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BackgroundWhy did you do this work?Paediatric major incidents are rare events but when they occur they cause devastating morbidity and mortality. A well-tested major incident plan allows for optimal management and improved outcomes for the maximum number of patients. Staff training is vital for preparedness for what you hope will be a never event at your hospital.Aimsdevelop a translational major incident in-situ simulation 6-monthly programmeidentify strengths and challenges in our plan and develop changes to strengthen itbuild on staff confidence in their roleutilise the simulation exercises as a form of staff training (non-technical skills, technical skills and system responses)ensure ongoing benefits to the above as the programme progressesMethodsWhat did you do?Through a major incident small working group at a paediatric major trauma centre, we identified an experienced faculty to plan, write and facilitate simulation. We have run 6-monthly major incident in-situ simulation for 3 years whilst maintaining the business continuity of the hospital. In the latest simulation we had 70 participants taking part plus faculty. Each time different areas within the plan have been tested or identified as an area for repeated testing following system and plan changes. Following each simulation, we run both a hot and organisational debrief in order to build staff confidence and ensure psychological safety whilst identifying areas of the plan to be strengthened. Participants complete a questionnaire to detail any changes in their knowledge and confidence. In view of the large scale of this simulation we have also had experienced external simulation educators as observers for feedback.ResultsWhat did you find?Consistently we have demonstrated an increase in confidence on the likert scale comparing before and after the simulation: sim 1 – 7.3 to 8.36, sim 2 – 6.3 to 7.1, sim 3 – 5.6 to 7.8, (sim 4 – break from feedback) and sim 5 5.2 to 7.5.In the 6th simulation using a likert scale staff confidence had increased from 6.73 (range 1 – 10) to 7.51 (range 4 -10) after the sim and staff knowledge from 6.74 (range 1-10) to 7.49 (range 3- 10) after the sim.The simulations have resulted in significant system changes each time for example the implementation of a major incident specific clinical proforma, additions to the major haemorrhage response and new action cards for new roles identified. There have been subsequent updates to the major incident plan.ConclusionsWhat does it mean?Translational major incident in-situ simulation facilitates strengthening your major incident plan and is an excellent addition to staff training for major incident management. It’s impact on strengthening systems also translates to daily practices outwith major incident.

A single, widely accepted definition of sport specialization does not exist. A consensus definition is necessary to guide youth sport stakeholders on issues associated with sport specialization. The aim of this study was to develop a consensus definition of youth sport specialization and to identify elements that support the construct of specialization. Delphi Study Setting: Directed Surveys Patients or Other Participants: A consensus panel of 17 experts was created to provide a broad multidisciplinary perspective on sport specialization in youth athletes. The final definition was developed per an iterative process that involved four rounds of review. A comprehensive review of literature and expert input supported our initial proposed umbrella definition that included six additional elements. The study team reviewed the results after each round and changes were made to the definition based on panel feedback. Panel members were provided with the definition and six elements and then asked to rate each specific to importance, relevance, and clarity using a 4-point Likert scale. In four Delphi consensus rounds, 17 experts reviewed the umbrella definition and six elements before consensus was reached. The umbrella definition and three of the initial six elements achieved >80% agreement for importance, relevance, and clarity after the fourth round of review. The remaining 3 components did not reach >80% agreement even after iterative edits and were removed. The process resulted in a final consensus definition: Sport specialization is intentional and focused participation in a single sport for a majority of the year that restricts opportunities for engagement in other sports and activities. A consensus-based conceptual definition for sport specialization has been developed using a Delphi method. This definition has important implications for clinicians and sports medicine professionals who support youth athletes.

Why did we do this work?Employing a structured approach to learning by reflecting and acting upon course feedback is essential. Kolb’s learning cycle provides a framework to reflect on candidates’ feedback and make targeted changes (Kolb, 2015). This work highlights this reflection process. By analysing post-course feedback, this work aims to identify how different stages of Kolb’s learning cycle—concrete experience, reflective observation, abstract conceptualisation, and active experimentation—are utilised to understand the residents’ learning process and plan course improvements. As educators, this reflective work helps in restructuring similar learning events to meet the needs of learners at every stage of the cycle.What did we do?In September 2024, the postgraduate medical education department of a London hospital organised a course to prepare resident doctors for the RCPCH clinical exam. The two-day course consisted of lectures about the clinical stations, small group practice and a mock examination. Responses have been collated from 22 participants using an online survey tool for post-course feedback. A sample of responses was linked to the stages of Kolb’s learning cycle.What did we find?Overall, 86% of the participants were satisfied with the course and the organisation was highly rated by 82% of them. The table 1 below shows how the feedback aligns with each stage of Kolb’s cycle.Abstract 8433 Table 1 Stage Sample feedback Theory link Concrete experience ‘Need smaller groups.’ ‘More realistic role players needed’ The feedback suggests a desire for more interactive experiences. Smaller groups could allow for a richer, more personal experience, allowing residents to engage more directly with patients and scenarios. Reflective Observation ‘There was some miscommunication during the mock’ ‘Some stations were unstructured’ Participants have reflected on organisational issues during the exam. Kolb’s theory stresses the importance of reflection on experiences, and here the residents are identifying gaps in the mock exam’s structure. This reflection can teach the impact of environment on learning and performance. Abstract Conceptualisation ‘More discussion about the exam techniques is needed.’ ‘Teachers need to be familiar with the exam’ This suggests that residents are seeking structured knowledge that can help them form concepts and strategies based on their practical experiences. They want clearer guidance on how to approach the exam, which is critical for effective conceptualisation. Active Experimentation ‘Need more time for practice’. ‘Would be great to have a variety of patients’ Residents want to apply what they have learned and experiment with better exam formats. Increasing time during practice stations would allow more practical engagement, enabling them to test out new approaches based on their reflections. What does it mean?Overall, the feedback highlights how residents move through Kolb’s learning cycle and aim to apply and refine their learning through active experimentation. An understanding of this cycle is central to the adaptation of the course to meet the participants’ desire for experiential learning.ReferenceKolb DA. Experiential learning: experience as the source of learning and development. 2nd ed. New Jersey: Pearson Education 2015.

Background Artificial intelligence (AI) is becoming increasingly important in healthcare. It is therefore crucial that today’s medical students have certain basic AI skills that enable them to use AI applications successfully. These basic skills are often referred to as “AI literacy”. Previous research projects that aimed to investigate medical students’ AI literacy and attitudes towards AI have not used reliable and validated assessment instruments. Methods We used two validated self-assessment scales to measure AI literacy (31 Likert-type items) and attitudes towards AI (5 Likert-type items) at two German medical schools. The scales were distributed to the medical students through an online questionnaire. The final sample consisted of a total of 377 medical students. We conducted a confirmatory factor analysis and calculated the internal consistency of the scales to check whether the scales were sufficiently reliable to be used in our sample. In addition, we calculated t-tests to determine group differences and Pearson’s and Kendall’s correlation coefficients to examine associations between individual variables. Results The model fit and internal consistency of the scales were satisfactory. Within the concept of AI literacy, we found that medical students at both medical schools rated their technical understanding of AI significantly lower ( M MS1 = 2.85 and M MS2 = 2.50) than their ability to critically appraise ( M MS1 = 4.99 and M MS2 = 4.83) or practically use AI ( M MS1 = 4.52 and M MS2 = 4.32), which reveals a discrepancy of skills. In addition, female medical students rated their overall AI literacy significantly lower than male medical students, t (217.96) = -3.65, p  <.001. Students in both samples seemed to be more accepting of AI than fearful of the technology, t (745.42) = 11.72, p  <.001. Furthermore, we discovered a strong positive correlation between AI literacy and positive attitudes towards AI and a weak negative correlation between AI literacy and negative attitudes. Finally, we found that prior AI education and interest in AI is positively correlated with medical students’ AI literacy. Conclusions Courses to increase the AI literacy of medical students should focus more on technical aspects. There also appears to be a correlation between AI literacy and attitudes towards AI, which should be considered when planning AI courses.

ObjectivesPost-graduate doctors typically apply for speciality training during, or soon after, their Foundation Two Year; however, many of them have very limited exposure to Paediatrics.We therefore provided an ‘Introduction to Paediatrics’ course, aimed at foundation doctors with an interest in Paediatrics training. The aims of the course were to: experience a range of common Paediatric presentations and procedural skills; learn about applying for Paediatrics; and learn about a career in Paediatrics.MethodsThe one-day programme consisted of mixed-methods teaching, designed to expose learners to a broad range of Paediatric-relevant experiences, whilst stimulating enthusiasm for the specialty.The course consisted of: four simulation scenarios of common Paediatric presentations, planned to be challenging but accessible to doctors without any previous Paediatric experience; two procedural skills stations (neonatal life support and umbilical venous catheterisation); and a series of short talks on Paediatric training and the application process. There was a large faculty of Paediatric trainees and consultants, with ample time for learners to ask questions. The course was offered at a minimal cost of £20, to limit financial discrimination.The participants were asked to feedback via online surveys, both immediately after the course, and a year following the course.ResultsThirty-nine doctors have attended the course, over three iterations; 20% of them had previous formal postgraduate experience in Paediatrics, and all of them were considering applying to Paediatric training.Immediately after the day, all the participants stated that they would recommend the course to someone who was considering Paediatric training, and that the day was useful in deciding whether to do Paediatrics training. Using a Likert scale, they rated all the teaching sessions as ‘Good’ or ‘Very good’. When asked to give a star rating out of 5, the mean was 4.9.Seven participants replied to a survey sent 12–18 months after the course. Using a Likert scale, they ranked how much attending the course had influenced (in either direction) how likely they were to apply for Paediatrics, and all chose ‘A lot’ or ‘Quite a lot’. Three of them have applied successfully, and the remaining 4 intend to apply in the future.ConclusionThis one-day low-cost course is an effective way of providing foundation doctors with a ‘taster’ of Paediatrics. Although not a substitute for a foundation programme placement in Paediatrics or a clinical taster day, it provides another opportunity for interested foundation doctors to learn about a specialty.

The central tendency bias is a robust finding in data from experiments using Likert scales to elicit responses. The present paper offers a Bayesian perspective on this bias, explaining it as a natural outcome of how participants provide point estimates of probability distributions over the items on a Likert scale. Two studies are reported that support this Bayesian explanation.

Objectives‘Milestones To Go: Accessibility and Development within Paediatrics’, was a 2023 National Undergraduate Paediatric conference, organised by undergraduate students from King’s College London (KCL) Paediatric Society. The conference aimed to highlight the general training pathway, alongside offering insight into the field of paediatrics for medical students and sixth-formers.MethodsA survey was emailed to participants pre and post-conference, which included questions assessed by the ten-point Likert scale.RStudio was used to conduct a Mann-Whitney U test comparing the mean rank Likert scale scores of students’ interest and understanding in paediatrics pre and post- conference and p <0.05 was considered statistically significant.Results111 students attended the conference. 105 students completed the pre-conference survey (n=65 university; n=40 sixth-form), and 90 students completed the post- conference survey (n=38 university; n=52 sixth-form).The results yielded by the Mann-Whitney U-Test demonstrated a statistically significant increase in the students’ understanding of what a paediatric career involves with the mean score being 6.12 pre-conference and 7.88 post-conference (U = 1810.5, p <0.001). Similarly, the students’ understanding of what is required to pursue a paediatric career has increased from a mean score of 5.12 pre-conference and 7.71 post-conference (U = 1318, p < 0.001).Comparatively, interest in paediatrics exhibited no statistically significant change (p = 0.1864).ConclusionThere were statistically significant changes in the understanding of student delegates of a paediatric career and the application process. Reasons for this could include:Limited paediatric placements during earlier years in medical school.Inviting a speaker from the Royal College of Paediatrics and Child Health, providing clarity regarding the paediatric application process.A range of subspecialties, demonstrating the breath of paediatrics.However, this association between student conferences and understanding in paediatrics may be confounded by both medical students and sixth formers filling out the feedback forms. Sixth formers would have had less exposure to paediatrics and therefore show a greater increase in understanding, hence positively skewing the results.This conference introduced the paediatric specialty pathway and opportunities available to aspiring paediatricians to fill the gap in the medical curriculum. Our statistically significant results demonstrate the value of student paediatric conferences to develop undergraduate understanding of a paediatric career. Undergraduate medical curricula should aim to introduce the specialty pathway at an earlier stage to aid a better foundation towards specialty application.

Background Emerging artificial intelligence (AI) technologies have diverse applications in medicine. As AI tools advance towards clinical implementation, skills in how to use and interpret AI in a healthcare setting could become integral for physicians. This study examines undergraduate medical students’ perceptions of AI, educational opportunities about of AI in medicine, and the desired medium for AI curriculum delivery. Methods A 32 question survey for undergraduate medical students was distributed from May–October 2021 to students to all 17 Canadian medical schools. The survey assessed the currently available learning opportunities about AI, the perceived need for learning opportunities about AI, and barriers to educating about AI in medicine. Interviews were conducted with participants to provide narrative context to survey responses. Likert scale survey questions were scored from 1 (disagree) to 5 (agree). Interview transcripts were analyzed using qualitative thematic analysis. Results We received 486 responses from 17 of 17 medical schools (roughly 5% of Canadian undergraduate medical students). The mean age of respondents was 25.34, with 45% being in their first year of medical school, 27% in their 2nd year, 15% in their 3rd year, and 10% in their 4th year. Respondents agreed that AI applications in medicine would become common in the future (94% agree) and would improve medicine (84% agree Further, respondents agreed that they would need to use and understand AI during their medical careers (73% agree; 68% agree), and that AI should be formally taught in medical education (67% agree). In contrast, a significant number of participants indicated that they did not have any formal educational opportunities about AI (85% disagree) and that AI-related learning opportunities were inadequate (74% disagree). Interviews with 18 students were conducted. Emerging themes from the interviews were a lack of formal education opportunities and non-AI content taking priority in the curriculum. Conclusion A lack of educational opportunities about AI in medicine were identified across Canada in the participating students. As AI tools are currently progressing towards clinical implementation and there is currently a lack of educational opportunities about AI in medicine, AI should be considered for inclusion in formal medical curriculum.

Background Research shows that there are connections among academic burnout, resilience, and life satisfaction in medical students. However, no study has yet examined the temporal relationships between academic burnout, resilience, and life satisfaction among medical students. This longitudinal study aimed to examine the temporal associations between academic burnout, resilience, and life satisfaction and to explore the possible mediating role of resilience in the relationship between academic burnout and life satisfaction among medical students. Methods This is a three-wave longitudinal study covering the preclinical education period of 20 months. From October 2018 to June 2020, a total of 190 students majoring in clinical medicine filled out the Chinese College Student Academic Burnout Inventory (CCSABI), the Connor-Davidson Resilience Scale (CD-RISC) and the Satisfaction With Life Scale (SWLS) three times. Cross-lagged models were constructed to examine the temporal relationships between academic burnout, resilience, and life satisfaction and longitudinal mediation models were constructed to explore the possible mediating role of resilience in the association of academic burnout with life satisfaction. Results Among medical students, resilience uni-directionally and positively predicted life satisfaction, while academic burnout uni-directionally and negatively predicted life satisfaction. However, the temporal association between resilience and academic burnout was negative and somewhat bidirectional. Resilience had a significant mediating effect on the relationship between academic burnout and life satisfaction in medical students. Conclusions Medical educators need to identify and take effective measures to combat academic burnout problems which can lead to reduced life satisfaction among medical students. Resilience-based interventions may be promising in buffering the negative impacts of academic burnout and improving life satisfaction. It is recommended that effective resilience-promotion interventions be developed and implemented in medical education to help enhance medical students’ psychological well-being.

Why did you do this work?A series of junior doctor (now known as resident doctor) strikes significantly disrupted the NHS medical workforce and undergraduate training across England from March 2023 to June 2024. This was exacerbated by medical consultant strikes from July 2023. Medical students at one large paediatric teaching hospital were not allowed to attend clinical placements during periods of industrial action. This included students whose undergraduate training had already been significantly impacted by the COVID-19 pandemic.1 To minimise further loss, this centre arranged a series of online ‘strike webinars’.What did you do?The undergraduate medical education team worked to ensure that the unique opportunity of clinical placement at the trust was not lost for students during industrial action. During five of the strike periods between September 2023 and June 2024, a half-day webinar was hosted by two clinical teaching fellows, designed for medical students missing their placement. The webinar covered clinically relevant paediatric skills such as history taking, and themes including child development, allergic conditions, and paediatric cases. Sessions were designed to be as interactive as possible. There was also a careers session run by a paediatric trainee, for those interested in a career in paediatrics. Online, anonymous feedback was collected after each session.What did you find?A total of 83 students attended across five webinars. Webinars were received positively. Anonymous feedback included the webinar being ‘very interesting’, ‘exceptionally helpful’, and ‘met a lot of my learning needs’. 75% of students strongly agreed with the statements ‘the topics were relevant to my learning needs’, ‘the webinar has increased my understanding of the topics’, and ‘I will use the knowledge I have gained from this session in my clinical practice’. In particular, sessions on history taking and paediatric emergencies were rated as ‘excellent’ by students.What does it mean?Students valued the interactive webinar in the absence of clinical placements. Due to the short notice of strikes, it was not possible to run the sessions face-to-face, though this may have been preferable to improve engagement and facilitate discussion. Based on student feedback, if future strikes were to occur, the webinar could be repeated, with an adjusted format, for example shorter, more frequent sessions. Although there is no direct replacement for clinical learning, clinically focused interactive teaching is beneficial and appreciated by medical students.ReferenceRainbow S, Dorji, T. Impact of COVID-19 on medical students in the United Kingdom. Germs. 2020;10(3):240–243.