The exceptional potential in extending primary care exposure for South African medical interns.

No abstract available.

Efficacy of the Gulu University Reproductive Health Simulation Training for final year medical students and interns: a before-and-after study.

Background: Reproductive health emergencies, such as postpartum hemorrhage, contribute significantly to maternal and neonatal morbidity and mortality in Uganda due to knowledge and skills gaps. Medical interns, intern midwives, and nurses are crucial as frontline healthcare workers in responding to these emergencies. Our proposed hands-on strategy involves comprehensive simulation-based training (SBT) to equip these healthcare workers with the essential knowledge to manage common reproductive health emergencies and procedures in the country. Objectives: The study aimed to assess the effectiveness of comprehensive SBT in improving the knowledge of interns and fifth-year medical students on reproductive health emergencies and procedures at Gulu University and its Teaching Hospitals in Uganda. Design: A before-and-after study. Methods: A 4-day SBT was conducted for fifth-year medical students and interns (nurses, midwives, and doctors) at Gulu University Teaching Hospitals, focusing on reproductive health emergencies. Pre- and post-tests with 40 multiple-choice questions were used to evaluate knowledge enhancement, the scores were summarized as medians and interquartile ranges. Paired sample t-tests was used to test the difference in pre- and post-test scores. Independent sample t-tests compared median post-test results between interns and students, with a p-value <0.05 considered significant. Results: A total of 153 participants were enrolled, the majority being males (78.4%, n = 120) and medical students (73.9%, n = 113). Among the 40 interns, 55% (n = 22) were doctors, 30% (n = 12) were midwives, and 15% (n = 6) were nurses. The study participants showed an increase in knowledge, with median post-test scores higher than pre-test scores for all participants [63% (interquartile ranges, IQR: 57-71%) versus 49% (42-54%), with a median difference of 14% (8-23%), p < 0.001]. Conclusion: The SBT effectively imparts key knowledge competencies to the interns and fifth-year medical students. We recommend that SBT be included as part of the course units that students should take and for continuous medical education for qualified healthcare workers in resource-limited settings.

Medical interns' training in family medicine at a district hospital and primary health care clinics in Middelburg, Mpumalanga.

Training of medical interns at the Middelburg district hospital has been introduced as part of the mandatory 6 months' rotation in Family Medicine department since 2021. This report provides an overview of what has been attained in 2021 and 2022. It covers various aspects of the activities medical interns have been exposed to in the Middelburg hospital and the surrounding primary health care clinics.Contribution: Sharing experiences of family medicine training for medical interns in district hospitals is essential because the 6 months' rotation is new for most family physician trainers, especially those in small hospitals and primary health care clinics. Taking into account the paucity of evidence on the topic, the report brings current information that supports that training medical interns in district hospitals and primary health care clinics prepares them to be comfortable and competent clinicians for the generalist work during the community service year ahead.

Risk of positive screening for anorexia nervosa, bulimia nervosa and night eating syndrome and associated risk factors in medical fellows in Northeastern Mexico: a multicenter study.

BACKGROUND: Eating disorders and food ingestion (EDs) are serious mental illnesses with a higher prevalence in young adults, with difficult diagnoses that cause serious morbidity and mortality problems. There is not much information about the risk of positive screening for EDs, specifically, anorexia nervosa (AN) and bulimia nervosa (BN) and night eating syndrome (NES) in undergraduate medical interns (UMI) and medical residents (MR) in Mexico. AIM: To determine the risk of AN, BN and NES and to determine the risk factors of such conditions such as age, body mass index (BMI) and gender of MR and UMI with AN/BN and NES at four private hospitals in northeastern Mexico. METHODS: A cross-sectional, descriptive, non-randomized survey in MR and UMI in four hospitals in Northeastern Mexico was conducted using an electronic questionnaire that included: informed consent signature, SCOFF questionnaire for AN and BN screening, NES questionnaire. Also, a survey on general sociodemographic data of each participant was included. Chi-square test and a logistic regression model were computed for analyses. RESULTS: The population included a total of 129 MR and UMI. It was observed that 48.8% were positive for AN or BN and 32.6% were positive for the NES. There was no difference between age, sex, BMI, or medical specialty (if they were MR); however, MR from the first year had a higher risk of AN or BN (OR 23.7, 95% CI 1.181-475.266). CONCLUSIONS: There was a higher risk of positive screening for AN or BN and NES in UMI and MR in our population. In the case of MR, those in first year have a higher risk of AN and BN. Timely diagnosis and treatment are mandatory in this population.

Eating disorders and food ingestion such as anorexia (AN) or bulimia (BN) nervosa and night eating syndrome (NES) are a group of mental illnesses that are frequently under diagnosed. Medical residents (MR) and undergraduate medical interns (UMI) are a high-risk population for such disorders due to their young age, stress environments, erratic eating patterns and long working hours. The aim of this study was to determine the risk of AN, BN and NES and to determine the risk factors of such conditions. One hundred twenty-nine UMI and MR were studied and showed that 48.8% were positive for AN or BN and 32.6% were positive for NES. MR in the first year of medical residency had a higher risk. Timely diagnosis and treatment are mandatory in this population.

Preferences, Career Aspects, and Factors Influencing the Choice of Specialty by Medical Students and Interns in Saudi Arabia: A Cross-Sectional Study.

Background and objective Choosing a medical specialty is one of the most critical career decisions medical students and interns make. However, little is known about the factors these graduates consider when choosing their specialty. Our study assessed factors that medical students and interns consider when determining their specialty. Methods This is a cross-sectional survey-based study, conducted from November to December 2022. We utilized a previously published questionnaire for 1074 participants, including 837 medical students and 237 interns from Saudi Arabian universities. Results The majority of female participants (80.4%), compared with only 19.6% of male participants, considered interest in specific procedures and techniques typical of the specialty an important factor in choosing a specialty (p = 0.036). Dissertation research experience was an important factor for 83.5% of female participants and 16.5% of male participants (p = 0.024). Additionally, good quality teaching within the study program framework was important for 81.2% of female participants and 18.8% of male participants (p = 0.033), suggesting that male and female participants viewed the importance of good quality teaching differently. Female participants accounted for 80% of those who considered the overseas experience a factor in their specialty choice. Also, 74.4% of female and 25.6% of male participants considered friends, relatives, or other connections in the healthcare field a factor that affects their choice. Furthermore, 79.6% of female and 20.4% of male participants reported having good experiences with physician role models as an impactful factor in their specialty choice. Conclusion Female participants were most interested in obstetrics and gynecology (12.1%,), internal medicine (11.8%), and family medicine (10.8%). Male participants, on the other hand, showed more interest in family medicine (12.7%,), internal medicine (11.0%), and emergency medicine (10.1%). Medical schools and healthcare institutions must provide students and interns with enough information and resources to help them explore different specialties and make well-informed decisions about their careers.

[Stigmatisation of patients with mental disorders by medical interns specialising in general practice: A national survey]. / Stigmatisation des patients atteints d'un trouble mental par les internes de médecine générale : une enquête nationale.

OBJECTIVES: The objective was to assess the level of stigmatisation of psychiatric patients by medical interns specialising in general practice (GP), and to assess the influencing factors of stigmatisation. METHODS: A national survey was carried out among interns in general practice (GP) contacted through their local associations from December 10, 2019 to March 9, 2020. An online questionnaire was diffused. The validated French version of the Mental Illness Clinicians' Attitudes (MICA) was used to measure stigmatising attitudes towards psychiatry and persons with psychiatric disorder by the interns. This 16-item scale is designed to measure attitudes of health care professionals towards people with mental illness with scores ranging from 16 to 96 (the most stigmatizing). Several covariates were collected: socio-demographics, personal experiences with mental health, and mental health trainings during medical studies. All questionnaires were strictly anonymized. Comparative analyses of the MICA score by group were performed using Student's tests. RESULTS: A total of 389 interns responded. The majority of respondents were female (n=277; 71%) and the mean age was 27years [standard deviation (SD)±2.39]. The mean MICA rate was 40.64 (SD±8.09) for a neutral score of 56, reflecting low overall stigmatizing attitudes. MICA scores were significantly lower among female interns (40.11 vs. 41.95; P=0.042), those who had benefited from personal psychological or psychiatric support (38.70 vs. 41.61; P=0.001), and those who had completed a psychiatric externship (39.47 vs. 42.16; P=0.001). CONCLUSIONS: GP interns had an attitude that is generally not very stigmatizing even if its improvement should still be sought. This is particularly verified among those who have completed a psychiatric internship during their externship. This suggested association should be supported by other studies. The stakes are high for the future management of patients since stigmatisation by a physician is strongly implied in the worse healthcare management of patients with psychiatric disorders, leading them to a shorter lifespan.

Using machine learning with intensive longitudinal data to predict depression and suicidal ideation among medical interns over time.

BACKGROUND: Use of intensive longitudinal methods (e.g. ecological momentary assessment, passive sensing) and machine learning (ML) models to predict risk for depression and suicide has increased in recent years. However, these studies often vary considerably in length, ML methods used, and sources of data. The present study examined predictive accuracy for depression and suicidal ideation (SI) as a function of time, comparing different combinations of ML methods and data sources. METHODS: Participants were 2459 first-year training physicians (55.1% female; 52.5% White) who were provided with Fitbit wearable devices and assessed daily for mood. Linear [elastic net regression (ENR)] and non-linear (random forest) ML algorithms were used to predict depression and SI at the first-quarter follow-up assessment, using two sets of variables (daily mood features only, daily mood features + passive-sensing features). To assess accuracy over time, models were estimated iteratively for each of the first 92 days of internship, using data available up to that point in time. RESULTS: ENRs using only the daily mood features generally had the best accuracy for predicting mental health outcomes, and predictive accuracy within 1 standard error of the full 92 day models was attained by weeks 7-8. Depression at 92 days could be predicted accurately (area under the curve >0.70) after only 14 days of data collection. CONCLUSIONS: Simpler ML methods may outperform more complex methods until passive-sensing features become better specified. For intensive longitudinal studies, there may be limited predictive value in collecting data for more than 2 months.

South African medical interns' perspectives on the use of point of care ultrasound.

BACKGROUND:  Point of care ultrasound (POCUS) has become such a part of patient care that it is included in undergraduate medical training in many high-income countries. In South Africa, despite the availability of ultrasound units, there is no information on the exposure or training required for medical interns to perform POCUS in their community service year. This study examines interns' self-reported POCUS training and competency, as well as their perceived readiness for their community service year. METHODS:  In this cross-sectional web-based survey, 43 interns were invited to complete a self-administered questionnaire after completing their 6-month decentralised family medicine rotation in 2022. RESULTS:  Thirty complete responses (69% response rate) were included for analysis. Eleven graduates from three medical schools reported undergraduate exposure to POCUS. Ten participants completed formal postgraduate ultrasound training. Eight participants felt confident to independently perform POCUS. Thirteen participants felt adequately prepared for their community service year, 10 of whom had received POCUS training. Nearly all the participants (29 of 30) felt that ultrasound training should be incorporated into both undergraduate and internship training. CONCLUSION:  Medical interns expressed a need for more POCUS training. Most of the studied sample did not feel adequately prepared to perform POCUS independently. The high uptake of additional ultrasound courses highlights the need to include POCUS training. More research is needed to determine the extent and level at which POCUS training should be offered to medical interns in the South African setting.Contribution: This study looks at the perceived need of South African medical interns for formal POCUS training. It highlights a potential gap in training based on the expected clinical requirements of the community service year.

Assessment of training of general practice interns in motivational interviews about vaccination.

The effectiveness of motivational interviewing (MI) for reducing vaccine hesitancy (VH) has been demonstrated in Quebec. We conducted a study to evaluate the acquisition of MI skills after MI training via videoconferencing for interns training as general practitioners (GPs) in southeastern France. A vaccination-specific MI training workshop was offered to interns in 2021, consisting of two separate Zoom videoconference sessions. Participants completed the Motivational Interviewing Skills in Immunization questionnaire before and after the training to measure skills acquisition. We used pairwise exact Wilcoxon-Pratt signed rank tests for the analysis. Among 45 GP interns enrolled in the first MI session, 34 (75.6%) attended both sessions and completed the questionnaire at 3 different time points. After the first session, MI knowledge scores improved significantly (+21.1 ± 21.6; P < .0001), as did application of MI skills (+36.8 ± 36.7; P < .0001), and MI practice confidence (+21.2 ± 11.1; P < .0001). The second MI session maintained the skills developed after the first session without further improvement. Participant satisfaction was high. This is the first study in France assessing the impact of a vaccination-specific MI training for GP interns. It shows a substantial improvement in knowledge, application of MI skills, and self-confidence in the practice of MI. GP interns were highly satisfied with the training despite the videoconference format. These promising results will allow the integration of MI training in GP medical curricula in order to prepare future GPs for communication in the field of vaccination.

Medical interns' views on the strategies for reducing antibiotic misuse in the hospitals-what guidelines do they follow?

Objectives: Although the topic of antibiotic misuse is taught in medical schools, interns (fresh medical graduates) still encounter barriers to appropriate antibiotic prescription when they practice in hospitals under supervision. The impact of teaching in medical school, antibiotics stewardship program (ASP), and prescription guidelines was uncertain. This study explored the medical interns' views on antibiotic use and resistance, and their perceived enablers to appropriate antibiotic prescription. Methods: Two focus groups were conducted among medical interns with rotation experiences in different public hospitals of Hong Kong. The identified themes about attitudes to antibiotic resistance and enablers to appropriate antibiotic prescription were further examined by a questionnaire survey with 77 respondents. Results: The interns had lower preferences for tackling antibiotic resistance as they feared of delayed prescriptions. Guidelines provided by international evidence-based clinical resources and the interns' working hospitals were stronger enablers to appropriate antibiotic use than education materials from schools and the government. Qualitative findings revealed that the interns were aware of the existing ASP but doubted its effectiveness as it failed to get the prescribers' attention. They followed guidelines in their wards but perceived guidelines from local health authorities user-unfriendly. Knowledge from medical school was not very applicable. Varying prescribing practices between hospitals and the densely placed hospital beds made it difficult to prevent the spread of antimicrobial resistance. Conclusions: Minimizing delayed prescription is of a higher priority than tackling antibiotic resistance in medical interns' perspective. Interventions should target guidelines in hospitals and simplify the interface of local guidelines.

Visual-spatial dimension integration in digital pathology education enhances anatomical pathology learning.

Literature review demonstrated a surprising lack of publications on digital e-learning pathology resources for senior medical undergraduates and interns. An interactive Digital Pathology Repository (iDPR) integrating two- and three-dimensional (2D, 3D) high-resolution anatomical pathology images with correlated digital histopathology was developed. The novel iDPR was rigorously evaluated using mixed methods to assess pathology knowledge gains (pre- and post-tests), quality impact analysis (questionnaire), user feedback (focus group discussions) and user visual behaviour (eye gaze tracking analysis of 2D/ 3D images).Exposure to iDPR appeared to improve user pathology knowledge, as observed by significantly increased test scores on topic-related quizzes (n = 69, p < 0.001). In addition, most users were highly satisfied with the key design elements of the iDPR tool. Focus group discussion revealed the iDPR was regarded as a relevant online learning resource, although some minor technical issues were also noted. Interestingly, visual behaviour trends indicated that specific diagnostic pathological lesions could be correctly identified faster in 3D images, when compared to 2D images.The iDPR offers promise and potential in pathology education for senior clinical students and interns, gauging from both qualitative and quantitative positive user feedback. With incorporation of image annotations and interactive functionality, and with further technology development, this would prove a useful tool for diagnostic pathology and telepathology. As images with added visual-spatial dimension can provide enhanced detail and aid more rapid diagnosis, future applications of the iDPR could include virtual reality or holographic images of anatomical pathology specimens.

Medical internship training during the COVID-19 pandemic - A case of 'sacrificial pawns' or not?

BACKGROUND: Newly qualified medical practitioners in South Africa (SA) are part of the frontline health care workers who face Africa's most severe coronavirus disease 2019 (COVID-19) pandemic. The experiences of interns during the pandemic reflect SA's preparedness to respond in a crisis and inform strategies that could be adopted to balance training and service in resource-challenged contexts. AIM: To explore the strengths, weaknesses, opportunities and threats posed during the first wave of the COVID-19 pandemic as reflected on by interns within the clinical training platforms in SA. SETTING: Public hospitals in KwaZulu-Natal. METHODS: An online questionnaire consisting of eight open-ended questions based on the SWOT framework related to personal and professional perspectives to clinical training during the COVID-19 pandemic was developed using SurveyMonkey. All data were collected remotely via social media platforms. Data were thematically analysed. RESULTS: Forty-six interns reflected on personal and systemic challenges as the major threats and weaknesses in intern training during the COVID-19 pandemic. Extrapolating on strengths and opportunities, there were three overarching learnings interns reflected on. These related to being a medical professional, communities of practice and the development and enhancement of clinical and non-clinical competencies. Existing challenges in the environment exacerbated the threats posed by COVID-19 and innovative strategies related to improving support, feedback, broadening the intern curriculum and online training. CONCLUSION: Although the clinical environment where interns learn and work is often stressful and overpowered by high service burdens, there are unique opportunities to enhance self-directed learning and graduate competencies, even in the midst of the COVID-19 pandemic.

ASSESSMENT OF INTERNS' TRAINING IN THE TEACHING HOSPITALS OF BAGHDAD MEDICAL CITY COMPLEX.

OBJECTIVE: The aim: The aim of this study is to assess the training of medical interns in Baghdad Medical City Complex. PATIENTS AND METHODS: Materials and methods: A cross-sectional observational study was conducted in the Medical City Complex, Baghdad. The study targeted all the medical interns who finished year one of internship. A questionnaire form was designed for data collection. A questionnaire form was done according to the Medical Interns' Guideline adopted by the Minister of Health in 2015. RESULTS: Results: A total of 60 interns filled the questionnaire, their mean age is 27.07 years (SD = 2.04), male respondents constituted 48.3%. Twenty-seven respondents (45%) were from Baghdad Medical College. More than half (58%) of them were singles. The mean pre-internship score was 69.32 (SD = 6.6). About half of the interns (29, 48.3%) have a future interest in surgery. Average preparedness for the internship was reported in 45% of interns. Half of the interns had prior ideas about the internship through variable means. A larger percentage of interns reported average/poor quality of training in different aspects of medical internships. Accepted quality of training (above average and excellent) and average one were reported respectively by 19 (31.7%) and 31(51.7%) of interns in general surgery, followed by the internal medicine branch. Thirty-one (51.7%) interns were moderately prepared for their future medical careers. Surgeons and general physicians gained better opinions (above average and excellent) from the interns (17, 28.3%, and 13, 21.6%) respectively. CONCLUSION: Conclusion: There was a deficiency in the preparedness of newly graduated doctors for the internship. But they reported an average skill performance in major medical branches, and some related laboratory and medical procedures, there was a defect in dealing with emergency cases. The Supervision of interns was below average in gynecology and obstetrics units and was good in other branches. The medical school training was poor to help interns in dealing with deaths and legal medicine cases. More than 50% of trainees were prepared for the future medical branches of interest.

Talking about firearm injury prevention with patients: a survey of medical residents.

BACKGROUND: Firearm injury and death are significant public health problems in the U.S. and physicians are uniquely situated to help prevent them. However, there is little formal training in medical education on identifying risk for firearm injury and discussing safe firearm practices with patients. This study assesses prior education, barriers to counseling, and needs for improved training on firearm safety counseling in medical education to inform the development of future education on clinical strategies for firearm injury prevention. METHOD: A 2018 survey administered to 218 residents and fellows at a large, academic medical center asked about medical training on firearm injury prevention, frequency of asking patients about firearm access, and perceived barriers. RESULTS: The most common barriers cited were not knowing what to do with patients' answers about access to firearms (72.1%), not having enough time (66.2%), not feeling comfortable identifying patients at-risk for firearm injury (49.2%), and not knowing how to ask patients about firearm access (48.6%). Prior education on firearm injury prevention was more strongly associated with asking than was personal exposure to firearms: 51.5% of respondents who had prior medical education reported asking compared with who had not received such education (31.8%, p=0.004). More than 90% of respondents were interested in further education about interventions, what questions to ask, and legal mechanisms to separate dangerous people from their firearms. CONCLUSIONS: Education on assessing risk for firearm-related harm and, when indicated, counseling on safe firearm practices may increase the likelihood clinicians practice this behavior, though additional barriers exist.

Effect of infection control training course on knowledge and practices of medical interns in a large academic hospital in Egypt: an intervention study.

Health care-associated infections are reported among the top causes of hospital deaths worldwide. Their prevention is a first priority for patient safety in acute care hospitals. Education and training is recommended as a core component for effective infection prevention and control programs. This study aimed to assess the effect of an infection control training course on the knowledge and practices of medical interns in a large academic hospital in Egypt. The study included 268 medical interns who were getting their practical training at Tanta University Hospitals, Egypt during the study period. Knowledge and practices regarding infection control measures were assessed using a predesigned questionnaire sheet and an observational checklist before and after intervention by infection control training course based on Egyptian national guide for infection control. The data have been analyzed through the application of descriptive frequency, percentages, mean of scores, and the inferential analysis that includes paired t test and Monte Carlo test. The level of statistical significance was adopted at p≤0.05. There was a statistically significant (p < 0.0001) increase in total knowledge score (65.4±13.9 versus 80.2 ±13.2) and total practices score (65±11.3 versus 108±7.9) of infection control measures among studied participants before intervention compared with after intervention. A significant strong positive correlation was detected (r= 0.8, p= 0.0001) between total knowledge and practice scores after intervention by training course. There is a strong positive correlation between knowledge and practices so intervention by infection control training course using teaching multimedia and role play significantly improves the knowledge and practice levels of the studied medical interns.

Medical internship training during the COVID-19 pandemic ­ A case of 'sacrificial pawns' or not?

Background: Newly qualified medical practitioners in South Africa (SA) are part of the frontline health care workers who face Africa's most severe coronavirus disease 2019 (COVID-19) pandemic. The experiences of interns during the pandemic reflect SA's preparedness to respond in a crisis and inform strategies that could be adopted to balance training and service in resource-challenged contexts. Aim: To explore the strengths, weaknesses, opportunities and threats posed during the first wave of the COVID-19 pandemic as reflected on by interns within the clinical training platforms in SA. Setting: Public hospitals in KwaZulu-Natal. Methods: An online questionnaire consisting of eight open-ended questions based on the SWOT framework related to personal and professional perspectives to clinical training during the COVID-19 pandemic was developed using SurveyMonkey. All data were collected remotely via social media platforms. Data were thematically analyzed. Results: Forty-six interns reflected on personal and systemic challenges as the major threats and weaknesses in intern training during the COVID-19 pandemic. Extrapolating on strengths and opportunities, there were three overarching learnings interns reflected on. These related to being a medical professional, communities of practice and the development and enhancement of clinical and non-clinical competencies. Existing challenges in the environment exacerbated the threats posed by COVID-19 and innovative strategies related to improving support, feedback, broadening the intern curriculum and online training. Conclusion: Although the clinical environment where interns learn and work is often stressful and overpowered by high service burdens, there are unique opportunities to enhance self-directed learning and graduate competencies, even in the midst of the COVID-19 pandemic.

The Impact of the COVID-19 Pandemic on Medical Interns' Education, Training, and Mental Health: A Cross-Sectional Study.

Background and objectives The novel coronavirus disease 2019 (COVID-19) pandemic has challenged healthcare systems worldwide. Various studies have revealed the negative impact of the pandemic on the education and mental health of medical students and residents. In this study, we aimed to explore the effects of the COVID-19 pandemic on medical interns' educational experience, clinical practice, and mental health. We also engage in a discussion on the compensatory methods that have been adopted to improve medical interns' learning processes during the ongoing pandemic. Methods This cross-sectional survey-based study was conducted at the King Saud University Medical City (KSUMC) in Riyadh, Kingdom of Saudi Arabia (KSA) from March to October 2020. The participants consisted of medical interns. The survey collected information on participants' demographics, training, and the educational and psychological impact of the pandemic. Results The survey was distributed to 480 medical interns, of whom 345 (71.8%) participated. Most of our sample (75.6%) believed that the COVID-19 pandemic has negatively impacted their cumulative experience. Regarding the pandemic's impact on training and education, it was found that the emergency department rotation was the most affected rotation (60.3%). The majority of the participants (55.9%) believed that all tracks have received equal education and the volume of patients seen by interns decreased by 91.9%. As for the compensatory methods, 73.3% reported the utilization of remote platforms. Regarding the pandemic's mental health impact, 36% believed that it has affected their mental health, where increased stress levels were noticed in 47.8% of participants. Statistical significance was found in both Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scores, which indicated that during the pandemic, 20.6% of the participants suffered from depression, and 13.9% had moderate to severe anxiety. Conclusions This study highlights the negative educational and psychological impact of COVID-19 on medical interns. With emerging infectious diseases on the rise, recognizing the impact of COVID-19 on medical interns is vital to improving interns' educational experiences and mental health during future crises.

The knowledge and perceptions regarding antibiotic stewardship of the interns rotating at the Bloemfontein Academic Complex.

BACKGROUND: Antibiotic resistance (ABR) is a global problem with the overuse of antibiotics accelerating this process. Antibiotic stewardship aims to optimise antibiotic treatment to enable cost-effective therapy and improve patients' outcome whilst limiting ABR. The study aimed to evaluate intern medical doctors' knowledge and perceptions about antibiotic stewardship and their perceptions regarding education on relevant topics. METHODS: This was a cross-sectional study on interns rotating at Bloemfontein Academic Complex. An anonymous, self-administered questionnaire was completed. The questionnaire recorded demographic information, perception and knowledge of antibiotic stewardship, and the quality of education as perceived by the interns. RESULTS: Of the 120 possible participants, 92 (76.7%) responded to all or part of the questionnaire. The median age of the respondents was 25 years, and 56.7% of the respondents were female. The mean score for the knowledge-based case scenarios was 5.4 out of 10. Only 4.4% participants could manage a drip site infection correctly, whilst 18.5% could treat Escherichia coli (E. coli) bacteraemia. The interns perceived that they have a lack of training and preparedness in certain areas of prescribing antibiotics. Though 77.2% of the interns had received education on starting antibiotic treatment, 29.3% claimed to be unsure when to start antibiotic therapy. Interns indicated that formal lectures (81.3%) and bedside tutorials (86.7%) have a high educational value. CONCLUSION: Intern medical doctors do not have sufficient knowledge to establish antibiotic stewardship but have a desire for improvement. The results identified specific areas where better antibiotic training is required.

Process of Developing Palliative Care Curriculum for Training Medical Interns in a Tertiary Care Teaching Hospital in Puducherry, India.

OBJECTIVES: The department of community medicine (DCM) has been training medical interns for palliative care in the hospital and community setting. There was no specific curriculum or course material available for training them. This study aims to develop, implement and evaluate the palliative care curriculum for training medical interns. MATERIALS AND METHODS: The present program development and evaluation of palliative care curriculum was done in the DCM, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India. We followed the Kern's six steps for curriculum development. It was done during July 2016 and May 2017. We framed expected outcomes from literature review and interviews with experts. The curriculum was delivered through small group sessions followed by hands-on exposure to hospital- and community-based palliative care programs guided by a workbook. Medical interns were given feedback on their field assignments on history taking, followed by reflection using structured template incorporated in the workbook. The reaction to the curriculum was collected from various stakeholders. RESULTS: Medical interns found the curriculum useful for them to acquire basic skills of pain management, communication skills and teamwork. Patients and family felt satisfied with the quality of care provided. CONCLUSION: The new palliative care curriculum was well received by all the stakeholders involved. This can be adopted in similar context for training medical interns in palliative care.

The effectiveness of training on daily progress note writing by medical interns.

INTRODUCTION: There is no formal education or training course about daily progress note writing in Iranian medical interns' curriculum. The current study aimed to assess the effectiveness of a training intervention on daily progress note writing by Iranian medical interns. METHODS: This quasi-experimental study (pre- and post-test) was conducted on 150 medical interns selected through the census method at Razi Hospital of Rasht, north of Iran from October-2018 to May-2019. In the baseline, daily progress notes written by 150 medical interns were assessed using a Subjective, Objective, Assessment, and Plan (SOAP)-based questionnaire by the expert panel. Content validity of the questionnaire was confirmed by experts and internal consistency was determined using Cronbach's alpha coefficient. In the intervention phase, training sessions (4 one-hour sessions) on how to write the daily progress note, based on SOAP format and its importance, were held for the interns. All medical interns were given a week to meet the SOAP standards. Then, the same expert panel reviewed and assessed the newly written daily progress notes of the same medical interns. Finally, the scores from the evaluation of progress note writing, before and after the intervention, were compared with paired sample t-test. RESULTS: The mean age of the medical interns was 23.1±5.2 years. The majority of them were male (56%). There was a significant improvement in all SOAP notes' components written by medical interns between the pre- and post-intervention periods (general rules: 52.7±24.5 vs. 85.4±18.2, P<0.001; subjective: 21.2±18.3 vs. 61.7±24.3, P<0.001; objective: 25.3±18.3 vs. 71.3±25.2, P<0.001; assessment: 10.7±13.0 vs. 51.4±29.6, P<0.001; plan: 11.2±15.2 vs. 49.6±27.5, P<0.001; total: 21.9±13.0 vs. 61.8±23.0, P<0.001). But the scores were still far from the desirable level after the training intervention. CONCLUSION: The finding of the present research suggests that a training intervention can lead to some improvements in the daily progress notes written by Iranian medical interns.