Attitude of Gratitude: Evaluation of a Wellness Program to Improve Dispositional Gratitude Among Medical Students

Introduction: Medical students face significant mental health challenges as they matriculate through medical training. Research has emphasized the need for more interventions that promote physician trainee well-being and resilience during the early stages of training. Recent interventions have shown to be effective in promoting mental health and well-being; however, no interventions have examined the impact that daily gratitude practice, which is linked to increased well-being, may have on dispositional gratitude levels among medical students. Methods: In Spring 2019, medical students at the University of South Florida were invited to participate in a gratitude program. Participants logged three good things that happened to them each day, for a period of 30 days. Their dispositional gratitude levels were assessed using the short-form Gratitude Resentment and Application Test (GRAT) before and after the 30-day intervention. Participant demographics and changes in GRAT scores from baseline to follow-up were examined. Results: Forty-six medical students volunteered to participate in a short-term, gratitude-focused wellness program. Overall levels of dispositional gratitude increased significantly among medical students (p\u3c.001). While a significant increase in GRAT score was found among the thirty-five female participants (p\u3c.001), no significant change was found among the eleven male participants (p=.154). GRAT scores increased significantly among both first- and second-year medical students (p=.001). However, no significant increases were reported among third- and fourth-year students (p=.109). GRAT scores increased significantly regardless of whether students used a tool to practice gratitude at baseline. Conclusion: Our results demonstrate that a 30-day gratitude practice program can improve dispositional gratitude among medical students, particularly among female students and pre-clinical students in years one and two

Comparative Benefits and Risks Associated with Currently Authorized COVID-19 Vaccines

This article provides a systematic assessment of the efficacy, risks, and methodological quality of evidence from five major publicly available vaccine trials. Results from Pfizer-BioNTech mRNA, Moderna-US NIH mRN-1273, AstraZeneca-Oxford ChAdOx1 nCov-19, Gamaleya GamCovidVac (Sputnik V), and Ad26.COV2.S Johnson & Johnson vaccines were included. Extracted benefits and risks data from each trial were summarized using the GRADE approach denoting the overall certainty of evidence along with relative and absolute effects. Relative risk reduction across all five vaccine trials ranged from 45% to 96%. Absolute risk reduction in symptomatic COVID-19 ranged from 6 to 17 per 1000 across trials. None of the vaccines were associated with a significant increase in serious adverse events compared to placebo. The overall certainty of evidence varied from low to moderate. All five vaccines are effective and safe, but suggest room for improvement in the conduct of large-scale vaccine trials. Certainty of evidence was downrated due to risk of bias, which can be mitigated by improving transparency and thoroughness in conduct and reporting of outcomes

A prospective, head-to-head comparison of 2 EUS-guided liver biopsy needles in vivo.

BACKGROUND AND AIMS: Procedural standardization in endoscopic ultrasound-guided liver biopsy (EUS-LB) is necessary to obtain core biopsy specimens for accurate diagnosis. The objective of this study was to directly compare the diagnostic yield of 2 EUS-LB fine-needle biopsy (FNB) systems in vivo. METHODS: In this prospective, single-center study, 108 adult patients undergoing EUS-LB over a 1-year period were included. Each EUS-LB consisted of an EGD, followed by EUS-guided biopsy of the left lobe of the liver sequentially using 2 different 19-gauge needles: the fork-tip (SharkCore) and Franseen (Acquire) FNB systems. Specimens were then reviewed by a GI histopathologist to determine diagnostic adequacy as well as the number of complete portal tracts, specimen length, and degree of fragmentation. RESULTS: In 79.4% of cases, the fork-tip FNB system yielded a final diagnosis compared with 97.2% of the Franseen FNB specimens (P \u3c .001). The mean number of complete portal tracts in the fork-tip FNB samples was 7.07 compared with 9.59 in the Franseen FNB samples (P \u3c .001). The mean specimen length was 13.86 mm for the fork-tip FNB and 15.81 mm for the Franseen FNB (P = .004). Cores were intact in 47.6% of the fork-tip FNB samples and in 75.2% of the Franseen FNB samples (P = .004). CONCLUSIONS: In EUS-LB, we found that the 19-gauge Franseen FNB system resulted in a statistically significant increase in diagnostic adequacy compared with biopsy using the fork-tip FNB system

Perception of Medical Student Mistreatment: Does Specialty Matter?

Purpose Medical student mistreatment is pervasive, yet whether all physicians have a shared understanding of the problem is unclear. The authors presented professionally designed trigger videos to physicians from 6 different specialties to determine if they perceive mistreatment and its severity similarly. Method From October 2016 to August 2018, resident and attending physicians from 10 U.S. medical schools viewed 5 trigger videos showing behaviors that could be perceived as mistreatment. They completed a survey exploring their perceptions. The authors compared perceptions of mistreatment across specialties and, for each scenario, evaluated the relationship between specialty and perception of mistreatment. Results Six-hundred fifty resident and attending physicians participated. There were statistically significant differences in perception of mistreatment across specialties for 3 of the 5 scenarios: aggressive questioning (range, 74.1%–91.2%), negative feedback (range, 25.4%–63.7%), and assignment of inappropriate tasks (range, 5.5%–25.5%) (P ≤ .001, for all). After adjusting for gender, race, professional role, and prior mistreatment, physicians in surgery viewed 3 scenarios (aggressive questioning, negative feedback, and inappropriate tasks) as less likely to represent mistreatment compared with internal medicine physicians. Physicians from obstetrics–gynecology and “other” specialties perceived less mistreatment in 2 scenarios (aggressive questioning and negative feedback), while family physicians perceived more mistreatment in 1 scenario (negative feedback) compared with internal medicine physicians. The mean severity of perceived mistreatment on a 1 to 7 scale (7 most serious) also varied statistically significantly across the specialties for 3 scenarios: aggressive questioning (range, 4.4–5.4; P < .001), ethnic insensitivity (range, 5.1–6.1; P = .001), and sexual harassment (range, 5.5–6.3; P = .004). Conclusions Specialty was associated with differences in the perception of mistreatment and rating of its severity. Further investigation is needed to understand why these perceptions of mistreatment vary among specialties and how to address these differences.12 month embargo; published online: 29 June 2021This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]