The Addis Ababa toxicology curriculum project: educational needs assessment for the toxicology modules of an emergency medicine training program.

BACKGROUND: The Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) is a bi-institutional partnership between the University of Toronto (UofT) and Addis Ababa University (AAU) focused on addressing the need for emergency medicine (EM) postgraduate training and care in Ethiopia. Toxicology is a key competency in EM. EM physicians are often the first and sole clinicians to identify and treat patients presenting with a wide range of intoxications. The goal of this project was to conduct an educational needs assessment to inform the development of a context-specific toxicology curriculum for the AAU EM training program. METHODS: Our needs assessment employed a survey (available electronically and in paper format) and face-to-face interviews conducted with Ethiopian EM faculty (all graduates of the AAU EM residency training program) and current AAU EM residents. The survey was distributed in October 2018 and the interviews were conducted in November 2018. RESULTS: Of the 63 surveys distributed, we received 17 complete responses and completed 11 interviews with AAU EM faculty and residents. The survey conducted on toxicology training highlighted overall satisfaction with current training, with thematic analysis revealing key areas for growth. System-related themes focused on resource availability, healthcare access, and public health education. Provider-related themes emphasized the need for context-specific training, including common local toxins, and for advanced toxicology training such as poison center rotations. Patient-related themes centered on specific toxicological presentations in Ethiopia, highlighting the importance of public health advocacy, education on safe handling, and governmental regulation of toxic substances. Both survey and interview data highlighted challenges stemming from inconsistent availability of resources and underscored the need for tailored education to manage poisoned patients with locally available resources. CONCLUSIONS: Our findings indicate the need to focus on the most prevalent local toxicological presentations and practical management challenges in local contexts, including resource limitations and delayed presentations. Moreover, it emphasizes the importance of public health initiatives such as regulation of the sale and promotion of safe handling of toxic substances to mitigate toxicological risks. These findings are likely relevant to other resource-constrained settings outside of Ethiopia.

Identifying skills required of new epidemiologists: a content analysis of Canadian job postings and master's programs.

Introduction: The rise of emerging public health threats has increased the need for qualified epidemiologists in Canada. Our study aimed to identify the knowledge, skills, and abilities (KSAs) required of epidemiologists entering the workforce and determine whether these align with those taught in graduate epidemiology programs. Methods: An inductive content analysis of Canadian job postings from May to December 2023 containing the keyword "epidemiology" and requiring master's degrees in epidemiology or related fields was conducted to identify the KSAs required in the workforce. Inductive content analysis of Master of Science (MSc) program descriptions and core course descriptions was completed to discern skills gained through Canadian graduate epidemiology and public health programs. Results: Based on the 295 job postings analyzed, five KSA categories were identified: communication skills (n = 268, 90.8%), analytical skills (n = 267, 90.5%), soft skills (n = 254, 86.1%), research methodology (n = 217, 73.6%), and knowledge of epidemiological concepts (n = 170, 57.6%). Analysis of 18 MSc programs found that that all of them described analytical skills, research methodology, and epidemiological concepts within their curriculum. Communication skills were described in 94.4% (n = 17) of programs, while soft skills were mentioned in 50.0% (n = 9). However, only 66.7% (n = 12) of programs outlined learning objectives or specified the skills acquired from their programs in their descriptions. Conclusion: There was alignment between the needs of the Canadian epidemiology job market and MSc programs, particularly in analytical skills and research methodology. However, development of soft skills should be emphasized within graduate epidemiology programs to better prepare graduates for the job market. Future research should aim to develop competency statements for epidemiologists in training to ensure consistency across graduate programs and promote career readiness.

Undergraduate dental sleep medicine teaching at German university dental schools - a questionnaire-based survey.

PURPOSE: Diagnosing and treating obstructive sleep apnea (OSA) requires fundamental understanding of sleep medicine, including training and clinical experience. So far, dental sleep medicine (DSM) has not yet become a mandatory part of dental education in Germany. This questionnaire-based survey for both lecturers and students aimed to evaluate DSM education among undergraduate students. METHODS: A structured questionnaire was sent to the managing directors and student councils of all 30 German university dental schools. The questionnaire contained 13 questions on teaching quantity and content, lecturers' knowledge, and future interest in DSM. For each university dental school, only one questionnaire should be completed by the student council and the managing director. A scoring system assessed lecturers' knowledge based on clinical experience and qualifications. Descriptive data and correlation coefficients were calculated (P < 0.05). RESULTS: The responses of 24 lecturers (80%) and 28 students (93.3%) could be evaluated. DSM was reported to be included in the curriculum by 14 lecturers (58.3%) and 4 students (14.3%). Mean teaching hours per semester were 1.4 ± 1.4 h (lecturers) and 0.2 ± 0.6 h (students) accordingly. Greater knowledge of lecturers in DSM was positively correlated with the inclusion of DSM in the curriculum (P = 0.022) and with the number of teaching hours per semester (P = 0.001). CONCLUSION: Postgraduate education and incorporating DSM knowledge into undergraduate education ("Teach the Teacher") seems to play a key role in fundamentally training future dentists in this field.

Curriculum and program evaluation in medical education: a short systematic literature review.

Medical education is constantly evolving worldwide and facing various challenges. To cope with these, continuous and fruitful evaluation of an educational program is the need of the day. This study aims to know the purpose of evaluation, various theories related to program evaluation, and different models of curriculum and program evaluation. This will help educationists evaluate their programs fruitfully and effectively according to their needs and objectives. Different search engines including Medline's PubMed interface, Google Scholar, and Cochrane Review databases using keywords, curriculum evaluation, evaluation models, and evaluation strategies in education, were searched without any date restrictions, and 20 full-text articles were selected for review and data extraction. While reviewing the literature it was found that most of the modern educational program and curriculum evaluation models are based on the reductionist, system, and complexity theories of evaluation. The experimental/quasi-experimental model is based majorly on the linear approach and reductionism, but its drawback is that it is impractical for the whole curriculum and sometimes ethically unfavorable. Kirkpatrick's model, Philips' model, the CIPP model, and the logic model are based on the system and complexity theory and are more practical in medical education. Each of these models has its advantages and limitations. In this review, the authors discussed the important distinctive features of these evaluation theories and models and their applicability and usefulness in evaluating different programs and curricula.

Curriculum guide for teaching house officers and faculty: applying procedure codes effectively using chemical denervation as a model.

Introduction: The healthcare system in the United States relies heavily on physician-and house officer-driven initiation of billing and coding for collection of hospital payments and professional fees. Under the umbrella of practice management is the ever-changing and suboptimally taught concept of procedural billing and coding to house officers and faculty. Clinical providers and practitioners initiate billing and coding for performed services based on the procedural visit encounter, supported by the appropriate documentation. Correct charge capture is dependent on accurately linking CPT codes and J codes, including waste documentation, modifiers, and charge collection. We discuss a perspective regarding a new curricular methodology that teaches learners to apply an algorithmic approach for coding CPT codes, J codes, and modifiers for chemical denervation procedures involving high-cost botulinum toxin. We further recommend the use of visuals with algorithm development for other pertinent procedures that are specific to a department. Methods: We developed a curriculum that includes algorithmic visuals, pre-and post-test questions, and reflections. It was implemented across various learner types. Results: This chemical denervation curriculum was well-received and impactful in meeting the objectives of the course. It further expanded a learner's vision of practice management that can be applied to other procedural examples. Discussion: The results demonstrate a clear gap in practice management education, with pre-education knowledge on applying appropriate codes being particularly low among resident physicians. Learners found the algorithm we developed especially valuable, as it serves as a practical tool for accurately accounting for all aspects of CPT codes, modifiers, and J-codes. The methodology of the algorithmic approach proved to be innovative for avoiding billing write-offs and loopbacks that were beneficial for the training process. Learners indicated that this approach can be applied to other procedural billing.

Applying an extended theoretical approach to identifying Canadian dental students' acceptance of teledentistry: A cross-sectional study.

Objective: Teledentistry is a promising innovation for improving service quality and patient outcomes. While studies have shown the relevance of theoretical frameworks in understanding behaviour change predictors for telehealth implementation efforts, their application in dentistry is limited. This study aimed to test different theoretical approaches to identify the factors affecting dental students' behavioural intention to use teledentistry. Methods: This cross-sectional study involved students in their final two years of undergraduate dental programmes, from three Canadian provinces (Quebec, Nova Scotia, and Saskatchewan) using an electronic self-reported questionnaire. Following descriptive analyses, we tested three theoretical models (the technology acceptance model, psychosocial model, and integrated model) using path analysis and multiple linear regression analysis. We analyzed the modifying effect of sociodemographic characteristics and prior use of teledentistry. Results: Out of the 46 students who participated, the majority were female (53.5%) and aged over 25 years (62.8%). The three models successfully explained a substantial portion of the variance in behavioural intention to use teledentistry, ranging from 58.0% to 76.6%. Social role beliefs (p < 0.001) and control beliefs (p < 0.001) were the most significant predictors of behavioural intention to use. Prior use of teledentistry modified the association between control beliefs and behavioural intention to use teledentistry. Conclusions: The original technology acceptance model was a good predictive model of behavioural intention to use teledentistry with perceived use as the strongest predictor. However, the integrated model performed the best in highlighting the relevance of training and education to foster teledentistry implementation in dental schools. The generalizability of the findings is constrained by the modest sample size, warranting larger studies for validation.

Development of a Prioritized Anesthesiology Residency Critical Care Content Outline.

Background: Critical care education is an important, mandatory component of residency training in anesthesiology. Currently, there is no accepted national standardized curriculum, and a prioritized critical care content outline would be beneficial to the creation of a pragmatic standardized residency curriculum. The modified Delphi method is a recognized method for establishing consensus in medical education. Methods: We developed a prioritized critical care content outline using the modified Delphi method. Topics were selected from critical care topics included in the Program Requirements for Graduate Medical Education in Anesthesiology and the American Board of Anesthesiology Content Outline. Panel members rated critical care topics on a 9-point Likert scale (1 = not important, 9 = mandatory). Consensus was defined as ≥75% rating the topic as very important to mandatory for inclusion (Likert scale 7-9). Topics with >80% consensus were removed from subsequent surveys and included in the final list, and topics with <50% were removed. Members were asked to select the ideal timing of topic delivery during residency (Foundational-Early Residency, Intermediate-Mid Residency, Advanced-Late Residency). Results: A total of 158 panel members who were contacted using national anesthesiology organization email lists completed the initial round, 119 (75%) completed the second iteration, and 116 (73%) completed the third. Response rate on the first survey was (22/55) 40% for anesthesiology critical care program directors, (18/132) 14% for core anesthesiology residency program directors, and (77/1150) 7% for the remaining respondents. Trainees (n = 41) were not included in response rate calculations. Most participants (103/158, 65%) had completed both core anesthesiology and subspecialty critical care medicine training and most (87/158, 55%) had formal roles in medical education. Forty-one (26%) responders were currently in training. All panelists worked in institutions with graduate medical education (GME) learners. Fifty-eight of 136 (43%) topics met consensus for inclusion. Most consensus topics (50/58, 86%) were recommended to be delivered early during residency with the other 8 topics to be delivered in the middle of residency. Conclusions: We developed a prioritized critical care content outline for anesthesiology residents that includes highly recommended critical care topics with ideal timing for inclusion in residency. This outline provides the first step in developing a pragmatic standardized curriculum to guide faculty and programs in critical care education.

The Efficacy of a Novel Board Game to Teach Cable Properties to Introductory Neuroscience Undergraduate Students.

Engagement activities in large classrooms (>100 students) are difficult due to space constraints, number of participants, and overall noise. Additionally, electrophysiological concepts in foundational neuroscience courses can be confusing and lack excitement. Providing students an opportunity to further engage in the material they are learning and apply their knowledge promotes community in the classroom, a deeper understanding of the topic, and an overall increase in retention. Game-based learning has been used in education across all levels and disciplines to provide students with this opportunity. You're Getting on my Nerves is a board game created to offer students a fun way to learn and apply cable properties of action potential propagation. This game allows students to practice vocabulary terms, apply their knowledge of changes in the cell that impact the speed of an action potential, and develop comradery with their classmates. In this article, we have assessed the board game for its efficacy in teaching concepts of cable properties, its ability to promote engagement in a large classroom, its feasibility and timing with a large class, and its potential to elicit comparable formative assessment scores to students who learned these concepts through didactic lecture. Overall, the board game was feasible for a large class to complete within the class period. The results showed an increase in understanding and retention of the material in addition to preference over didactic lectures with students reporting higher engagement, interaction with their peers, and enjoyment in the activity.

Touch of Medical Ethics at the Beginning of Medical School.

ABSTRACT: There comes a great responsibility to make patients feel better with the title of doctor. Often we meet certain moral and ethical dilemmas that cannot be solved by our medical textbook alone. It requires a certain assistance which can only be provided by medical ethics. Medical ethics is the guiding moral that guides Health Care Workers to provide a holistic approach while treating a patient. Medical ethics is the soul that can not only prevent future dilemmas but can overall make a healthcare worker 'feel' and have empathy for the patient. From the story of Paul and the true life stories of patients we encountered during our visit to the Leprosy center, we got a sense of empathy. Ethical practice and empathy are the pillars that can play a vital role in the rapidly increasing level of violence against the Health care professionals. So it is an emerging need to have medical ethics as a part of the curriculum among medical students.

Acquiring musculoskeletal skills with curriculum-based reinforcement learning.

Efficient musculoskeletal simulators and powerful learning algorithms provide computational tools to tackle the grand challenge of understanding biological motor control. Our winning solution for the inaugural NeurIPS MyoChallenge leverages an approach mirroring human skill learning. Using a novel curriculum learning approach, we trained a recurrent neural network to control a realistic model of the human hand with 39 muscles to rotate two Baoding balls in the palm of the hand. In agreement with data from human subjects, the policy uncovers a small number of kinematic synergies, even though it is not explicitly biased toward low-dimensional solutions. However, selectively inactivating parts of the control signal, we found that more dimensions contribute to the task performance than suggested by traditional synergy analysis. Overall, our work illustrates the emerging possibilities at the interface of musculoskeletal physics engines, reinforcement learning, and neuroscience to advance our understanding of biological motor control.

Assessment of an Airway Curriculum in a Pulmonary and Critical Care Fellowship Program.

Background: Endotracheal intubations (EIs) in the intensive care unit are high-risk procedures often performed by pulmonary and critical care medicine (PCCM) providers. The Accreditation Council for Graduate Medical Education mandates PCCM fellows' competency in this procedure; however, the learning experiences vary across programs. After conducting a needs assessment, we developed a curriculum unique to our institution to supplement our fellows' existing EI experiences in the operating room and the intensive care unit. Objective: To assess the curriculum's short-term objectives: knowledge acquisition, maintenance, and practical skills 1 year after participation. Methods: We administered a survey to the graduating PCCM fellows for two consecutive years. We designed the comprehensive airway curriculum to include didactic lectures and simulation-based education. The knowledge acquisition and maintenance were measured by administering a 26-question knowledge survey before and after curriculum participation and after 1 year. The fellows also received a practical examination 1 year after participation. To compare knowledge survey scores, we used paired t tests and permutation tests. Results: In the needs assessment, 56% of graduating fellows believed they were proficient in performing EI, whereas 33% were undecided and 11% believed they were unprepared. Most believed they would need more than two courses after graduation to be confident in independently performing EIs. Most will only occasionally have backup for EI from anesthesiology or emergency medicine in their future jobs. One identified barrier to learning EI was the lack of a formal curriculum. In the knowledge assessment, nine first-year fellows participated in the curriculum. The cohort's mean presurvey score was 13.0 (standard deviation [SD], 4.5) versus 18.6 (SD, 3.6) mean postsurvey score. One year after participation, the mean survey score was 17 (SD, 1.2). The postsurvey and 1-year postparticipation survey scores were significantly higher than the presurvey scores (P < 0.05). One year after participation, the practical examination showed most fellows retained skills in EI using ramped position, video and direct laryngoscopy, bag-mask ventilation, and oropharyngeal airway placement. Conclusion: The airway curriculum enhances fellows' knowledge acquisition and maintenance 1 year after participation. The practical examination 1 year after participation highlighted the skills retained and those still needing improvement.

Reimagining Undergraduate Critical Care Medical Education: A Path for the Next Decade.

Foundational training in critical care medicine is an integral part of both undergraduate and graduate medical education. Yet, many medical school graduates enter residency underprepared to care for critically ill patients because of a lack of ubiquity of undergraduate critical care education and the heterogeneity of existing didactic and clinical experiences. This Perspective explores the importance of undergraduate critical care education, the current national and international landscape, innovative educational strategies and exemplar curricula, and recent advances in assessment that may better reflect learner-centered educational outcomes. As broad curricular reforms push medical education toward a more innovative, interactive, and collaborative future, now is the time to rethink and reimagine undergraduate critical care education.

Implementing the Infectious Diseases Society of America Antimicrobial Stewardship Core Curriculum: Survey Results and Real-World Strategies to Guide Fellowship Programs.

Background: The Infectious Diseases Society of America (IDSA) developed the Core Antimicrobial Stewardship (AS) Curriculum to meet the increasing demand for infectious diseases (ID) providers with AS expertise. Notable diversity in implementation approaches has been observed among ID fellowship programs using the curriculum. We sought to describe individual approaches and develop a curriculum implementation roadmap. Methods: We surveyed ID fellowship programs that had previously implemented the IDSA Core AS curriculum. The survey included questions regarding program characteristics, curriculum participants and presentation format, resources and barriers, and implementation strategies. Commonly reported program features were summarized in the context of the self-reported implementation strategies. Implementation guides were developed based on the most common characteristics observed. Results: Of 159 programs that had purchased the curriculum, 37 responded, and 34 (21%) were included in the analysis. The curriculum was primarily taught by AS physicians (85%) and AS pharmacists (47%). The most common conference structure was a longitudinal conference series (32%), and eLearning was the most common presentation format. Limited AS faculty time (76%) and limited first-year fellow availability (62%) were frequently reported as barriers, and dedicated AS curricular time was a resource available to most programs (67%); implementation guides were created for these 3 program features. Conclusions: Programs reported a variety of implementation barriers and resources, with several common themes emerging, allowing for the development of tailored curriculum planners for 3 commonly observed program characteristics. This work will equip fellowship programs with curriculum implementation strategies and guide future enhancements of the IDSA Core and Advanced AS curricula.

An Evaluation of the First Clinical Posting in Psychiatry of the Competency-Based Medical Education (CBME) Curriculum for Undergraduate Medical Students in India.

Background: The new competency-based medical education (CBME) curriculum presents an opportunity to address the many deficiencies in undergraduate (UG) psychiatry education in India. There are no published reports of such evaluations of psychiatry teaching programs based on the new CBME curriculum. Methods: We performed a cross-sectional evaluation of the first clinical posting in psychiatry of the new CBME curriculum using the following metrics: clinical skills, knowledge, attitudes towards psychiatry, self-efficacy in performing the specific learning objectives (SLOs), and satisfaction with specific teaching-learning and assessment methods implemented. Results: The mean knowledge score after the posting was significantly higher compared to the mean knowledge score at baseline (7.79 vs 5.45, p<0.001). The mean clinical skills score after the posting was 13.77 (0-20 range). Improvement was noted in the mean scores on all three sub-scales of the attitudes toward psychiatry scale. However, the improvement in scores was statistically significant only on the 'Stigma of Psychiatry' sub-scale. The mean scores on the items of the self-efficacy scale were between 63.41 and 77.73 (0-100 range). The mean scores on all items of the satisfaction scale were between 4 (somewhat satisfied) and 5 (very satisfied). Conclusion: We have described an evaluation of the first clinical posting in psychiatry of the new CBME curriculum. The posting was effective in imparting knowledge and clinical skills and potentially bringing about favorable changes in the attitudes toward psychiatry among UG medical students. The students also perceived confidence in performing the SLOs and were satisfied with the teaching-learning methods and assessment methods implemented.

Perceived Learning and Feedback of Students Following the Competency-based Clinical Rotation in Psychiatry: A Retrospective Review From Tertiary-care Teaching Institute in Central India.

Background: Competency-based medical education (CBME) offers avenues for effective psychiatry teaching to medical students. However, data concerning the feasibility, effectiveness, and students' perspectives on CBME-based clinical rotation, including psychiatry, needs to be explored in India. Therefore, this research aims to evaluate the student's learning effectiveness and feedback on the CBME-informed psychiatry posting. Methods: This cross-sectional retrospective research evaluated the 7th-semester MBBS students (n = 101, 39 [38.6%] females and 62 [71.4%] males), from a tertiary-care teaching hospital in central India, perceived change in Knowledge, Attitude, and Skill and feedback on the CBME-based clinical rotation (July-December 2023) using a mixed-method approach through an online feedback form. Results: A "considerable or marked perceived change," ranging from 70% to 97%, in the knowledge, attitude, ethical aspects, psychomotor skills, and soft skills were noted. 84%-91% of students were "satisfied/quite satisfied (or rated it good to very good)" with the pattern and content of the program, including the assessment. 37% expressed their desire to take psychiatry as an elective. Descriptive responses showed that participants felt improvement in their communication skills, knowledge about non-pharmacological interventions, opportunity to observe and present cases in the Outpatient Department, and satisfaction with the teaching and assessment methods. The need for minor changes regarding case-based formative assessment and the opportunity for more case workups were also cited. Conclusion: The CBME-informed psychiatry clinical rotation can be instrumental in improving psychiatry training and promoting mental health among students. Research involving a comparison arm, longitudinal design, and validated assessment tools can bring greater insights into the subject.

Identifying Needs and Preparing for Curriculum Changes in Indian Dental Education.

The aims of dental professional courses are to prepare dental healthcare providers to manage common dental diseases, perform surgeries, and offer prevention. They should also be equipped to understand the needs of the society they are serving and willing to amend their skills. As they are expected to be a part of a team providing health care, they should have the requisite leadership and managerial skills for leading the team to serve its objectives in the best possible way. Thus, with changing times, there is a need to bring reforms in dental curricula. Traditional classroom teaching is now shifting to a competency-based education system across the globe. The Dental Council of India (DCI), as a dental health regulator in the country, implements reforms periodically in an attempt to further strengthen the training process and bring quality improvement in dental education. A process of redesigning the curriculum started a couple of years ago. The technical team supporting this work brainstormed the need for such reforms and studied the existing pattern of undergraduate curricula in other developed countries. It was found that many countries are following outcome-based teaching-learning methods. There are several institutions and professional associations proposing recommendations on curricular reforms, and India also suggests following the same. The new education policy (NEP) of the Government of India (GoI) is also in sync with the changes proposed to the DCI. Though such changes are challenging and require time to strategize and implement, it is essential to have reforms in curriculum, especially related to methods of teaching-learning and assessment, and for this, the dental faculty needs to be trained. How to cite this article: Deshpande AN, Mathur VP, Lele GS, et al. Identifying Needs and Preparing for Curriculum Changes in Indian Dental Education. Int J Clin Pediatr Dent 2024;17(7):842-850.

Moral Harassment and Mental Health in Medical Residents: A Longitudinal Study.

OBJECTIVE: This study investigates if moral harassment contributes to anxiety, depression and burnout among medical residents. METHODS: This three-stage longitudinal study involves 218 first-year residents, with 76 (34.9%) participating throughout all stages. The questionnaire covered demographics, mental health (using Patient Health Questionnaire - 4 - PHQ-4), burnout (using Maslach Burnout Inventory Human Services Survey - MBI-HSS), and harassment experiences. Logistic regression analyzed mental health outcomes and harassment. RESULTS: The study found significant variations in anxiety and depression scores, along with a notable decrease in the personal accomplishment dimension of burnout. Harassment prevalence was above 90%, and most victims were disturbed by harassment suffered. While a direct correlation between harassment victimization and decreased mental health was not found, seeking help exacerbated suffering, and surgical program residents had a smaller increase in depression and emotional exhaustion. CONCLUSIONS: To the extent of our knowledge, this is the first longitudinal study on mental health and harassment among medical residents. Mental suffering after taking action against harassment suggests that safe environments for addressing these issues are lacking in residency. Further studies concerning surgical residents could shed light on their lower levels of suffering. Institutional changes are necessary to embrace victims and create a healthy environment.

Development of home-based care educational programme for the family caregivers of activity limited older people: an educational programme model for community nurses.

BACKGROUND/AIM: A home-based care educational programme for family caregivers of activity-limited older people was developed and implemented to provide caregiver education and to teach basic caregiving techniques. The purpose of the home-based care educational programme was to improve the caregivers' knowledge, skills and attitudes necessary to perform the caregiving tasks with reduced physical strain. METHODS: The educational programme model comprises the knowledge and skills necessary to carry out the caretaking responsibilities of older people, especially those with limited activities. It was conducted as an interventional study recruiting two groups (n=72) as intervention (n=36) and control group (n=36), and the knowledge of the caregivers was evaluated. The teaching sessions were planned considering the adult educational learning theories and guided by a developed educational handbook. RESULTS: The pre and post mean±SD knowledge scores of the intervention group (43.78±12.41; 89.78±5.61) showed a significant difference (p<0.001), whereas the pre and post knowledge mean±SD scores of the control group (50.69±17.90; 51.43±17.79) showed no significant improvement (p>0.05). The difference between the pre-test and post-test between the two groups was significant (p<0.0001). CONCLUSIONS: At the end of the educational programme, participants valued the opportunity that they received, and the assessment of knowledge before and after the programme showed an improvement in caregivers' knowledge. The study suggests conducting home-based or community-based health education programmes for caregivers of older people with limited activities, with the involvement of responsible healthcare professionals and leaders.

Fellow perceptions of robotic surgery preparedness for fellowship.

INTRODUCTION: Many surgical fellowship programs incorporate robotic surgery, yet not all residency programs offer robotic training for residents. Given the variability of pre-fellowship robotic exposure, the goal of this study was to explore whether standardized robotic skills assessment would be useful to fellows at the start of their training. METHODS: In partnership with the Fellowship Council, we surveyed current fellows of accredited Thoracic, Colorectal, HPB, and Advanced GI/MIS/Bariatrics/Foregut Fellowship programs. Main outcome measurements included amount of robotic exposure during residency, fellows' robotic skills at the start of fellowship, and fellows' attitudes towards a standardized skills assessment. RESULTS: In total, 78 fellows completed the survey. Mean percentage of cases performed robotically during fellowship was 38.1% (SD ± 32.25%). From our respondents, 46% had no robotic curriculum during residency and 86.9% felt a standardized robotic curriculum during residency would have been beneficial. When asked if they started fellowship with adequate robotic skills to operate autonomously, 31% strongly agreed, but 24.4% strongly disagreed. The majority of fellows reported their fellowship program did not conduct an assessment of their robotic skills (71.5%), or provide a specific robotic curriculum (75.6%). On the other hand, 73.3% felt a formal proficiency assessment at the start of fellowship would be helpful for individualized support and training. CONCLUSIONS: Given the significant variability in resident exposure to robotic surgery, a standardized robotic curriculum during residency would likely be beneficial. Additionally, a robotic skills assessment at the start of fellowship could help provide a tailored training experience for fellows interested in this skillset.