Medical Students’ First Male Urogenital Examination: Investigating the Effects of Instruction and Gender on Anxiety

Objectives: To investigate the effect that standardized instruction of the male urogenital examination had on the anxiety levels of students and to determine what influence, if any, the gender of the student had on this experience. Methods: One hundred thirty six second year medical students were asked to report their level of anxiety before and after participation in a small group teaching session on the male urogenital examination. We gathered both qualitative and quantitative information to better understand students’ anxiety surrounding this instruction. Results: Students had significantly lower state-anxiety scores following the instruction than before (F(1, 76)=102.353, p=.000, eta2=.574) and female students were more likely to have greater state-anxiety than male students (F=6.952, p=.010, eta2=.084). Ninety-nine percent of students reported that the teaching associates successfully reduced their anxiety. This decrease was attributed predominantly to the personal qualities of the teaching associates and to the format of the instruction. Conclusions: This study provides both quantitative and qualitative evidence that the use of male teaching associates to provide standardized instruction on the urogenital exam is effective at reducing students’ anxiety, particularly with regard to female students. Added standardized instruction may lead to increased confidence, skill, and future compliance with intimate physical exam screening practices

Effectiveness of a comprehensive mental skills curriculum in enhancing surgical performance: Results of a randomized controlled trial

INTRODUCTION: We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. METHODS: Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS training while the intervention group also participated in the MSC. Skill transfer and retention were assessed on a live porcine model after training and 2 months later, respectively. Performance was assessed using the Test of Performance Strategies-2 (TOPS-2) for mental skills, FLS metrics for laparoscopic performance, and the State Trait Anxiety Inventory (STAI-6) and heart rate (HR) for stress. RESULTS: Fifty-five participants (92%) completed training and the transfer test, and 46 (77%) the retention test. There were no significant differences between groups at baseline. Compared to controls the intervention group significantly improved their mental skill use, demonstrated higher laparoscopic skill improvement during retention, and reported less stress during the transfer test. CONCLUSIONS: The MSC implemented in this study effectively enhanced participants' mental skill use, reduced cognitive stress in the operating room with a small impact on laparoscopic performance

Unifying interdisciplinary education: designing and implementing an intern simulation educational curriculum to increase confidence in critical care from PGY1 to PGY2

Abstract Background A longitudinal, multidisciplinary critical care simulation curriculum was developed and implemented within a teaching hospital to address the need for consistent, safe, efficient, and unified critical care training within graduate medical education. Primary goals were to increase learner confidence in critical care topics and procedural skills across all specialties. Secondary goals included improving communication skills and obtaining a high level of learner satisfaction. All interns caring for adult patients within our hospital participated in three 4-h simulation-based sessions scheduled over the second half of their intern year. Pre- and postcurricular surveys evaluated self-confidence in critical care topics, procedures, and communication skills. The Debriefing Assessment for Simulation in Healthcare Student Version (DASH-SV) Short Form was used to evaluate facilitator debriefing. Data were compared with Wilcoxon rank sum and signed rank test. Results Pre- and postcurricular surveys were collected from 51 of 52 interns (98% response rate) in curricular year 1 and 59 of 59 interns (100% response rate) in curricular year 2 in six programs within the hospital. Resident confidence significantly improved in all areas (p  75% of interns in both curricular years 1 and 2 expressed a desire for future educational sessions. Conclusions The implemented curriculum increased learner confidence in select critical care topics, procedures, and communication skills and demonstrated a high level of learner satisfaction. The curriculum has expanded to learners from three other teaching hospitals within our system to unify critical care education for all interns caring for adult patients

Physicians' continuing medical education activities and satisfaction with their ability to stay current in medical information and practice: A cross‐sectional study

Abstract Background and Aims Little is known about physicians' approaches to continuing medical education (CME) for continuing professional development despite the rapid evolution of CME offerings. We sought to identify the extent to which demographic, career, and experiential CME‐activity variables were independently associated with physicians' satisfaction with their ability to stay current on medical information and practice. Methods Using the 2019 Association of American Medical Colleges' National Sample Survey of Physicians data, we ran multivariable logistic regression models examining demographic, career, and experiential (participation in 11 CME activities in the past year) variables for their associations with physicians' satisfaction (satisfied vs. not satisfied/neutral) with their ability to stay current. Results Of 5926 respondents, 90% (5341/5926) were satisfied with their ability to stay current. Significant (each two‐sided p  0.05). Conclusion We observed independent associations between physicians' satisfaction with their ability to stay current in medical information and practice and each specialty, academic affiliation, race/ethnicity, age, and CME activity type (for 2 of 11 examined). Findings may be relevant to organizations and institutions designing and implementing CME activities in the current context of COVID‐19 pandemic‐related in‐person activity limitations and can inform targeted interventions addressing differences in the satisfaction we observed to better support physicians' CME

Implementation Results of a Novel Comprehensive Mental Skills Curriculum during Simulator Training

Background Mental skills training refers to the implementation of cognitive performance-enhancing strategies to promote optimal performance. We aimed to develop a surgery-specific mental skills curriculum (MSC) and obtain initial evidence of efficacy. Methods The developed MSC consisted of 8 proven performance-enhancing modules. Its efficacy was assessed during laparoscopic simulator-based practice by novices using validated instruments of mental skills, workload, and stress, in addition to a skill transfer test to a porcine model. A paired t test was used to analyze the data. Results Nine surgical novices completed the curriculum. Compared with baseline assessment, participants improved significantly their laparoscopic performance and mental skills after completion of the MSC. All participants completed the task in the porcine model without an appreciable change in their perceived stress. During the skill transfer test, 8 participants were observed using mental skills taught in the MSC. Conclusions A surgery-specific simulator-based MSC was developed, and its efficacy in improving mental skills and surgical performance was supported during a surgical skill transfer test