for next 5 years till next revalidation. The author followed an agreed action plan with his supervisor to accomplish this work. Realistic goals and time frame was set with the help of supervisor. Subsequently, the author had a chance to critically analyse below mentioned three different activities, in order to explore all the achieved learning themes behind these events. The author was fortunate enough to be involved into three different personal and professional development programmes. Firstly, he managed a regional colorectal conference and attained an excellent management experience from that conference. He learnt a lot about better time management. He came to know about different management theories and models and is now able to use these theories for his future management responsibilities. Then he had a communication challenge and difficulty in theatre. He was able to resolve that issue with his strong communication skills. He developed his communication skills and assertiveness with the help of this first-hand experience and different communication models. Lastly, the author had a wonderful opportunity to demonstrate and develop his leadership and team working skills in an International Conference. He realized that leader needs to be a role model for his team and should be leaded by his example. He observed and demonstrated different roles of a leader according to needs of his team. He also learnt about different leadership theories and models. He also acquired a good understanding of a team development. Conclusion: It is extremely important for every health care individual to have personal and professional development. The author recommends that lessons learnt from the author’s experience and results can be applied in a broad generalised way to achieve development. It is crucial for us to keep a structured record of this development and provide evidence of the improvement. In short, it was an extremely useful exercise for the author that resulted in significant lifelong development in his management, communication and leadership attributes.

How Trainee Translators＇ On-line Communication Influencing Their Competence Development

Translation competence （TC） is the knowledge and skills that a translator needs to know in order to implement translation activities. The current research is based on the website translation project of Xianning News Online. Contrastive analysis is carried out on the trainee translators＇ TC development. By comparing the TC prior and post the project, conclusion is made on the dynamic development of the trainee translators＇ TC within the same environment and a detailed analysis is given on the factors that influence their TC development. The final part is about possible suggestions for future translator training.

An Experiment Report on the Linguistic Readiness of Simultaneous Interpreting Trainees

Linguistic readiness,which refers to language efficiency required for simultaneous interpretation,is different from that in daily communication.This experiment aims at observing the linguistic readiness of simultaneous interpreting trainees,targeting eight post-graduate students majoring in interpretation.After a mock simultaneous interpreting task,the performance of the trainees will be assessed by themselves and three native speakers as well.Through the comparison of the assessment made by the trainees and the native speakers,the author aims at exploring the gap between the number of information points that the trainees think they have delivered and the number that native speakers obtain from the trainees’production,and classifying those information points that could not be understood by native speakers into different types.A conclusion is reached that their linguistic readiness needs to be improved.Therefore,it is necessary to pay more attention to linguistic readiness in interpreting training.

高校附属医院学生思想政治工作体系的构建与实践

基于医学育人特殊性、人员管理分段性、数字化转型紧迫性等背景,结合高校附属医院学生思想政治工作体系特征和构建难点,开展以“一心双导,四梁八柱”为特点的高校附属医院学生思想政治工作体系构建与实践。以“医教协同,乐在医行”创新高校附属医院学生思政教育和理论实践研究;以“教学思政,共建共享”创新高校附属医院学生日常事务管理和学风建设;以“网格管理,数智赋能”创新高校附属医院学生党团班建和心理健康教育,以期为全国高校附属医院健全思政工作体系、夯实人才培养主阵地功能、加强医院党建思政文化建设提供有益借鉴。

Application of Microteaching Combined with Problem-Based Learning(PBL)Teaching Model in Teaching Clinical Nursing Interns in Otorhinolaryngology Department

Objective:To explore the application effect of microteaching combined with problem-based learning(PBL)teaching mode in teaching clinical nursing interns in otorhinolaryngology department.Methods:A total of 72 nursing students who interned in our hospital from June 2022 to February 2023 were selected,and all of them were comprehensively trained in basic theoretical knowledge as well as practical skills before the beginning of their learning tasks.The students were randomly divided into the control group and the experimental group,with 36 students in each group.The control group was taught using the traditional clinical nursing teaching mode,and the experimental group was taught using microteaching combined with the PBL teaching mode,subsequently comparing the differences between the two groups of interns in the degree of mastery of theoretical knowledge,hands-on skills,teamwork ability,patient satisfaction,and other aspects.Results:In terms of mastery of theoretical knowledge,the interns in the experimental group(97.22%)were significantly better than that of the control group(75.00%)(P<0.05);the interns in the experimental group had significantly better practical skills(77.78%)than that of the control group(55.56%)(P<0.05);the interns in the experimental group had significantly better teamwork ability than the control group(P<0.05);through the questionnaire survey,it was found that students’satisfaction with teaching in the experimental group(97.22%)was also significantly higher than that in the control group(75.00%)(P<0.05).Conclusion:The application of microteaching combined with PBL teaching mode in the teaching of clinical nursing interns in otorhinolaryngology department achieved significant results.It can not only improve the professional knowledge and application ability of nursing students,but also cultivate their independent thinking,problem-solving skill,as well as teamwork ability.It can also improve the teaching quality and patient satisfaction,and contribute positively to the development of medical education.

A Small Scale Retrospective Study on Chinese EFL Teachers'Experienc-es in the Practicum

The goal of this small scale retrospective study is to examine the perceptions of Chinese EFL(English as a foreign language) teacher trainees of what they do and what they develop in the practicum. Research questions guiding this research are:(1)How much relative attention do Chinese teachers attribute to teaching EFL areas in the practicum in retrospect?(2) What activities do Chinese EFL teachers recollect doing in the practicum? and(3) What are the areas which they are aware of having developed in during the practicum? A questionnaire targeting EFL areas and general activities is employed to collect data; items contain 5-point Likert scales and three open-ended questions. Forty-eight respondents(44 female) are included in the sample. In the teaching of EFL areas, the results indicate that the participants experienced more emphasis on exam-oriented areas. The means for practicum activities show that participants highlighted learning by observation, discussion, and journals, among their various recalled activities. When evaluating development and learning opportunity in the practicum, participants reported improvements in general pedagogical knowledge, but they missed out on other aspects of teacher knowledge. The findings bring about evidence in what is effective and what is not of the practicum. It gives guidance to what could be changed for the practicum.

Establishing Standardized Biomedical Laboratory Technician Education for the Development of Biotech no logy Research in China

Chinese scientists have been actively engaged in biotechnology research since the mid-2Oth century.However,biotechnology education,especially biomedical laboratory technology education,is relatively scarce in China.More and more cutting-edge equipment and techniques have been introduced into biomedical laboratories in China,but there is a lack of high-quality techni&ans to apply these advancements to scientific research.In addition,the traditional education and apprenticeship systems have been demonstrated little progress.To address this gap,West China Hospital of Sichuan University established a 2-year educational program for laboratory technology in 2006 based on the residency training program.The project integrates scientific methods into the research laboratory technician training in relevant disciplines,and has developed a systematic,scientific,and effective standardized training system to cultivate high-level and stable experimental technician team for the need of advanced laboratories,which has been demonstrated gready improve the efficiency of biomedical researchers and laboratory facilities.In this article,we introduce the practical experience in establishment and development of a standardized training system for biomedical laboratory technicians to ensure the sustainable development of medical researches.

高校附属医院学生和学员网格化管理模式的探索与创新

基于高校附属医院学生和学员的人员特点和管理难点,回顾网格化管理的定义和应用,总结和凝练网格化管理模式在高校附属医院学生和学员中的构建和实践重点,包括明确网格主要功能、优化网格设置原则、强化网格日常管理,通过创新网格化管理的管理理念和产学实践,发挥网格化管理与传统学生管理模式各自的优势、实现两者深度融合,开发人员信息系统实现多方精准管理,更好地适应高校附属医院所面临的新形势、新要求,以期为全国高校附属医院学生和学员管理提供有益借鉴。

The Impact of a Structured Clinical Pathway on the Application of Management Standards in Patients with Diabetic Ketoacidosis and Its Acceptability by Medical Residents

Diabetic Ketoacidosis (DKA) is a serious and potentially a fatal complication of diabetes mellitus. Tools to guarantee proper, evidence-based, guideline implementation are of paramount importance and an essential element for quality patient care. Clinical pathways represent one such tool that clearly promotes the implementation of guidelines and research evidence into clinical practice. The aims of this study were to measure quantitatively and qualitatively the impact of a specially structured Resident-friendly, DKA clinical pathway on the application of evidence-based management standards and its acceptability by the treating resident physicians. A retrospective chart review of patients who were admitted prior to and after the launching of the clinical pathway and a questionnaire assessment of resident’s acceptance of the pathway format were undertaken. Eighty one episodes of DKA in a total of 58 patients fulfilled the criteria for inclusion in the study. Thirty seven admissions were on the pathway (45.7%) and 44 were not (54.3%). Documentation of severity indices of patients who were admitted under the pathway were significantly improved with a trend for a shorter hospital stay. The duration of intravenous insulin therapy, intensive care unit consultation and diabetes educator involvement in patient care were not different between the two groups. Residents found the pathway user-friendly, educationally very valuable, reduced their workload and had a positive effect on their DKA management skills.?Conclusions: Use of specially structured, resident-friendly pathway led to significant improvement in documentation of DKA severity indices and empowered our residents with evidence-based knowledge and skills to deal with this serious diabetic complication.

Through the Feces Can Detect Intestinal Disease(英文)

The test analyses the chemical compounds emitted and recognises the profile of different diseases.In a study of 182 stool samples from patients with inflammatory bowel disease and irritable(过敏的)bowel syndrome,the results were 76%accurate.

Medical malpractice litigation involving otolaryngology residents and fellows:A case-based 30-year review

BACKGROUND Errors,misdiagnoses,and complications can occur while trainees are involved in patient care.Analysis of such events could reveal areas for improvement by residency and fellowship programs.AIM To examine lawsuits tried at the state and federal level involving otolaryngology trainees.METHODS The LexisNexis database,an online legal research database containing state and federal case records from across the United States,was retrospectively reviewed for malpractice cases involving otolaryngology residents or fellows from January 1,1990 to December 31,2020.Case data collected:Plaintiff/trainee/defendant characteristics,allegations,medical outcomes,and legal outcomes.RESULTS Over the study period,20 malpractice lawsuits involving otolaryngology trainees were identified.Plaintiffs raised numerous allegations including procedural error(n=12,25.5%),incorrect diagnosis and/or treatment(n=8,17.0%),and lack of knowledge of trainee involvement(n=6,12.8%).Nine cases(45%)had verdicts in favor of the plaintiff,whereas 5 cases(25%)had verdicts in favor of the defense.Six cases(30%)ended in a settlement.Awards to plaintiffs were heterogenous,with a median of$617,500(range$32K-17M)for settled cases and verdicts favoring plaintiffs.CONCLUSION The findings enclosed herein represent the first published analysis of trainee involvement in otolaryngology malpractice cases held at the state/federal level.Otolaryngology trainees can be involved in lawsuits for both procedural and nonprocedural events.This study highlights the importance of education specifically in the domains of procedural errors,informed consent,proper diagnosis/management,and clear communication within patient care teams.Training programs should incorporate these study findings into effective simulation courses and didactic sessions.Educating trainees about common pitfalls holds the promise of decreasing healthcare systems costs,reducing trainee burnout,and,most importantly,benefiting patients.