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Simulation is a well-established component of central venous catheter (CVC) training. However, there is little published regarding how to train residents to supervise CVC insertion. We describe a curriculum designed to help trainees identify potential procedural errors and improve their comfort with supervising CVC insertion. We conducted a one-group, pre-post-posttest study. All participants completed a pre-simulation assessment (Time 1) that evaluated residents' ability to identify potential complications with CVC insertion and their procedural completion and procedural supervision comfort. Residents then participated in a simulation in which they supervised a mock proceduralist insert a CVC and commit five pre-specified errors. Participants completed the same comfort assessment immediately following the simulation (Time 2) and repeat knowledge and comfort assessments five months later (Time 3). Forty-seven interns participated in the study. Relative to Time 1 (M = 3.00, SD = 1.02), interns were significantly more comfortable supervising CVC insertion at Time 2 (M = 3.75, SD = 0.85) and at Time 3 (M = 4.08, SD = 0.58). We describe a simulation designed to help residents identify errors when supervising CVC insertion. Due to a poor survey response rate, no comparisons between pre- and post-simulation error identification could be determined. However, following our CVC supervisor simulation, participants reported immediate and sustained increases in their comfort supervising CVC placement.

To understand the current state of neurology residents training in neuropathology, we electronically distributed a 16-item survey to 150 adult and 70 child neurology program directors (PDs). The survey inquired about their program characteristics, neuropathology curriculum and assessment methods, trainee performance, and attitudes. Descriptive analysis was used to summarize categorical variables as frequencies and percentages and continuous as means and standard deviations. We conducted a series of Mann-Whitney U and Fisher’s exact tests to evaluate differences between various program characteristics. Sixty-four (29%) PDs responded to the survey, including 45 (30%) adult and 19 (27%) child neurology PDs. Thirty-one programs required a dedicated neuropathology rotation. The majority (92%) used the Residency In-Service Training Examination (RITE) to assess trainee’s knowledge. Approximately 86% of the PDs agreed that neuropathology is essential and a defined curriculum is necessary during residency training. There was no difference in the RITE scores between programs. We conclude that a neuropathology rotation was felt to be essential even though the RITE scores did not differ between programs with and without a dedicated rotation. Alternative evaluation and training methods may need consideration. A future survey of all the stakeholders may be required to thoroughly understand and disseminate the neuropathology education well.

Our original work addresses the biological sex impact on low back pain (LBP) management and prognosis in primary care settings. To our knowledge, our study is the first in the United States to evaluate the differences in clinicians' approaches to LBP in the ambulatory setting specifically based on patient gender. Our findings suggest that there is a knowledge gap among primary care providers (PCPs) toward the potential impact of biological sex on LBP and a bias toward gender roles when counseling patients for home chores or occupational tasks. Further evaluation of this knowledge gap and its impact on LBP management and prognosis is recommended in US healthcare settings. This study aims to explore PCP experiences and practice patterns regarding LBP in females compared to males in US healthcare settings. We utilized a cross-sectional study design and convenience sampling. Data were collected anonymously utilizing a 27-item online survey sent periodically via email to PCPs working in Ohio. We had 58 responses for analysis; data were analyzed utilizing bivariate and multivariate analyses. On average, approximately 9 out of 10 responding clinicians reported experiencing LBP. PCPs were not in agreement that LBP is different in women than men. Clinicians with a women's health, osteopathic, or sport's medicine background were more likely to agree that LBP is different in women than in men. PCPs were more likely to counsel female patients about pelvic floor exercises; however, their intake of present pelvic symptoms in LBP female patients is suboptimal. PCPs were more likely to counsel females for home chores than males, which is aligned with the perceived traditional gender roles among PCPs. There may be a knowledge gap among PCPs toward the potential impact of biological sex on LBP and a bias toward gender roles when counseling patients for home chores or occupational tasks. Further investigation of this knowledge gap and counseling approaches is recommended to better bridge the gender disparity.

The LINKS curriculum, adapted from Britt et al. (2018a), was designed to improve unit climate, knowledge, and attitudes about mental health treatment seeking in military personnel. The present study extends this research by examining implementation options, comparing the effectiveness of LINKS to an active control condition with training delivered by non-experts and comparing modules that varied in training length. Eight Army platoons were randomly assigned to one of four conditions: (1) 1-h Active Control, (2) 2-h Active Control, (3) 1-h LINKS, or (4) 2-h LINKS. Two platoons were assigned to each condition. Surveys were administered at pre-training (T1), post-training (T2), and 3 months later (T3). Eighty-four participants completed all study phases. Regardless of training content, participants receiving the 2-h modules reported greater training acceptability than those receiving the 1-h modules. At T3, participants in the LINKS conditions reported more mental health knowledge than participants in the Active Control conditions. Sustained effects were also observed on a number of treatment barriers and facilitators, with the LINKS conditions generally leading to better outcomes. At T3, 2-h LINKS condition participants reported receiving more mental health treatment relative to the other conditions. Findings suggest that LINKS can be effectively delivered by non-expert trainers, is a viable intervention for targeting mental health treatment-seeking, and is optimally packaged in a 2-h module. The training might benefit from additional leadership training efforts.

Graduate medical education (GME) orientation/onboarding is conventionally an in-person activity, but the COVID-19 pandemic prompted virtual approaches to learner onboarding. However, online GME onboarding strategies have not been disseminated in the literature. To determine the usefulness of an online curriculum for GME learner orientation at a large sponsoring institution using an electronic survey. The primary outcome was to discover the usefulness of our online curriculum for GME onboarding, and secondary outcomes included identifying barriers to implementation and weaknesses associated with online GME orientation. We created an online GME orientation curriculum to onboard incoming learners (from June 1 to August 31, 2020) and electronically surveyed our learners to determine the usefulness of this novel approach. We conducted orientation sessions and electronically recorded questionnaire responses using CarmenCanvas, our institutional learning management system. Linear regression analysis was performed to identify factors predicting satisfaction with virtual GME orientation using IBM SPSS Statistics, Version 26.0 (Armonk, NY, USA). Of 353 trainees, 272 completed the survey for a 77% response rate. 97% of respondents reported that the curriculum supported performance of learner duties. 79% of trainees perceived the overall quality as \"very good\" or \"good\", 91% responded that the curriculum provided \"effective learning\", 94% reported \"accessing the course content easily\", 92% reported \"easily navigating the curriculum\", 91% described the curriculum as \"well-organized\", and 87% reported that the lectures \"supported their learning\". Online delivery of a comprehensive GME orientation curriculum is useful and facilitates learner education, training, and integration into a large GME institution in the COVID-19 era.

The Disablement in the Physically Active (DPA) scale is a patient-reported outcome instrument recommended for use in clinical practice and research. Analysis of the scale has indicated a need for further psychometric testing. To assess the model fit of the original DPA scale using a larger and more diverse sample and explore the potential for a short-form (SF) version. Observational study. Twenty-four clinical settings. Responses were randomly split into 2 samples: sample 1 (n = 690: 353 males, 330 females, and 7 not reported; mean age = 23.1 ± 9.3 years, age range = 11-75 years) and sample 2 (n = 690: 351 males, 337 females, and 2 not reported; mean age = 22.9 ± 9.3 years, age range = 8-74 years). Participants were physically active individuals who were healthy or experiencing acute, subacute, or persistent musculoskeletal injury. Confirmatory factor analysis was conducted to assess the factor structure of the original DPA scale. Exploratory factor, internal consistency, covariance modeling, correlational, and confirmatory factor analyses were conducted to assess potential DPA scale SFs. The subdimensions of the disablement construct were highly correlated (≥0.89). The fit indices for the DPA scale approached recommended levels, but the first-order correlational values and second-order path coefficients provided evidence for multicollinearity, suggesting that clear distinctions between the disablement subdimensions cannot be made. An 8-item, 2-dimensional solution and a 10-item, 3-dimensional solution were extracted to produce SF versions. The DPA SF-8 was highly correlated ( = 0.94, ≤ .001, = 0.88) with the DPA scale, and the fit indices exceeded all of the strictest recommendations. The DPA SF-10 was highly correlated ( = 0.97, ≤ .001, = 0.94) with the DPA scale, and its fit indices values also exceeded the strictest recommendations. The DPA SF-8 and SF-10 are psychometrically sound alternatives to the DPA scale.

Purpose: To explore the preparation methods, perceptions, and clinical profile of athletic trainers who use instrument-assisted soft tissue mobilization and to compare group differences regarding the use of one's hands versus instruments to apply soft tissue mobilization. Methods: Athletic trainers completed an electronic survey. Descriptive statistics were calculated for participant demographics, clinical profile items, and items assessing instrument-assisted soft tissue mobilization application. Exploratory factor analysis was conducted to determine underlying factors. Results: Athletic trainers completed formal (59.7%) and informal (95%) instrument-assisted soft tissue mobilization training. Those who completed professional courses rated instruments as more effective than those who did not. Conclusions: Instruments were perceived to be as or more effective than one's hands when applying soft tissue mobilization to treat chronic musculoskeletal pathologies. Further research is needed to determine whether type of preparation affects the application strategies or clinical efficacy of instrument-assisted soft tissue mobilization. [Athletic Training & Sports Health Care. 2018;10(4):169–180.]

The imposter phenomenon (IP) refers to an experience of self-perceived intellectual phoniness (Clance & Imes, 1978). Imposters believe they are frauds, having fooled people around them into believing they are more capable than they actually are (Clance, 1985). Three separate but related studies were conducted to investigate the measurement, prevalence, antecedents, and consequences of imposter phenomenon in a large, convenience sample of sport coaches. Study 1 developed and validated the Imposter Phenomenon Scale (IPS). Initial evidence suggested the IPS was a valid and reliable measure of imposter feelings, although additional work will need to be done to refine the instrument. A two-factor (i.e., Self-Perceptions of Fraudulence and Concerns about Others’ Perceptions of My Success), seven-item instrument emerged from exploratory and confirmatory factor analyses, and based on Cronbach’s alpha, the items within each hypothesized dimension were similar and closely related. Following the psychometric validation of the IPS, Studies 2 and 3 assessed the nature of IP in sport coaches. Study 2 estimated the prevalence of IP in sport coaches and examined key demographic and background correlates of IP. Less than 12% of coaches in this convenience sample reported that they were experiencing imposter feelings. Imposters in this sample tended to be female, white, and less experienced as a coach and as an athlete, to have coached and competed at lower competitive levels, and to have had less training and no coaching mentor, but these variables accounted for a minimal amount of the variance in IP. Finally, Study 3 examined possible motivational antecedents and consequences of IP in coaches. Two full latent variable (FLV) models were assessed—one model predicting burnout and one model predicting engagement. In each model, implicit theories of ability were predictor variables, and perfectionism and IP were mediator variables, mediating the relationships between implicit theories and burnout and between implicit theories and engagement. The hypothesized FLV models were near estimations of the observed relationships among implicit theories, perfectionism, IP, burnout, and engagement in this sample of coaches, although support for the hypothesized models could only be cautiously concluded. Results were discussed in light of limitations and future directions.

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