"Busting the hidden curriculum" a realist and innovative perspective to foster professional behaviors.

Contemporary health professions education has long delineated the desired attributes of medical professionalism in the form of standard curricula and their role in forming professional behaviors (PBs) among aspiring doctors. However, existing research has shown the contradictory and powerful role of hidden curriculum (HC) in negatively influencing medical students' PBs through unspoken or implicit academic, cultural, or social standards and practices. These contrasting messages of formal curricula and HC lead to discordance and incongruence in future healthcare professionals developing professional identity formation.

Reclaiming the concept of professionalism in the digital context: a principle-based concept analysis.

Background: There has been an alarming surge in the usage of social networking sites (SNSs) by healthcare professionals (HCPs) without adherence to the principles of professionalism. The widespread use of SNSs in medical practices has been coupled with reports of breaches of professional behaviors. Despite the benefits of SNSs, skepticism prevails about a clearly defined role for SNSs within medicine based upon the core principles of professionalism.

Illness Trajectories After Revascularization in Patients With Peripheral Artery Disease: A Unified Approach to Understanding the Risk of Major Amputation and Death.

Background: The aim of this study was to investigate the illness trajectories of patients with peripheral artery disease (PAD) after revascularization and estimate the independent risks of major amputation and death (from any cause) and their interaction.

Methods: Data from Hospital Episode Statistics Admitted Patient Care were used to identify patients (≥50 years of age) who underwent lower limb revascularization for PAD in England from April 2013 to March 2020. A Markov illness-death model was developed to describe patterns of survival after the initial lower limb revascularization, if and when patients experienced major amputation, and survival after amputation.

Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis.

Introduction: Professional identity formation (PIF) is an ongoing, self-reflective process involving habits of thinking, feeling and acting like a physician and is an integral component of medical education. While qualitative work has suggested that PIF is informed by professionalism, resilience, and leadership, there is a dearth of quantitative work in this area. Multiple methods build rigor and the present study aimed to quantitatively assess the relative psychometric contributions of professionalism, resilience, and leadership constructs to informing PIF, using a latent factor analysis approach.

Varicose Vein Education and Informed coNsent (VVEIN) Study: A Randomized Controlled Pilot Feasibility Study.

Background: The primary aim of this study was to assess the feasibility of introducing a digital health education tool (dHET) for varicose vein surgery.

Methods: This randomized, feasibility study allocated 40 patients, into dHET (n = 20) or standard consent (SC) (n = 20) groups. Primary outcomes were related to feasibility.

Validating a theory of planned behavior questionnaire for assessing changes in professional behaviors of medical students.

Introduction: Teaching professionalism is a fundamental aspect of medical undergraduate education, delivering important domains of professional attitudes, ethics, and behaviors. The effects of educational interventions can be assessed by measuring the change in such domains, but validated assessment tools for these professionalism domains are lacking. In this study, we constructed and conducted expert validation of a modified theory of planned behavior (TPB) questionnaire to assess changes in professional behaviors (PBs) in medical students.

Paradigms unfolded - developing, validating, and evaluating the Medical Education e-Professionalism framework from a philosophical perspective.

In order to ensure a strong research design, literature stresses the adoption of a research paradigm that is consistent with the researcher's beliefs about the nature of reality. In this article we provide an overview of research paradigm choices in relation to the creation of a Medical Education e-Professionalism (MEeP) framework discussing the research design, research methods, data collection and analysis to enhance the transparency of our previously published research. The MEeP framework was conceived to help Health Care Professionals (HCPs) safeguard the construct of professionalism in the digital context.

Understanding medical professionalism using express team-based learning; a qualitative case-based study.

Medical Professionalism (MP) defined as values, behaviours and attitudes that promote professional relationships, public trust and patient safety is a vital competency in health profession education. MP has a distinctive uniqueness due to cultural, contextual, conceptual, and generational variations. There is no standard instructional strategy to probe the understanding of MP in a cohesive, structured, interactive manner.

Varicose Vein Education and Informed coNsent (VVEIN) study: a randomised controlled pilot feasibility study.

Introduction: Doctors have a legal requirement and duty of care to ensure patients are enabled to make an informed decision about their treatment, including discussion of the benefits, risks and alternatives to a procedure. A patient-centred approach to consent has been firmly established in Ireland, and fundamental to this is the ability to engage in a dialogue that offers comprehensible information to patients. Telemedicine has revolutionised the way we can deliver care to patients in the modern era of computers, tablets, and smartphones, and its use has been rapidly expanded.

A modified Delphi process to form an expert consensus in Ireland on the essential information to be included in shared decision making for varicose vein surgery.

Objective: To reach consensus on a core set of essential information for inclusion in the informed consent process to standardize consent for VV surgery.

Methods: Using a modified electronic Delphi (e-Delphi) method, a panel of experts in Ireland, were asked to rate statements of essential information to include in the informed consent process with patients. Statements were rated using a 5-point Likert scale.

Medical students, mental health and the role of resilience - A cross-sectional study.

Background: Medical students have reported high prevalence of mental health difficulties and burnout. However, there are limited investigations examining the association between resilience and these difficulties. We investigated: (1) depression, anxiety, personal and professional burnout, and comorbidity; (2) demographic and education characteristics associated with these outcomes; (3) the association between resilience and these outcomes; and (4) whether these results were attributable to sampling bias.

Vascular Surgery Workforce: Evaluation and Estimation of Future Demand in the United Kingdom.

Background: Vascular disease is a common cause of death and disability in our growing elderly population and the demand for vascular procedures is increasing worldwide. Workforce planning is essential to meet future demand and provide safe vascular services. Our aim was to evaluate the current workforce in the United Kingdom and estimate future demand for vascular surgeons.

Changing Professional Behaviors in the Digital World Using the Medical Education e-Professionalism (MEeP) Framework-A Mixed Methods Multicentre Study.

Background: There is increasing evidence on the exponential use of technology-based social media in medical field that has led to a proliferation of unprofessional behaviors in digital realm. Educating, training, and changing the behaviors of healthcare professionals are essential elements to restrain the rising unprofessional incidents. Therefore, this research was designed to determine the impact of an interventional workshop on the medical and dental students in improving their professional behaviors in the digital world using the newly developed medical Education e-Professionalism (MEeP) framework.

Medical Education e-Professionalism (MEeP) framework; from conception to development.

Background: Medical professionalism education intends to produce virtuous and humanistic healthcare professionals who demonstrate perseverance and professional integrity. However, today's medicine has embodied a mammoth transformation of medical practice towards sns and the digital realm. Such paradigm shift has challenged the medical professional's values, behaviors, and identities, and the distinct boundaries between personal and professional lives are blurred.

Ethics for surgeons during the COVID-19 pandemic, review article.

The Covid-19 pandemic is a devastating global healthcare emergency with seismic impact on how modern surgical services function. Surgeons worry, that whilst healthcare-resources are directed against the pandemic, double effect may predict these benevolent public health efforts will cause unintended maleficent effects through delays to surgical treatment. Surgeons will make many challenging ethical judgements during this pandemic, here we conduct a narrative review of how medical ethics may help us make the best available choices.

Endovascular treatment for ruptured abdominal aortic aneurysm.

Background: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved.

A randomized clinical trial of ascorbic acid in open abdominal aortic aneurysm repair.

Background: Open AAA repair is associated with ischaemia-reperfusion injury where systemic inflammation and endothelial dysfunction can lead to multiple organ injury including acute lung injury. Oxidative stress plays a role that may be inhibited by ascorbic acid.

Methods: A double blind, allocation concealed, randomized placebo-controlled trial was performed to test the hypothesis that a single bolus dose (2g) of intra-operative parenteral ascorbic acid would attenuate biomarkers of ischaemia-reperfusion injury in patients undergoing elective open AAA repair.

Endovascular treatment for ruptured abdominal aortic aneurysm.

Background: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) can develop in both men and women as they grow older. It is most commonly seen in men over the age of 65 years. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, a fatal event unless timely repair can be achieved.

A systematic review and meta-analysis of abdominal compartment syndrome after endovascular repair of ruptured abdominal aortic aneurysms.

Objective: Limited data exist regarding the development of abdominal compartment syndrome (ACS) after endovascular repair of ruptured abdominal aortic aneurysms (RAAAs). We aimed to record the incidence, management, and outcome of this complication.

Methods: A systematic review and meta-analysis of the English language literature was undertaken through June 2012.

Upper limb deep vein thrombosis due to Langer's axillary arch.

Langer's axillary arch is a recognized muscular anomaly characterized by an accessory muscular band crossing the axilla that rarely causes symptoms. We describe a patient who presented with an upper limb deep vein thrombosis caused by this aberrant muscle, which we believe is the first reported case. Axillary surgery with division of the aberrant muscle relieved upper limb venous obstruction in this patient.