Main stages of the development of the specialty "Orthopedics and traumatology"

The most significant components of the educational process at the Department of Traumatology and Orthopedics of the Odessa National Medical University (Ukraine) under modern conditions are highlighted. Purpose: To determine the future orthopedist-traumatologist professional training main stages, including the means of implementing the development of the specialty. Materials and methods. The specific conditions of the specialty "Orthopedics and Traumatology" development under certain circumstances (COVID-19 pandemic; martial law) in the phased professional training of specialists. The following empirical methods were used: observation, test, questionnaire method and method of conversation and interview. Results: It has been determined that there is a significant difference between full-time and distance/on-line learning for higher education applicants, since most clinical competencies require the personal presence of a doctor. It is live contact at the bedside of the patient, as well as with the staff of the in - patient departments and colleagues of the chairs will create a situation of real professional growth, which cannot be replaced by any virtual technology of a specialty practical mastery. Conclusions: The main stages of education affect the development of the specialty, depending on the pace and body of acquired knowledge and skills. The professional qualities of an orthopedist- traumatologist are subject to education by all available methods and means, starting from the student bench of a medical university. Further deepening and improvement of knowledge and skills should continue until the end of one’s professional activity, especially in difficult and unforeseen situations

Point-of-care ultrasonography for the diagnosis of testicular torsion: A practical resident curriculum

Background: Prompt Doppler ultrasonography to aid in diagnosis is often key to managing testicular torsion, but there may be delays in access; a faster, more widely available alternative is point-of-care ultrasonography (POCUS). The purpose of this study was to develop and evaluate a scrotal POCUS curriculum for urology and emergency medicine residents. Methods: Content experts in urology, emergency medicine and diagnostic imaging collaborated in a modified Delphi method to design a practical didactic curriculum for scrotal POCUS for the identification of testicular torsion. Training included 3 online video teaching modules and a 1-hour hands-on teaching session with standardized adult patients. We evaluated participants\u27 competency in scrotal POCUS using a validated scale. We assessed participants\u27 knowledge, comfort and confidence in performing scrotal POCUS before and after the intervention and at 3 months. Results: Twenty-four urology (n = 12) and emergency medicine (n = 12) residents participated in the curriculum. After hands-on practice, 23 participants (96%) were deemed competent at scrotal POCUS. Pre-post testing showed significant improvement in knowledge (mean score 63% v. 80%, p \u3c 0.001), comfort (mean Likert score 0.6 v. 3.6, p \u3c 0.001) and confidence (mean Likert score 1.0 v. 2.1, p \u3c 0.001) after the intervention. These effects were maintained at the 3-month assessment. Conclusion: The scrotal POCUS curriculum was effective and acceptable to both urology and emergency medicine residents. The findings suggest that scrotal POCUS can be learned effectively through a short hands-on session and didactic instruction

Neurologic Issues in Patients Receiving Extracorporeal Membrane Oxygenation Support

Extracorporeal membrane oxygenation (ECMO) is a well-established therapy for patients experiencing acute severe cardiac and/or respiratory failure. Unfortunately, despite noteworthy improvements in patient selection, technology, and multidisciplinary team management, significant complications are still common. The most dramatic and potentially severe complications are neurologic. However, the incidence of neurologic complications (i.e. embolic stroke, intracerebral hemorrhage, seizures, and anoxic injuries) has not been completely defined. Unfortunately, brain death and neurologic injuries are significant causes of morbidity and mortality for patients requiring an ECMO support. Critical to the management of patients requiring ECMO is a broader understanding of neurologic monitoring along with the clinical assessment and management of neurologic events. It is important to evaluate and potentially intervene early in the event of a neurologic problem to minimize its clinical significance. Hopefully, with a better understanding of the pathophysiology, diagnostic and therapeutic tools, and prevention strategies, the true incidence of neurologic complications can be understood and minimized

Opioid-Sparing Anesthesia in Cardiac Surgery Requiring Cardiopulmonary Bypass

Background: Traditional anesthesia for cardiac surgery involved high opioid use associated with adverse events and poor outcomes which led to the adoption of multi-modal analgesic approaches. Although improvements in the overall opioid consumption are seen with multi- modal analgesic approaches, recent studies in opioid-sparing anesthesia and regional anesthesia can further reduce the operative use of opioids in cardiac surgery to improve patient outcomes. Methods: A comprehensive study search was conducted using CINAHL and MEDLINE (ProQuest) to identify research studies from the past three years that have focused on opioid- sparing anesthesia or opioid-free techniques in patients undergoing cardiac surgery with cardiopulmonary bypass. Results: Six research studies were identified as relevant for review. The studies included in this literature review address opioid-sparing anesthesia in cardiac surgery through different techniques, investigate the feasibility for implementation, the role of regional anesthesia, and individual intraoperative pharmacological adjuvants in cardiac surgery requiring cardiopulmonary bypass (CPB). Keywords: Opioid-sparing anesthesia, cardiac surgery, cardiac anesthesia, cardiopulmonary bypass, regional anesthesia, opioid crisis, dexmedetomidine

Factors that Influence Device Selection by Parents of Pediatric Cochlear Implant Candidates

The purpose of this study was to investigate factors/variables and the importance of those factors during cochlear implant (CI) device selection by parents of recent pediatric CI recipients in the United States. The researcher created an electronic survey and asked audiologists and hearing-related professionals at various hospitals and CI centers across the United States to distribute the survey link to the parents of any of their pediatric CI patients who received CI surgery within the past two years under the age of five years. The survey included both Likert-type and open-ended questions regarding the importance of various factors/variables to the parents during their child’s CI device selection. Results of the study found that the participants ranked reported reliability and speech perception performance of the respective manufacturer’s CI device as the most important factor. Individually, the parents of Cochlear, Ltd. recipients found recommendations from others and the popular brand of the company to be most important; based on a limited sample, parents of Advanced Bionics recipients found the CI device’s waterproof capabilities to be most important; and, also based on a limited sample, parents of MED-EL recipients found the reported speech perception performance to be most important

The rules of the game: interprofessional collaboration on the intensive care unit team

BACKGROUND: The intensive care unit (ICU) is a nexus for interspecialty and interdisciplinary tensions because of its pivotal role in the care of the hospital's most critically ill patients and in the management of critical care resources. In an environment charged with temporal, financial and professional tensions, learning how to get results collaboratively is a critical aspect of professional competence. This study explored how team members in the ICU interact to achieve daily clinical goals, delineate professional boundaries and negotiate complex systems issues. METHODS: Seven 1-hour focus groups were conducted with ICU team members in two hospitals. Participants consisted of four nursing groups (n = 27), two resident groups (n = 6) and one intensivist group (n = 4). Interviews were audio-recorded, anonymized and transcribed. With the use of a standard qualitative approach, transcripts were analyzed iteratively for recurrent themes by four researchers. RESULTS: Team members articulated their perceptions of the mechanisms by which team collaboration was achieved or undermined in a complex and high-pressure context. Two mechanisms were recurrently described: the perception of 'ownership' and the process of 'trade'. Analysis of these mechanisms reveals how power is commodified, possessed and exchanged as team members negotiate their daily needs and goals with one another. CONCLUSION: Our data provide a non-idealized depiction of how health care professionals function on a team so as to meet both individual and collective goals. We contend that the concept of 'team' must move beyond the rhetoric of 'cooperation' and towards a more authentic depiction of the skills and strategies required to function in the competitive setting of the interprofessional health care team