BACKGROUND: Nursing interns encounter numerous professional pressures during clinical practice. Assessing adversity quotient levels and understanding the influencing factors are crucial for supporting students\' seamless transition to professional nurses.
OBJECTIVE: This study examined the adversity quotient subtypes of nursing interns and explored the relationships between adversity quotient and depression, coping styles, positive psychological capital, and professional adaptability.
METHODS: This study employed a cross-sectional research design, involving a survey of 287 nursing interns in five general hospitals in Shanghai, China. Latent profile analysis was conducted to explore the subtypes of adversity quotient with the four domains as input variables. Multinomial logistic regression models and multiple correspondence analysis were used for subsequent data analysis.
RESULTS: The average adversity quotient score of the nursing interns was 116.63 ± 32.22. A three-profile solution was obtained based on the latent profile analysis results. Three distinct subtypes emerged: a high-adversity quotient subtype (n = 50, 17.4%), a medium-adversity quotient subtype (n = 189, 65.9%), and a relatively low-adversity quotient subtype (n = 48, 16.7%). Multinomial logistic regression revealed that nursing interns in the high-adversity quotient subtype tended to be male, and had higher scores for positive psychological capital, negative coping style, and professional adaptability (p < 0.05).
CONCLUSIONS: Most of the nursing interns were in the medium adversity quotient subtype. Gender, positive psychological capital, negative coping style and professional adaptability were all significantly related to the adversity quotient. Boosting the positive psychological capital of nursing interns is an effective way to improve the adversity quotient.

OBJECTIVE: In the surgery-focused field of obstetrics and gynecology (OB-GYN), the development of residents\' skills is paramount. This study aims to evaluate the impact of an enhanced Peyton Four-Step Teaching Model on the foundational skill training of first-year OB-GYN residents.
METHODS: Utilizing a cohort study design, we assessed 116 first-year residents from the OB-GYN residency program at Shengjing Hospital of China Medical University from June 2021 to June 2023. The 57 residents beginning their training in 2022 were part of the Refined Peyton (RP) group, introduced to the RP method; the 59 residents from 2021 served as the Traditional Teaching-mode (TTM) group, receiving conventional simulation-based instruction. Teaching effectiveness was assessed by comparing theoretical knowledge and skill performance assessments, National Medical Licensing Examination (NMLE) pass rates, direct observation of procedural skills (DOPS) one year post-training, and survey feedback.
RESULTS: The theoretical knowledge scores for both groups were comparable at 78.78 ± 4.08 and 78.70 ± 3.83, with no significant difference (P = 0.76). However, the experimental group demonstrated superior performance in skill operation assessments, first-time NMLE pass rates, and DOPS evaluations one year after training [(77.05 ± 5.39) vs. (84.60 ± 5.65), 100.0% (57/57) vs. 86.4% (51/59), and (75.22 ± 3.56) vs. (82.54 ± 3.43)], as well as higher teaching satisfaction scores [(4.63 ± 0.46) vs. (3.92 ± 0.62)], with all differences being statistically significant (P < 0.05).
CONCLUSIONS: The refined Peyton Four-Step Teaching Model significantly improves the immediate acquisition and long-term retention of clinical basic skills among OB-GYN residents, enhancing both teaching efficacy and resident satisfaction.

BACKGROUND: The significance of problem-solving ability has been confirmed in numerous studies worldwide, highlighting its role in enhancing the skills of nursing interns and reducing psychological pressure. However, existing research indicates that the problem-solving ability of nursing interns urgently needs to be further improved. Limited research has been conducted on the problem-solving ability of nursing interns, and the correlations among problem-solving ability, future time perspective, and future work self of Chinese nursing interns are unclear.
OBJECTIVE: To investigate problem-solving ability, future time perspective, and future work self among the Chinese nursing interns, and to examine the relationships among these variables. Additionally, the study aims to explore the mediating role of future work self between problem-solving ability and future time perspective.
METHODS: A cross-sectional and correlational design was employed, adhering to the quality reporting conformed to the STROBE Checklist. From May 8, 2023, to February 15, 2024, 1,251 nursing interns were recruited from 15 tertiary grade-A hospitals across six cities in China. The Demographic Characteristics Questionnaire, Social Problem-Solving Inventory, Future Time Perspective Inventory, and Future Work Self Scale were used. The data was analyzed using descriptive statistics, univariate, correlation, and process plug-in mediation effect analyses.
RESULTS: The total scores for problem-solving ability, future time perspective, and future work self were 64.39 ± 18.55, 45.08 ± 11.37, and 16.92 ± 5.28, respectively. Problem-solving ability was positively correlated with future time perspective (r = 0.638, p < 0.001) and future work self (r = 0.625, p < 0.001). Additionally, future work self partially mediated mediating role between problem-solving ability and future time perspective, accounting for 39.7% of the total effect.
CONCLUSIONS: The problem-solving ability, future time perspective, and future work self among the Chinese nursing interns were relatively moderate, indicating a need for improvement. It is suggested that nursing managers and educators should actively implement career management and planning programs. By enhancing the future time perspective and future work self of nursing interns, their problem-solving ability can be improved. This, in turn, will facilitate their adaptation to clinical work, enhance the quality of nursing care, and promote the development of their nursing profession.

Purpose: To identify the main variables affecting the academic adaptability of hospital nursing interns and key areas for improvement in preparing for future unpredictable epidemics. Methods: The importance of academic resilience-related variables for all nursing interns was analyzed using the random forest method, and key variables were further identified. An importance-performance analysis was used to identify the key improvement gaps regarding the academic resilience of nursing interns in the case hospital. Results: The random forest showed that five items related to cooperation, motivation, confidence, communication, and difficulty with coping were the main variables impacting the academic resilience of nursing interns. Moreover, the importance-performance analysis revealed that three items regarding options examination, communication, and confidence were the key improvement areas for participating nursing interns in the case hospital. Conclusions: For the prevention and control of future unpredictable pandemics, hospital nursing departments can strengthen the link between interns, nurses, and physicians and promote their cooperation and communication during clinical practice. At the same time, an application can be created considering the results of this study and combined with machine learning methods for more in-depth research. These will improve the academic resilience of nursing interns during the routine management of pandemics within hospitals.

Objective: To explore the current situation of professional identity of intern nursing students in Shandong Province, to analyze the potential characteristics of different categories of intern nursing students\' professional identity, and to provide reference for formulating relevant intervention programs. Methods: From September to October 2023, using convenient cluster sampling, selected nursing students from different regions of Shandong Province colleges and universities as the research objects, a total of 1298 questionnaires were released and recovered, with 1221 valid questionnaires, and the effective recovery rate of questionnaires was 94.07%. General demographic data was collected, and information on nursing students\' professional identity was investigated with the Nursing Students\' Professional Identity Questionnaire, the Work Readiness Scale, and the Feedback Seeking Behavior Scale. Latent potential profiles of nursing students\' sense of professional identity were analyzed by Mplus 8.3 software, and the best-fitting model was selected by the test of fitness and difference. The χ(2) test was used for comparison between groups of count data, analysis of variance (ANOVA) was used for comparison between groups of measure data, and the effects of each factor on different potential profiles were analyzed by multivariate logistic analysis. Results: A total of 1221 intern nursing students were 984 (80.6%) females and 237 (19.4%) males, aged (21.12±2.96) years old, with a total score of (64.23±14.99) for nursing students\' professional identity. Nursing students\' professional identity was divided into 3 categories: 98 (8.0%) in the low identity group, 624 (51.4%) in the medium identity group, and 496 (40.6%) in the high identity group. The gender, region, age, work readiness scores and feedback seeking behavior scores of nursing students in different categories were different, and the differences were statistically significant (P<0.05). Compared with the high identity group, the nursing students in the low identity group were more likely to be included in the high identity group (OR=0.390, 0.167, P=0.005, 0.006) with higher work readiness and better feedback seeking behavior. Compared with the high identity group, the higher work readiness and non-Jinan areas of the medium identity group were more likely to be included in the high identity group (OR=0.597, 1.470, P=0.011, 0.012). Compared with the medium identity group, the more feedback seeking behaviors of the low identity group were more likely to be included in the medium identity group (OR=10.411, P<0.001) . Conclusion: The level of professional identity of intern nursing students can be classified into 3 categories, and nursing administrators can improve work readiness and increase feedback seeking behaviors according to the potential characteristics of the different types to enhance the professional identity of nursing students.
目的： 探讨山东省实习护生职业认同感的现状，分析不同类别实习护生职业认同感的潜在特征差异，为制定相关干预方案提供参考。 方法： 于2023年9至10月，采用方便整群抽样，选取山东省不同地区高校实习护生作为研究对象，共发放和回收问卷1 298份，有效问卷1 221份，有效回收率94.07%。收集一般人口学资料，用《护生职业认同感问卷》《工作准备度量表》《反馈寻求行为量表》对护生职业认同感等信息进行调查。通过Mplus 8.3软件对护生职业认同感进行潜在剖面分析，通过适配性和差异性检验选择最佳拟合模型；计数资料组间比较采用χ(2)检验，计量资料组间比较采用方差分析，各因素对不同潜在剖面的影响采用多元logistic分析。 结果： 1 221名实习护生中女性984人（80.6%），男性237人（19.4%），年龄（21.12±2.96）岁，护生职业认同感总得分（64.23±14.99）分。护生职业认同感分为3个类别：低认同感组98人（8.0%），中认同感组624人（51.4%），高认同感组496人（40.6%）。不同类别护生的性别、地区、年龄、工作准备度得分及反馈寻求行为得分不同，差异均有统计学意义（P<0.05）。与高认同感组护生比较，低认同感组护生工作准备度越高、反馈寻求行为越好，越容易纳入高职业认同感组（OR=0.390、0.167，P=0.005、0.006）；与高认同感组比较，中认同感组工作准备度越高、非济南市地区，越容易纳入高职业认同感组（OR=0.597、1.470，P=0.011、0.012）；与中认同感组比较，低认同感组寻求反馈行为越多，越容易纳入中职业认同感组（OR=10.411，P<0.001）。 结论： 实习护生职业认同感水平可分为3类，护理管理者可根据不同类型的潜在特征，提高工作准备度、增加反馈寻求行为，提升护生的职业认同感。.

UNASSIGNED: Nursing students often make clinical errors due to their limited clinical experience and their orientation toward errors, revealing their attitude and behavioral tendencies regarding nursing errors. Understanding how self-efficacy, motivation, and a sense of security influence the error orientation of nursing students is important for developing strategies to enhance their error orientation.
UNASSIGNED: This study aimed to explore the relationship between self-efficacy, motivation, and error orientation of nursing students during clinical internships.
UNASSIGNED: This was a cross-sectional study. An electronic questionnaire was distributed to nursing students from 14 September 2023 to 30 September at a comprehensive tertiary A teaching hospital in Zhengzhou, Henan province. The instruments used in this study included the General Information Questionnaire, General Self-efficacy Scale, Achievement Motives Scale, Security Scale, and Error Orientation Scale. Statistical Product and Service Software Automatically (SPSSAU) was used to perform statistical description, mediation analysis, and moderated mediation analyses.
UNASSIGNED: A total of 510 nursing students were included in this study. The motivation for success and failure-escaping fully mediated the relationships between self-efficacy and error orientation of nursing students, with a mediation effect of 0.101 (95% CI: 0.058-0.144). The security of nursing students moderated both the direct effect of this model and the indirect effect of motivation for failure-escaping. When security was high, the self-efficacy of nursing students was positively correlated with their error orientation, with an effect of 0.059 (95% CI: 0.003~0.116). When security was high, the moderation effect was significant, with an effect of -0.012 (95% CI: -0.026~-0.002). However, at low and median levels of security, the mediation effect was non-existent.
UNASSIGNED: The motivation for success and failure escaping play different roles in the paths between self-efficacy and error orientation. Clinical nursing teachers should take measures to enhance the motivation for success but reduce the failure-escaping motivation to improve the error orientation of nursing students. Additionally, it is crucial to pay attention to and improve the sense of security of students during clinical internships.

UNASSIGNED: To train highly qualified medical talent in 5-year programs and improve students\' analytical and problem-solving abilities, it is necessary to change the traditional teaching method. This study introduces the combined teaching method of case-based learning (CBL) and clinical pathway and evaluates its role in practical gynecological teaching.
UNASSIGNED: Medical students in a 5-year program who were enrolled in the fourth year were selected as the research subjects; these students were randomized into two groups that separately received either the traditional teaching method or the combined teaching method of CBL and clinical pathway. Before the internship, a questionnaire was administered to explore students\' views of internship in gynecology, and after the internship, the questionnaire was administered to assess the two teaching methods. Furthermore, theoretical and skill tests were performed both before and after the internship.
UNASSIGNED: A total of 206 medical students in a 5-year program who were in their fourth year were enrolled in the study. Students in the experimental group performed significantly better than those in the control group. They performed significantly better in the postinternship test than in the preinternship test (P < 0.001). The questionnaire showed that more students in the experimental group thought that their learning interests, clinical skills, case analysis ability, clinical communication ability, understanding of theoretical knowledge and clinical thinking ability had improved and significantly differed between the two groups (P < 0.05).
UNASSIGNED: Compared to traditional teaching methods, combined teaching method of CBL and clinical pathway can elevate students\' academic performance, improve their learning enthusiasm and help promote clinical teachers\' teaching quality. Additionally, this novel method is effective in facilitating the achievement of teaching objectives and improving the quality of talent training. Therefore, the combined teaching method of CBL and clinical pathway should be popularized and applied in gynecological practice.

BACKGROUND: Burnout is prevalent among pediatric residents. Self-efficacy and resilience, as concepts of positive psychology, may be protective factors for burnout. However, no current data demonstrates the mechanism of their interaction.
OBJECTIVE: To investigate the pediatric residents\' status of self-efficacy, resilience, and job burnout in a university-affiliated hospital in western China. To explore relationships among them, especially the mediating effects of resilience.
METHODS: The study was conducted with 190 pediatric residents from an A-Class women\'s and children\'s hospital in western China. Data included demographic characteristics, status of pediatric residents, measures of burnout (using the Physicians\' Career Burnout Questionnaire), self-efficacy (using the General Self-Efficacy Scale) and resilience (using the Connor-Davidson Resilience Scale). Multiple regression analysis and mediation analysis with bootstrapping were used to identify whether resilience mediates the relationship between self-efficacy and burnout.
RESULTS: Female pediatric residents exhibited significantly lower self-efficacy (t = 2.53, p<0.05) and higher levels of job burnout (t=-2.64, p<0.01) compared to male residents. Residents in the standardized training stage experienced higher levels of job burnout compared to those who had completed the training, as indicated by t-values of -3.21, -2.13, and - 2.80 (p<0.05). Significant correlations (p ≤ 0.01) were found among self-efficacy, resilience, and burnout. Additionally, our findings indicated that pediatric residents\' self-efficacy can positively predict job burnout and its three dimensions through a major mediating effect of resilience.
CONCLUSIONS: The findings regarding the mediating effect of resilience on the influence of self-efficacy on burnout, and their association with gender and residency status, have practical implications for interventions aimed at reducing burnout and improving the well-being of pediatric residents.

OBJECTIVE: To explore the application effect of mini clinical evaluation exercise (Mini-CEX) combined with direct observation of procedural skills (DOPS) in the standardized training of general practitioners in community clinics.
METHODS: From June 2022 to June 2023,20 general practitioners who received standardized training for residents in the general outpatient department of Changqing Community Health Service Center of Wuhan Fourth Hospital were collected as the research objects. Mini-CEX combined with DOPS was used to evaluate the general practitioners at the time of admission, 2 weeks of training and 4 weeks of training, and the results were fed back.
RESULTS: The scores of 20 general practitioners at 2 weeks and 4 weeks of training were compared with the scores at the time of admission, and the difference was statistically significant, p < 0.05.
CONCLUSIONS: Mini-CEX combined with DOPS can improve the teaching effect of standardized training of residents in community general clinics.

BACKGROUND: To evaluate the efficiency of artificial intelligence (AI)-assisted diagnosis system in the pulmonary nodule detection and diagnosis training of junior radiology residents and medical imaging students.
METHODS: The participants were divided into three groups. Medical imaging students of Grade 2020 in the Jinzhou Medical University were randomly divided into Groups 1 and 2; Group 3 comprised junior radiology residents. Group 1 used the traditional case-based teaching mode; Groups 2 and 3 used the \'AI intelligent assisted diagnosis system\' teaching mode. All participants performed localisation, grading and qualitative diagnosed of 1,057 lung nodules in 420 cases for seven rounds of testing after training. The sensitivity and number of false positive nodules in different densities (solid, pure ground glass, mixed ground glass and calcification), sizes (less than 5 mm, 5-10 mm and over 10 mm) and positions (subpleural, peripheral and central) of the pulmonary nodules in the three groups were detected. The pathological results and diagnostic opinions of radiologists formed the criteria. The detection rate, diagnostic compliance rate, false positive number/case, and kappa scores of the three groups were compared.
RESULTS: There was no statistical difference in baseline test scores between Groups 1 and 2, and there were statistical differences with Group 3 (P = 0.036 and 0.011). The detection rate of solid, pure ground glass and calcified nodules; small-, medium-, and large-diameter nodules; and peripheral nodules were significantly different among the three groups (P<0.05). After seven rounds of training, the diagnostic compliance rate increased in all three groups, with the largest increase in Group 2. The average kappa score increased from 0.508 to 0.704. The average kappa score for Rounds 1-4 and 5-7 were 0.595 and 0.714, respectively. The average kappa scores of Groups 1,2 and 3 increased from 0.478 to 0.658, 0.417 to 0.757, and 0.638 to 0.791, respectively.
CONCLUSIONS: The AI assisted diagnosis system is a valuable tool for training junior radiology residents and medical imaging students to perform pulmonary nodules detection and diagnosis.