Practice and perceptions of pediatric residents in a Tertiary Government Hospital on mental healthcare as part of general practice

Objective@#This study aimed to describe mental health practice patterns, perceptions, perceived responsibility, confidence, barriers, and supports of pediatric residents in a tertiary government hospital to arrive at recommendations in enhancing their mental health competencies.@*Methodology@#As part of needs and baseline assessment within an existing collaboration, written self-administered questionnaires were distributed among pediatric residents of the hospital. Frequency of answers were tallied to see clustering and trends. RESULTS: Most of the 37 Pediatric residents had positive perceptions i.e. 78.83% - 83.78% and planned to incorporate all aspects mental healthcare in their future practice as consultants i.e. 89.19 %- 97.29 %. However, they did not get to practice or apply it as much during training. All respondents perceived that diagnosing the neurodevelopmental disorders of Autism Spectrum, Attention Deficit and Hyperactivity, Intellectual Disability and Learning was their responsibility. When it came to confidence in diagnosing other psychiatric disorders less than half to 3/5 (45.9%- 64/9%) were confident or very confident in doing so. Approximately three fifths (56.75% -67.56%) of them were confident in managing neurodevelopmental disorders. There was an even lower proportion i.e. one fourth (16.21% - 32.43%) of pediatric residents who were confident in managing other psychiatric disorders. Time was the most often perceived barrier while more exposure and training were the supportive factors for integrating mental healthcare into practice.@*Conclusion@#With such positive perceptions already in place, programs to improve knowledge and skills can be developed to increase confidence, focusing on diagnosing and managing psychiatric conditions. Target areas as guided by this research can be on how to use screening tools and psychotropics, diagnosing anxiety and behavioral addictions, and managing psychosis and trauma. These should be incorporated in a time-efficient manner into usual patient interviews. Training and added exposure can be utilized in the short-term as well as institutionalization of collaboration, liaison, and feedback systems in the future.

Hepatitis B: Anticuerpos contra antígeno de superficie en residentes de pediatría, Hospital Central de Maracay

Introducción: Los profesionales del área de la salud tienen un riesgo incrementado de contraer la infección por el virus de hepatitis B (VHB). Objetivo: Evaluar anticuerpos contra el antígeno de superficie de la hepatitis B, en los residentes de pediatría del Hospital Central de Maracay en el período junio-agosto de 2021. Materiales y métodos: Estudio clínico epidemiológico, no experimental y de corte transversal, en el que se tomó muestra sanguínea a 54 médicos residentes para la determinación de anticuerpos contra el antígeno de superficie del VHB (Anti-HBs). Resultados: El promedio de edad fue 27,48 años con una desviación estándar de 1,6. El 83,33 % pertenecían al sexo femenino, 51,85.% cursaban el 1er año del posgrado, 33,33 % con esquema de vacunación documentado, de estos, 66,67.% completaron el esquema y 77,78 % cumplidos en la adultez. Con respecto al tiempo de la última dosis, el 66,67 % hasta 10 años. Se detectaron niveles de Anti-HBs mayores de 10 mUl/mL en el 94,44 %, con mayor prevalencia de niveles protectores a favor del sexo femenino. Se evidenció una correlación lineal positiva entre los niveles de Anti-HBs y el tiempo desde la última dosis de la vacuna contra la hepatitis B. Conclusiones: Aunque existe una debilidad en los médicos residentes en cuanto a la tenencia y cumplimiento del esquema de inmunización, la mayoría de ellos mostraron niveles protectores de anti-HBs. A mayor tiempo transcurrido desde la última dosis de la vacuna hay un descenso en los niveles de anti-HBs lo que justifica dosis de refuerzo a los 10 años.

Introduction: Health professionals have an increased risk of contracting hepatitis B virus infection (HBV). Objective: To evaluate antibodies against hepatitis B surface antigen in residents of pediatrics of the Central Hospital of Maracay in the period June-August. 2021. Materials and methods: Clinical epidemiological, nonexperimental and cross-sectional study, in which blood samples were taken from fifty-four medical residents for the determination of antibodies against the HBV surface antigen. Results: The average age was 27.48 years with a standard deviation of 1.6. 83.33 % were female, 51.85 % were in the first year of postgraduate studies, 33.33 % had a documented vaccination schedule, of these, 66.67 % completed the schedule and 77.78 % completed it in adulthood. Regarding the time of the last dose, for 66.67 % of the study population, it was up to 10 years ago. Anti-HBs levels greater than 10mUl/ml were detected in 94.44 %, with a higher prevalence of protective levels in favor of the female sex. A positive linear correlation between the levels of Anti-HBs and the time since the last dose of the hepatitis B vaccine was evidenced. Conclusions: Although there is a weakness in the resident doctors in terms of possession and compliance with the immunization schedule, the most of them showed protective levels of anti-HBs. The longer the time elapsed since the last dose of the vaccine, there is a decrease in anti-HBs levels, which justifies a booster dose at 10 years.

Self-evaluation of doctor-patient communication ability of pediatric residents and investigation on the training needs of them / 中华医学教育探索杂志

Objective:To investigate the current status of doctor-patient communication of pediatric residents, and to explore the specific demand of communication skills training in clinical practice.Methods:A self-made questionnaire was conducted to investigate 77 residents taking standardized residency training of pediatrics in Beijing Children's Hospital training base, including basic information, self-satisfaction of communication ability and the needs of doctor-patient communication courses, etc. SPSS 22.0 statistical software was used for data processing and analysis.Results:In terms of the doctor-patient communication ability, the results showed that the satisfaction degree of pediatric resident surgeons was higher than that of pediatric resident physicians (78.9% vs. 58.5%, P=0.108) and the satisfaction degree of high-seniority residents was higher than that of low-seniority residents (78.6% vs. 62.5%, P=0.330; 78.6% vs. 58.9%, P=0.278). Besides, the importance of communication objectives and the degree of difficulty were sorted in order, and the top three were family members, superior and children for importance, and family members, children and nurses for difficulty, respectively. The main reasons of difficult communication included heavy work (41.6%) and lack of communication skills (46.7%), with no statistical difference between different majors and seniorities ( P >0.05). More than 80% residents agreed that effective doctor-patient communication could promote the clinical work. The lower of seniority, the higher demands for the class time allocation and teaching frequency of doctor-patient communication training courses. Conclusion:Pediatric residents have a good cognition of medical doctor-patient communication. There are some obvious communication problems in pediatric physicians and low-seniority pediatric residents. Therefore, it's necessary to adjust courses according to different majors and seniorities, so as to improve the training quality, thereby promoting the clinical work and reform of medical education.

The establishment and evaluation of the application of assessment system in the ability of physician-patient communication of pediatric residents / 中华医学教育探索杂志

Objective To explore the assessment system of humanistic communication in the grad-uation examination of pediatric residents. Methods A humanistic communication assessment program and an evaluation form were designed and put into practice in the graduation examination of pediatric residents in 2016 and 2017 in Beijing Children's Hospital affiliated to Capital Medical University and the scores were collected and analyzed to compare the differences in pediatric residents who have undergone system-atic physician-patient communication scene training and who didn't. With this analysis, the assessment system was further improved. Results Of all the 5 dimensions, communication content, nonverbal skills, and communication effects and the comparison of their respective scores were statistically significant. The scores of the residents who have undergone systematic physician-patient communication scene training are much better than those who didn't. Conclusion This assessment system focuses on the investigation of ability. From the design of examination questions and assessment scenes, to the evaluation of students per- formances, only when candidates have mastered the skills of communication can they do well in examina-tions and achieve good results.

Validation of the Script Concordance Test as an instrument to assess clinical reasoning of residents in pediatric emergency medicine in Mexico

Background. Clinical reasoning is a crucial skill to be acquired during a residency training program. In pediatric emergency medicine, physicians are challenged by diagnostic, investigative, and treatment uncertainties. The Script Concordance Test (SCT) uses authentic clinical scenarios to compare trainee’s judgement skills with those of experts. The purpose of this study was to evaluate the clinical reasoning using a pediatric emergency medicine SCT and to determine if it would be able to differentiate between different levels of residency training, validating it in Mexico. Methods. A SCT containing 58 questions nested in 14 cases was administered to pediatric and senior residents at one academic institution. Fourteen experienced emergency medicine pediatricians were part of a reference panel to establish the basis for the scoring process. Results. Ninety six residents consented to participate. Thirteen residents were fellows of pediatric intensive care medicine or pediatric emergency medicine, and there were 83 pediatric residents. Overall, there was a significant difference in performance across levels of training. The difference between all levels was significant. Conclusions. This pediatric emergency medicine Script Concordance Test was useful to assess the progression of clinical reasoning during residency training in Mexico.

Analysis of professional situation and talent drain of pediatric residents / 上海交通大学学报（医学版）

Objective To investigate the professional situation and talent drain of pediatric residents,and explore the coping strategies. Methods One hundred and twenty pediatric residents and 6 administrative personnels were selected from three hospitals featured in pediatrics.Questionaires were administered to pediatric residents,and interviews were conducted with administrative personnels. Results Only 28.85% pediatric residents were satisfied with present professional situation.The talent drain of pediatric residents was severe,and the major causes were hard work,low incomes and unfavourable career development prospects. Conclusion A considerate number of pediatric residents are not satisfied with the professional situation,and the talent drain is a common occurrence.Government should attach great importance to pediatric medical education and increase health care investment.Besides,the view of value of pediatric residents should be improved and a harmonious medical environment should be established.

A cross-sectional survey on the awareness and basic knowledge on newborn hearing screening of obstetric and pediatric residents

OBJECTIVES: To determine whether the obstetric and pediatric residents are aware of newborn hearing screening; To determine whether the obstetric and pediatric residents are knowledgeable regarding newborn hearing screening; To compare the results as a function of the type of training institution (private or government). STUDY DESIGN: Cross sectional study SETTING: Randomly selected tertiary hospitals in the National Capital Region METHODOLOGY: A structured questionnaire pertaining to the awareness and basic knowledge of newborn hearing screening was distributed to tertiary hospitals in the National Capital Region (NCR) of the Republic of the Philippines. All obstetric and pediatric residents of each of the tertiary hospitals were the respondents of this study. Frequencies were determined from the respondent's responses to the questionnaire. RESULTS: Out of 175 questionnaires distributed, there were 134 respondents (86 pediatrics and 48 obgyne) Eighty (93 percent) pediatric residents were aware of newborn hearing screening but only 43 (50 percent) of pediatric residents were knowledgeable of the hearing test. Thirty five (73 percent) of obstetric residents were aware of newborn hearing screening and only 5 (10 percent) were knowledgeable about the hearing test. Majority of those who were knowledgeable are from private institutions (79.2 percent) as compared to respondents from government institution (20.8 percent). CONCLUSION: A majority of obstetric and pediatric residents were aware of the newborn hearing screening but only a third of respondents had basic knowledge of the hearing test. Of those who were knowledgeable, most were training in private institutions where the machine was available. It is essential for the physician to be both aware and knowledgeable about newborn hearing screening to counsel and educate parents about the importance of early identification of and intervention for congenital or newborn hearing problems. A program to provide more knowledge regarding newborn hearing screening among pediatric and obstetric residents should be therefore developed. (Author)