Male Catheterization in the Wards:

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Enhancement of Medical Interns\u27 Levels of Clinical Skills Competence and Self-Confidence Levels via Video iPods: Pilot Randomized Controlled Trial

Background: Designing and delivering evidence-based medical practice for students requires careful consideration from medical science educators. Social Web (Web 2.0) applications are a part of today’s educational technology milieu; however, empirical research is lacking to support the impact of interactive Web 2.0 mobile applications on medical educational outcomes.Objectives: The aim of our study was to determine whether instructional videos provided by iPod regarding female and male urinary catheter insertion would increase students’ confidence levels and enhance skill competencies.Methods: We conducted a prospective study with medical trainee intern (TI) participants: 10 control participants (no technological intervention) and 11 intervention participants (video iPods). Before taking part in a skills course, they completed a questionnaire regarding previous exposure to male and female urinary catheterization and their level of confidence in performing the skills. Directly following the questionnaire, medical faculty provided a 40-minute skills demonstration in the Advanced Clinical Skills Centre (ACSC) laboratory at the University of Auckland, New Zealand. All participants practiced the skills following the demonstrations and were immediately evaluated by the same faculty using an assessment rubric. Following the clinical skill evaluation, participants completed a postcourse questionnaire regarding skill confidence levels. At the end of the skills course, the intervention group were provided video iPods and viewed a male and a female urinary catheterization video during the next 3 consecutive months. The control group did not receive educational technology interventions during the 3-month period. At the end of 3 months, participants completed a follow-up questionnaire and a clinical assessment of urinary catheterization skills at the ACSC lab.Results: The results indicate a decline in skill competency over time among the control group for both male and female catheterizations, whereas the competency level was stable among the experimental group for both procedures. Interaction results for competency scores indicate a significant level by group and time (P = .03) and procedure and group (P = .02). The experimental group’s confidence level for performing the female catheterization procedure differed significantly over time (P \u3c .001). Furthermore, confidence scores in performing female catheterizations increased for both groups over time. However, the confidence levels for both groups in performing the male catheterization decreased over time.Conclusions: Video iPods offer a novel pedagogical approach to enhance medical students’ medical skill competencies and self-confidence levels. The outcomes illustrate a need for further investigation in order to generalize to the medical school population

Clinical skill learning for tomorrow’s doctors - a step towards better obstetric care

Background: Female urethral catheterization is the most commonly performed procedure in obstetrics and gynecology, for the assessment of urinary output. Many times catheterization is done by junior colleagues with improper technique resulting in improper catheterization and urethral injury. It is a must to know skill for every graduating medical student to avoid devastating consequences of performing it poorly. The objectives of this study are to evaluate the effectiveness of four step method of skill learning of bladder catheterization in female patients by interns and demonstrate the competency in the proper insertion and removal of an indwelling urinary catheter and also the study aimed to determine the effectiveness of bladder simulator training for medical interns.Methods: A prospective, observational and skill imparting study done using a specially designed model, after ethical committee approval. 30 Interns were divided in to six groups of five each for skill learning. It was done with Kirkpatrik model using specially designed objective structured clinical examination forms and scoring sheets. Sample paired t test was used.Results: 80% of the interns could perform the skill with maximum scores.Conclusions: It is an innovative teaching learning method for incoming interns which will help them to improve knowledge and practice and finally reduce the risk of complications and injury.

Perception, career choice and self-efficacy of UK medical students and junior doctors in urology

Introduction: there is a growing concern about the reduced clinical exposure to urology at undergraduate level in the United Kingdom. As a consequence, the competencies of junior doctors are considered inadequate. The views of these doctors in training towards urology remain under reported.Methods: a modified Delphi method was employed to construct a questionnaire. Given the rise of social media as a platform for scientific discussion, participants were recruited via a social networking site. Outcomes assessed included career preference, exposure to urology, perceived male dominance, and confidence at core procedures.Results: in total, 412 and 66 responses were collected from medical students and junior doctors, respectively. Overall, 41% of participants felt that they had received a good level of clinical exposure to urology as part of their training and 15% were considering a career in this speciality. Female students were significantly less likely to consider urology as a career option (p &lt; 0.01). Of these, 37% of the students felt confident at male catheterization and 46% of students regarded urology as a male-dominated speciality.Conclusions: urology is perceived as male dominated and is the least likely surgical speciality to be pursued as a career option according to our survey. Increased exposure to urology at the undergraduate level and dedicated workshops for core urological procedures are needed to address these challenges.</p

Medical interns' knowledge and training regarding urethral catheter insertion and insertion-related urethral injury in male patients

<p>Abstract</p> <p>Background</p> <p>Improper catheterization can lead to urethral injury. Yet research from four continents suggests training of junior doctors in catheterization is insufficient. European research suggests a majority of catheterization related morbidities occur when the procedure is performed by interns.</p> <p>Methods</p> <p>To assess the knowledge and practices of medical interns relating to urethral catheterization and iatrogenic urethral injury secondary to traumatic catheter insertion, a questionnaire survey was conducted of all first year medical interns at a tertiary national university hospital in the Philippines. The questionnaire contained 17 items covering 4 areas: methods of training in catheterization and level of experience; perceived adequacy of training; theoretical knowledge of catheterization; the mechanisms of catheter-related urethral injury.</p> <p>Results</p> <p>225/240 interns (94%) completed the survey (130 (57.8%) female). 125 (55.6%) responded that they had adequate theoretical training and 150 (66.7%) adequate practical training. All had performed more than 10 catheterizations and 204 (90%) were supervised when they first performed catheterization. Despite relatively high levels of experience and confidence, deficits were identified in detailed knowledge of correct catheterization procedures and of risks associated with urethral injury.</p> <p>Conclusions</p> <p>More thorough training of incoming medical interns in urinary catheterization may help to reduce the risk of complications and injury. Training should be universal and thought given to its timing within the curriculum. Training should include step by step instruction in the process, emphasis on history taking and awareness of factors associated with increased risk of urethral injury.</p

Equal Pay: The Hospital-Nursing Home Dilemma

The Equal Pay Act of 19631 (EPA) is not an independent piece of legis- lation, but rather an amendment to existing legislation. The EPA simply adds an additional fair labor standard to the already familiar Fair Labor Standards Act of 19382 (FLSA) [hereinafter alternately referred to as the Act ]. By utilizing the process of amendment, Congress hoped to avoid the creation of a new bureaucratic structure to enforce the new law,8 and hoped to facilitate compliance because both industry and labor were already aware of the operation and provisions of the FLSA.4 However, what appeared to be a simple matter has nevertheless become the subject of considerable litigation. Although equal pay for equal work is a now familiar concept to attorneys practicing in the field of labor law, litigation has recently taken on a new look as hospitals and nursing homes now begin to feel the effect of the EPA. It is the purpose of this article to explore the provisions of the Equal Pay Act in an attempt to determine when and how it should be applied to these institutions, and through an examination of a body of cases, to reflect a trend that is now unfavorably emerging for the employer

Learning methodology in surgical training

This manuscript aimed to review the literature data related to the surgical training program. This review showed some of the requirements to perform effective surgical training were direct supervision, predetermined repetitions according to surgical skill complexity, valid simulator models, number of students per model. This manuscript discussed how the surgical program could achieve competence using a critical thinking framework, integrated curriculum based on the rationale behind simulation training program.Esse manuscrito tem como objetivo revisar dados da literatura relacionados ao treinamento cirúrgico para  alunos de graduação me medicina.  Essa revisão demostrou que  alguns  pré requesitos são necessários para se realizar treinamento cirúrgico de maneira eficaz: supervisão direta, repetições  pré-determinadas de acordo com a complexidade  da atividade a ser ensinada, modelos de simuladores válidos, número de alunos por modelo. Esse manuscrito também  discutiu como o programa cirúrgico pode levar a competência  pelo desenvolvimento do pensamento crítico e pela integração curricular baseado no racional da  utilização de um programa de treinamento por  simuladores

Medical Education Impact Assessment: Knowledge of Final Year Medical Students of Obafemi Awolowo University about Male Urethral Catheterization

Urethral catheterization is one of the commonest procedures performed by doctors either for prophylactic, diagnostic or therapeutic purposes. Themedical education impact of this procedure on graduating medical students was assessed using a structured questionnaire.This is a questionnaire - based study and the respondents were final year medical students who have completed their final examinations.There were 86 respondents with M:F ratio of 1. About a third of the respondents have not done urethral catheterization during their training while only 7% have done the procedure more than 5 times. All the students know that urethral catheterization is a sterile procedure and 96% knew that sterile gloves should be donned during the procedure. 92.4% of the respondents knew that skin preparation was necessary during the procedure with 75% of them responding that cetriomide andchlorhexidine solution was appropriate. 54% of the students used xylocaine as lubricant while 46% used KY Jelly. On the quantity of the lubricant for catheterization, only 2.7% of the respondents felt that 11-15mls should be injected into the urethra. On the maximum amount of fluid to retain the balloon, only 36% of the students respondedthat it should be according to the specified capacity of the balloon. Majority of the students (88%) know that the catheter should get to theY-junction before it is inflated. Most of the students in this study were taught appropriately the procedure of urethral catheterization; however, about a third had not performed the procedure as a medical student.Keywords: Medical education, knowledge, male catheterizatio