Explore the vast range of titles available.

ObjectiveThe COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this study was to explore the perceptions and experiences of healthcare workers (HCWs) in relation to COVID-19 and care delivery models implemented to deal with the pandemic in the UK.MethodsThe study was designed as a rapid appraisal combining: (1) a review of UK healthcare policies (n=35 policies), (2) mass media and social media analysis of front-line staff experiences and perceptions (n=101 newspaper articles, n=1 46 000 posts) and (3) in-depth (telephone) interviews with front-line staff (n=30 interviews). The findings from all streams were analysed using framework analysis.ResultsLimited personal protective equipment (PPE) and lack of routine testing created anxiety and distress and had a tangible impact on the workforce. When PPE was available, incorrect size and overheating complicated routine work. Lack of training for redeployed staff and the failure to consider the skills of redeployed staff for new areas were identified as problems. Positive aspects of daily work reported by HCWs included solidarity between colleagues, the establishment of well-being support structures and feeling valued by society.ConclusionOur study highlighted the importance of taking into consideration the experiences and concerns of front-line staff during a pandemic. Staff working in the UK during the COVID-19 pandemic advocated clear and consistent guidelines, streamlined testing of HCWs, administration of PPE and acknowledgement of the effects of PPE on routine practice.

Audience: This session is intended for first- and second-year medical students, or any pre-clinical medical students. Introduction: Preclinical learners build skills and confidence when they practice first responder tasks early in training, and simulation helps them to perform basic procedures better.1,2 A small group case competition uses a game format to reinforce rapid assessment, clear team roles, and closed-loop communication.3,4 Out-of-hospital cardiac arrest affects hundreds of thousands of people in the United States each year, and survival to discharge is low. Bystander cardiopulmonary resuscitation (CPR) and early use of an automated external defibrillator (AED) improve outcomes.5,6 Anaphylaxis is a time-sensitive emergency seen in the community and in the emergency department (ED). Epinephrine is the first-line treatment, and delay to administration worsens outcomes.7,8 Opioid overdose remains a major cause of preventable death. Early recognition, respiratory support, and Naloxone administration are key steps.9 Educational Objectives: By the end of this activity, learners will be able to: 1) demonstrate the application of skills in real-life first responder scenarios, including suspected opioid overdose, cardiac arrest, and anaphylaxis; 2) apply knowledge of scene safety and the role of the first responder in various situations; and 3) assess the challenges while applying the skills necessary for collaborative work within a medical team. Educational Methods: A competition combining simulation-based and team-based learning reinforced first responder skills among first- and second-year medical students. Attending physicians evaluated simulated out-of-hospital emergency scenarios using a detailed rubric. This method was chosen to engage learners in a lower-stakes (but still simulated high-pressure) assessment of their skills where undifferentiated patients challenge recall and application in new, previously unknown scenarios. This format was chosen to keep preclinical students active and focused while they practice time-critical first responder skills. Simulation allows decision-making, hands-on actions, and immediate feedback in a safe setting. Team-based learning mirrors ED teamwork by assigning clear roles, prompting closed-loop communication, and requiring shared problem-solving. Station design supports repeated practice and brief debriefs, which builds retention and confidence for early learners. Faculty-scored rubrics provide observable, standardized performance measures and make feedback specific and actionable. Research Methods: Pre- and post-intervention surveys assessed the effectiveness of the case competition featuring three simulation scenarios in improving students' confidence in managing emergency situations. Results: The competition increased participants' confidence in responding to various scenarios, particularly opioid overdoses. Most participants expressed high likelihood of participating in future competitions. Ten preclinical students completed pre- and post-session surveys. Confidence increased across the cohort. For the opioid overdose scenario, “complete confidence” rose from 1/10 (10%) pre- to 6/10 (60%) post. Confidence in cardiac arrest and anaphylaxis also trended upward. Likelihood to respond to a public emergency changed minimally. Interest in future events was high, with 6/10 (60%) extremely likely and 4/10 (40%) somewhat likely to participate again. Discussion: The competition successfully increased confidence and fostered collaboration but faced recruitment challenges due to its optional nature and scheduling. Future implementations could include more advanced learners.

Background In 2024 in the United States there is an attack on diversity, equity, and inclusion initiatives within education. Politics notwithstanding, medical school curricula that are current and structured to train the next generation of physicians to adhere to our profession’s highest values of fairness, humanity, and scientific excellence are of utmost importance to health care quality and innovation worldwide. Whereas the number of anti-racism, diversity, equity, and inclusion (ARDEI) curricular innovations have increased, there is a dearth of published longitudinal health equity curriculum models. In this article, we describe our school’s curricular mapping process toward the longitudinal integration of ARDEI learning objectives across 4 years and ultimately creation of an ARDEI medical education program objective (MEPO) domain. Methods Medical students and curricular faculty leaders developed 10 anti-racism learning objectives to create an ARDEI MEPO domain encompassing three ARDEI learning objectives. Results A pilot survey indicates that medical students who have experienced this curriculum are aware of the longitudinal nature of the ARDEI curriculum and endorse its effectiveness. Conclusions A longitudinal health equity and justice curriculum with well-defined anti-racist objectives that is (a) based within a supportive learning environment, (b) bolstered by trusted, structured avenues for student feedback and (c) amended with iterative revisions is a promising model to ensure that medical students are equipped to effectively address health inequities and deliver the highest quality of care for all patients.

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted the delivery of elective surgery in the United Kingdom. The majority of planned surgery was cancelled or postponed in March 2020 for the duration of the first wave of the pandemic. We investigated the experiences of staff responsible for delivering rapid changes to surgical services during the first wave of the pandemic in the United Kingdom, with the aim of developing lessons for future major systems change (MSC). Methods: Using a rapid qualitative study design, we conducted 25 interviews with frontline surgical staff during the first wave of the pandemic. Framework analysis was used to organise and interpret findings. Results: Staff discussed positive and negative experiences of rapid service organisation. Clinician-led decision-making, the flexibility of individual staff and teams, and the opportunity to innovate service design were all seen as positive contributors to success in service adaptation. The negative aspects of rapid change were inconsistent guidance from national government and medical bodies, top-down decisions about when to cancel and restart surgery, the challenges of delivering emergency surgical care safely and the complexity of prioritising surgical cases when services re-started. Conclusion: Success in the rapid reorganisation of elective surgical services can be attributed to the flexibility and adaptability of staff. However, there was an absence of involvement of staff in wider system-level pandemic decision-making and competing guidance from national bodies. Involving staff in decisions about the organisation and delivery of MSC is essential for the sustainability of change processes.

With the rise of new and emerging Pre-Exposure Prophylaxis (PrEP) modalities, greater attention is needed to better understand how people who could benefit from PrEP make decisions to initiate, stop, pause, or switch PrEP regimens. In this study we borrow from the field of consumer research to create a consumer-derived PrEP Consumer Journey Model that describes key decision-making touchpoints a PrEP consumer moves through within and outside of a clinical context. Using in-depth interviews (n = 29) with gay and bisexual men who have sex with men, we evaluate which system 1 (emotional) and system 2 (cognitive) attributes are used for decision-making at different touchpoints along the PrEP Consumer Journey. Our results suggest system 1 attributes, such as feeling protected, reducing anxiety, enhancing pleasure, social norms, and taking ownership over health were more salient when consumers moved from pre-contemplation to information gathering, as well as evaluating post-uptake experience. System 2 attributes, including cost, side effects, dosing schedule, and sexual frequency, were present throughout the PrEP Consumer Journey, but particularly influential in the information gathering stage and when pausing, switching, or opting out of PrEP. We contend the PrEP Consumer Journey, and our findings related to decision-making, can help orient medical providers to anticipated patient concerns around PrEP use and ultimately provide more supportive and engaging PrEP counseling and services.

Studies have shown that social drinkers are poor estimators of alcohol-induced impairment. Underestimates of blood alcohol concentration and other indices of intoxication are associated with decisions to perform risky behaviors, such as operating a motor vehicle. It is possible that self-evaluations of impaired functioning under alcohol might be particularly compromised in the presence of other sources of impairment. A common source of impairment that co-occurs with alcohol is visual degradation. The present study compared actual and self-evaluated impairment in response to four conditions (0.65 g/kg alcohol, degradation of task-relevant stimuli, alcohol plus visual degradation, and no-treatment control) to determine whether social drinkers would perceive an increase in impairment from the combined treatments. Actual psychomotor impairment was measured in 16 social drinkers (eight men) by a pursuit rotor task and their self-evaluations of this impairment were obtained on a rating scale. Alcohol and visual degradation impaired participants' actual performance to a similar degree and, in combination, the impairing effects were additive. Participants' self-evaluation ratings showed that they underestimated the additive impairment produced by the combination of alcohol and visual degradation. The findings suggest that social drinkers might be unable to appreciate an increase in behavioral impairment when alcohol is consumed in the context of another impairing influence.

Past research on social drinkers shows that prior experience performing a task in a visually degraded environment results in the reduction of alcohol-induced impairment. It is possible that task experience under alcohol might similarly carry over to reduce impairment from visual degradation. The purpose of this study was to test the symmetry of the transfer of learning between two distinct sources of impairment, visual degradation and alcohol. Psychomotor impairment was measured by a pursuit rotor tracking task. Forty two participants were randomly assigned to one of six treatment groups. Two groups were tested under alcohol after having prior task experience performing with or without visual degradation. Two groups were tested under visual degradation after having prior task experience performing under active (0.65 g/kg) or inactive (placebo) doses of alcohol. The remaining two groups served as controls that tested the learning effects of repeating each active treatment. Clear evidence for asymmetrical transfer of learning was observed. Prior task experience with visual degradation reduced the impairing effects of alcohol. By contrast, prior task experience under alcohol had no effect on impairment produced by visual degradation. Evidence for differential transfer of learning to compensate for alcohol- and visual-degradation-induced impairment is of practical interest, given that the two disturbances commonly co-occur outside the laboratory. Reasons for the asymmetry are unclear, and likely involve differences in mechanisms by which each treatment impairs psychomotor function.

Mental illness and addiction are frequently comorbid. This volume is a major contribution to the literature and covers virtually every topic on a key clinical nexus, from long-established theories to the most modern research and development in the field.