Postgraduate Medical Journal最新文献

{"title":"Dicle University Hospital's hospital disaster plan and emergency service management: Kahramanmaraş earthquake experience.","authors":"Mahmut Yaman, Şilan Göger Ülgüt, Abdullah Şen, Ali Fırat Ülgüt, Sema Belek, Hasan Mansur Durgun","doi":"10.1093/postmj/qgae171","DOIUrl":"https://doi.org/10.1093/postmj/qgae171","url":null,"abstract":"<p><strong>Background: </strong>Hospitals, being establishments with varying functions and capacities, must have disaster plans that reduce vulnerability, ensure the continuity, and possibly increase the capacity of healthcare services; these measures are crucial for reducing mortality and facilitating the normalization of life after a disaster. In this study, the aim was to analyze the operational process of the disaster management plan at Dicle University Faculty of Medicine Hospital following the earthquake in Kahramanmaraş on 6 February 2023.</p><p><strong>Methods: </strong>This is a retrospective observational study. The study focused on determining the role of the hospital's disaster plan in crisis situations, specifically examining the emergency service task distribution and management.</p><p><strong>Results: </strong>The study included patients aged 1 to 85 years (median 34, mean 36.9 ± 19.0), with 52.5% being female. The median injury severity score was 17 (mean 20.1 ± 19.2). Hospital admission was 65.7%, with nephrology and orthopedics being the most common departments. Higher injury severity scores were significantly associated with mortality (P < .05), and dialysis and surgery rates were significantly higher in deceased patients (P < .05). No significant differences were found in age, gender, or comorbidities between groups.</p><p><strong>Conclusion: </strong>The earthquake highlighted the importance of disaster preparedness in hospitals for effective patient care, collaboration among disciplines, and resource management. Detailed data on the hospital's disaster plan and its operational process during the earthquake were provided to underscore its critical role in managing the crisis. Lessons learned will shape future disaster response protocols, stressing continual evaluation and improvement in healthcare disaster readiness.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What should you have in your little black bag? A letter to a young doctor.","authors":"Ami Schattner","doi":"10.1093/postmj/qgae174","DOIUrl":"https://doi.org/10.1093/postmj/qgae174","url":null,"abstract":"<p><p>Rather than looking at which instruments to put in the traditional physician's black bag, the changing face of medicine suggests that some virtual assets assume prime importance. With a solid background of core knowledge and skills acquired through medical school but continuously developed and updated, several habitual attitudes are advocated-each aiming to address a different facet of concerns in today's time-constrained, often impersonal, fast-changing, information-overloaded, and highly technological practice. They include humility, curiosity, \"red flag\" identification, and reflexive database consultation-each with myriad, diverse advantages.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT versus expert feedback on clinical reasoning questions and their effect on learning: a randomized controlled trial.","authors":"Feray Ekin Çiçek, Müşerref Ülker, Menekşe Özer, Yavuz Selim Kıyak","doi":"10.1093/postmj/qgae170","DOIUrl":"https://doi.org/10.1093/postmj/qgae170","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness of ChatGPT-generated feedback compared to expert-written feedback in improving clinical reasoning skills among first-year medical students.</p><p><strong>Methods: </strong>This is a randomized controlled trial conducted at a single medical school and involved 129 first-year medical students who were randomly assigned to two groups. Both groups completed three formative tests with feedback on urinary tract infections (UTIs; uncomplicated, complicated, pyelonephritis) over five consecutive days as a spaced repetition, receiving either expert-written feedback (control, n = 65) or ChatGPT-generated feedback (experiment, n = 64). Clinical reasoning skills were assessed using Key-Features Questions (KFQs) immediately after the intervention and 10 days later. Students' critical approach to artificial intelligence (AI) was also measured before and after disclosing the AI involvement in feedback generation.</p><p><strong>Results: </strong>There was no significant difference between the mean scores of the control (immediate: 78.5 ± 20.6 delayed: 78.0 ± 21.2) and experiment (immediate: 74.7 ± 15.1, delayed: 76.0 ± 14.5) groups in overall performance on Key-Features Questions (out of 120 points) immediately (P = .26) or after 10 days (P = .57), with small effect sizes. However, the control group outperformed the ChatGPT group in complicated urinary tract infection cases (P < .001). The experiment group showed a significantly higher critical approach to AI after disclosing, with medium-large effect sizes.</p><p><strong>Conclusions: </strong>ChatGPT-generated feedback can be an effective alternative to expert feedback in improving clinical reasoning skills in medical students, particularly in resource-constrained settings with limited expert availability. However, AI-generated feedback may lack the nuance needed for more complex cases, emphasizing the need for expert review. Additionally, exposure to the drawbacks in AI-generated feedback can enhance students' critical approach towards AI-generated educational content.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"London Major Trauma System: a review of an organised trauma system and the challenges it faces.","authors":"Matthew Edmunds","doi":"10.1093/postmj/qgae168","DOIUrl":"https://doi.org/10.1093/postmj/qgae168","url":null,"abstract":"<p><p>London Major Trauma System (LMTS) was the first organised trauma system in the United Kingdom. It was created in 2010 in response to multiple reviews that suggested a large number of deaths from trauma may have been preventable. LMTS has all the features of a modern organised trauma system, including regionalisation, integration of care, transfer services, trauma teams, and a world leading research service. Since its introduction the benefits on mortality, morbidity, and other key metrics have been widely demonstrated. Despite its success, LMTS still faces a number of challenges; most notably from the ageing population, but also in ensuring equity of improvements across the entirety of the trauma network and throughout the whole patient journey. The very nature of LMTS being an inclusive and organised trauma system will help it in facing these challenges.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using freedom of information requests to access novel data sources in health professions education research.","authors":"Sophie E Yale, Megan E L Brown, Matthew H V Byrne","doi":"10.1093/postmj/qgae166","DOIUrl":"https://doi.org/10.1093/postmj/qgae166","url":null,"abstract":"<p><p>Educators and researchers are reliant upon access to data to drive teaching methods, curricular improvements, and progress in medical education research. However, data are not always accessible, due to resource constraints, institutional policies, and privacy concerns. Researchers have attempted to access novel data sources through surveys, semistructured interviews, and databases; however, these methodologies are limited. To improve access to data, Freedom of Information (FOI) Acts grant researchers the ability to formally request data that any public institute holds. Researchers have been reluctant to use this tool due to negative perceptions, despite its unique benefits. To increase awareness of this underutilized methodology, we summarize the process of FOI Act requests, its strengths and weaknesses, and the ways in which health professions education can leverage FOI requests within research. We provide examples of the use of FOI requests as a research method within adjacent fields and nascent use within the field of health professions research. In doing so, we hope to highlight how FOI requests can be a useful tool in health professions education researchers and its potential to increase access to unique data sources.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seductive emails, dangerous consequences: how predatory journals, conferences, and publishers target early-career researchers.","authors":"Hamrish Kumar Rajakumar","doi":"10.1093/postmj/qgae167","DOIUrl":"https://doi.org/10.1093/postmj/qgae167","url":null,"abstract":"<p><strong>Background: </strong>In recent years, early-career researchers and medical students have become targets of predatory publishers and conference organizers. These groups exploit the pressure to publish and gain recognition. They often offer tempting opportunities, such as fast publication, free travel, and prestigious positions. However, these offers often hide a profit-driven agenda. They lack academic integrity. Many of these events have little or no peer review. The impact metrics they claim are often inflated, and event details are vague.</p><p><strong>Objective: </strong>This paper aims to highlight the rise of predatory journals and conferences. It focuses on the harmful effects these organizations have on young researchers. We will identify the tactics they use. We will also point out key red flags. The goal is to help researchers, particularly medical students, understand how to navigate academic publishing and protect their careers.</p><p><strong>Conclusion: </strong>Predatory publishers and conferences pose a growing threat to academic integrity. Young researchers are especially vulnerable to these deceptive practices. It is important for academics to recognize warning signs. They should focus on quality over quantity when publishing. Educating the next generation of researchers is essential for preserving academic credibility.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An introduction to anatomical pathology.","authors":"Jack D Hywood, Albert H Yin","doi":"10.1093/postmj/qgae160","DOIUrl":"https://doi.org/10.1093/postmj/qgae160","url":null,"abstract":"<p><p>Our experience in the Australian context is that medical students and clinicians receive minimal exposure to anatomical pathology throughout the course of their training. In this paper, we bring this topic to light by describing the process of converting an intact specimen into glass slides for microscopic analysis. We also explain how a pathological report is composed, along with brief discussions about ancillary tests, such as immunohistochemistry, special stains, and molecular testing. Our main goal is to familiarize clinicians with anatomical pathology in order to improve communication between clinicians and pathologists, as well as improve the quality of testing and patient care.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the pathophysiology of restless leg syndrome: focus on white matter structure and function.","authors":"Zairan Wang, Zhimin Li, Jingjing Wang, Jun Gao, Yongning Li","doi":"10.1093/postmj/qgae156","DOIUrl":"https://doi.org/10.1093/postmj/qgae156","url":null,"abstract":"<p><strong>Background: </strong>Restless legs syndrome (RLS) is a sleep disorder characterized by an irresistible urge to move the legs, with pathogenesis involving genetic, environmental, and neurobiological factors. Recent advancements in imaging techniques have provided valuable insights into the pathophysiological mechanisms of RLS.</p><p><strong>Objective: </strong>To synthesize recent research on white matter fiber alterations in RLS and their role in disease pathology.</p><p><strong>Materials and methods: </strong>This review synthesized recent research on RLS, focusing on neuroimaging findings, particularly white matter fiber alterations, and their implications for disease mechanisms. Studies involving structural and functional MRI were analyzed.</p><p><strong>Results: </strong>Imaging studies suggested that RLS was associated with white matter integrity changes, affecting areas linked to sensory and motor control. These alterations may reflect disruptions in central nervous system pathways regulating movement.</p><p><strong>Conclusion: </strong>White matter changes provide valuable insights into the pathophysiology of RLS, enhancing our understanding of the disorder and potentially guiding future therapeutic strategies.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a major amputation prediction model and nomogram in patients with diabetic foot.","authors":"Yi Chen, Jun Zhuang, Caizhe Yang","doi":"10.1093/postmj/qgae087","DOIUrl":"10.1093/postmj/qgae087","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus, as one of the world's fastest-growing diseases, is a chronic metabolic disease that has now become a public health problem worldwide. The purpose of this research was to develop a predictive nomogram model to demonstrate the risk of major amputation in patients with diabetic foot.</p><p><strong>Methods: </strong>A total of 634 Type 2 Diabetes Mellitus (T2DM) patients with diabetic foot ulcer hospitalized at the Air Force Medical Center between January 2018 and December 2023 were included in our retrospective study. There were 468 males (73.82%) and 166 females (26.18%) with an average age of 61.64 ± 11.27 years and average body mass index of 24.45 ± 3.56 kg/m2. The predictive factors were evaluated by single factor logistic regression and multiple logistic regression and the predictive nomogram was established with these features. Receiver operating characteristic (subject working characteristic curve) and their area under the curve, calibration curve, and decision curve analysis of this major amputation nomogram were assessed. Model validation was performed by the internal validation set, and the receiver operating characteristic curve, calibration curve, and decision curve analysis were used to further evaluate the nomogram model performance and clinical usefulness.</p><p><strong>Results: </strong>Predictors contained in this predictive model included body mass index, ulcer sites, hemoglobin, neutrophil-to-lymphocyte ratio, blood uric acid (BUA), and ejection fraction. Good discrimination with a C-index of 0.957 (95% CI, 0.931-0.983) in the training group and a C-index of 0.987 (95% CI, 0.969-1.000) in the validation cohort were showed with this predictive model. Good calibration were displayed. The decision curve analysis showed that using the nomogram prediction model in the training cohort and validation cohort would respectively have clinical benefits.</p><p><strong>Conclusion: </strong>This new nomogram incorporating body mass index, ulcer sites, hemoglobin, neutrophil-to-lymphocyte ratio, BUA, and ejection fraction has good accuracy and good predictive value for predicting the risk of major amputation in patients with diabetic foot.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"908-916"},"PeriodicalIF":3.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authentic assessment in medical education: exploring AI integration and student-as-partners collaboration.","authors":"Syeda Sadia Fatima, Nabeel Ashfaque Sheikh, Athar Osama","doi":"10.1093/postmj/qgae088","DOIUrl":"10.1093/postmj/qgae088","url":null,"abstract":"<p><strong>Background: </strong>Traditional assessments often lack flexibility, personalized feedback, real-world applicability, and the ability to measure skills beyond rote memorization. These may not adequately accommodate diverse learning styles and preferences, nor do they always foster critical thinking or creativity. The inclusion of Artificial Intelligence (AI), especially Generative Pre-trained Transformers, in medical education marks a significant shift, offering both exciting opportunities and notable challenges for authentic assessment practices. Various fields, including anatomy, physiology, pharmacy, dentistry, and pathology, are anticipated to employ the metaverse for authentic assessments increasingly. This innovative approach will likely enable students to engage in immersive, project-based learning experiences, facilitating interdisciplinary collaboration and providing a platform for real-world application of knowledge and skills.</p><p><strong>Methods: </strong>This commentary paper explores how AI, authentic assessment, and Student-as-Partners (SaP) methodologies can work together to reshape assessment practices in medical education.</p><p><strong>Results: </strong>The paper provides practical insights into effectively utilizing AI tools to create authentic assessments, offering educators actionable guidance to enhance their teaching practices. It also addresses the challenges and ethical considerations inherent in implementing AI-driven assessments, emphasizing the need for responsible and inclusive practices within medical education. Advocating for a collaborative approach between AI and SaP methodologies, the commentary proposes a robust plan to ensure ethical use while upholding academic integrity.</p><p><strong>Conclusion: </strong>Through navigating emerging assessment paradigms and promoting genuine evaluation of medical knowledge and proficiency, this collaborative effort aims to elevate the quality of medical education and better prepare learners for the complexities of clinical practice.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"959-967"},"PeriodicalIF":3.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}