Post competency training in standardized training of resident physicians and integrated postgraduates

We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities.Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice.Post competency training represents a commitment to excellence in medical education,striving to produce competent,skilled practitioners to meet the challenges of modern healthcare.

Implementation of an international medical student pen-pal club:survey outcomes of perceptions in cultural competency and global health

Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such experiences.It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.Objective:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health engagement.Methods:In 2021,a novel medical student PPC was established that began between an American and Japanese medical school.Following a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences.In total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income countries.The primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their discretion.In February 2022,American PPC members were emailed a qualitative survey to assess the PPC's impact.Results:The survey was completed by 42%of American PPC members,95%of which were 22-26 years.Participants were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts.Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.

How Emotion Nurtures Mentality:The Influencing Mechanism of Social-Emotional Competency on the Mental Health of University Students

Social-Emotional Competency(SEC),regarded as a critical psychological resource for individuals to adapt to social environments,is an effective protective factor for students’mental health,impacting their future success and well-being.Analyzing the impact of SEC on university students’mental health can offer valuable insights for nurturing talents with healthy psychological and physical development.Based on data from two large-scale surveys of Chinese university students,this study designed two comprehensive Multiple Mediation Models involving SEC,stress,coping strategies,and stress reaction to explore the pathway of emotion nurturing mentality.Study 1 utilized a parallel mediation model to examine the relationships between SEC,academic stress,interpersonal stress,and stress reactions.The results indicated that SEC negatively predicted academic stress,interpersonal stress,and stress reactions.Additionally,academic and interpersonal stress mediated the relationships between SEC and stress reactions in parallel.Extending these findings,Study 2 further investigated the role of coping strategies.By constructing a multiple-chain mediation model,it examined the predictive relationships among SEC,academic stress,interpersonal stress,three types of coping strategies,and stress reactions.The findings indicated that SEC negatively predicted stress,problemavoiding strategy,and stress reactions,while positively predicting problem-solving and assistant-seeking strategies.Furthermore,the two stress types and three coping strategies significantly mediated the relationship between SEC and stress reactions.This indicated that higher SEC was associated with reduced stress and more adaptive coping strategies and subsequently contributed to more favorable stress reactions.This research explored the impact of university students’SEC on mental health and its relational mechanisms,aiming to provide theoretical reference and practical insights for future efforts in cultivating SEC among university students to adjust academic and interpersonal stress,to enhance problem-solving and stress resistance capabilities,and to maintain their mental health.

Review: update on performance assessment and monitoring systems for ophthalmologists

Performance assessment and monitoring systems are the process by which ophthalmologists demonstrate they are fit to continue practicing.Revalidation is the process by which licensed doctors are legally required to demonstrate to medical regulators that they are up to date and fit to practice in order to maintain their medical license,and began in the United Kingdom(UK)in 2012 following well-publicized events.Recertification is a different process which began in North America and demonstrates doctors have maintained competence,without involvement of external stakeholders.Arguments for and against the concept of performance assessment are reviewed.Stakeholders in performance assessment,whether part of the process or not,are doctors themselves,peers and other health care providers,patients,hospitals and health systems,medical regulators,and health policy makers.Early models of performance assessment included portfolios,credit accumulation,and closed-book examinations.Models are in evolution with the value of formative rather than summative assessments,and the need for methods of assessing procedural competency increasingly recognized.Emerging methods of performance assessment of practicing ophthalmologists include use of performance indicators,simulation,and workplace-based assessments.Alternate methods of assuring the public by improved detection of outliers are discussed.Despite weak evidence supporting performance assessments in demonstrating continuing competency to practice,the process is gradually being accepted worldwide.Further research into optimum methods of performance assessment and monitoring processes is required,along with cost-benefit analysis.

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.

A Study on Aligning Nursing Curriculum with Hospital Clinical Competency Requirements

The purpose of this study is to coordinate the alignment between the nursing curriculum and hospital clinical competencies,identify the reasons for the gaps,evaluate the impact of these gaps on the nursing profession,and propose strategies to bridge these gaps.This study will help strengthen nursing education,improve nursing students’skills,and help students adapt to complex clinical environments.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

A Study on the Problems and Solution Paths in the Conduct of Elderly Competency Assessment

Exploring the problems existing in the process of carrying out an elderly competency assessment aims to provide useful references for its improvement.Starting from the importance of elderly competency assessment in the field of elderly services,this paper analyses the problems in the process of carrying out elderly competency assessment and explores the corresponding solutions.The analysis finds that problems in the process of carrying out elderly competency assessment are inevitable,but as long as the study continues to explore and innovate and actively seek solution paths,the study will be able to overcome these difficulties and provide the elderly with better and more efficient elderly services.

以Competency为导向的临床专科师资培养的构建和教学能力的提升

目的:研究在新形势下以Competency为导向的临床教师理论教学和实践教学在眼科研究生住院医师规范化培训中的应用和评价,及对研究生规培学生在临床过程中以Competency为导向学习和工作态度、能力、思维、运用等多方面受到的影响和作用。方法:选择在校研究生规培学生作为研究对象,随机抽样分为正常组和实验组,正常组采用传统教学方法,实验组采用以Competency为导向的临床教师教学,学习后采用调查问卷和实践技能水平考试评估教学成果。结果:对教师评价,实践技能考试实验照组均优于正常组。结论:以Competency为导向的教学理念在各个层面教学中的应用,可以为不同人才培养层次分别构建系统、连续、阶梯式的人才培养体系,为共性培养下的个性化培养提供理论依据,对于推动我国医学教育的科研创新、临床思维培养,具有一定价值。

The Essence and Structure of Information Competency of an Interpreter in the System of Continuing Education

The paper highlights the problem of training of interpreters in the system of continuing education in Russia. The theoretical analysis of the essence and structure of the information competency of an interpreter in continuing education as subjects is proposed. The research techniques were document analysis, interviews, participant observation, work process analysis, and focus groups. This paper presents a brief overview of the information competency of an interpreter. The importance of the information competency in the structure of professional competency of an interpreter is acknowledged by the majority of modern experts. But there still exists the problem of determining the set of skills which present the information competency of an interpreter. This paper introduces the author＇s view on the problem of defining the essence and structure of the information competency of an interpreter.

Clinical Competency: Simulation Compared with Lectures in Training Registered General Nursing (RGN) at Time of Completion of Program—A Systematic Review

Background: Advancing the science of nursing education through technology into teaching and learning is essential to prepare nurses for the changing healthcare environment. Objective: To synthesise evidence in nursing students’ competency in the clinical setting immediately after completion of training with simulation compared with lectures. Methods: Databases were sourced electronically from CINAHL and PubMed using keywords Simulation, lecture, clinical competency and new graduates. Study Eligibility Criteria, Participants and Interventions: Published articles addressing the research objectives, written in English, spaning between September 2010 and March 2019 directly answer the PSCOT question with results applicable to the population specific-nursing students, simulation was utilized. Study Appraisal and Synthesis Methods: Extracted data from sorted studies were analysed and assessed for quality using the John Hopkins Evidence-Based Appraisal Tools. Results: The two-database yielded 520 articles, 10 met the eligibility criteria. Findings documented three important themes: 1) Clinical competence among nurses;2) Medical residents’ clinical competence and 3) Was about the competence of anaesthesiology residents. Limitations: The identified studies used small sample sizes ranging from 20 to 98 participants in the single research studies. Conclusions: The review of the literature found that the active teaching strategy of simulation was more effective in promoting clinical competency in nursing students compared with the lecture method. The evidence-based teaching project proposes the use of simulation as the primary teaching method to improve the clinical competency abilities of registered general nursing (RGN) diploma students.

Flux pinning evolution in multilayer Pb/Ge/Pb/Ge/Pb superconducting systems

Multicomponent superconductors exhibit nontrivial vortex behaviors due to the various vortex–vortex interactions,including the competing one in the recently proposed type-1.5 superconductor.However,potential candidate that can be used to study the multicomponent superconductivity is rare.Here,we prepared an artificial superconducting multilayer to act as an alternative approach to study multicomponent superconductivity.The additional repulsive length and the coupling strength among superconducting films were regulated by changing the thickness of the insulting layer.The magnetization measurements were performed to clarify the effect of the competition between the repulsive vortex interactions on the macroscopic superconductivity.The vortex phase diagram and the optimum critical current density have been determined.Furthermore,a second magnetization effect is observed,and is attributed to the upper layer,which provides the weak pinning sites to localize the flux lines.The pinning behaviors switches to the mixed type with the increase of the insulting layer thicknesses.Our results open a new perspective to the study and related applications of the multilayer superconducting systems.

Teaching Reform Based on the Competency Model for Software Engineering-related Courses

This paper explores the reform and practice of software engineering-related courses based on the competency model of the Computing Curricula,and proposes some measures of teaching reform and talent cultivation in software engineering.The teaching reform emphasizes student-centered education,and focuses on the cultivation and enhancement of students’knowledge,skills,and dispositions.Based on the three elements of the competency model,specific measures of teaching reform are proposed for some professional courses in software engineering,to strengthen course relevance,improve knowledge systems,reform practical modes with a focus on skill development,and cultivate good dispositions through student-centered education.The teaching reform’s attempts and practice are conducted in some courses such as Advanced Web Technologies,Software Engineering,and Intelligent Terminal Systems and Application Development.Through the analysis and comparison of the implementation effects,significant improvements are observed in teaching effectiveness,students’mastery of knowledge and skills are noticeably improved,and the expected goals of the teaching reform are achieved.

System reliability assessment based on Wiener process and competing failure analysis

Considering the dependence and competitive relation-ship between traumatic failure and degradation,the reliability assessment of products based on competing failure analysis is studied.The hazard rate of traumatic failure is regarded as a Weibull distribution of the degradation performance,and the Wiener process is used to describe the degradation process.The parameters are estimated with the maximum likelihood estimation（MLE）method.A reliability model based on competing failure analysis is proposed.A case study of the GaAs lasers is given to validate the effectiveness of the model and its solving method.The results indicate that if only the degradation failure is considered,the estimated result will be comparably optimistic.Meanwhile,the correlation between the degradation and traumatic failure has a great influence on the accuracy of reliability assessment.

基于Competency的高职商务英语写作实践教学

基于Competency的高职商务英语写作实践教学以CBLT和Competency职业能力发展结构为理论依据,旨在通过实践教学切实提高学生的商务英语写作能力。本文提出高职商务英语写作实践教学应以涉外商务助理岗位为基础,将以课程内容为导向的写作教学和以企业涉外商务助理岗位真实项目为导向的写作实践相结合,以取得较好的教学效果。

Multiple myeloma survival in New South Wales, Australia, by treatment era to 2020

Objective: Australia has relatively high multiple myeloma(MM) incidence and mortality rates. Advancements in MM treatment over recent decades have driven improvements in MM survival in high-income countries;however, reporting in Australia is limited. We investigated temporal trends in population-wide MM survival across 3 periods of treatment advancements in New South Wales(NSW), Australia.Methods: Individuals with an MM diagnosis in the NSW Cancer Registry between 1985 and 2015 with vital follow-up to 2020, were categorized into 3 previously defined treatment eras according to their diagnosis date(1985±1995, chemotherapy only;1996±2007, autologous stem cell transplantation;and 2008±2015, novel agents including proteasome inhibitors and immunomodulatory drugs). Both relative survival and cause-specific survival according to Fine and Gray's competing risks cumulative incidence function were calculated by treatment era and age at diagnosis.Results: Overall, 11,591 individuals were included in the study, with a median age of 70 years at diagnosis. Five-year relative survival improved over the 36-year(1985±2020) study period(31.0% in 1985±1995;41.9% in 1996±2007;and 56.1% in 2008±2015). For individuals diagnosed before 70 years of age, the 5-year relative survival nearly doubled, from 36.5% in 1985±1995 to 68.5% in 2008±2015. Improvements for those > 70 years of age were less pronounced between 1985±1995 and 1996±2007;however, significant improvements were observed for those diagnosed in 2008±2015. Similar overall and age-specific patterns were observed for causespecific survival. After adjustment for gender and age at diagnosis, treatment era was strongly associated with both relative and cause-specific survival(P < 0.0001).Conclusions: Survival of individuals with MM is improving in Australia with treatment advances. However, older age groups continue to experience poor survival outcomes with only modest improvements over time. Given the increasing prevalence of MM in Australia, the effects of MM treatment on quality of life, particularly in older age, warrant further attention.

Mitigating Straggler Effect in Federated Learning Based on Reconfigurable Intelligent Surface over Internet of Vehicles

To protect vehicular privacy and speed up the execution of tasks,federated learning is introduced in the Internet of Vehicles(IoV)where users execute model training locally and upload local models to the base station without massive raw data exchange.However,heterogeneous computing and communication resources of vehicles cause straggler effect which weakens the reliability of federated learning.Dropping out vehicles with limited resources confines the training data.As a result,the accuracy and applicability of federated learning models will be reduced.To mitigate the straggler effect and improve performance of federated learning,we propose a reconfigurable intelligent surface(RIS)-assisted federated learning framework to enhance the communication reliability for parameter transmission in the IoV.Furthermore,we optimize the phase shift of RIS to achieve a more reliable communication environment.In addition,we define vehicular competence to measure both vehicular trustworthiness and resources.Based on the vehicular competence,the straggler effect is mitigated where training tasks of computing stragglers are offloaded to surrounding vehicles with high competence.The experiment results verify that our proposed framework can improve the reliability of federated learning in terms of computing and communication in the IoV.

Geriatric nursing competence of clinical nursing staff at different hospital levels in Chongqing,China:A cross-sectional study

Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.

Transcriptomic and bioinformatics analysis of the mechanism by which erythropoietin promotes recovery from traumatic brain injury in mice

Recent studies have found that erythropoietin promotes the recovery of neurological function after traumatic brain injury.However,the precise mechanism of action remains unclea r.In this study,we induced moderate traumatic brain injury in mice by intrape ritoneal injection of erythro poietin for 3 consecutive days.RNA sequencing detected a total of 4065 differentially expressed RNAs,including 1059 mRNAs,92 microRNAs,799 long non-coding RNAs,and 2115circular RNAs.Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analyses revealed that the coding and non-coding RNAs that were differentially expressed after traumatic brain injury and treatment with erythropoietin play roles in the axon guidance pathway,Wnt pathway,and MAPK pathway.Constructing competing endogenous RNA networks showed that regulatory relationship between the differentially expressed non-coding RNAs and mRNAs.Because the axon guidance pathway was repeatedly enriched,the expression of Wnt5a and Ephb6,key factors in the axonal guidance pathway,was assessed.Ephb6 expression decreased and Wnt5a expression increased after traumatic brain injury,and these effects were reversed by treatment with erythro poietin.These findings suggest that erythro poietin can promote recove ry of nerve function after traumatic brain injury through the axon guidance pathway.

Long noncoding RNA protein-disulfide isomerase-associated 3 regulated high glucose-induced podocyte apoptosis in diabetic nephropathy through targeting miR-139-3p

BACKGROUND Podocyte apoptosis plays a vital role in proteinuria pathogenesis in diabetic nephropathy(DN).The regulatory relationship between long noncoding RNAs(lncRNAs)and podocyte apoptosis has recently become another research hot spot in the DN field.AIM To investigate whether lncRNA protein-disulfide isomerase-associated 3(Pdia3)could regulate podocyte apoptosis through miR-139-3p and revealed the underlying mechanism.METHODS Using normal glucose or high glucose(HG)-cultured podocytes,the cellular functions and exact mechanisms underlying the regulatory effects of lncRNA Pdia3 on podocyte apoptosis and endoplasmic reticulum stress(ERS)were explored.LncRNA Pdia3 and miR-139-3p expression were measured through quantitative real-time polymerase chain reaction.Relative cell viability was detected through the cell counting kit-8 colorimetric assay.The podocyte apoptosis rate in each group was measured through flow cytometry.The interaction between lncRNA Pdia3 and miR-139-3p was examined through the dual luciferase reporter assay.Finally,western blotting was performed to detect the effect of lncRNA Pdia3 on podocyte apoptosis and ERS via miR-139-3p.RESULTS The expression of lncRNA Pdia3 was significantly downregulated in HG-cultured podocytes.Next,lncRNA Pdia3 was involved in HG-induced podocyte apoptosis.Furthermore,the dual luciferase reporter assay confirmed the direct interaction between lncRNA Pdia3 and miR-139-3p.LncRNA Pdia3 overexpression attenuated podocyte apoptosis and ERS through miR-139-3p in HG-cultured podocytes.CONCLUSION Taken together,this study demonstrated that lncRNA Pdia3 overexpression could attenuate HG-induced podocyte apoptosis and ERS by acting as a competing endogenous RNA of miR-139-3p,which might provide a potential therapeutic target for DN.