Abstract Intestinal ultrasound (IUS) is increasingly recognized as a vital, non-invasive tool for managing inflammatory bowel disease (IBD) due to its real-time assessment capabilities and patient comfort. However, the lack of standardized training pathways remains a significant barrier to its widespread adoption, particularly in low- and middle-income settings. This editorial evaluates the implementation of a mastery learning-based workshop in Indonesia designed to enhance IUS skills among physicians. The mastery learning framework—incorporating flipped learning, deliberate practice, and real-time feedback led to significant improvements in technical performance with large effect sizes. Despite these gains, only about two-thirds of participants achieved competency in sigmoid colon scanning, and only half met the standard for terminal ileum assessment. This suggests that while short-term intensive workshops are effective for early skill acquisition, they may be insufficient for ensuring consistent proficiency in technically demanding tasks. Mastery learning offers a structured and reproducible approach to gastroenterology procedural training. To translate these initial educational gains into durable clinical expertise, future programs should consider longitudinal curricula that include sustained practice, mentorship, and ongoing assessment.
Intestinal ultrasound ; mastery learning ; Inflammatory bowel disease ; medical education ; competency-based training ; gastroenterology

BACKGROUND : Artificial intelligence (AI) offers innovative and efficient training methods for neurosurgery residents, yet existing evidence remains fragmented, often limited to specific technological applications and failing to fully assess their impact on clinical competence. Therefore, this study aimed to map the current evidence on AI applications in neurosurgery and curriculum development. METHODS : This study was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines by searching for observational or experimental studies on AI in neurosurgery residency education (2020–2025) in PubMed, ScienceDirect, and Google Scholar. Keywords included variations of “training,” “artificial intelligence,” and “neurosurgery”. After screening 719 initial records and assessing their eligibility, 10 studies were selected for narrative synthesis. RESULTS : A review of 10 studies reveals 2 key roles for AI in neurosurgical training: improving psychomotor skills through machine learning-integrated simulators and reinforcing theoretical knowledge through large language models (LLMs). Virtual reality (VR) simulators such as NeuroVR and virtual operative assistant provide objective metrics and personalized feedback, with assessment accuracy of up to 80%. LLMs such as ChatGPT show 50.4–84.8% accuracy in answering exam questions. However, simulators cannot yet capture all surgical competencies, and LLMs are still weak in processing image-based data. CONCLUSIONS AI can improve neurosurgical training through personalized, objective learning tools, but AI simulators and LLMs remain supplements and cannot replace human expertise in clinical reasoning and complex image interpretation.
artificial intelligence ; education ; internship and residency ; medicine ; neurosurgery ; simulation training

Resistance training promotes protein synthesis and hypertrophy, enhancing strength of skeletal muscle through the activation of the mammalian target of rapamycin (mTOR) and the subsequent increases of ribosome biogenesis and translation capacity. Recent studies indicate that resistance training has positive effects on physical fitness and illness treatment, yet the mechanisms underlying hypertrophic adaptation remain insufficiently understood. Human studies focused on the correlation between mTOR signals and hypertrophy-related protein production, while animal research demonstrated that mTOR complex 1 (mTORC1) is the main regulator of resistance training induced-hypertrophy. A number of upstream factors of mTORC1 have been identified, while the downstream mechanisms involved in the resistance training induced-hypertrophy are rarely studied. mTORC1 regulates the activation of satellite cells, which fuse with pre-existing fibers and contribute to hypertrophic response to resistance training. This article reviews the research progress on the mechanism of skeletal muscle hypertrophy caused by resistance training, analyzes the role of mTOR-related signals in the adaptation of skeletal muscle hypertrophy, and aims to provide a basis for basic research on muscle improvements through resistance training.
TOR Serine-Threonine Kinases/physiology* ; Resistance Training ; Humans ; Signal Transduction/physiology* ; Muscle, Skeletal/physiology* ; Hypertrophy ; Animals ; Mechanistic Target of Rapamycin Complex 1

The purpose of the present study was to investigate the effects of resistance combined with aerobic chrono-exercise on the common carotid artery elasticity and hemodynamics. 24 healthy young men (21.96±0.43 years old) underwent a single acute resistance combined with aerobic exercise intervention at eight time periods (6, 8, 10, 12, 14, 16, 18, and 20 o'clock). The axial flow velocity and diameter waveforms of the common carotid artery were measured, and the hemodynamics were calculated using the classical hemodynamic theory before exercise, immediately after exercise, 10 min and 20 min after exercise. The results showed that during exercise recovery, systolic and mean pressures decreased more markedly after exercise at 8 o'clock (P < 0.05); At 20 min post-exercise, arterial stiffness index and pressure-strain elastic modulus after exercise at 6 o'clock were reduced compared with the resting state, but were significantly elevated after exercise at 20 o'clock (P < 0.05). Immediately after exercise, the pressure rise was higher after exercise at 6 o'clock and the mean wall shear stress was higher after exercise at 20 o'clock (P < 0.05). These results suggest that resistance combined with aerobic chrono-exercise produces different effects on common carotid artery hemodynamics in young men. A single acute session of resistance combined with aerobic exercise at 8 o'clock is more effective in lowering blood pressure. Exercise at 6 o'clock is beneficial to improve arterial elasticity but is not recommended for young male individuals with cardiovascular disease risks because of the excessive increase in blood pressure immediately after exercise. Exercise at 20 o'clock is more effective in improving wall shear stress but is accompanied by elevated arterial stiffness indices and pressure-strain elastic modulus. These results provide a scientific basis for healthy young men in choosing the time of exercise by exploring the common carotid artery elasticity and hemodynamic-related indices.
Humans ; Male ; Young Adult ; Exercise/physiology* ; Carotid Artery, Common/physiology* ; Hemodynamics/physiology* ; Vascular Stiffness/physiology* ; Elasticity ; Resistance Training ; Adult

Objective To analyze the research status of in situ simulation in the medical field and explore its hotspots and trends. Methods Relevant literature was searched in China National Knowledge Infrastructure and Web of Science core collection from the inception to February 2024.CiteSpace 6.3.R1 was used to analyze the authors,institutions,and keywords and draw visual knowledge maps. Results A total of 25 Chinese articles and 438 English articles were included.Only 14 English articles were from China.In Chinese articles,the authors with the largest number of articles were Dai Hengmao and Liu Shangkun,and the institution with the largest number of articles was Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.There was little cooperation between the authors and institutions.In English articles,the author and institution with the largest number of articles was Auerbach Marc and Yale University,respectively,and the cooperation between authors and institutions was close.Emergency medicine,emergency event handling,and on-the-job training were the keywords with high frequency in Chinese articles.Patient safety,medical education,and cardiac arrest were the keywords with high frequency in English articles.A total of 4 clusters were generated for Chinese keywords and 13 clusters for English keywords. Conclusions The application of in situ simulation in the medical field is still in the initial stage,and the development is not balanced at home and abroad.The number of articles published and the cooperation between authors and institutions in China obviously lags behind those abroad.Treatment and care of emergency critical patients,emergency event handling and skill training,identification of latent safety threats,improvement of readiness,and promotion of medical quality improvement are the future research hotspots and research trends in this field.
Bibliometrics ; Humans ; China ; Simulation Training ; Education, Medical ; Emergency Medicine/education*

The country’s cardiology centers have been producing subspecialists in the field of Invasive and Interventional Cardiology. To date, 11 hospitals and/or medical centers are involved in training these subspecialists in a 1 to 2-year program. And to this date, there have been no uniform standards and guidelines as to what comprises the basic and/or acceptable training outcomes for the interventionalist in training. This paper describes the development of the core curriculum for an interventional cardiovascular training program to prepare its trainees to be competent in performing invasive diagnostic and interventional cardiovascular procedures as part of comprehensive patient care. The task force for the core curriculum of the interventional training program gathered several officers and leaders of the PSCCI, the training heads of the various interventional programs in the country, as well as experts in the field of cardiology education. Through a series of meetings, consultations, and workshops, the task force laid out the template on which all the training programs would be based. Such a framework considered the international standards regarding minimum caseloads for interventional training and the peculiar situation of each training institution. International standards like the Core Cardiovascular Training Statement (COCATS 4) Task Force 10: Training in Cardiac Catheterizations and the 2020 EAPCI Core Curriculum for Percutaneous Cardiovascular Interventions served as the reference framework for key recommendations. A consensus was achieved that upheld the highest standards of competence without disenfranchising certain institutions due to intricacies and uniqueness of hospital set-up and training situation.

BACKGROUND

Simulation immerses learners in guided replications of real-life experiences. Simulation-based learning in the health profession allows trainees and professionals to practice skills in a controlled environment using various modalities, enhancing patient safety and minimizing clinical errors.

To describe the profile of Philippine studies on clinical simulation in healthcare professional education and assess the methodological quality of these studies.

We conducted a scoping review of studies on clinical simulation studies in healthcare education in the Philippines. We followed the methods for scoping review and reported using the PRISMA Scoping review checklist. We searched for relevant studies from electronic databases (PubMed, Scopus, CENTRAL, Herdin, and Cochrane) as of May 17, 2024, and summarized descriptive data on the characteristics of the study, population, clinical simulation technique, and outcomes, using graphical summaries and tables. We assessed the methodological quality of included studies using the Modified Medical Education Research Study Quality Instrument (MMERSQI).

We included 13 studies mostly published in the 2020s (7), by faculty as main author (9), with hospital affiliation (10), single-center (11), setting in NCR (11), analytic (10), medical field (10), educational purpose (7), using task trainers (5), low- to medium-fidelity (11), with technical competencies (mostly skills) as desired outcome (9), median sample size of 40, and including mostly postgraduate level participants (7). There was moderate methodological quality (median MMERSQI score, 51 [range, 40, 77] with the ‘type of data’ item being highly reported and ‘validity of instrument tool’ item poorly reported.

The observed gaps in methodological rigor, study design, and fidelity of simulation techniques in healthcare education in the Philippines highlight opportunities for advancing the field. Future research should aim to address these gaps, particularly by increasing the use of RCTs, enhancing the validity of measurement tools, and incorporating comprehensive simulation components.

BACKGROUND AND OBJECTIVE

Anatomical education utilizes mainly cadaver dissection, but it also depends on innovations such as novel preservation techniques, simulation models, and virtual dissection apps. There is no review on anatomical patents. This study aimed to review the worldwide landscape of existing patents on anatomical education to identify gaps and opportunities for utilization and further innovations.

We conducted a scoping review for inventions, utility models, and industrial design applications on anatomical education. We searched the following databases as of December 31, 2022 (WIPO Patentscope, Espacenet, and Derwent). We deduplicated the records, screened them for eligibility, and extracted information on characteristics of the patent application and applicant. We computed frequency and percentage according to country, type of applicant, number of inventors, type of patent, scope of patent, purpose of patent, organ system, status of patent, and time to patent granting.

Out of 667 merged records from the initial search, we removed 312 duplicates, excluded 97 records, and included 258 reports in the review. The median number of patent applications per year was 58 (range, 32, 61). Majority of the applications were from China and USA (36.0 and 34.9%, respectively), national in scope (62.8%), industry as applicant (49.6%), inventions (77.5%), usable beyond anatomy (70.9%), physical models (53.1%) and with pending status (63.6%). The median time to granting for 65 patents was 316 days (range, 40 to 1568).

For the period 2018-2022, there were 258 patent applications related to anatomical education, both as a basic science and in clinical applications, were mostly inventions, applied for by industry, contributed by US and China, only national in scope, physical 3D models (mostly musculoskeletal, head/neck and sensory organs, and whole body), and usable beyond basic anatomy. The majority of patent applications are still pending with only 65 granted patents. Plastinated specimens, and the urinary, reproductive, and pulmonary organ system models were least represented.

BACKGROUND AND OBJECTIVE

Morbidity and mortality conferences (M&M) have been an important part of the hospital governance since the early 1900s. It has been shown to improve overall quality of care, minimize adverse occurrences and preventable fatalities, and provide chances for educational learning. However, medical trainees have different perceptions of M&M conferences which may affect its effectiveness in improving patient outcomes. The aim of this study is to determine the perception of surgical trainees towards M&M conferences.

The study is a questionnaire-based survey among surgical trainees of the Department of Surgery, Philippine General Hospital (PGH), for the training year of 2023. The survey consisted of 24 questions on their perception regarding the conduct of M&M. A Likert scale was used by the respondents to rate their perceptions (1 – negative, 10 – positive). Descriptive analysis and ANOVA were used to summarize the responses to the survey.

A total of 64 surgical trainees from the Department of Surgery responded to the survey (response rate = 71.9%). Most respondents (68.8%) reported that the ideal frequency of M&M conferences is once a month. 78.1% were not aware of the inclusion criteria of the cases discussed in the departmental M&M conferences. Most reported (64.1%) that M&M conferences did not regularly include data on outpatient events. A mean rating of 5.2 was observed among surgical trainees on how judgmental they feel about the environment of M&M conferences. Surgical trainees were willing to talk openly about their complications (mean rating 7.1). They were fearful of criticism (mean rating 4.4) and the negative repercussions of their presentations (mean rating 4.1) during M&M conferences. The respondents perceive M&M conferences to be conducive for learning and service improvement with both having a mean rating of 7.8. Most felt that M&M conferences focused on the individual performance (mean rating 7.3) while participants were divided regarding the focus on systems and processes (mean rating of 5.6). In terms of dissemination, about half (45.3%) mentioned that they did not know how the discussions/outcomes were disseminated following an M&M conference. The mean rating of willingness to talk openly of complications were significantly higher among senior residents (7.7) compared to junior residents (6.3) (p=0.008).

This study observed variability in the perceptions of surgical trainees on M&M conferences. Surgical trainees tend to feel fear of criticism and negative repercussions during M&M conferences. There are opportunities for improving the format of M&M in terms of clarity of inclusion criteria and dissemination, and focusing on systems and processes rather than individual faults.

RATIONALE AND OBJECTIVES

The COVID- 19 pandemic and the subsequent designation of the Philippine General Hospital lead to necessary adjustments in internal medicine residency training. This study investigated the impact of the COVID-19 pandemic on internal medicine (IM) residents in the Philippine General Hospital.

A questionnaire was developed and distributed among internal medicine residents employed in the years 2020 and 2021. Qualitative data was then gathered through on line and face-to-face interviews.

A total of 43 Internal Medicine residents responded. This study found that the pandemic significantly affected internal medicine residents and their overall training. The participants reported changes in the number and profile of patients seen, the limited outpatient clinical exposure, the difficulties of telemedicine, and the reduced interactions with consultants and subspecialty fellows. Infection control protocols and workforce limitations also affected the number of procedures done by the residents. Resident participants reported that they were able to allot more time to studying from the textbook because of the skeletal schedules and decreased number of patients. Other learning avenues were shifted to online conferences and lectures.

The COVID-19 pandemic a lso brought about changes in residents' day-to-day routines, schedules, and rotations. Communicating with patients and relatives was also reported to be more difficult. Lifestyle changes varied among resident s. Socialization also shifted to online avenues and social messaging platforms. Having colleagues who test positive tor COVID and subsequently requiring quarantine lead to constant changes in workforce dynamics. This lead to feelings of anxiety and isolation among its trainees.

However, a number of participants still believed that the pandemic allowed them to become better physicians. This was brought about by a sense of service and pride, camaraderie among colleagues, commitment to finishing the program, financial stability, and administrative support. Still, the participants stated areas for improvement, including more consistent protocol measures, additional financial compensation, added workforce, and more transparent administrative support. All in all, participants felt that they were still able to meet the learning outcomes and minimum competencies. Majority of the participants believed the experiences brought about by the pandemic helped them become a better internist.

Ultimately, the new challenges from the pandemic strengthened the sense of service, resilience and clinical acumen of the residents.