The Hidden Impact of Neonatology Boot Camp: A Qualitative Study.

INTRODUCTION: Simulation-based boot camps have been evaluated by fellows as an effective way to learn, to improve self-confidence, and to prepare for new responsibilities. However, existing studies do not explore how boot camps may contribute to other critical aspects of trainee development. Our objective was to use qualitative research methodology to characterize trainees' experiences of boot camp and its impact on their professional development. METHODS: This study used a phenomenological framework to explore fellows' experience of boot camp. Semistructured phone interviews were conducted with first-year neonatology fellows after attending the Regional Neonatology Boot Camp. Interviews were transcribed and coded for themes. The authors continually evaluated the coding categories in an iterative process until consensus was reached. RESULTS: Seventy-seven first-year neonatal-perinatal medicine fellows representing 16 fellowship programs participated in the Regional Neonatology Boot Camp in 2016 and 2017. Fifteen fellows from 10 institutions were interviewed before reaching thematic saturation. Five themes were identified: introspection about starting fellowship, learning to lead and communicate, gaining reassurance from the shared experience, understanding the fellow role, and developing future identity as a neonatologist. CONCLUSIONS: Participation in boot camp enhances fellows' professional identity formation (PIF) by incorporating key aspects of socialization, including role models and mentors, a variety of experiential learning, and opportunities for conscious self-reflection. In designing future boot camp experiences, educators should integrate these elements into the curriculum to support PIF and explicitly state PIF as a learning objective.

Evaluation of the analgesic effects of phenylbutazone administered at a high or low dosage in horses with chronic lameness.

OBJECTIVE: To compare analgesic effects of phenylbutazone administered at a dosage of 4.4 mg/kg/d (2 mg/lb/d) or 8.8 mg/kg/d (4 mg/lb/d) in horses with chronic lameness. DESIGN: Controlled crossover study. Animals-9 horses with chronic forelimb lameness. PROCEDURE: Horses were treated i.v. with phenylbutazone (4.4 mg/kg/d or 8.8 mg/kg/d) or saline (0.9% NaCl) solution once daily for 4 days. All horses received all 3 treatments with a minimum of 14 days between treatments. Mean peak vertical force (mPVF) was measured and clinical lameness scores were assigned before initiation of each treatment and 6, 12, and 24 hours after the final dose for each treatment. RESULTS: Compared with values obtained after administration of saline solution, mPVF was significantly increased at all posttreatment evaluation times when phenylbutazone was administered. Clinical lameness scores were significantly decreased 6 and 12 hours after administration of the final dose when phenylbutazone was administered at the low or high dosage but were significantly decreased 24 hours after treatment only when phenylbutazone was administered at the high dosage. No significant differences in mPVF and clinical lameness scores were found at any time when phenylbutazone was administered at the low versus high dosage. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the high dosage of phenylbutazone was not associated with greater analgesic effects, in terms of mPVF or lameness score, than was the low dosage. Considering that toxicity of phenylbutazone is related to dosage, the higher dosage may not be beneficial in chronically lame horses.