BACKGROUND AND OBJECTIVE

The Philippines has significant potential as a clinical trial hub but faces a shortage of skilled clinical research professionals (CRPs). In 2022, a cross-sectional study assessed the self-assessed competencies of CRPs in four countries (Thailand, Vietnam, Congo, Philippines) using the Joint Task Force for Clinical Trial Competency (JTF) framework. This paper presents findings on the self-assessed competency and training needs of Filipino CRPs.

We conducted a cross-sectional online survey among Filipino clinical research professionals from March to April 2022. We asked for their self-assessed competency, relevance to their roles, and training needs in the competency domains according to the JTF framework. We also asked for the skills in community engagement and research grant application of the investigators. Results were summarized and analyzed according to their primary roles.

One hundred seventy-five (175) Filipino CRPs participated in the survey. They described themselves as “skilled” across all competency domains in conducting clinical research but did not rate themselves at an advanced level. They reported the lowest confidence in their skills related to study management, investigational product development and regulation, and data management. They exhibited greater confidence in competencies such as ethical considerations, professionalism, and communication. Notably, surveyed investigators had the lowest ratings in research design.

This study provides a comprehensive assessment of the self-perceived competencies of a sample of Filipino CRPs using the JTF Clinical Research Competency Framework. It highlights key areas for capacity building, particularly in operational and regulatory competencies. However, due to the non-probability sampling and reliance on self-assessment, findings should be interpreted with caution.

Objectives To learn the echocardiography skills of intensivists after receiving a basic critical care echocardiography training course, and investigate factors that may influence their performance. Methods We completed a web-based questionnaire that assessed the skills in ultrasound scanning techniques of intensivists who took a training course on basic critical care echocardiography held in 2019 and 2020. Mann-Whitney test was used to analyze the factors which might affect their performance on image acquisition, recognizing clinical syndrome, and measuring the diameter of inferior vena cava, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral.Results We enrolled 554 physicians from 412 intensive care units across China. Among them, 185 (33.4%) reported that they had 10%-30% chance of being misled by critical care echocardiography when making therapeutic decision, and 34 (6.1%) reported that the chance was greater than 30%. Intensivists who performed echocardiography under the guidance of a mentor and finished ultrasound scanning more than 10 times per week reported significant higher scores in image acquisition, clinical syndrome recognition, and quantitative measurement of inferior vena cava diameter, left ventricular ejection fraction and left ventricular outflow tract velocity-time integral than those without mentor and performing echocardiography 10 times or less per week respectively (all P < 0.05).Conclusion The skills in diagnostic medical echocardiography of Chinese intensivists after a basic echocardiographic training course remain low, and further quality assurance training program is clearly warranted.
Humans ; Clinical Competence ; East Asian People ; Echocardiography/standards* ; Stroke Volume ; Ventricular Function, Left ; Self-Assessment ; Physicians/standards* ; Internal Medicine/standards*

Atrial Fibrillation/diagnosis* ; Humans ; Quality of Life ; Self Report ; Symptom Assessment

Background: The skill of active listening is important in the diagnosis and management of patients by physicians. Objective: The aim of the study was to determine the self-assessed active listening skills and attitude among resident physicians in a tertiary hospital in Iloilo City. Methods: This is a cross sectional study which recruited all sixty-two resident physicians of the different residency training programs of Iloilo Mission Hospital. The participants answered a self-administered questionnaire in January 2020. Data entry and data analysis were done using Microsoft Excel and SPSS. Descriptive statistics were used to summarize the level of active listening skills and attitude of the respondents. ANOVA, T-test, and Pearson chi square at alpha level 0.05 were used to determine the association between the variables. Results: Majority (87%) of resident physicians had medium level of active listening skills and attitude based on their Active Listening Attitude Scale (ALAS) score. The remaining 13% had high ALAS score. There was no socio-economic variable that was found to be associated with ALAS score. Conclusions The resident physicians of Iloilo Mission Hospital have a medium to high level of active listening skills and attitude. The respondents believe that having good active listening skills will help them deal with their patients and honing such skills should be encouraged during residency training.
Self-Assessment ; Attitude ; Tertiary Care Centers ; Physicians

Background: Self-evaluation can augment the facilitation of acquiring knowledge, skills and attitude through a reflective method. Self-assessment video (SAV) can be a very useful reflective method tool that is student-centered and self-directed.

Objective: This study aimed to identify if SAV is an effective supplementary learning tool in improving cardiovascular examination knowledge, skills and attitude of second year medical students.

Methodology: A quasi-experimental two-group design with pre- and post-test was used. The study population by convenience sampling involved second year medical students of the University of Santo Tomas Faculty of Medicine and Surgery. A structured direct observation checklist on cardiovascular precordial examination was used, done on two occasions in a week interval period. The said examinations were recorded in a video and evaluated and scored by two independent facilitators on these two occasions. The experimental group had the opportunity to review their videos immediately after the two examinations and accomplished self-assessment form. One-Way Repeated Measures Multivariate Analysis of Variance (One-Way RM-MANOVA), a parametric multivariate test for between- and within group comparison of multiple dependent variables was used.

Results: It showed that there was a significant improvement in all parameters measured after the intervention (SAV in the experimental group compared to the control group).

Conclusion: The study showed that SAV is an effective supplementary learning tool in cardiovascular examination attitude, knowledge, and skills, and can be a very useful teaching and learning self-evaluation tool.

PURPOSE: The main purpose of this study was to compare the relationships between physical activity (measured using an accelerometer vs. self-reported) and cardiovascular disease risk factors. Differences in accelerometry physical activity between 10-minute bouts and total bouts were also compared.METHODS: Data originated from the Korea National Health and Nutrition Examination Survey. Logistic regression was used to predict cardiovascular disease risk from physical activity levels.RESULTS: Self-reported physical activity could not significantly predict the odds of having cardiovascular risk. However, the insufficiently active group classified according to the total-bout physical activity had significantly greater odds of having hypertension or prehypertension (odds ratio [OR], 1.35; 95% confidence interval [95% CI], 1.00–1.82), diabetes mellitus (OR, 1.77; 95% CI, 1.01–3.19), and dyslipidemia (OR, 1.65; 95% CI, 1.17–2.36) than the highly active group. Regarding the 10-minute bout physical activity, the inactive group had significantly greater odds of having only hypertension or prehypertension (OR, 1.67; 95% CI, 1.02–2.76) than the highly active group.CONCLUSION: Total-bout physical activity measured using an accelerometer could significantly predict the cardiovascular disease risk compared to 10-minute bout physical activity. However, self-reported physical activity could not significantly predict the cardiovascular disease risk.
Accelerometry ; Cardiovascular Diseases ; Diabetes Mellitus ; Dyslipidemias ; Hypertension ; Korea ; Logistic Models ; Motor Activity ; Nutrition Surveys ; Prehypertension ; Risk Assessment ; Risk Factors ; Self Report

BACKGROUND: The living arrangement has been suggested as an important factor affecting health. Recent studies have also suggested that there was a risk among elderly persons who were not alone. This study examined whether the detailed living arrangement was associated with a future decline in functional capacity in the elderly, by gender, in a Japanese suburban city. METHODS: A 3-year longitudinal questionnaire survey (baseline: 2011; follow-up: 2014) for aged 65 years or older was conducted in Kurihara city, Japan. Of the respondents in the baseline survey, we analyzed those who scored 13 points (a perfect score which indicates the highest functional capacity; n = 2627) on the Tokyo Metropolitan Institute of Gerontology Index of Competence at the baseline. The exposure was living arrangement at baseline, divided into five categories: "with spouse only," "living alone," "with child and his/her spouse," "with child without his/her spouse," and "with other family/person." The outcome was the decline in functional capacity at the follow-up survey (score decreased to 10 points or less from 13 points). RESULTS: Of the 2627 analyzed population, 1199 (45.6%) were men. The incidence of the decline was 5.8% in men and 5.9% in women. Multivariable logistic regression analyses adjusted for age, educational attainment, and health behavior and condition revealed that in women, the odds ratio of the decline was higher in living with child and his/her spouse (2.41, 95% confidence interval; 1.10-5.28) referring to living with spouse only. When adjusting activities inside and outside the home such as housework additionally, the association was attenuated to marginal significance (2.25, 0.98-5.18). No statistical significance was observed in men. CONCLUSIONS These results suggested that living with child and spouse of a child was associated with the future decline in women's functional capacity.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Geriatric Assessment ; Humans ; Independent Living ; statistics & numerical data ; Japan ; Longitudinal Studies ; Male ; Self Report

BACKGROUND: Clear and proper feedback is necessary to decrease the gap between knowledge and practice. Feedback can improve clinical competence of medical students up to expertise level.METHODS: A total of 180 4th-year students of Daegu-Kyungbuk consortium area participated in the scheduled feedback program of clinical performance examination on August 26th in 2017. Among them, 167 students filled out the questionnaire on helpfulness of the direct observation and feedback of faculty and standardized patient (SP), helpfulness for history taking (Hx), physical examination (PE), and patient-physician interaction (PPI), and any change of clinical competence and clinical reasoning of the students preand post-feedback. All the responses were measured on 5-point Likert scale.RESULTS: Among the total students, 88.6% responded that direct feedback at the practice is helpful, particularly 95.2% of faculty and 76.6% of SP. A 37.3% answered that it was helpful for all the categories of feedback, but only 25.3% for PE and 24.7% for Hx. A 56.3% responded that feedback is helpful for both disease questions and counseling practice. Mean score of self-assessment by the students increased from 2.52 to 3.36 for Hx, 2.30 to 3.24 for PE, 2.46 to 3.33 for clinical reasoning, 2.84 to 3.59 for PPI, and 2.44 to 3.28 for overall competence. And all these differences were found to be statistically significant (P <0.001)CONCLUSION: A majority of students responded that the direct feedback from faculty and SP was helpful at the clinical practice of Hx, PE, and PPI, and increased the level of clinical competence.
Clinical Competence ; Counseling ; Humans ; Mental Competency ; Physical Examination ; Self-Assessment ; Students, Medical

PURPOSE: The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls.METHODS: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls.RESULTS: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ≥81, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs.CONCLUSION: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.
Accidental Falls ; Comorbidity ; Gait Disorders, Neurologic ; Hospitalization ; Humans ; Incidence ; Inpatients ; Joints ; Nursing ; Organization and Administration ; Patient Care ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Self-Help Devices ; Survival Analysis ; Survival Rate ; Tertiary Care Centers

BACKGROUND: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. METHODS: We investigated 12 patients with indoor air–related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. RESULTS: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. CONCLUSION: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.
Anxiety ; Autonomic Nervous System ; Depression ; Disability Evaluation ; Fungi ; Humans ; Hydrocortisone ; Hypersensitivity ; Lung ; Multiple Chemical Sensitivity ; Odors ; Rehabilitation ; Self-Assessment ; Sleep Initiation and Maintenance Disorders ; Weights and Measures