Search

Background: Burnout is being experienced by medical students, residents, and practicing physicians at significant rates. Higher levels of Hardiness and Emotional Intelligence may protect individuals against burnout symptoms. Previous studies have shown both Hardiness and Emotional IntelIigence protect against detrimental effects of stress and can be adapted through training; however, there is limited research on how training programs affect both simultaneously. Therefore, the objective of this study was to define the association of Hardiness and Emotional Intelligence and their potential improvement through hyper realistic immersion simulation training in military medical students., Methods: Participants in this study consisted of 68 second year medical students representing five medical schools who were concurrently enrolled in the United States military scholarship program. During a six day hyper-realistic surgical simulation training course, students rotated through different roles of a medical team and responded to several mass-casualty scenarios. Hardiness and Emotional Intelligence were assessed using the Hardiness Resilience Gauge (HRG) and the Emotional Quotient Inventory (EQ-I 2.0) respectively, at two time points: on arrival (pre-event) and after completion of the course (post-event)., Results: Hardiness and Emotional Intelligence scores and sub scores consistently improved from pre-event to post-event assessments. No difference in training benefit was observed between genders but differences were observed by age where age was more often associated with Emotional Intelligence. In addition, factor analysis indicated that the HRG and EQ-I 2.0 assessment tools measured predominately different traits although they share some commonalities in some components., Conclusion: This study indicates that Hardiness and Emotional Intelligence scores can be improved through immersion training in military medical students. Results from this study support the use of training course interventions and prompt the need for long term evaluation of improvement strategies on mitigating burnout symptoms., (Copyright © 2020 White, Zapata, Lenz, Ryznar, Nevins, Hoang, Franciose, Safaoui, Clegg and LaPorta.)

Intro: This project expanded upon previous exploration of emotional intelligence during the habituation for military second year medical students undergoing high-stress simulation with trauma and surgical skill training. The objective was to interpret emotional intelligence data before and after hyper-realistic immersion trauma training and to include a larger sample size than previously investigated., Methods: Fifty increasingly intense mass casualty scenarios with simulated Emergency Department (ED) and Operating Room (OR) procedures were performed while students lived as if deployed in an Afghan village. Students rotated through a variety of roles in both the ED and the OR throughout the weeklong program. Second year medical students completed the EQ-i 2.0 Model for Emotional Intelligence on the first and last day of the intensive surgical skills week. Three different cohorts from three different graduating classes were followed with a total sample size of 96. Emotional intelligence in this model is defined as a combination of 5 domains each with three subdomains., Results: A statistical analysis of the EQ data shows significant improvement in almost every subdomain of Emotional Intelligence from pre to post testing. The total EQ score was significantly higher with an average improvement of 3.95 points. All of the subdomains, except for emotional expression, empathy, and problem solving significantly improved following the intensive skills course. A 3 factor ANOVA including year and gender was also performed. R 2 of the change in pre to post scores was around 90%, indicating practical significance in the score improvements., Conclusion and Impact: Total emotional intelligence significantly improved from pre to post scores as well as each of the 5 domains and most subdomains. Scores improved an average of 4 points after only a 5-day training course. This training led to the most improvement in the self-perception and stress management categories. Medicine, especially high stress specialties like surgery and trauma, require physicians who are able to make decisions at a moment's notice and cope well with stressful situations. It is essential that individuals develop these intangible skills, which can be measured by emotional intelligence. Further research is needed to determine the long-term impacts of the increased emotional intelligence seen with hyper-realistic training. Some specific areas to investigate include physician performance and emotional wellbeing., (Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Shotguns cause a wide variety of injuries, depending on the weapon-victim distance and the type of the gun and pellets. It has been suggested that the probability of significant internal injuries cannot be predicted using physical examination alone, and several wound classification systems have been proposed to facilitate clinical decision-making., Objective: To evaluate the sensitivity of clinical examination and assess the role of a new classification system to detect significant injuries caused by shotguns., Patients and Methods: The medical records of 56 consecutive patients admitted to a Level I trauma center with shotgun wounds from January 1994 to December 1996 were reviewed. Clinical examination was the main tool to select patients for emergency operation or nonoperative management. Wounds were classified by the number of body areas (abdomen, chest, head and neck, extremities) involved: grade I involved more than two areas, grade II two adjacent areas, and grade III one area., Results: Twelve patients had type I wounds, 25 had type II wounds, and 19 had type III wounds. Nineteen major operations for intrathoracic, intra-abdominal or peripheral vascular injuries were done on 16 patients, as well as 10 orthopedic, ophthalmological and urological procedures and three emergency room thoracotomies,. No differences were found in the incidence of operations, morbidity, mortality, or length of hospital stay among the three groups. Clinical examination was 100% sensitive and 93% specific in identifying the presence of significant organ injuries and need for emergency operation. Three patients had unnecessary abdominal explorations because they received anesthesia for other procedures and could not be reliably followed up clinically., Conclusions: Clinical examination is the most reliable tool to identify patients who require emergency operation after shotgun wounds. Classification systems provide only crude information and do not predict reliably the presence of significant internal injuries.