Faculty Entrustment and Resident Entrustability.

Importance: As the surgical education paradigm transitions to entrustable professional activities, a better understanding of the factors associated with resident entrustability are needed. Previous work has demonstrated intraoperative faculty entrustment to be associated with resident entrustability. However, larger studies are needed to understand if this association is present across various surgical training programs. Objective: To assess intraoperative faculty-resident behaviors and determine if faculty entrustment is associated with resident entrustability across 4 university-based surgical training programs. Design, Setting, and Participants: This cross-sectional study was conducted at 4 university-based surgical training programs from October 2018 to May 2022. OpTrust, a validated tool designed to assess both intraoperative faculty entrustment and resident entrustability behaviors independently, was used to assess faculty-resident interactions. A total of 94 faculty and 129 residents were observed. Purposeful sampling was used to create variation in type of operation performed, case difficulty, faculty-resident pairings, faculty experience, and resident training level. Main Outcomes and Measures: Observed resident entrustability scores (scale 1-4, with 4 indicating full entrustability) were compared with reported measures (faculty level, case difficulty, resident postgraduate year [PGY], resident gender, observation month) and observed faculty entrustment scores (scale 1-4, with 4 indicating full entrustment). Path analysis was used to explore direct and indirect effects of the predictors. Associations between resident entrustability and faculty entrustment scores were assessed by pairwise Pearson correlation coefficients. Results: A total of 338 cases were observed. Cases observed were evenly distributed by faculty experience (1-5 years' experience: 67 [20.9%]; 6-14 years' experience: 186 [58%]; ≥15 years' experience: 67 [20.9%]), resident PGY (PGY 1: 28 [8%]; PGY 2: 74 [22%]; PGY 3: 64 [19%]; PGY 4: 40 [12%]; PGY 5: 97 [29%]; ≥PGY 6: 36 [11%]), and resident gender (female: 183 [54%]; male: 154 [46%]). At the univariate level, PGY (mean [SD] resident entrustability score range, 1.44 [0.46] for PGY 1 to 3.24 [0.65] for PGY 6; F = 38.92; P < .001) and faculty entrustment (2.55 [0.86]; R2 = 0.94; P < .001) were significantly associated with resident entrustablity. Path analysis demonstrated that faculty entrustment was associated with resident entrustability and that the association of PGY with resident entrustability was mediated by faculty entrustment at all 4 institutions. Conclusions and Relevance: Faculty entrustment remained associated with resident entrustability across various surgical training programs. These findings suggest that efforts to develop faculty entrustment behaviors may enhance intraoperative teaching and resident progression by promoting resident entrustability.

Analysis of Social Media Use, Mental Health, and Gender Identity Among US Youths.

Importance: Mental health among children and adolescents is a critical public health issue, and transgender and gender nonbinary youths are at an even greater risk. Social media has been consistently associated with youth mental health, but little is known about how gender identity interacts with this association. Objective: To use a risk and resilience approach to examine the association between social media use and mental health among transgender, gender nonbinary, and cisgender youths. Design, Setting, and Participants: This cross-sectional study analyzed data collected from an online survey between May and August 2021. Participants included a random sample of US youths; eligibility requirements included being aged 10 to 17 years and residing in the US. Statistical analysis was performed from February to April 2022. Main Outcomes and Measures: Social media use (time, type of use, favorite site, social comparisons, mindfulness, taking intentional breaks, cleaning and curating feeds, problematic use, and media literacy programs at their school) and mental health (depression, emotional problems, conduct problems, and body image) as main outcomes. Results: Participants included 1231 youths aged 10 to 17 years from a national quota sample from the United States; 675 (54.8%) identified as cisgender female, 479 (38.9%) as cisgender male, and 77 (6.3%) as transgender, gender nonbinary, or other; 4 (0.3%) identified as American Indian or Alaska Native, 111 (9.0%) as Asian, 185 (15.0%) as Black, 186 (15.1%) as Hispanic or Latinx, 1 (0.1%) as Pacific Islander, 703 (57.1%) as White, and 41 (3.3%) as mixed and/or another race or ethnicity. Gender identity moderated both the strength and the direction of multiple associations between social media practices and mental health: active social media use (eg, emotional problems: B = 1.82; 95% CI, 0.16 to 3.49; P = .03), cleaning and/or curating social media feeds (eg, depression: B = -0.91; 95% CI, -1.98 to -0.09; P = .03), and taking intentional breaks (eg, depression: B = 1.03; 95% CI, 0.14 to 1.92; P = .02). Conclusions and Relevance: In this cross-sectional study of gender identity, social media, and mental health, gender identity was associated with youths' experiences of social media in ways that may have distinct implications for mental health. These results suggest that research about social media effects on youths should attend to gender identity; directing children and adolescents to spend less time on social media may backfire for those transgender and gender nonbinary youths who are intentional about creating safe spaces on social media that may not exist in their offline world.

Development and Validation of the Single-Item Mindfulness Scale (SIMS).

Mindfulness is a focused attention to and acceptance of present experiences. Although several reliable and valid multi-item measures of trait mindfulness exist, researchers may sometimes want a short and quick measure of mindfulness. In this project, we developed and validated the Single-Item Mindfulness Scale (SIMS) to assess trait mindfulness. We conducted eight studies involving 3,125 adult and adolescent participants. The studies consisted of cross-sectional, short longitudinal, and daily diary designs. We first developed the wording of the SIMS in Studies 1 and 2 and then examined the validity and reliability in Studies 3-8. The SIMS was found to be reliable and valid. It correlated with several multi-item measures of mindfulness at effect sizes in the medium to large range. It also correlated in expected ways with variables known to be related to existing multi-item measures of mindfulness such as self-compassion, anxiety, negative affect, positive affect, depression, neuroticism, empathy, prosocial behavior, and self-consciousness. Furthermore, it correlated positively with daily reports of mindfulness in a two-week diary study. Although existing multi-item trait mindfulness scales should be used, when possible, the SIMS is recommended in situations when time, question quantity, or researcher focus is constrained.

Shelter in Place, Connect Online: Trending TikTok Content During the Early Days of the U.S. COVID-19 Pandemic.

PURPOSE: In the U.S., TikTok surged in popularity as the COVID-19 virus spread nationally. TikTok posts may both reflect and shape young people's perceptions of the pandemic. This mixed methods study applied a uses and gratifications framework to a systematic analysis of trending TikToks related to COVID-19, with attention to changes over a 2-month period. METHODS: Analyses are based on an original data set of 2,675 TikToks (529 unique videos across 68 COVID-relevant hashtags) viewed over 2,840,347,014 times. TikToks were tracked daily for 65 days after the beginning of U.S. stay-at-home orders (March 17 to May 20, 2020). A thematic analysis used 28 content codes and nine codes related to subject(s) to examine content patterns. Chi-square tests facilitated analyses of changes over time. RESULTS: Trending TikToks related to COVID-19 most often featured details of everyday circumstances and/or relatable commentary on Pandemic Life. These posts were similarly prevalent in Months 1 and 2. Health-Promoting TikToks outnumbered those exhibiting Risky or Concerning Health Practices (58:13) and were more common in Month 1. Advertisements and sponsored campaigns also shaped trending COVID-relevant content during the study period. CONCLUSIONS: On TikTok, public health information appears to coexist with an abundance of commentary about everyday life during the pandemic. Posts arguably reflect documented social media use goals such as information seeking/sharing, archiving, and self-expression. Yet, TikToks during the pandemic period perhaps most often connect to another previously undocumented use goal: a digital search for common humanity in seeing difficult experiences as part of a larger human experience.

Positive and negative uses of social media among adolescents hospitalized for suicidal behavior.

INTRODUCTION: There is public concern about potential associations between adolescent social media/smartphone use and risk for suicide. However, no prior studies leverage qualitative methods to explore the experiences of adolescents currently at-risk for suicide. METHODS: This study examined social technology use from the perspectives of adolescents (n = 30; Mage = 16.1 years) currently hospitalized for a recent suicide attempt or severe ideation. We conducted in-depth interviews and coded transcripts using thematic analysis. We had three research questions: What (1) negative and (2) positive experiences do suicidal adolescents report related to their use of social media/smartphones? (3) How do adolescents describe their disconnection from these technologies use during inpatient hospitalization and views on a subsequent return to digital connectivity after discharge? RESULTS AND CONCLUSIONS: Results reveal both positive and negative social technology uses, with most participants reporting mixed (positive and negative) experiences. Negatives/risks included trouble regulating use, stress related to social media metrics, encounters with "triggering" content, hostility and meanness, self-denigrating comparisons, and burdensome friendship expectations. Positives/benefits included social connection, social support, affect-enhancing content, shared interests, and resources for mental health and coping. Overall, the documented risks and benefits of social technology use correspond with established (offline) risk and protective factors for suicidal thoughts and behaviors. Participants generally valued the break from social technologies during hospitalization, and also viewed them as integral to social re-entry and identified related concerns. Future studies should test well-being focused 'digital hygiene' interventions for maximizing potential benefits and minimizing potential harms of social technologies for at-risk adolescents.

Digital Life and Youth Well-being, Social Connectedness, Empathy, and Narcissism.

Youth well-being, social connectedness, and personality traits, such as empathy and narcissism, are at the crux of concerns often raised about the impacts of digital life. Understanding known impacts, and research gaps, in these areas is an important first step toward supporting media use that contributes positively to youth's happiness, life satisfaction, and prosocial attitudes and behaviors. By examining existing work addressing these issues across domains, we found that a complex interplay of individual factors, type of digital media engagement, and experiences in media contexts informs outcomes related to well-being, social connectedness, empathy, and narcissism. We argue that further research is needed to uncover how, where, when, and for whom digital media practices support positive well-being and social connectedness outcomes. Specifically, research needs to move beyond correlational studies to uncover causal connections between traits like narcissism and media use. Longitudinal studies are also needed to explore patterns of media use over time and related impacts. Further research is needed to explore how specific technologies can be designed to support positive well-being, social outcomes, and prosocial personality traits. Finally, research is needed regarding parenting, educational practices, and policies that support positive digital media use and related outcomes. Although existing research suggests that digital life has mixed potentials and effects for well-being, social connectedness, empathy, and narcissism, we provide recommendations for clinicians, policy makers, and educators in partnering with caregivers and youth to support media use that promotes positive outcomes in these areas.