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Background: POCUS is valuable in primary care, yet outpatient‐specific point‐of‐care ultrasound (POCUS) curriculum integration into internal medicine (IM) residency is limited. We addressed this gap by developing a thyroid POCUS workshop for IM residents. Aim: Develop and implement an educational curriculum to integrate thyroid POCUS into an IM residency program and evaluate the impact on resident knowledge, perceived skills, and attitudes. Setting: The study was conducted in a resident primary care clinic at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Residency Program in Internal Medicine at North Shore University Hospital and Long Island Jewish Medical Center. Participants: All 108 IM residents (PGY1‐3) in one program participated in the study during their ambulatory clinic block. Program description: Residents participated in a 1‐hour workshop involving a didactic session and two breakout groups: one for hands‐on practice and another for case‐based discussions with image review. Program evaluation: Residents completed pre‐ and post‐session surveys assessing knowledge, perceived skills, and attitudes toward thyroid POCUS. These data showed statistically significant increases in all assessed areas. Discussion: Integrating thyroid POCUS into an IM residency curriculum significantly improved resident knowledge, attitudes, and perceived skills related to these exams. Residents valued this learning experience and expressed intentions to incorporate it into their future practice. [ABSTRACT FROM AUTHOR]

Background: A growing number of wearable devices claim to provide accurate, cheap and easily applicable heart rate variability (HRV) indices. This is mainly accomplished by using wearable photoplethysmography (PPG) and/or electrocardiography (ECG), through simple and non-invasive techniques, as a substitute of the gold standard RR interval estimation through electrocardiogram. Although the agreement between pulse rate variability (PRV) and HRV has been evaluated in the literature, the reported results are still inconclusive especially when using wearable devices.

Objective: A paradigm shift towards a PBL bidirectional dialogic feedback can enhance learners' performance. This study aimed to investigate undergraduate medical students' perceptions of their PBL feedback. Methods: We sent e-mail invitations to a web-based survey to year one and two students at College of Medicine, King Saud University. Items included the process, content, and benefits of PBL feedback. Results: Of 209 respondents, 110 (53%) were first and 99 (47%) were second-year students. About 50% agreed that the feedback was regularly provided at scheduled timing and 72% perceived feedback environment as non-threatening. Agreement rates that the tutors asked students first to assess their performance, tell them what went well, what the areas for improvement are and develop with them an improvement plan were 59%, 61%, 61% and 52%, respectively. 61% agreed that tutors judged performance not personality. More year one students significantly agreed that the PBL feedback helped them to improve their knowledge acquisition and non-technical skills. Conclusion: Many of our PBL tutors have started the shift to a dialogic bidirectional feedback. We recommend continuing the faculty development efforts, peer-reviewing, and seeking student's feedback within the academic quality satisfaction surveys. [ABSTRACT FROM AUTHOR]

Background/Aims: This study aimed to design a structured simulation training curriculum for upper endoscopy and validate a new assessment checklist. Materials and Methods: A proficiency-based progression stepwise curriculum was developed consisting of didactic, technical and non-technical components using a virtual reality simulator (VRS). It focused on: scope navigation, anatomical landmarks identification, mucosal inspection, retro-flexion, pathology identification, and targeting biopsy. A total of 5 experienced and 10 novice endoscopists were recruited. All participants performed each of the selected modules twice, and mean and median performance were compared between the two groups. Novices pre-set level of proficiency was set as 2 standard deviations below the mean of experts. Performance was assessed using multiple-choice questions for knowledge, while validated simulator parameters incorporated into a novel checklist; Simulation Endoscopic Skill Assessment Score (SESAS) were used for technical skills. Results: The following VRS outcome measures have shown expert vs novice baseline discriminative ability: total procedure time, number of attempts for esophageal intubation and time in red-out. All novice trainees achieved the preset level of proficiency by the end of training. There were no statistically significant differences between experts' and trainees' rate of complications, landmarks identification and patient discomfort. SESAS checklist showed high degree of agreement with the VRS metrices (kappa = 0.83) and the previously validated direct observation of procedural skills tool (kappa = 0.90). Conclusion: The Fundamentals of Gastrointestinal Endoscopy simulation training curriculum and its SESAS global assessment tool have been primarily validated and can serve as a valuable addition to the gastroenterology fellowship programs. Follow up study of trainee performance in workplaces is recommended for consequences validation. [ABSTRACT FROM AUTHOR]

Academic misconduct/dishonesty has become widespread behavior among many university students across the globe, and medical education is not an exception. Until recently, few efforts have been made to study the dishonest behavior in Middle-Eastern universities. This study examined the prevalence and predisposing factors of cheating among medical students in Saudi Arabia and suggests suitable preventive measures. A cross-sectional survey-based study was conducted at a government medical college during the 2014–2015 academic year. The response rate was 58.5% (421/720). The overall cheating behavior practiced by the participants was 29%, predominantly by male students. High GPA scoring students were the least likely to cheat. The participants living with their families were more likely to cheat compared to those who were living apart from their families. The reasons participants gave to justify their cheating behavior included getting better grades, passing the course, and lacking preparation while still recognizing that cheating is a ‘mistake.’ Overall, significant academic misconduct concerning cheating was found among the Saudi medical students; this misconduct is alarming in a reputable government institution. The implementation of strict punishments, requiring ethical courses and creating ethical awareness by exploiting the potential of Islamic religious belief might help to control this problem. [ABSTRACT FROM AUTHOR]

Background: Information technology (IT) is widely used in medical education. However, there are not enough studies about IT uses and preferences among traditional and problem-based learning (PBL) medical students. Aim: To compare IT skills, uses and preferences for education between traditional and PBL medical students’. Method: A cross-sectional study; a modified Educause Center for Analysis and Research online survey was sent to traditional curriculum 5th and PBL 4th year medical students of King Saud University. Results: Most of the responding 176 students prefer mobile devices and moderate amount of IT in education. Fourth and fifth year students perceived high academic value of Google (94.2 vs. 86.7%, p = 0.34), YouTube (90.7 vs. 92.2%, p = 0.83) and PubMed (83.7 vs. 86.7%, p = 0.06). More 4th year than 5th year students rated themselves as skilled in learning management system (54.7 vs. 21.1%, p = 0.0001) and Smartboard use (40.7 vs. 23.3%, p = 0.04). Most students rated faculty IT skills as effective. Students agreed that technology helps working faster (95.5%) and make learning creative (85.9%). Conclusions: More integration of information literacy and IT training in medical curricula is needed to enhance better utilization of full features of IT resources available for learning and problem solving. National multi-institutional studies are recommended. [ABSTRACT FROM AUTHOR]

Background: Qualitative and quantitative evaluation of academic programs can enhance the development, effectiveness, and dissemination of comparative quality reports as well as quality improvement efforts. Objectives: To evaluate the five research methodology workshops through assessing participants' satisfaction, knowledge and skills gain and impact on practices by the Kirkpatrick's evaluation model. Methods: The four level Kirkpatrick's model was applied for the evaluation. Training feedback questionnaires, pre and post tests, learner development plan reports and behavioral surveys were used to evaluate the effectiveness of the workshop programs. Results: Of the 116 participants, 28 (24.1%) liked with appreciation, 62 (53.4%) liked with suggestions and 26 (22.4%) disliked the programs. Pre and post MCQs tests mean scores showed significant improvement of relevant basic knowledge and cognitive skills by 17.67% ( p ≤ 0.005). Pre-and-post tests scores on workshops sub-topics also significantly improved for the manuscripts ( p ≤ 0.031) and proposal writing ( p ≤ 0.834). As for the impact, 56.9% of participants started research, and 6.9% published their studies. The results from participants' performance revealed an overall positive feedback and 79% of participant reported transfer of training skills at their workplace. Conclusion: The course outcomes achievement and suggestions given for improvements offer insight into the program which were encouraging and very useful. Encouraging 'research culture' and work-based learning are probably the most powerful determinants for research promotion. These findings therefore encourage faculty development unit to continue its training and development in the research methodology aspects. [ABSTRACT FROM AUTHOR]

An abstract of the article "Diagnostic accuracy of fibroscan in assessment of fibrosis stage in patients with chronic liver disease" by Awny A. Abdelrahman and others is presented.

Background Traditionally, learning is thought to occur best when prerequisite cognitive background information is delivered before simulation training. More recent studies have attempted to analyze the transformative nature of simulation by placing simulation before didactics. However, these studies were flawed as they provided background on the subject before the simulation itself. Our study aims to isolate the transformative effect of simulation and answer the question of whether lecture or simulation should come first. Methodology We designed a novel simulation session and accompanying lecture for 18 Emergency Medicine residents in all three years of training regarding a subject they were entirely unfamiliar with, the emergent management of a left ventricular assist device (LVAD). The residents were randomized into two groups. One group had the lecture (8/18) before their simulation, while the other group (10/18) had the simulation first and the lecture afterward, testing the motivational nature. Thereafter, both groups responded to a post-session survey with Likert-style and open-ended comment questions to assess the reaction to the session and a knowledge-based multiple-choice question test. Results Both groups did not score significantly differently on either the immediate post-test or a retention post-test that we administered four weeks later. Three of eight participants reported in open comments that they were much more comfortable with a lecture-first than a simulation-first format. Conclusions Despite controlling for some of the limitations of previous studies, our results including learners' preferences do not support a transformation in the sequence of clinical skills learning. Until other larger studies prove the opposite, we recommend continuing with the lecture followed by the simulation sequence as per existing conceptual simulation learning frameworks., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Khowong et al.)

Background and Objectives: In 2016 we published a stepwise evidence-based model (subsequently named SimSteps) for curriculum development (CD) of simulation-based courses. The current study aimed to assess the uses, user friendliness, and perceived effectiveness of this model and its worksheet and to obtain suggestions for improvement., Methods: We sent e-mail invitations for a 14-question web-based survey to 13 health professionals who requested the supplemental worksheet of the stepwise model and 11 authors who cited the model's publication in 14 articles. The survey included quantitative and qualitative items., Results: Sixteen (67%) from seven countries and six professions responded. Ten (63%) used the model: six for both course and faculty development, three for course development only, and one for faculty development only. Both users and nonusers found the model and worksheet applicable and user friendly and agreed that they guided use of a systematic, comprehensive approach to CD. 94% (15 of 16) agreed that they helped CDers integrate educational effectiveness criteria, develop more objective learners' assessment tools, and enhance validity for their courses. Sixty-nine percent (11 of 16) agreed that model and its worksheet helped CDers include nontechnical skills in courses. The highest reported role in enhancing program evaluation results was in the gain of knowledge (five of eight, 63%) and least was clinical outcomes (two of eight, 25%). All respondents would recommend the model and worksheet to a colleague., Conclusion: Respondents find the stepwise model and its worksheet user friendly and helpful in developing simulation curricula of high educational standards. Future studies should include larger sample size, objective measures of impact, and longer-term follow-up., Competing Interests: Conflicts of Interest: The authors declare no conflict of interest., (© 2020 by JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons.)

Introduction: In addition to their lipid-lowering effect, statins have pleiotropic effects that may extend their use to the treatment and prevention of various other diseases such as cancer, osteoporosis, multiple sclerosis, rheumatoid arthritis, type 2 diabetes, and Alzheimer's disease. Consequently, the number of patients taking statins is expected to increase. A side effect of statins, statin-induced myopathy, which may result from reduced muscular coenzyme Q10 levels, limits their use. The current study investigates if supplementing with CoQ10 could ameliorate statin induced myopathy., Materials and Methods: Forty adult male albino rats were randomized into 4 groups, with 10 rats per group. The following was administered to the rats using oral gavage for 4 weeks: Group 1: 2 ml of 0.5% carboxymethyl cellulose once daily. Group 2: 100 mg/kg/ day coenzyme Q10 dissolved in 2 ml of cotton seed oil. Group 3: 10 mg/kg once daily atorvastatin dissolved in 0.5% carboxymethyl cellulose. Group 4: concomitantly received CoQ10 and atorvastatin similar to groups 2 and 3 respectively. Plasma creatine kinase levels were measured by using spectrophotometer. The right extensor digitorum longus muscle sections were stained for histological (Haematoxylin & Eosin, Masson trichrome and Phosphotungstic acid haematoxylin) and immunohistochemical (cytochrome C and Bax) examinations. Quantitative measures of cytochrome C and Bax were carried out using image analyzer., Results: Atorvastatin induced increased total creatine kinase, skeletal muscle variations in the sizes and shapes, necrosis, disorganization, nuclear pyknosis, karyorrhexis, karyolysis, dismantled plasma membrane, excess collagen fibers and lipid deposition in addition to loss of cross striation. Atorvastatin increased the intensity of the immune-positive reactions of cytochrome C and Bax. These changes were ameliorated by concomitantly giving coenzyme Q10., Conclusion: CoQ10 may ameliorate atorvastatin induced skeletal muscle injury.