Postgraduate medical journal
-
Clinical reasoning is a crucial skill and defining characteristic of the medical profession, which relates to intricate cognitive and decision-making processes that are needed to solve real-world clinical problems. However, much of our current competency-based medical education systems have focused on imparting swathes of content knowledge and skills to our medical trainees, without an adequate emphasis on strengthening the cognitive schema and psychological processes that govern actual decision-making in clinical environments. ⋯ In this article, we discuss the psychological constructs of clinical reasoning in the form of cognitive 'thought processing' models and real-world contextual or emotional influences on clinical decision-making. In addition, we propose practical strategies, including pedagogical development of a personal cognitive schema, mitigating strategies to combat cognitive bias and flawed reasoning, and emotional regulation and self-care techniques, which can be adopted in medical training to optimize physicians' clinical reasoning in real-world practice that effectively translates learnt knowledge and skill sets into good decisions and outcomes.
-
In recent years, triglyceride glucose (TyG) index, as a popular metabolic index, has been proposed as an alternative index of insulin resistance, and it has been proved to be associated with many cardiovascular diseases, but the relationship between it and aortic valve calcification is still unknown. ⋯ TyG index was significantly associated with the presence and severity of AVC, suggesting that TyG index may be a valid predictor of AVC.
-
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. ⋯ 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.
-
In "The Alternative Fairytale," I explore my journey as a cardiology registrar/fellow, a path influenced deeply by my early displacement from war-torn Sudan. This piece reflects on the interplay between my professional choices and personal identity amidst the backdrop of a male-dominated field and societal expectations. It examines how my roots in a family that once fled conflict have shaped my approach to medicine-emphasizing community, empathy, and a leadership style that diverges from traditional norms. Through this narrative, I aim to redefine and help others to reflect on what success looks like in cardiology and medicine; advocating for diversity in leadership styles and highlight the importance of personal background in shaping professional paths.
-
To analyze the changes in the characteristics of randomized controlled trials (RCTs) in the field of scarring over the last two decades, unveil the components of research waste (RW) within these RCTs, and identify targets for improvement. ⋯ This study delineates the changes in the characteristics of scar RCTs globally over the past two decades, uncovering a substantial burden of RW in scarring research. It provides an evidential reference for more rational planning of future scar-related RCTs and for minimizing RW.