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It is widely known that the opportunity for medical students to be observed and to receive feedback on their procedural skills performance is variable in the senior years. To address this problem, we provided our Pre-Intern (PrInt) students with \"one-to-one\" formative feedback on their ability to perform urethral catheterization (U/C) and hypothesized that their future practice of U/C as interns would benefit. This study sought to evaluate the performance and practice of interns in U/C 4-5 months after having received feedback on their performance of U/C as PrInt students. Between 2013 and 2014, two cohorts of interns, (total n=66) who had received recent formative feedback on their U/C performance as PrInt students at Central Clinical School, were invited to complete an anonymous survey. The survey contained nine closed unvalidated questions and one open-ended question, designed to allow interns to report on their current practice of U/C. Forty-one out of 66 interns (62%) completed the survey. Thirty-five out of 41 respondents (85%) reported that the assessment with feedback during their PrInt term was beneficial to their practice. Thirty of 41 (73%) reported being confident to perform U/C independently. Eleven out of 41 respondents (27%) reported that they had received additional training at intern orientation. Nine of the 11 interns (82%) reported that they had a small, but a significant, increase in confidence to perform U/C when compared with the 30 of the 41 respondents (73%) who had not ( =0.03). Our results substantiate our hypothesis that further education by assessment with feedback in U/C during PrInt was of benefit to interns' performance. Additional educational reinforcement in U/C during intern orientation further improved intern confidence. Our results indicate that extra pre- and post-graduation procedural skills training, with feedback, should be universal.

Domestic violence is a deeply entrenched issue in Indian society, with global implications, especially for women's physical and mental health. Healthcare providers play important role in early identification and support of the victims. Medical interns, the future generation of Health care professionals, often acting as primary caregivers are uniquely positioned and expected to recognize and assist victims. This study aims to evaluate their knowledge, attitudes, practices, and readiness to manage domestic violence and its associating factors. This cross-sectional study was conducted among 157 medical interns at a Medical college and hospital in West Bengal, India, from December 2022 to February 2023. Simple random sampling was done. Data were collected using a semi-structured questionnaire, Medical Intern Readiness to manage domestic violence scale (MIREDS), validated after adoption from Physician Readiness to manage Intimate partner violence scale (PREMIS). Ethical approval was obtained, and participants gave informed written consent for inclusion. Satisfactory threshold was determined to be more than 50 percent. Data analysis was performed using MS Excel and SPSS software, including descriptive and inferential statistics, with a significance level of p less than 0.05, along with logistic regression analysis. Only 45.2% of medical interns demonstrated satisfactory knowledge, 54.8% had a satisfactory attitude. Most interns (91.7%) exhibited poor practice in dealing with domestic violence cases, only 31.2% considered themselves ready to manage domestic violence cases. Interns who attend more patients was found to have better attitude. Positive associations were found between knowledge, attitude, and readiness to manage domestic violence cases among doctors . A substantial proportion of medical interns demonstrated inadequate knowledge, negative attitudes, and poor practice and inadequate readiness to manage domestic violence. Comprehensive training and education with cultural sensitivity training along with more practical exposures are in need to address this issue properly.

Background Antibiotic resistance is a global burden and reduction of antimicrobial resistance requires change in antimicrobial prescribing behavior of health workers. The current study aimed to evaluate the attitude and perception of Ethiopian medical interns towards antimicrobials resistance. Methods A multi center cross-sectional institutional based survey was conducted from August 2016 to October 2016 among medical interns in Ethiopia. Data entered and analyzed using Statistical Package for Social Sciences program (SPSS) software version 21.0 for Windows. Descriptive statistics, chi-square test and binary logistic regression analysis were used and statistical significance was set at P-value  < 0.05 as a cut of point. Results Out of the 278 questionnaires distributed, 270 were returned completed giving a response rate of 97.1%. Most of the participants 256 (94.8%) wants to receive further education about antimicrobial stewardship. Chi-square test showed a significant difference between institutions about interns’ attitude and perception concerning over usage of antimicrobials in their institutions; description of correct antimicrobial coverage; handling patients who demands antimicrobial therapy that is not indicated and finding reliable sources of information to treat infections ( P-value  < 0.05). Attaching at internal medicine wards during the survey and receiving antimicrobial stewardship training during the past 6 months were found to improve their attitude significantly by 2.68 and 3.48 times respectively. Conclusions The current study demonstrates an enormous desire of medical interns for further education about antimicrobial stewardship. Hence, it is strongly recommended to provide a comprehensive, regular, standard and up to date educational training in all medical institutions for our future prescribers. Medical institutions and stakeholders are recommended to advocate curriculums and policies that build up antimicrobial stewardship programs.

Background: In recent times, dietary supplements have started playing a very critical role in overcoming the micronutrient deficiencies in a person. The health and well-being of medical practitioners itself are also important for them to efficiently carry out their practice. Moreover, their knowledge, attitude and practices influence their prescribing and treating tendencies. This study will demonstrate how the science of dietary supplements has advanced in relation to a number of nutrients, such as Vitamin A, iron, calcium, and folic acid. The health-care practitioners knowledge, attitude, and practices influence their prescribing and treating tendencies. Aims and Objectives: This study is done to assess and contrast the Knowledge, Attitude and Practices Related to Dietary Supplements and Micronutrients in Medical Students and Interns of a Tertiary Care Hospital. Materials and Methods: Cross-sectional, questionnaire-based study conducted at a ESIC Medical College, KK Nagar, Chennai, which included 2nd year students and interns. A questionnaire containing questions that test theoretical knowledge of micronutrients, and assesses personal supplementation habits was prepared. All students within the sample were mailed the questionnaire and consent was sought electronically. Those not willing to give consent were excluded from the study. The responses of the questionnaire were linked to an Excel sheet and analyzed using Microsoft Access. During this process, utmost confidentiality of the information was maintained. Results: A total of 140 participants responded, with 82 of them undergoing phase 2 medical training and 58 of them undergoing internship. On the dietary front, 12.2% of 2nd year students as compared to 15.5% of CRMI students were vegetarian. About 34.1% of 2nd year students and 41.4% of CRMIs consumed nutrient supplements. About 14.7% of 2nd years and 10.3% of CRMIs consumed supplements daily. About 67.8% of 2nd year students and 54.1% of interns consumed dietary supplements after medical advice. Concerningly, 15.5% of all medical interns and 9.8% of all 2nd-year students self-prescribed health supplements. Most interns (54.1%) who consumed supplements did so to maintain adequate nutrition. Concerningly 42.8% of 2nd year students and 33.3% of interns consumed supplements to maintain good health. Vitamins either singly, or as multivitamin tablets were the most consumed supplements amongst both sections of the study group. Concerningly 48.8% of 2nd year students and 58.6% of interns felt that supplements are generally harmless; and around a third of both groups felt that health personnel should promote supplement use. Conclusion: Knowledge regarding micronutrient usage among medical students is good; however, there is scope for improvement, particularly in the area of micronutrient-related prevalent diseases. Both 2nd year students and CRMIs consumed nutrient supplements in lesser quantity and frequency than other health science student groups; and more than half of them did so after medical advice. Good health and nutrition were the main reasons for supplement consumption. Students and interns were quite favorable toward patient consumption of nutrient supplements. The teaching-learning process needs to address this.

Use of intensive longitudinal methods (e.g. ecological momentary assessment, passive sensing) and machine learning (ML) models to predict risk for depression and suicide has increased in recent years. However, these studies often vary considerably in length, ML methods used, and sources of data. The present study examined predictive accuracy for depression and suicidal ideation (SI) as a function of time, comparing different combinations of ML methods and data sources. Participants were 2459 first-year training physicians (55.1% female; 52.5% White) who were provided with Fitbit wearable devices and assessed daily for mood. Linear [elastic net regression (ENR)] and non-linear (random forest) ML algorithms were used to predict depression and SI at the first-quarter follow-up assessment, using two sets of variables (daily mood features only, daily mood features + passive-sensing features). To assess accuracy over time, models were estimated iteratively for each of the first 92 days of internship, using data available up to that point in time. ENRs using only the daily mood features generally had the best accuracy for predicting mental health outcomes, and predictive accuracy within 1 standard error of the full 92 day models was attained by weeks 7-8. Depression at 92 days could be predicted accurately (area under the curve >0.70) after only 14 days of data collection. Simpler ML methods may outperform more complex methods until passive-sensing features become better specified. For intensive longitudinal studies, there may be limited predictive value in collecting data for more than 2 months.

Background Intern physicians, in the final stage of medical training, face increasing clinical responsibility and workload, which may heighten vulnerability to errors and second victim experiences. This study aimed to explore interns’ second victim experiences using an escape-room–based educational intervention and to examine the emotional and systemic dimensions underlying these experiences. Methods A mixed-methods design was employed. Sixty-six Year 6 medical students in the Emergency Medicine rotation at XXX University Faculty of Medicine participated. Interns who voluntarily attended the escape-room activity and structured reflection session (n = 33) were compared with those who did not participate but completed the quantitative assessment (n = 33). Quantitative data were collected using the Second Victim Experience and Support Tool–Revised (T-SVEST-R), and qualitative data were derived from reflection transcripts. Results A statistically significant difference was observed in perceived organizational support, with higher scores in the intervention group compared with the comparison group (p < 0.05). Although psychological distress scores were lower among interns who participated in the escape-room activity, this difference did not reach statistical significance. Qualitative findings indicated that the gamified and reflective process made emotional experiences more visible and shareable, strengthened team identity, and increased awareness of systemic and interpersonal dimensions of second victimization. Themes included emotional confrontation, peer support, coping through reflection, and recognition of structural challenges within clinical training. Conclusion The integration of experiential learning and structured reflection through an escape-room approach can effectively address second victimization by fostering resilience, emotional awareness, and compassionate teamwork among medical interns.

Background The Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) approach is crucial in emergency care, but there may be variability in adherence among healthcare professionals. Inconsistent application of this approach may lead to variations in patient care quality and outcomes. Identifying the factors influencing adherence can help improve training to ensure more effective application across emergency settings. This study explores the theoretical knowledge of the ABCDE approach among Egyptian resident doctors and medical interns. Methods An online survey was conducted in Egypt targeting resident doctors and medical interns. Statistical analyses were performed using SPSS 26 and Excel, descriptive statistics and association tests were used to measure the relationship between knowledge and demographic factors. Results The study included 422 medical residents and interns, with most in university hospitals. The average knowledge score of 59.1% exposed specific gaps in understanding, emphasizing deficiencies in 12 questions answered by less than 50%. Notably, 49.5% acquired ABCDE knowledge from medical school, while 28.2% had ALS/BLS courses. Encouragingly, 91.2% expressed willingness for life support training. Statistical analyses unveiled significant associations between knowledge scores and both medical practice settings and sources of ABCDE knowledge. Surgeons exhibited the lowest knowledge scores among participants, emphasizing the need for tailored interventions across specialties. Conclusion This study addresses a critical gap in ABCDE approach knowledge among Egyptian resident doctors and medical interns. The study points to the need for focused education, especially for surgeons, to improve emergency care skills and patient outcomes through continued training.

Abstract Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep–wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Results: Interns averaged 6.93 hours (95% confidence interval [CI] 6.84–7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06–7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02–2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post‐call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69–3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56–1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Conclusions: Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged.

Background Internship is a phase of training wherein medical graduates acquire the skills and competencies required to function independently. It has been reported that interns lack confidence in performing common procedures, as these skills are often learnt through self-learning or performing without supervision. This type of learning endangers patient safety and fails to instil the required confidence in the student. Training in skills laboratories provide opportunity to learn clinical skills in a safe environment. However, skills laboratories are resource-intensive, and there is limited information on different training approaches, such as blended learning, and how the trainees perceive their usefulness. Hence, we conducted this pilot study to assess the perceived usefulness of a blended learning approach for skills training among medical interns. Methods This mixed methods study was conducted in the skills laboratory of an apex medical institute in India, among 42 interns posted for the Interns Skill-based Clinical Induction Program (ISCIP). In this training, a blended learning approach was adopted, which comprised of two components - an online e-learning module, followed by a hands-on training session. The trainees were asked to complete a feedback form and grade different components of the online session, and hands-on session on a five-item Likert-based scale. The scores were expressed as the mean (SD) of a maximum possible score of 5 for each of the components. In order to gain insight of the perceived usefulness of skills training among learners, focused group discussions (FGDs) were conducted. Results The mean (SD) score for perceived importance ranged from 5 (0) to 4.9 (0.2) for various skills. The proportion of interns who felt confident in performing the skill after the training was 88.1% for IV cannulation to 97.6% handwashing, and gloving and gowning. The findings of the qualitative component revealed that interns found the training to be useful and interesting. It was perceived to be more ethical, uniform, well-structured, and provided an opportunity to practice a skill repeatedly. Conclusions The blended learning approach was perceived to be useful among the medical interns. Further research may be conducted in other medical institutes to assess the effectiveness of skills training. Clinical trial registration number Not applicable, as the study is not a trial.