Approach to syncope in the era of medical technology

Syncope is a common medical condition that continues to challenge residents and specialists. It is responsible for 6% of general medical admissions and imposes a financial burden for unnecessary tests up to $16,000 per patient. Because of its disabling potential and lack of a "gold standard" test, syncope often leads to multiple hospital admissions and to the performance of many tests thought to be useful in diagnosis. Our survey consisted of a series of medical questions aimed at assessing the medical knowledge among nurses, residents and cardiologists. Despite the frequency of syncope, our survey showed a lack of medical knowledge among nurses, residents and cardiologists. It is hoped that improving medical knowledge will allow appropriate tailoring of the workup for syncope and reduce the cost of admissions to the hospital for this condition.

[Using podcasts for the cardiologist's education and update]

Podcasting is a new technology tool for the automatic dissemination of audiovisual material to anyone with an Internet connection. For this and other reasons it is now proposed as a new service to educate and continuously update doctors, health professionals and medical students. International medical journals such as the New England Journal of Medicine and the Journal of the American Medical Association, medical associations such as the American Heart Association and the American College of Cardiology, government agencies and health institutions such as the Food and Drug Administration and the National Institutes of Health, international medical websites, and a number of universities in the US and UK have begun to publish digital information via audio and video podcasts. A podcast is easy to use, can be automatically downloaded to a portable media player as soon as it is posted on the provider's website, and can be listened to or viewed at any time and in any place. Furthermore, a subscribed user can aggregate podcasts from a variety of sources. The purpose of this paper is to describe what podcasting and podcasts are, and how they are currently used to educate and update cardiologists and health professionals working in the cardiology field.

The imperative for metrics in training

A twenty-first century model for the training and assessment of cardiac interventionists’ skills, outlined by Prof. John Morgan FRCP FESC.

1st Guidelines of the Brazilian Society of Cardiology on processes and skills for education in cardiology in Brazil--executive summary

This article summarizes the "1st Guidelines of the Brazilian Society of Cardiology on Processes and Skills for Education in Cardiology in Brazil," which can be found in full at: <http://publicacoes.cardiol.br/consenso/2011/diretriz-tec.asp>. The guideline establishes the education time required in Internal Medicine and Cardiology with Specialization through theoretical and practical training. These requirements must be available at the center forming Specialists in Cardiology and the Cardiology contents.

Adult congenital heart disease training in Europe: current status, disparities and potential solutions

OBJECTIVES

This study aimed to determine the status of training of adult congenital heart disease (ACHD) cardiologists in Europe.

METHODS

A questionnaire was sent to ACHD cardiologists from 34 European countries.

RESULTS

Representatives from 31 of 34 countries (91%) responded. ACHD cardiology was recognised by the respective ministry of Health in two countries (7%) as a subspecialty. Two countries (7%) have formally recognised ACHD training programmes, 15 (48%) have informal (neither accredited nor certified) training and 14 (45%) have very limited or no programme. Twenty-five countries (81%) described training ACHD doctors 'on the job'. The median number of ACHD centres per country was 4 (range 0-28), median number of ACHD surgical centres was 3 (0-26) and the median number of ACHD training centres was 2 (range 0-28). An established exit examination in ACHD was conducted in only one country (3%) and formal certification provided by two countries (7%). ACHD cardiologist number versus gross domestic product Pearson correlation coefficient=0.789 (p<0.001).

CONCLUSION

Formal or accredited training in ACHD is rare among European countries. Many countries have very limited or no training and resort to 'train people on the job'. Few countries provide either an exit examination or certification. Efforts to harmonise training and establish standards in exit examination and certification may improve training and consequently promote the alignment of high-quality patient care.

Paediatric/congenital cardiology physician scientists-An endangered species

Producing excellent physician scientists starts with the active discovery of talent and dedication, supported by the strong belief that physician involvement in biomedical research is essential to make fundamental discoveries that improve human health. The revolution of surgical and interventional therapy of structural heart disease has had 'profoundly positive effects on survival and quality of life over the decades. (…) Small increments in clinical improvement will still be possible in the future, but for the most part, the potential for major advancement using these techniques has been exhausted' (Frank Hanley, MD; Stanford). Personalized medicine, rapid genetic diagnostics, RNA and extracellular vesicle biology, epigenetics, gene editing, gene and stem cell-derived therapy are exemplary areas where specialized training for paediatric/congenital cardiology physician scientists will be increasingly needed to further advance the field. About a decade ago, a series in Circulation discussed academic career models and highlighted the major challenges facing the cardiovascular 'clinician scientist' (syn. physician scientist), which have not abated since. To develop the skills and expertise in both clinical congenital cardiology and basic research, the training of fellows must be focused and integrated. The current pandemic COVID-19 puts additional pressure and hurdles on fellows-in-training (FIT) and early career investigators (ECI) who aim to establish, consolidate or expand their own research group. Here, we discuss the major challenges, opportunities and necessary changes for academic institutions to sustain and recruit physician scientists in paediatric/congenital cardiology in the years to come.

[Ivan Alekseevich Chernogorov--the professor-cardiologist of the Moscow Stomatologic Institute]

The article presents the scientific biography of Ivan Alekseyevitch Tchernogorov, the prominent Moscow cardiologist, the disciple of D.D. Pletnyev and VF Zelenin.

Learning cardiac embryology on YouTube-What videos are there to view?

In modern medical curricula, embryology is typically taught through lectures, with a few institutions providing tutorials. The use of 3-D videos or animations enables students to study these embryological structures and how they change with time. The aim of this study was to assess the quality of cardiac embryology videos available on YouTube. A systematic literature review regarding the use of YouTube in teaching or learning cardiac embryology identified no papers that examined this specific question, and next, a systematic search of YouTube was performed. A total of 1200 cardiac embryology videos were retrieved using 12 specific search terms, with 370 videos retrieved under two or more search terms and excluded. A further 511 videos were excluded under additional, specific criteria. The remaining 319 videos were evaluated with the YouTube Video Assessment Criteria (UTvAC), with 121 rated as "useful." Videos on YouTube are uploaded with a wide audience in mind, from children to cardiologists, and content control is imperfect. Multiple videos were identified as duplicates of videos from original channels, typically without attribution. While 49 videos showed operations or human material, none contained an ethical statement regarding consent, and only 10 of these included an age restriction or graphical advisory. While there are useful videos for medical students studying cardiac embryology on YouTube, intuitive search strategies will also identify many with irrelevant content and of variable quality. Digital competence and search strategies are not innate skills, so educators should teach students to assess information so as to avoid overload or "filter failure."

Contemporary Training in American Critical Care Cardiology: Minnesota Critical Care Cardiology Education Summit: JACC Scientific Expert Panel

This consensus statement emerges from collaborative efforts among leading figures in critical care cardiology throughout the United States, who met to share their collective expertise on issues faced by those active in or pursuing contemporary critical care cardiology education. The panel applied fundamentals of adult education and curriculum design, reviewed requisite training necessary to provide high-quality care to critically ill patients with cardiac pathology, and devoted attention to a purposeful approach emphasizing diversity, equity, and inclusion in developing this nascent field. The resulting paper offers a comprehensive guide for current trainees, with insights about the present landscape of critical care cardiology while highlighting issues that need to be addressed for continued advancement. By delineating future directions with careful consideration and intentionality, this Expert Panel aims to facilitate the continued growth and maturation of critical care cardiology education and practice.