Advances in medical education and practice
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The autopsy has traditionally been used as a tool in undergraduate medical education, but recent decades have seen a sharp decline in their use for teaching. This study reviewed the current status of the autopsy as a teaching tool by means of systematic review of the medical literature, and a questionnaire study involving UK medical schools. ⋯ Maximal use of autopsies for teaching may be achieved by involvement of anatomical pathology technologists and trainee pathologists in teaching, the development of alternative teaching methods using the principles of the autopsy, and clarification of the law. Students gain most benefit from repeated attendance at autopsies, being taught by enthusiastic teachers, when they have been effectively prepared for the esthetic of dissection and the mortuary environment.
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The transition period from foundation program doctor to specialty trainee can be difficult for junior doctors. This difficult period often acts as a major obstacle for learning in the workplace. Existing induction programs are commonly seen as inadequate at easing this transition, and therefore, a pilot study intervention was undertaken to assess if the initiation of "learner-centered induction programs" could help improve the confidence, knowledge acquisition, and satisfaction of junior doctors as they begin specialty training in neurosurgery. ⋯ Finally, as the induction program was of a greater duration than the traditional half day, they felt they had sufficient time to ask questions and address concerns while "on the job". Overall, "learner-centered induction programs" did appear to show promise in this pilot study with regards to increasing the confidence of junior doctors starting a neurosurgical placement and helped ease the transition process from foundation doctor to specialty trainee in neurosurgery. We believe further work to formalize and quantify these findings using questionnaires and a larger sample group as well as across successive is indicated and may help junior doctor learning and transition processes in future practice.
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Although Peyton's four-step approach is a widely used method for skills-lab training in undergraduate medical education and has been shown to be more effective than standard instruction, it is unclear whether its superiority can be attributed to a specific single step. ⋯ Our study identified Peyton's Step 3 as being the most crucial part within Peyton's four-step approach, contributing significantly more to learning success than the previous steps and reaching beyond the benefit of a mere repetition of skills demonstration.
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Stress and burnout impact resident physicians. This prospective study tests the hypothesis that a mindfulness-based resilience intervention would decrease stress and burnout in residents. ⋯ Residents who are female, PGY1 and PGY2, and who perceive residency to be stressful may benefit most from a mindfulness-based resilience intervention.
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Assessment of clinical competencies by direct observation is problematic for two main reasons the identity of the examinee influences the assessment scores, and direct observation demands experts at the exact location and the exact time. Recording the performance can overcome these problems; however, managing video recordings and assessment sheets is troublesome and may lead to missing or incorrect data. ⋯ A local software solution may also ease the need for customization to local needs and integration into existing user databases or project management software. We developed an integrable web-based solution for easy assessment of video-recorded performances (ISEA).