Evaluating Stigmatization Toward Mental Illnesses Among Resident Physicians.

Background  Individuals with mental illness are stigmatized by peers in societal, workplace, and healthcare settings. The stigmatization individuals experience from healthcare providers is well documented and pervasive, often being a detriment to the quality of healthcare these individuals receive. Objective Recognizing and addressing stigmatization toward individuals with mental illnesses is imperative during residency training in Graduate Medical Education (GME) programs and throughout professional practice. We hope that this cross-sectional study will cultivate mindfulness and improve the healthcare outcomes of stigmatized individuals. Methodology A cross-sectional study using a web-based Attitude to Mental Illness Questionnaire (AMIQ) with additional scenarios was utilized to assess stigma among resident physicians in differing specialties in a hospital training system. The research investigators collected anonymous data on demographics, characteristics, specialties, and the AMIQ. In eight vignettes, participants responded to five items using a five-point Likert scale assessing attitudes toward individuals. Results Of the 104 resident physicians enrolled in the hospital training system where the study was conducted, 58 (56%) volunteered to participate. The participating residents markedly exhibited negative attitudes toward the individual in the vignette with multiple inpatient psychiatric admissions. Residents also exhibited more negative attitudes toward individuals with schizophrenia, self-harm by way of overdose, psychedelic users, cannabis users, and alcohol problems compared to diabetic and Christian individuals. Conclusions Residents exhibited negative attitudes toward individuals with mental illness. Additional research would further our understanding of the reasons for physician bias. Moreover, GME programs and medical educators can play a crucial role in mitigating stigma among future physicians, thereby enhancing care for individuals with mental illness.

Effect on Diabetes Control in a Resident Clinic Following the Integration of a Clinic Pharmacist.

The impact of a pharmacist has been evaluated within the primary care setting but not within a resident-managed internal medicine clinic. This retrospective study found that the integration of a clinical pharmacist within a resident clinic improved the mean HbA1c of a high-risk patient group by 3% in 3 months and 2.6% in 6 months. None of the residents surveyed reported that the presence of a clinical pharmacist hindered their learning experience. The study also found the residents perceived the clinical pharmacist to be helpful with co-management of diabetes. This data supports the addition of a clinical pharmacist into a resident clinic and continues to support the benefits in the primary care setting.

Prioritizing Health Literacy Educational Objectives for Pediatric Residents - A Delphi Study.

OBJECTIVE: Children of caregivers with limited health literacy are at risk of poorer health outcomes. Thus, health literacy-informed communication tools are critical to achieving a more equitable health system. However, there is no agreement on the health literacy skills pediatric residents should attain. We used Delphi methodology to establish consensus on health literacy objectives to inform development of a pediatric resident curriculum. METHODS: Our Delphi panel participated in 3 rounds of anonymous surveys to rank the importance of health literacy objectives in pediatric resident education. Consensus was defined as ≥70% of panelists identifying an objective as essential or 100% agreeing an objective was recommended or essential. RESULTS: Thirteen pediatric health literacy experts comprised a racially, geographically, and professionally-diverse panel. After 3 survey rounds, 27 of the initial 65 objectives met consensus. All final objectives aligned with Accreditation Council for Graduate Medical Education (ACGME) core competencies. CONCLUSIONS: A panel of pediatric health literacy experts established consensus on health literacy objectives specific to pediatric resident training. These prioritized objectives align with ACGME core competencies, as well as evidence-based strategies like teach-back, and newer considerations like addressing organizational health literacy. They should inform future health literacy curricula and assessment within pediatric residency programs.

CD38 and extracellular NAD+ regulate the development and maintenance of Hp vaccine-induced CD4+ TRM in the gastric epithelium.

Tissue-resident memory T cells (TRM) can be induced by infection and vaccination, and play a key role in maintaining long-term protective immunity against mucosal pathogens. Our studies explored the key factors and mechanisms affecting the differentiation, maturation, and stable residence of gastric epithelial CD4+ TRM induced by Helicobacter pylori (Hp) vaccine and optimized Hp vaccination to promote the generation and residence of TRM.CD38 regulated mitochondrial activity and enhanced TGF-ß signal transduction to promote the differentiation and residence of gastric epithelial CD4+ TRM by mediating the expression of CD105. Extracellular nucleotides influenced the long-term maintenance of TRM in gastric epithelium by P2RX7. Vitamin D3 and Gram-positive enhancer matrix particles (GEMs)as immune adjuvants combined with Hp vaccination promoted the production of CD69+CD103+CD4+ TRM.

Enhancing Intraoperative Cholangiography Interpretation Skills: A Perceptual Learning Approach for Surgical Residents.

OBJECTIVE: Laparoscopic cholecystectomy is a commonly performed surgery with risk of serious complications. Intraoperative cholangiography (IOC) can mitigate these risks by clarifying the anatomy of the biliary tree and detecting common bile duct injuries. However, mastering IOC interpretation is largely through experience, and studies have shown that even expert surgeons often struggle with this skill. Since no formal curriculum exists for surgical residents to learn IOC interpretation, we developed a perceptual learning (PL)-based training module aimed at improving surgical residents' IOC interpretation skills. DESIGN: Surgical residents were assessed on their ability to identify IOC characteristics and provide clinical recommendations using an online training module based on PL principles. This research had 2 phases. The first phase involved pre/post assessments of residents trained via the online IOC interpretation module, measuring their IOC image recognition and clinical management accuracy (percentage of correct responses), response time and confidence. During the second phase, we explored the impact of combining simulator-based IOC training with the online interpretation module on same measures as used in the first phase (accuracy, response time, and confidence). SETTING: The study was conducted at Rush University Medical College in Chicago. The participants consisted of surgical residents from each postgraduate year (PGY). Residents participated in this study during their scheduled monthly rotation through Rush's surgical simulation center. RESULTS: Total 23 surgical residents participated in the first phase. A majority (95.7%) found the module helpful. Residents significantly increased confidence levels in various aspects of IOC interpretation, such as identifying complete IOCs and detecting abnormal findings. Their accuracy in making clinical management decisions significantly improved from pretraining (mean accuracy 68.1 +/- 17.3%) to post-training (mean accuracy 82.3 +/- 10.4%, p < 0.001). Furthermore, their response time per question decreased significantly from 25 +/- 12 seconds to 17 +/- 12 seconds (p < 0.001). In the second phase, we combined procedural simulator training with the online interpretation module. The 20, first year residents participated and 88% found the training helpful. The training group exhibited significant confidence improvements compared to the control group in various aspects of IOC interpretation with observed nonsignificant accuracy improvements related to clinical management questions. Both groups demonstrated reduced response times, with the training group showing a more substantial, though nonsignificant, reduction. CONCLUSION: This study demonstrated the effectiveness of a PL-based training module for improving aspects of surgical residents' IOC interpretation skills. The module, found helpful by a majority of participants, led to significant enhancements in clinical management accuracy, confidence levels, and decreased response time. Incorporating simulator-based training further reinforced these improvements, highlighting the potential of our approach to address the lack of formal curriculum for IOC interpretation in surgical education.

Association between regional phase angle and level of locomotion among older females requiring long-term care in a health facility.

[Purpose] This study aimed to determine the characteristics of regional phase angles based on locomotion level among older Japanese females requiring long-term care in a health facility. [Participants and Methods] This was a cross-sectional observational study. The participants included 91 residents (mean age ± standard deviation: 90.2 ± 5.6 years) admitted to an older health facility. Based on their indoor locomotion status, the participants were divided into three groups: group I, able to walk with or without walking aids; group II, able to move in a wheelchair without assistance; and group III, able to move in a wheelchair with assistance. The regional phase angle was measured using a bioimpedance device. [Results] Significant differences were observed in the regional phase angle of the upper limbs between groups I and III and between groups II and III; in that of the lower limbs among all groups; and in that of the trunk between groups I and II and between groups I and III. [Conclusion] The level of locomotion may be explained by the regional phase angles of the lower limbs.

Brown trout in Oder estuary tributaries: genetic structure, stocking, and admixture.

Several rivers that are tributaries of the Oder estuary are inhabited by Salmo trutta L, the most important of which are Ina, Gowienica, and Wolczenica. Both forms of the species, sea trout and resident brown trout, are present. All rivers are traditionally stocked with either sea trout from the neighboring Pomeranian river Rega basin or resident brown trout from various locations. To examine populations in these rivers in terms of genetic structure, genetic diversity, and origin, they were analyzed using 13 microsatellite loci. Relatedness was also assessed for fish stocked in the same year. The obtained genotypes were compared with breeding stocks used for stocking in Poland. The analyses revealed a significant genetic distance between adult individuals from Ina and Rega Rivers and fish caught during electrofishing. Strong kinship relationships were identified in the sampled areas, with high proportions of fish originating from stocking and their dominance in numbers over wild juveniles, primarily in smaller tributaries. Additionally, clear separation in the origin of stocked individuals was observed. Adult trout from Ina and Rega are genetically closer to northern brown trout lineages, providing crucial information for the management and biodiversity conservation of Polish Salmo trutta populations.

Tissue-resident memory CD103+CD8+ T cells in colorectal cancer: its implication as a prognostic and predictive liver metastasis biomarker.

BACKGROUND: Tissue-resident memory CD103+CD8+ T cells (CD103+CD8+ TRMs) are important components of anti-tumor immunity. However, the significance of CD103+CD8+ TRMs in colorectal cancer (CRC) and their advantages remain unclear. METHODS: Clinical data and specimens were used to evaluate the significance of CD103+CD8+ TRMs in CRC. A mouse subcutaneous tumorigenesis model and colony-formation assay were conducted to evaluate the anti-tumor effects of CD103+CD8+ TRMs. Finally, the infiltration density and function of CD103+CD8+ TRMs in the tumors were evaluated using flow cytometry. RESULTS: In this study, we showed that highly infiltrated CD103+CD8+ TRMs were associated with earlier clinical stage and negative VEGF expression in CRC patients and predicted a favorable prognosis for CRC/CRC liver metastases patients. Interestingly, we also found that CD103+CD8+ TRMs may have predictive potential for whether CRC develops liver metastasis in CRC. In addition, we found a positive correlation between the ratio of the number of α-SMA+ vessels to the sum of the number of α-SMA+ and CD31+ vessels in CRC, and the infiltration level of CD103+CD8+ TRMs. In addition, anti-angiogenic therapy promoted infiltration of CD103+CD8+ TRMs and enhanced their ability to secrete interferon (IFN)-γ, thus further improving the anti-tumor effect. Moreover, in vivo experiments showed that compared with peripheral blood CD8+ T cells, CD103+CD8+ TRMs infused back into the body could also further promote CD8+ T cells to infiltrate the tumor, and they had a stronger ability to secrete IFN-γ, which resulted in better anti-tumor effects. CONCLUSION: We demonstrated that CD103+CD8+ TRMs have the potential for clinical applications and provide new ideas for combined anti-tumor therapeutic strategies, such as anti-tumor angiogenesis therapy and CAR-T combined immunotherapy.

Service provision conditions for foreign residents in municipalities in Japan.

Objectives: This study examined the actual conditions of service provision to foreign residents (FRs) addressing prevention of lifestyle-related diseases (LRDs) and disaster preparedness/disaster responses (DPRs) in Japanese municipalities. Materials and Methods: A cross-sectional study was performed using a self-administered questionnaire with representatives of public health nurses in each municipality in Japan from December 2021 to January 2022. Results: Services considering FRs are more likely to be implemented in cities than in towns, and in municipalities where FRs account for ≥2.2% of the population (proportion of FRs in the Japanese population at the time of the study) than in those with fewer FRs. Cities have larger populations and greater financial resources than towns. Factors associated with the implementation of services and measures necessary for providing services to FRs were the classification of the municipality as a city, a high percentage of FRs, and large variation in corresponding nationalities/countries of origin. Conclusions: Cross-disciplinary efforts and collaborations need to be strengthened to share available resources within local governments and experiences in providing services for FRs in other divisions/sections, rather than considering only how to provide services for FRs in the public health division/section.

A review on the energy in buildings: Current research focus and future development direction.

Currently, although energy conservation related research in buildings is a matter of great urgency in the context of an ever more serious energy crisis, people seem to pay more attention on the field of civil engineering, such as the design, construction, monitoring and maintenance management of building structures. This is also evidenced by the authors' extensive research and strong practical engineering experience in infrastructure projects such as bridges. This study first presents the general building energy situation. The state of the art of the energy in buildings is then reviewed, followed by pointing out the intelligent monitoring-based future direction, and then the final goal towards the smart city can be expected. Specifically, more than one hundred published papers are selected for sample analysis, taking into account different research topics and different publication dates etc. The research topics, research methods and research conclusions of these published papers are very different, and they have not yet produced results that could be generally accepted. Actually, most of the published papers focus on the analysis and conservation of building energy, including the energy model for analysis and prediction, the energy affected by resident behavior and building forms, the renewable energy utilization and zero energy building. While a small part of the published papers is concerned with the resilient structural energy dissipation and collapse-resistant. Furthermore, the intelligent monitoring of building energy, supported by advanced sensor development and big data analysis technology, is also providing us a more promising future on the way to the smart city. It should be further noted that the design and construction codes or standards related to building energy have not yet been retrieved, and these have a strong guiding significance for engineering practice. Therefore, more research needs to be done to expect a better practical outcome.

Generation of functionally active resident macrophages from adipose tissue by 3D cultures.

Introduction: Within adipose tissue (AT), different macrophage subsets have been described, which played pivotal and specific roles in upholding tissue homeostasis under both physiological and pathological conditions. Nonetheless, studying resident macrophages in-vitro poses challenges, as the isolation process and the culture for extended periods can alter their inherent properties. Methods: Stroma-vascular cells isolated from murine subcutaneous AT were seeded on ultra-low adherent plates in the presence of macrophage colony-stimulating factor. After 4 days of culture, the cells spontaneously aggregate to form spheroids. A week later, macrophages begin to spread out of the spheroid and adhere to the culture plate. Results: This innovative three-dimensional (3D) culture method enables the generation of functional mature macrophages that present distinct genic and phenotypic characteristics compared to bone marrow-derived macrophages. They also show specific metabolic activity and polarization in response to stimulation, but similar phagocytic capacity. Additionally, based on single-cell analysis, AT-macrophages generated in 3D culture mirror the phenotypic and functional traits of in-vivo AT resident macrophages. Discussion: Our study describes a 3D in-vitro system for generating and culturing functional AT-resident macrophages, without the need for cell sorting. This system thus stands as a valuable resource for exploring the differentiation and function of AT-macrophages in vitro in diverse physiological and pathological contexts.

Dural Closure Training With Prototyped Model.

INTRODUCTION: The hermetic closure of the dura mater is a critical step in neurosurgical training, often undervalued but crucial to preventing serious complications such as cerebrospinal fluid (CSF) leaks leading to meningitis and death. Inadequate closure, often due to insufficient training, can result in challenging complications, including prolonged hospitalization and reoperation. OBJECTIVE: To address the deficiencies in dural closure training, this study aims to describe a 3D prototype for simulating post-craniotomy dura mater suturing. The objective is to reduce the incidence of CSF leaks and improve the training of neurosurgery residents. DESIGN: The study involves the creation of a 3D prototype based on magnetic resonance imaging and computed tomography scans. The additive manufacturing of structures is performed using ABS filament, and a silicone rubber membrane is used to simulate the meningeal dura mater. Neurosurgery residents undergo training using this model, and the effectiveness is evaluated. SETTING: The study is conducted at the Institute of Neurology of Curitiba (Hospital INC), focusing on neurosurgery residents from the first to fifth year of residency. PARTICIPANTS: Seven residents participate in the study, with varying levels of experience in dural closure procedures. The training involves a simulated surgical environment using the 3D prototype. RESULTS: After training, residents show improvements in confidence and theoretical knowledge related to dural closure. Binary questions indicate a strong desire for more practical training on dural closure, with 85.7% believing in the essential role of 3D molds in their neurosurgery training. CONCLUSION: The study highlights the importance of adequate training for dural closure to prevent serious complications in neurosurgery. The use of 3D simulation models, despite some limitations, proves to be an effective educational strategy. The emerging technology of bioprinting holds promise for further enhancing simulation materials, bringing medical education closer to realistic tissue replication.

Examining the Most Impactful Strategies for In-service Preparation: A Systemic Review.

INTRODUCTION: Resident performance on the Plastic Surgery In-Service Examination (PSITE) is used as a predictor of success on the American Board of Plastic Surgery Written Examination, as well as resident progression and fellowship applications. However, information specifically addressing strategies on optimal PSITE preparation is lacking in the plastic surgery literature when compared to general surgery. For this reason, we aim to understand if the topic is well-studied and denote effective study strategies and curricular interventions in both fields that can help residents and programs optimize PSITE performance. METHODS: A literature search including studies from 2012 to 2022 was conducted following PRISMA guidelines in PubMed and EMBASE to identify articles on strategies to improve in-service exam scores for general surgery and plastic surgery. Only studies that reported measurable outcomes in raw score, percentile score, or percent correct were included. RESULTS: Qualitative analysis of 30 articles revealed 2 categories of interventions: individual study habits and institutional curricular interventions. In general surgery literature, 27 articles examined interventions positively impacting resident ABSITE scores, with 21 studies classified as institutional curricular interventions and 6 articles addressing individual study habits. Themes associated with improved ABSITE performance included mandatory remediation programs, dedicated study time, and problem-based learning interventions. In contrast, only 3 articles in plastic surgery literature discussed interventions associated with improved PSITE scores, all falling under curricular interventions. CONCLUSION: Unfortunately, the plastic surgery literature lacks concrete evidence on how residents can improve performance. Future research in plastic surgery should replicate successful strategies from general surgery and further investigate optimal preparation strategies for the PSITE. Such endeavors can contribute to improving resident performance and advancing plastic surgery education and patient care.

Reconstitution of human microglia and resident T cells in the brain of humanized DRAGA mice.

Humanized mouse models are valuable tools for investigating the human immune system in response to infection and injury. We have previously described the human immune system (HIS)-DRAGA mice (HLA-A2.HLA-DR4.Rag1KO.IL-2RgKO.NOD) generated by infusion of Human Leukocyte Antigen (HLA)-matched, human hematopoietic stem cells from umbilical cord blood. By reconstituting human cells, the HIS-DRAGA mouse model has been utilized as a "surrogate in vivo human model" for infectious diseases such as Human Immunodeficiency Virus (HIV), Influenza, Coronavirus Disease 2019 (COVID-19), scrub typhus, and malaria. This humanized mouse model bypasses ethical concerns about the use of fetal tissues for the humanization of laboratory animals. Here in, we demonstrate the presence of human microglia and T cells in the brain of HIS-DRAGA mice. Microglia are brain-resident macrophages that play pivotal roles against pathogens and cerebral damage, whereas the brain-resident T cells provide surveillance and defense against infections. Our findings suggest that the HIS-DRAGA mouse model offers unique advantages for studying the functions of human microglia and T cells in the brain during infections, degenerative disorders, tumors, and trauma, as well as for testing therapeutics in these pathological conditions.

Is it time for anatomists to enter the OT? Their role in clinical anatomy education of residents: A pre-trial survey research among surgeons.

OBJECTIVE: This study aimed to assess the perceived need among surgical residents to revisit their anatomical knowledge and evaluate their attitude towards integrating clinical anatomists into surgical residency program curriculum. BACKGROUND: While medical students learn human anatomy during undergraduate years, the practical application of clinically oriented anatomy becomes vital in surgical specialties. However, this aspect has not been adequately addressed in Indian surgical residency programs. METHODS: An 11-item questionnaire, including closed-ended and Likert-scale questions, was administered to 153 surgical residents. Consent was obtained, and responses were collected via Google Forms. RESULTS: Half of the respondents (50%) felt confident in their self-directed anatomy learning, but 87% believed integrating clinical anatomists would enhance their surgical expertise. Additionally, 88% saw value in revisiting cadaveric dissection. Third-year residents showed a significantly higher inclination towards cadaveric dissection. Deficiencies in the curriculum and time constraints were identified as major barriers. CONCLUSION: The study highlights a perceived need among surgical residents to augment their anatomical knowledge, advocating for the integration of clinical anatomists and cadaveric dissection into training. A collaborative approach, emphasizing both horizontal and vertical integration of anatomy, is recommended to enhance surgical education and practice. (Tab. 4, Fig. 1, Ref. 25).

The Multifaceted Role of Tissue-Resident Memory T Cells.

Regionalized immune surveillance relies on the concerted efforts of diverse memory T cell populations. Of these, tissue-resident memory T (TRM) cells are strategically positioned in barrier tissues, where they enable efficient frontline defense against infections and cancer. However, the long-term persistence of these cells has been implicated in a variety of immune-mediated pathologies. Consequently, modulating TRM cell populations represents an attractive strategy for novel vaccination and therapeutic interventions against tissue-based diseases. Here, we provide an updated overview of TRM cell heterogeneity and function across tissues and disease states. We discuss mechanisms of TRM cell-mediated immune protection and their potential contributions to autoimmune disorders. Finally, we examine how TRM cell responses might be durably boosted or dampened for therapeutic gain.

Microcirculatory disturbance in acute liver injury is triggered by IFNγ-CD40 axis.

BACKGROUND: Acute liver failure (ALF) is a life-threatening disorder that progresses from self-limiting acute liver injury (ALI). Microcirculatory disturbance characterized by sinusoidal hypercoagulation and subsequent massive hypoxic hepatocyte damage have been proposed to be the mechanism by which ALI deteriorates to ALF; however, the precise molecular pathway of the sinusoidal hypercoagulation remains unknown. Here, we analyzed ALI patients and mice models to uncover the pathogenesis of ALI with microcirculatory disturbance. METHODS: We conducted a single-center retrospective study for ALI and blood samples and liver tissues were analyzed to evaluate the microcirculatory disturbance in ALI patients (n = 120). Single-cell RNA sequencing analysis (scRNA-seq) was applied to the liver from the concanavalin A (Con A)­induced mouse model of ALI. Interferon-gamma (IFNγ) and tumor necrosis factor-alpha knockout mice, and primary human liver sinusoidal endothelial cells (LSECs) were used to assess the mechanism of microcirculatory disturbance. RESULTS: The serum IFNγ concentrations were significantly higher in ALI patients with microcirculatory disturbance than in patients without microcirculatory disturbance, and the IFNγ was upregulated in the Con A mouse model which presented microcirculatory disturbance. Hepatic IFNγ expression was increased as early as 1 hour after Con A treatment prior to sinusoidal hypercoagulation and hypoxic liver damage. scRNA-seq revealed that IFNγ was upregulated in innate lymphoid cells and stimulated hepatic vascular endothelial cells at the early stage of liver injury. In IFNγ knockout mice treated with Con A, the sinusoidal hypercoagulation and liver damage were remarkably attenuated, concomitant with the complete inhibition of CD40 and tissue factor (TF) upregulation in vascular endothelial cells. By ligand-receptor analysis, CD40-CD40 ligand interaction was identified in vascular endothelial cells. In human LSECs, IFNγ upregulated CD40 expression and TF was further induced by increased CD40-CD40 ligand interaction. Consistent with these findings, hepatic CD40 expression was significantly elevated in human ALI patients with microcirculatory disturbance. CONCLUSION: We identified the critical role of the IFNγ-CD40 axis as the molecular mechanism of microcirculatory disturbance in ALI. This finding may provide novel insights into the pathogenesis of ALI and potentially contribute to the emergence of new therapeutic strategies for ALI patients.

Unlocking Peer Review: Elevating Scholarly Writing and Research Competence in Urology Residency.

PURPOSE OF REVIEW: It is incumbent upon training programs to set the foundation for evidence-based practices and to create opportunities for trainees to develop into academic leaders. As dedicated resident research time and funding have declined in recent years, residency programs and the field at large will need to create new ways to incorporate scholarly activity into residency curricula. RECENT FINDINGS: Literature across specialties demonstrates barriers to resident involvement including lack of time, cost, and absent scholarly mentorship. Peer review stands as a ready-made solution that can be formalized into a collaborative relationship with journals. A formal relationship between professional societies, academic journals, and residencies can facilitate the use of peer review as a teaching tool for residency programs.

Comparison of human cadaver and blue phantom for teaching ultrasound-guided regional anesthesia to novice postgraduate students of anesthesiology: A randomized controlled trial.

Background and Aims: Simulation is increasingly used in medical teaching. Various studies have evaluated different simulation models for training of regional anesthesia (RA). We compared the use of human cadaver and blue phantom models for training of regional anesthesia to novice postgraduate students of anesthesiology. Material and Methods: Fifty students were taught knobology of the ultrasonography (USG) machine. They were divided into two equal groups by computer-generated random number table, and the groups assigned were kept in sealed envelopes. In group BP, students were trained on a blue phantom model, and in group HC, students were trained on human cadaver. After training, a didactic video of sonoanatomy of the supraclavicular block was shown to all participants. The block performance was then judged on patients requiring supraclavicular block. The primary objective of the study was to compare the block performance time, and secondary objectives were the quality of image acquired, orientation of transducer to the target, identification of ultrasound artifacts, errors committed, complications, and success rate. Results: The mean block performance time was shorter in group HC compared to group BP (451.96 ± 50.25 and 526.48 ± 43.486 s, respectively; P < 0.001). The image quality score, transducer orientation to the target, and identification of USG artifacts were better in group HC compared to group BP, with lesser number of needle passes. Conclusion: Cadaver-based training produced better results compared to blue phantom simulator model for teaching of ultrasound-guided RA to novice postgraduate trainees of anesthesiology.