Machine learning validation of the AVAS classification compared to ultrasound mapping in a multicentre study.

The Arteriovenous Access Stage (AVAS) classification simplifies information about suitability of vessels for vascular access (VA). It's been previously validated in a clinical study. Here, AVAS performance was tested against multiple ultrasound mapping measurements using machine learning.

Assessing ethics and law in medical schools: there is no single best answer.

Medical ethics and law (MEL) have a well-established place in medical curricula within the UK, but appropriately assessing MEL in a medical school context can be extremely challenging. The Institute of Medical Ethics convened a working group focused on assessment in 2021, and in this article, we present a summary of the work undertaken by this group. We start by explaining the challenges presented by the assessment of MEL, highlighting the potentially demanding requirements set out by the General Medical Council in the UK.

Shattering the Shield: Embracing Complexity in Undergraduate Medical Education.

Background: Multimorbidity and patient complexity are increasing, yet undergraduate medical education curricula remain dominated by single disease frameworks, where students are often shielded from exposure to this complexity. Why this shielding continues to occur is understandable; however, this may leave graduates feeling underprepared for real-world practice. This study aimed to explore medical students' experiences of encountering, managing and dealing with complexity and to provide informed recommendations for integrating complexity into clinical teaching.

Classifications of haemodialysis vascular access stenosis: a scoping review.

Objectives: Vascular access (VA) stenoses play a significant role in the morbidity of the haemodialysed population. Classifications for diagnosis, assessment and proposal of treatment strategies can be useful clinical and methodological tools. This review aims to present a comprehensive summary and propose further methodological approaches.

Perceived faculty development needs and motivations of Chinese general practice trainers: a narrative review of the literature.

Background: Like other countries developing standardized general practice training, China faces the challenge of training vast numbers of new general practice faculty. However, little is known about these clinician-teachers' motivations and perceived needs for faculty development. This review intended to explore available published data on Chinese general practice faculty development needs and motivation for ongoing professional development.

Fedratinib combined with ropeginterferon alfa-2b in patients with myelofibrosis (FEDORA): study protocol for a multicentre, open-label, Bayesian phase II trial.

Background: Myelofibrosis (MF) is a clonal haematopoietic disease, with median overall survival for patients with primary MF only 6.5 years. The most frequent gene mutation found in patients is JAK2, causing constitutive activation of the kinase and activation of downstream signalling.

Change in frailty status in the 12 months following solid organ transplantation: a systematic review and meta-analysis.

Objectives: To investigate if frailty status alters following solid organ transplantation (lung, liver, kidney and heart) without rehabilitation intervention.

Research Design And Methods: Studies published between 1 January 2000 and 30 May 2023 were searched across five databases. Studies measuring frailty, using a validated or established frailty measure, pre- and post-transplant were included.

Beyond reliability: assessing rater competence when using a behavioural marker system.

Background: Behavioural marker systems are used across several healthcare disciplines to assess behavioural (non-technical) skills, but rater training is variable, and inter-rater reliability is generally poor. Inter-rater reliability provides data about the tool, but not the competence of individual raters. This study aimed to test the inter-rater reliability of a new behavioural marker system (PhaBS - pharmacists' behavioural skills) with clinically experienced faculty raters and near-peer raters.

Can I Phone a Friend? Exploring the Use of Digital Devices in Clinical Exams.

Background: Objective structured clinical examinations (OSCEs) are used globally to assess health professional learners' clinical skills and applied knowledge. Despite innovations with simulated participants, manikin technology and real patient involvement, there remains a gap between 'real-life' practice and 'OSCE experience'. For example, although mobile phone use is increasingly common in clinical practice; however, it would represent a significant disruption to established assessment practices in OSCEs.

Big data analysis: examination of the relationship between candidates' sociodemographic characteristics and performance in the UK's Membership of the Royal College of Physicians Part 1 examination.

Big datasets and data analytics enable granular analyses examining group differences in performance. Our focus is on differential attainment (DA) in postgraduate College (Board) examinations. We asked: Are candidates' sociodemographic characteristics associated with performance on the UK's Membership of the Royal College of Physicians (MRCP) Part 1 after adjusting for medical school performance (MSP) and type of medical programme? This was a retrospective longitudinal cohort study of 6040 medical graduates with linked sociodemographic data in the UK Medical Education Database qualifying from a UK medical school (2012-2014) and sitting MRCP Part 1 before October 2019.

Impact of microbial diversity on inflammatory cytokines and respiratory pattern measured in whole-body plethysmography in guinea pig models.

Objective: This study investigates the breathing patterns and immune status of guinea pigs raised under specific pathogen-free (SPF) conditions compared to conventionally bred (CON).

Methods: Breathing pattern parameters were assessed using whole-body plethysmography (WBP) during quiet breathing and saline nebulisation. Blood and bronchoalveolar lavage fluid (BALF) were analysed for white blood cell, neutrophil and eosinophil counts, and cytokine levels (TNF-α, IL-1β, IL-4).

What impact does widening participation to medicine have on the medical workforce in the UK: a scoping review.

Purpose: Widening participation in medicine refers to the recruitment policy of encouraging those who are traditionally under-represented in medical school. Whilst research in the UK has investigated the processes around improving participation through recruitment and selection to medical schools, there is less focus around the period after medical school and how students from widening participation backgrounds fare in the workforce.

Methods: This study employed scoping review methodology to collate, map and summarise research in the field.

Simulate to stimulate? A systematic review of stress, learning, and performance in healthcare simulation.

In recent years, simulation has come to prominence as an educational method within the healthcare professions, aiming to shield learners from real-world consequences. However, the associated risks of this educational method have largely remained unaddressed. One of the most potent risks of simulation is felt to be the experience of psychological stress.

The influence of hierarchy as an Implicit curriculum on medical trainees during the COVID-19 pandemic.

Background: Understanding the hierarchy in medical education is considered one of the hidden curriculum agendas that help to guide the medical trainees throughout their careers in healthcare. However, many negative aspects to the hierarchy and a few positive aspects have been uncovered in recent years. The COVID-19 pandemic had a tremendous impact on the healthcare system, deploying healthcare workers, including trainees from their primary speciality training to help caring for COVID-19 patients.

Indonesian Medical Interns' Intention to Practise in Rural Areas.

The maldistribution of physicians, especially in rural areas, remains a global public health challenge. The internship programme for medical doctors is one of the efforts undertaken to address this issue. However, evidence aiming to disentangle this persistent challenge in the Indonesian context has been scant.

The effects of controlled acute psychological stress on serum cortisol and plasma metanephrine concentrations in healthy subjects.

Background: As cortisol and metanephrine are involved in the stress response, it is often recommended that individuals are relaxed at the time of venepuncture, however, evidence behind these recommendations is lacking. We investigated the effects of acute psychological stress on serum cortisol and plasma metanephrine concentrations in healthy individuals exposed to varying levels of psychological stress and compared these results to self-reported measures of stress.

Methods: Ten medical students completed two medical in-person simulations (one low-complexity, one high-complexity) in a random order.

A Systematic Review of 207 Studies Describing Validation Aspects of the Dermatology Life Quality Index.

This study systematically analysed peer-reviewed publications describing validation aspects of the Dermatology Life Quality Index (DLQI) and used Naicker's Critically Appraising for Antiracism Tool to assess risk of racial bias. Seven online databases were searched from 1994 until 2022 for articles containing DLQI validation data. Methodology followed PRISMA guidelines, the protocol was registered in PROSPERO, and articles reviewed independently by two assessors.

Transforming healthcare with integrated inter-professional education in a research-driven medical school.

Singapore, located strategically at the meeting point of the Malacca Strait and the South China Sea, has established itself as a global financial and economic hub. Despite its small geographical size, Singapore is home to over 5 million people from diverse cultural backgrounds. The city-state's medical education landscape has evolved significantly over the past century.

What can be done to ease the transition to becoming a new paediatric registrar?

Background: The transition period of becoming a new paediatric registrar has limited study. Consequently, the learning needs of such trainees are unclear including educational interventions that may improve the process. This qualitative study examined the negative and positive experiences of transitioning paediatric trainees to identify learning needs and subsequently derive educational interventions that are perceived to ease transition.

Novice clinician educator professional identity formation through a longitudinal mentorship: a qualitative study.

Background: The professional identity of doctors is evolving with physicians now required to be 'scholars', facilitating the education of students and healthcare teammates as educators. Mentoring is widely practiced and is postulated to facilitate professional identity formation (PIF) through socialization. Preliminary literature review suggested few studies looking into how formal mentoring programmes affect PIF of novice clinician educators, particularly an Asian context.

'Dancing with emotions': An Interpretive Descriptive study of facilitators recognition and response to students' emotions during simulation.

Introduction: Immersive simulations can evoke a range of emotions in students. However, little is known about how facilitators recognise and respond to students' emotions during simulations. This study aims to understand how simulation facilitators perceive and respond to students' emotions during simulation-in order to optimise learning.