Development of a Clinical Simulation Video to Evaluate Multiple Domains of Clinical Competence: Cross-Sectional Study

BACKGROUND

Medical students in Japan undergo a 2-year postgraduate residency program to acquire clinical knowledge and general medical skills. The General Medicine In-Training Examination (GM-ITE) assesses postgraduate residents' clinical knowledge. A clinical simulation video (CSV) may assess learners' interpersonal abilities.

OBJECTIVE

This study aimed to evaluate the relationship between GM-ITE scores and resident physicians' diagnostic skills by having them watch a CSV and to explore resident physicians' perceptions of the CSV's realism, educational value, and impact on their motivation to learn.

METHODS

The participants included 56 postgraduate medical residents who took the GM-ITE between January 21 and January 28, 2021; watched the CSV; and then provided a diagnosis. The CSV and GM-ITE scores were compared, and the validity of the simulations was examined using discrimination indices, wherein ≥0.20 indicated high discriminatory power and >0.40 indicated a very good measure of the subject's qualifications. Additionally, we administered an anonymous questionnaire to ascertain participants' views on the realism and educational value of the CSV and its impact on their motivation to learn.

RESULTS

Of the 56 participants, 6 (11%) provided the correct diagnosis, and all were from the second postgraduate year. All domains indicated high discriminatory power. The (anonymous) follow-up responses indicated that the CSV format was more suitable than the conventional GM-ITE for assessing clinical competence. The anonymous survey revealed that 12 (52%) participants found the CSV format more suitable than the GM-ITE for assessing clinical competence, 18 (78%) affirmed the realism of the video simulation, and 17 (74%) indicated that the experience increased their motivation to learn.

CONCLUSIONS

The findings indicated that CSV modules simulating real-world clinical examinations were successful in assessing examinees' clinical competence across multiple domains. The study demonstrated that the CSV not only augmented the assessment of diagnostic skills but also positively impacted learners' motivation, suggesting a multifaceted role for simulation in medical education.

Smartphone Usage Patterns Among Postgraduate Medical Students: A Central India Perspective on Adaptive Learning in Medicine

Introduction Technological developments are drawn on a path of continuous inventions. Smartphones have been used in educational activities to access course content, acquire information related to students' performance, and encourage discussion and sharing between students and teachers. Students as learners are the drivers of using new technology for their learning needs, and this is always evolving. Aim The aim of the study is to assess the usage of smartphones for academic learning among postgraduate medical students in a teaching institute in Central India. Materials and methods This cross-sectional, questionnaire-based study was conducted on 130 postgraduate medical students for a period of four months from 1 January 2022 to 30 April 2022. Results The mean age of the study subjects was 28.34 ± 3.22 years with the range being 23 to 44 years. Smartphones had a significant impact on the academic learning of postgraduate medical students. The major impacts of smartphones on academic learning were in the form of improved learning skills (60.91%), timely completion of assignments (40%), increased participation in discussions (34.55%), enhanced academic performance (33.64%), and development of critical and innovative thinking (29.09%). Conclusion A significant proportion of medical postgraduates are utilizing smartphones and social media for academic purposes. Although this new technology offers the potential to enhance learning and patient care, it has some inherent problems associated with its use. However, it may go a long way in redefining how we manage information in medicine.

Identifying entrustable professional activities for MD program in biochemistry-A modified Delphi approach

Entrustable professional activities (EPAs) facilitate competency-based assessments. India is on the verge of implementing competency-based training for postgraduate programs. MD degree in Biochemistry is a unique program available exclusively in India. Postgraduate programs in most specialties have started working toward EPA-based curriculum, in both India and other countries. However, EPAs for MD Biochemistry course are yet to be defined. This study aims to identify EPAs for postgraduate training program in Biochemistry. Identification and attaining consensus on the list of EPAs for MD Biochemistry curriculum was done by modified Delphi method. The study was conducted in three rounds. In round 1, tasks expected from an MD Biochemistry graduate were identified by working group followed by expert panel validation. The tasks were organized and reframed to EPAs. Two rounds of online survey were conducted to achieve a consensus on the list of EPAs. Consensus measure was calculated. A cut-off value of 80% and above was considered to reflect good consensus. The working group identified 59 tasks. This was validated by 10 experts based on which, 53 items were retained. These tasks were reframed into 27 EPAs. In round 2, 11 EPAs achieved good consensus. Among the remaining EPAs, 13 achieved consensus of 60%-80% and were selected for round 3. Five EPAs achieved good consensus in this round. A total of 16 EPAs were identified for MD Biochemistry curriculum. This study provides a frame of reference for experts to develop an EPA-based curriculum in the future.

Understanding the need for developing a structured competency-based curriculum for health policy and programs among community medicine postgraduates: A grounded theory approach

Introduction

Many plans and policy changes about health outcomes have evolved, but none of them have ever given a definite shape to the postgraduate (PG) curriculum so as to make it more intensive and integrative, which needs to be so structured and tailored that it is more patient, community centric, and less knowledge based.

Objectives

The objective of this study was to identify the gap in existing curriculum in learning of health policy and program among PGs of community medicine and recommend a structured model for the same.

Materials and Methods

A qualitative study (grounded theory approach) with all PGs of community medicine in one teaching institute in South India (8 PG students) was taken up.

Results

PGs felt that they never had any day-to-day update. They wanted to understand the working pattern and ground reality of policy and program which was unavailable to them. People who came to postgraduation after being medical officers felt that the monitoring and evaluation done by inexperienced MD Community Medicine students was never accepted by state public health because they did not understand the implementation problems and so could not rightly critically evaluate the programmatic challenges.

Conclusion

With the shift in medical education patterns and expectations of residents, it becomes important to justify the need of developing a structured based curriculum, more so for policy and programs, which will make them capable enough by polishing their managerial and financial skill set. The evaluation technique should focus more on practical aspects on field instead of their theory examination.

Molar-incisor hypomineralisation: Knowledge and perception of Syrian undergraduate and postgraduate dental students

INTRODUCTION

Dentists' knowledge and expertise, especially in their early career, are primarily shaped during undergraduate studies. This cross-sectional study aimed to assess the knowledge and perception of Syrian under- and postgraduate students regarding diagnosing and managing molar-incisor hypomineralisation (MIH)-affected teeth.

MATERIALS AND METHODS

Final-year dental students (FY-students), postgraduates in paediatric dentistry (PD-postgraduates) and postgraduates in other lines of specialty (OS-postgraduates) in all Syrian dental schools were invited to participate in an established web-based survey covering the knowledge and attitudes regarding the prevalence, aetiology, diagnosis and management of MIH. Data were analysed with descriptive statistics and Fisher's exact/chi-squared tests at 5%.

RESULTS

In total, 1142 post- and undergraduate students from six public and five private dental schools in Syria participated in this study (867 FY-students, 74 PD-postgraduates and 201 OS-postgraduates). PD-postgraduates were found to present statistically significantly better knowledge regarding MIH compared with the two other groups. Only 19% of FY-students and 54% of OS-postgraduates reported themselves familiar with MIH (compared with 97% of PD-postgraduates). Similarly, 18% of FY-students and 27% of OS-postgraduates were capable of diagnosing MIH (compared with 81% of PD-postgraduates). Stainless-steel crowns and direct composite fillings were chosen as most suitable for treating MIH-affected molars from all responders.

CONCLUSIONS

FY-students and even OS-postgraduates in Syria lack knowledge and confidence when confronted with MIH. The university curricula need to include more educational materials to equip the students with the necessary tools to manage MIH clinically.

Relationship between Job Burnout, Depressive Symptoms, and Career Choice Regret among Chinese Postgraduates of Stomatology

A qualified Chinese dental postgraduate requires at least eight years of training. The huge academic burden, strict clinical requirements, and high workload increases the risk of job burnout, depression symptoms, and career choice regret of dental postgraduates, which may cause one to waver in their choice of a career as a doctor. Therefore, we aimed at assessing the relationship between job burnout, depressive symptoms, and career choice regret among Chinese dental postgraduates. The Chongqing Stomatological Association conducted an online cross-sectional study among 558 dental postgraduates in China, with an average age of 22.54 ± 2.44. Demographic information, the Maslach Burnout Inventory, the 2-item Primary Care Evaluation of Mental Disorders scale, and career choice regret scale were included in the questionnaire. About 41.0% of dental postgraduates experienced job burnout, 44.1% had depressive symptoms, and 41.6% reported career choice regret. Logistic regression analysis indicated the risk factors for job burnout were time worked/studied per week, depressive symptoms, and career choice regret. Job burnout and career choice regret was significantly related to depressive symptoms (p < 0.001). Risk factors for career choice regret were gender, postgraduate entrance examination score, daily hours of sleep, job burnout, and depressive symptoms. Such results suggest that job burnout, depressive symptoms, and career choice regrets are prevalent among dental postgraduates. Accurate measures should be taken to change this situation.

Perceptions of Patient Safety Competence Using the Modified Version of the Health Professional Education in Patient Safety Survey (H-PEPSS) Instrument Among Dental Students in Riyadh, Saudi Arabia

AIM

To investigate dental students' self-reported confidence in learning about various domains of patient safety during their clinical training years.

METHODS

The Health Professional Education in Patient Safety Survey (H-PEPSS) was distributed to the fourth- and fifth-year undergraduate students, interns and postgraduate dental students. The survey explores how the seven domains of the Canadian Patient Safety Institute Safety Competencies Framework and wider cases of patient safety issues are presented in dental education, as well as participants' self-reported comfortability regarding revealing about patient safety issues. A comparison of the patient safety domains scores were assessed through learning scenarios (classroom and clinical), gender, level of study and type of institution.

RESULTS

Out of 409 participants, 359 undergraduate dental students and 131 postgraduate dental students responded to the survey. Irrespective of the groups, all dental students were most confident regarding their learning aspects about skills pertaining to clinical safety and effective communication and least confident in learning related to managing safety risks. All the patient safety factors irrespective of the scenario, scored above 75% and thus interpreted as good competence. Statistically significant differences were reported among the genders in the classroom scenario for learning about communicating effectively with the patients regarding patient safety issues (p < 0.05). Male dental students, undergraduates and those in the private institution were significantly less confident about recognizing and reporting to immediate risks in the clinical scenario compared to their respective counterparts (p < 0.05).

CONCLUSION

Based on the results, the dental students are quite confident with regard to the learning aspects of clinical patient safety, nevertheless, their confidence in learning certain patient safety aspects warrants further improvement. This implies a need to address the impact of regular interventions, extra motivation and repeated mentoring in both the classroom and clinical scenarios on improving dental students' confidence about patient safety.

The Relationship Between Postgraduates' Emotional Intelligence and Well-Being: The Chain Mediating Effect of Social Support and Psychological Resilience

Background

Postgraduates usually face more life challenges than undergraduate students, including social, emotional and financial issues, and the prevalence of mental health problems in postgraduates is higher than undergraduates. Therefore, the attention on postgraduates' mental health status is needed.

Objectives

The current study explored the relationship between postgraduates' emotional intelligence and well-being by investigating the mediating effects of social support and psychological resilience and the relationship between them through the construction of a chain mediation model.

Method

1,228 postgraduates completed the Emotional Intelligence Scale, the Social Support Rate Scale, the Psychological Resilience Scale, and the Subject Well-being Scale.

Results

There is a chain effect between postgraduates' social support and psychological resilience mediated by their emotional intelligence and well-being, with a total effect value of 0.049.

Conclusion

Emotional intelligence has a predictive effect on postgraduates' well-being. The mechanism of this effect includes the indirect effects of social support and psychological resilience. Study results revealed the relationship mechanism between emotional intelligence and postgraduates' well-being, and provide reference for explorations of how to development postgraduates' emotional intelligence and further improving their abilities to strengthen their emotional resilience.

Research on the Initiative Scientific Research and Innovation Behavior of Postgraduates: Based on the Theory of Planned Behavior

To clarify the generative mechanism and influencing factors of graduate students' willingness and behavior of initiative scientific research and innovation, this research builds a quantitative model consisting of six variables: academic interest, regulatory pressure, conditions for improving scientific research and innovation capabilities, willingness to take initiative in scientific research and innovation, the promotion of achievements in scientific research, and initiative scientific research and innovation behavior. In total, 684 valid questionnaires were distributed and collected through WeChat Moments. Descriptive statistical analysis, reliability and validity analysis, factor analysis, path analysis, and conditioning analysis were conducted using the SPSS and structural equation model (SEM). The results showed that: (1) academic interest, regulatory pressure, and conditions for improving scientific research and innovation capabilities have a positive impact on the intention of initiative scientific research and innovation, but the impact of regulatory pressure is extremely insignificant. (2) The willingness to take initiative in scientific research and innovation has a positive and significant impact on initiative scientific research and innovation behavior, and the promotion of achievements in scientific research plays a negative moderating effect. Finally, this manuscript puts forward the suggestions on how to promote the initiative scientific research and innovation behavior of postgraduate students based on the research results.

[Practice in fostering postgraduates' creativity through teaching the course of Modern Microbial Biotechnology]

Improving the creativity is crucial to postgraduate training nowadays. The course of Modern Microbial Biotechnology is an optional specialized course for microbiology-related postgraduates. To explore a new teaching mode for improving the creativity of postgraduate students, we reformed the teaching content, the teaching method and the evaluation mode of this course. Through case study teaching, seminar-style classroom and implementation of a new assessment method, the students not only mastered professional knowledge and disciplinary frontiers of modern microbiology technology, but also improved their ability of discovering, analyzing and solving problems. The reformed course teaching mode is effective in fostering postgraduates' creativity.

Mini-Clinical Evaluation Exercise as a Tool for Formative Assessment of Postgraduates in Psychiatry

Context

Introduction of competency-based medical education in India has necessitated a diversion from traditional methods of teaching and assessment.

Aim

The aim of this study was to assess the feasibility and acceptability of mini-clinical evaluation exercise (mini-CEX) as a tool for formative assessment of postgraduates in psychiatry at our institute.

Settings and Design

It was a prospective, quasi-experimental study carried out in the Department of Psychiatry, PGIMS, Rohtak (India).

Materials and Methods

After obtaining written informed consent, trainees (18) were sensitized and faculty members (5) were trained to use mini-CEX and regarding the feedback process with the help of workshops.

Statistical Analysis Used

Data collected were analyzed using descriptive statistics. Mean differences between the sessions were assessed using a paired sample t-test. P < 0.05 was considered as level of significance.

Results

Statistically significant difference was found between session 1 and session 6 for counseling skills but not for three sessions of diagnostic skills. Mini-CEX was accepted as a better learning method by 61% of the postgraduates, 36% felt that it improved their clinical skills, 64% reported a boost in their confidence, and 89% looked forward to these encounters. Majority of the postgraduates and faculty members suggested that the mini-CEX should be regularly used in academic settings and should be introduced early in the training.

Conclusions

Mini-CEX is a feasible formative assessment tool for postgraduates in psychiatry and an effective method of learning by the postgraduates, inducing a significant improvement in the counseling skills of students. Teaching faculty also accepted mini-CEX as an effective method of formative assessment.

Assessment of knowledge of oral pathologists and postgraduate students on safe laboratory practices during the COVID-19 pandemic

Background:

Oral pathologists are involved in laboratory diagnosis and receive specimens of biopsy, oral cytologic smears and samples for hematology, biochemistry and microbiology and thus are at a risk for laboratory-acquired infections, which may occur inadvertently and can be considered as an occupational hazard.

Aim and Objectives:

This study was conducted during the coronavirus disease (COVID-19) pandemic to assess the knowledge of oral pathologists and oral pathology postgraduate students regarding the safe laboratory practices, procedures and guidelines.

Materials and Methods:

The study was a cross-sectional online questionnaire-based study. Questions were framed to evaluate the knowledge on specimen/sample collection, its handling, disposal and protective measures for laboratory personnel. The study population comprised oral pathologists and oral pathology postgraduate students of various dental colleges in India. A Google Doc format was used to create an effective computerized questionnaire system, and the link was forwarded to around 500 participants. The survey was fielded online between August 29, 2020, and September 5, 2020. Three hundred and twelve responses were received, which were downloaded as spreadsheets for subsequent data analysis.

Results:

Mean value of right answers for the oral pathologists was 8.11 ± 2.02 and for postgraduate students was 7.38 ± 1.75. When the knowledge score between the two groups was compared, a statistically significant difference was found.

Conclusion:

This article compares and highlights the knowledge lacunae among the oral pathologists and oral pathologists postgraduate students in relation to guidelines to be followed for safety in the laboratory. Adhering to these biosafety regulations reduces occupational health hazards and enhances a safe working environment in the laboratory.

Formative assessment in practical for Indian postgraduates in health professions education: A strategic initiative towards competency-based education

Background:

Observational assessment (OA) or Workplace Based Assessment (WPBA) is being increasingly used to assess the trainees by direct observation to shape their learning. The current deficiencies in our conventional assessment system are due to lack of conceptualization of assessment as a process for continuous improvement and learning, leading to non-utilization of many available tools of assessment.

Objective:

The present study aimed to introduce formative assessment (FA) for postgraduates at all the constituent colleges (Medical, Dental, Ayurveda, Nursing) under the ambit of Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi (M) Wardha, (Maharashtra), India.

Methodology:

Observational Assessment tools used for FA were Mini CEX (Mini Clinical Evaluation Exercise) and DOPS (Direct Observation of Procedural Skills)in addition to Objectively Structured Clinical/Practical Examination (OSCE/OSPE). Six encounters of OAs were conducted at the end of each semester. The OA tool used was either the MiniCEX or/and DOPS, depending on the type of subject (Preclinical, Para-clinical, Clinical).

Results:

A significant improvement in scores from one semester to other as the postgraduate learner progresses, was observed. The overall response from the postgraduate students and faculty for FA was satisfactory.

Conclusion:

Formative assessment in practical's, was feasible, acceptable and effective program to improve the overall learning and competency of postgraduates.

Survey of Basic Laparoscopic Training Exposure of Nigerian Postgraduate Trainees

Background:

The practice of laparoscopy involves the use of training models that are different from conventional open surgery. These concepts are not captured in the traditional models of surgical residency training. Residency training in surgery has been seen as an ample opportunity for early introduction and training in laparoscopy.

Objectives:

This study aimed to assess the level of exposure and training experience of some surgical resident doctors in accredited training institutions in Nigeria on laparoscopy.

Methodology:

A cross-sectional survey was conducted among the resident doctors undergoing revision course in surgery at the National Orthopaedic Hospital, Igbobi, Lagos, and Lagos University Teaching Hospital, Lagos, in March 2018. Using the quantitative method of data collection, a pre-tested structured questionnaire was used to collect information on the demography and training exposure of the residents in laparoscopy.

Results:

A total of 54 of 96 residents surveyed returned the questionnaire, giving a response rate of 56%. There were 53 (98.1%) males and 1 (1.9%) female. The age range of the respondents was between 30 and 46 years, with a mean of 34.2 ± 3.96 years. Thirty-two (59.3%) respondents had spent at least 2 years training in surgery. Thirty-six (66.7%) respondents had not participated in more than four laparoscopic procedures during their rotation. Forty-six percent of respondents reported that their experience in laparoscopy was mainly by observation of the procedures. Forty-nine (90.7%) of respondents surveyed had not attended any training program in laparoscopy. Eighty-one (81.0%) of respondents had a strong motivation and desire for future practice of laparoscopy.

Conclusion:

This study revealed that few Nigerian postgraduate trainees sampled in the survey were exposed and had training experience in laparoscopy.

Depressive symptoms and quality of life among Chinese medical postgraduates: a national cross-sectional study

High workloads and heavy academic pressure can have significant implications for the risk for depression and poor quality of life (QoL). This study aimed to investigate QoL and depressive symptoms in medical students undergoing postgraduate neurology specialty training in China. The survey covered demographic characteristics, the 8-itemMedical Outcomes Study Short-Formquestionnaire (SF-8), and the 2-itemPrimary Care Evaluation of Mental Disorders depression screening tool. Logistic regression analysis was used to investigate the determinants of QoL and depressive symptoms. Participants were 1,814 postgraduates from 249 hospitals in 27 Chinese provinces. The mean SF-8 physical and mental component summary scores were 78.17 (standard deviation [SD] 15.20) and 68.33 (SD 17.15), respectively. One-third of respondents had depressive symptoms, and those without depressive symptoms had significantly higher QoL scores. The multivariate regression analysis showed that factors independently associated with depressive symptoms were being in the second year of study, a lower household income, and less sleep  time. Although QoL among our sample of Chinese medical students undergoing postgraduate neurology specialty training was favorable relative to other comparable populations, one-third of respondents had depressive symptoms. Accurate measures should be taken to change this situation.

Knowledge, attitude, and practice of dental implants among dental postgraduates and practitioners in Davangere City, Karnataka: A cross-sectional study

Background

Implant therapy has become an important part of treatment to restore function and esthetics in partially/completely edentulous patients. Inspite of the progress made in implant dentistry since its inception, there have been some loopholes in scientific based knowledge and established clinical experience amongst dental professionals and postgraduates.So,an analysis was performed of the real picture.

Objectives

A study was conducted to assess and compare the knowledge, attitude and practice of dental implants among dental postgraduate students and dental practitioners (General and institutional)in Davangere City, Karnataka and to identify the variations in their knowledge, attitude and practice with respect to dentist's factors (years of experience, implant training and their specialization).

Materials and Methods

A cross sectional questionnaire based survey was conducted using census approach with informed consent. A pretested, self administered questionnaire containing demographic details and knowledge ,attitude and practice based questions was distributed and collected back from the respondents. Responses were coded before and decoded after the analysis. Statistical analysis was performed using SPSS SoftwareV17.0.

Results

The results were determined after the statistically analyzed and concluded that the knowledge was widespread among postgraduates and dental practitioners and variations existed amongst the subjects with respect to age, gender, years of experience, practice type, implant training and their specialization. It was also found that the attitude and practice towards implants and their evidence based knowledge about the same was variable.

Are postgraduate qualifications the 'new frontier of social mobility'?

We investigate the relationship between social origin, postgraduate degree attainment, and occupational outcomes across five British age-group cohorts. We use recently-available UK Labour Force Survey data to conduct a series of logistic regressions of postgraduate (masters or doctorate) degree attainment among those with first degrees, with controls for measures of degree classification, degree subject, age, gender, ethnicity and national origin. We find a marked strengthening of the effect of class origin on degree- and occupational attainment across age cohorts. While for older generations there is little or no difference by class origin in the rates at which first-degree graduates attain postgraduate degrees, those with working-class-origins in the youngest age-group are only about 28 per cent as likely to obtain a postgraduate degree when compared with their peers from privileged origins. Moreover, social origin matters more for occupational destination, even among those with postgraduate degrees, for those in younger age groups. These findings demonstrate the newly important, and increasing, role of postgraduate degrees in reproducing socio-economic inequality in the wake of the substantial expansion of undergraduate and postgraduate education. Our findings lend some support to the Maximally Maintained Inequality thesis, suggesting that gains in equality of access to first-degrees are indeed at risk from postgraduate expansion.

Evaluating the impact of pain education: how do we know we have made a difference?

1. Education is a core activity for most healthcare professionals working in pain management and an effective evaluation strategy should assess its impact. 2. Evaluation may have one or more purposes: accountability, development or knowledge generation. Other key principles include making evaluation integral to the education process, reflecting with learners on progress, self-evaluation by the pain educator and involving all the key stakeholders. 3. A wide variety of methods are available, but the choice will be influenced by the nature and amount of the pain education, number of learners, purpose of the evaluation and time and resources available. 4. Patient education can be evaluated through knowledge and attitude questionnaires, concordance with the treatment plan, satisfaction and pain- and disability-related measures. 5. Further research is needed to explore the specific strategies or combination of techniques that are effective for different groups, and build on the theoretical base underpinning effective pain education and evaluation for patients and professionals. 6. The importance of education for the public has also been recently recognised, but this wider educational initiative should also be fully evaluated to assess whether this initiative is making a difference.