Research Medical Journal

The Role and Impact of Artificial Intelligence in Shaping Resident Doctor Education

Witthawin Sae-Lee — 2026-01-26

Artificial intelligence (AI) holds immense potential to transform resident doctor education by offering personalized, adaptive learning experiences and enhancing clinical skill development. Drawing from a literature search of key academic databases for articles published between 2018 and 2024, this review explores the current applications, benefits, challenges, and future directions of AI integration into residency training programs. AI facilitates structured curriculum design, enabling customized pathways based on individual resident needs and performance data. It enhances mentorship and monitoring through virtual tutors, improved accessibility, and data-rich workplace-based assessments, while complementing traditional human oversight. AI-driven simulations provide safe environments for procedural practice with immediate, objective feedback, showing promise in specialties like radiology, dermatology, and ophthalmology. However, significant challenges remain, including the need for robust validation, addressing risks of over-reliance that may hinder critical thinking, managing medicolegal concerns, ensuring faculty development, and meeting infrastructure requirements. Concerns about AI's impact on the job market also influence residents. Successfully leveraging AI requires addressing these challenges through further research, developing ethical guidelines, and integrating AI literacy throughout medical training to prepare future physicians effectively.

Plantar Pressure Asymmetries and Low Back Pain in Pregnancy: A Smart Insole-Based Analysis

Jennara Wongpalee — 2026-01-26

Background: Low back pain is a common condition affecting pregnant women that arises from hormonal and biomechanical changes that alter posture, gait, and balance. Traditional studies focus on general biomechanical adaptations, often neglecting dynamic plantar pressure changes, left-right foot asymmetries, and their link to low back pain.

Objectives: To study the effects of plantar pressure analysis on walking and balance, and to explore the relationship between plantar pressure and low back pain in pregnant women.

Methods: This was a cross-sectional study of 85 pregnant women recruited through simple random sampling and participated in a 10-meter walk test using SuraSole insoles to collect plantar pressure data across eight-foot zones. Data were analyzed using descriptive statistics, paired t test assessed plantar pressure differences between the left and right feet in the pregnant women, and Pearson correlation, paired measurements, and relationships involving continuous variables.The Scheffe’ method was used to test the mean of each pair of means. The relationship between low back pain and plantar pressure using a multiple linear regression analysis.

Results: Pregnant women exhibited significantly higher plantar pressure in the forefoot and heel zones (P < .05). Pregnant participants showed significantly greater plantar pressure in the left heel, medial forefoot, and medial midfoot than the right side (P < .01), reflecting left-side dominance. Plantar pressure positively correlated with gestational age and body mass index. Heel pressure was strongly associated with lower back pain, while toe and forefoot zones showed weaker correlations.

Conclusions: Pregnancy affects plantar pressure distribution and foot asymmetry. Increased plantar pressure, particularly in the heel zone, strongly correlates with low back pain. Left-right foot asymmetries in the pregnant women emphasize the need for targeted interventions, such as improving gait mechanics and suitable shoes and promoting walking exercises to reduce low back pain during pregnancy.

Child and/or Guardian Satisfaction With Pediatric Anesthesia Services and Understanding of Enhanced Recovery After Surgery Protocols at Srinagarind Hospital

Duangned Litu — 2026-01-26

Background: Pediatric anesthesia presents unique challenges requiring specialized expertise in managing both patient care and parental anxiety. Patient satisfaction has become a crucial quality indicator in anesthesia services, with satisfaction rates varying from 78% to over 95%. Enhanced recovery after surgery (ERAS) protocols have shown improved perioperative outcomes, but require significant patient education. However, most studies have been conducted in Western settings, with limited data from Southeast Asian healthcare contexts.

Objectives: To assess satisfaction with pediatric anesthesia care among children and their guardians at Srinagarind Hospital, while also evaluating their understanding of ERAS protocols.

Methods: A descriptive cross-sectional study collected data from 103 children/guardians between September 2024 to October 2024 using questionnaires with 4-point Likert scales. High satisfaction or understanding was defined as scores 3 to 4, and low satisfaction or understanding as 1 to 2.

Results: Respondents were predominantly female (87.4%) and aged 31 to 40 years (43.7%). General anesthesia was used in 94.2% of cases. Full satisfaction (100%) was reported for preoperative, intraoperative, and postanesthesia care unit services, with mean (SD) overall satisfaction scores of 3.96 (0.05), 3.99 (0.01), and 3.99 (0.01), respectively. Ward follow-up satisfaction reached 96.8%, with mean (SD) overall satisfaction scores of 3.88 (0.01). ERAS protocol understanding varied, with mean (SD) overall understanding score of 3.07 (0.79); high for fasting guidelines (99.0%), low for thrombosis prophylaxis (22.3%), and smoking cessation (23.3%).

Conclusions: While child/guardian satisfaction with anesthesia services was excellent, particularly during perioperative periods, targeted improvements in ERAS education are recommended, especially regarding thrombosis prophylaxis and lifestyle modifications.

Effectiveness of a Hypothermia Prevention Guideline in Adult Patients Undergoing General Anesthesia at Srinagarind Hospital

Wilawan Somdee — 2026-01-26

Background: Perioperative hypothermia (POH), associated with various complications, has a reported incidence ranging from 30% to 70%. A previous incidence of 31% at Srinagarind Hospital prompted the development and implementation of a copyrighted clinical practice guideline (CPG) for the prevention and management of hypothermia in adults.

Objective: To assess the effectiveness and user satisfaction of this CPG.

Methods: This retrospective descriptive study included adult patients undergoing general anesthesia, with or without regional anesthesia, at Srinagarind Hospital between 1 January 2023, and 30 April 2023. POH was defined as a core temperature below 36 °C. Following induction, all patients received forced-air warming using either upper-body warming (UBW) or lower-body warming (LBW) blankets, depending on the surgical procedure and patient position. Body temperature was recorded every 15 minutes for up to 120 minutes. Postoperative satisfaction with the CPG was assessed among patients and anesthesia nurses.

Results: A total of 356 patients, predominantly male with the American Society of Anesthesiologists (ASA) classifications I-II, were enrolled. Sixty-seven patients (18.8%) developed POH. Patients receiving LBW tended to experience POH more frequently than those receiving UBW, although the difference was not statistically significant (P = .444). No patient's temperature fell below 35.5 °C. High satisfaction with CPG implementation was reported by both patients (99.4%) and anesthesia nurses (100%).

Conclusions: Implementation of a CPG emphasizing forced-air warming effectively reduced the incidence of POH in adult patients. The CPG demonstrated high satisfaction among both patients and anesthesia nursing staff.

Incidence and Factors Related to Reintubation After Planned Extubation in Patients Receiving General Anesthesia in Srinagarind Hospital

Krittiya Wanphon — 2026-01-26

Background: Reintubation after planned extubation (RAP) is associated with adverse outcomes. Understanding the incidence and related factors can reduce complications and improve outcomes.

Objectives: To identify the incidence, related factors, causes, and outcomes of RAP in patients undergoing general anesthesia (GA).

Methods: This retrospective descriptive study was done at the Srinagarind Hospital. After screening incident reports from January 2022 to June 2024, an RAP, which is defined as an intubation conducted within 24 hours after surgery was identified. The primary outcome was the incidence of RAP. The secondary outcomes were the characteristics, causes, and outcomes. Logistic regression analysis was used to identify the factors related to poor long-term outcomes.

Results: The incidence of RAP was 8.59 per 10 000 GA (40/46 543 patients). The incidence per 10 000 GA was higher among male (12.08), the elderly (22.80), patients with an American Society of Anesthesiologists (ASA) classification of 4 (24.72), patients with respiratory disease (63.09), and individuals undergoing hepatobiliary surgery (26.90). Most RAP (50%) occurred in the postanesthesia care unit. The most common indications for RAP were hypoxemia (32.5%), altered consciousness (25%), and airway obstruction (20%). RAP was primarily attributed to patient factor (65%). Male gender was associated with an odds ratio of 0.11 for poor long-term outcomes (95% CI, 0.02-0.51; P = .005).

Conclusions: RAP occurred at a lower rate than previously reported. Incidence of RAP was high among males, the elderly, classified as ASA 4, preexisting respiratory diseases, and hepatobiliary surgery. The major cause of RAP was related to patient-related factors.

Psychometric Testing of the Thai Version of the Short-Form Practice Environment Scale of the Nursing Work Index Among Nurses Within the Thai Social Context

Vachira Posai — 2026-01-26

Background: A standardized assessment of the nursing practice environment is essential as a foundation for planning and implementing improvements that enhance the suitability and efficiency of nurses’ work settings. While comprehensive evaluations provide valuable insights, they can be resource-intensive, particularly in settings with limited capacity. The Practice Environment Scale of the Nursing Work Index (PES-NWI) is a widely validated instrument for assessing nursing work environments, and its short-form version, the PES-5, was developed to reduce respondent burden. Adapting the PES-5 to the Thai context ensures cultural and organizational appropriateness, thereby enhancing its applicability and utility in Thai healthcare settings.

Objectives: To translate the PES-5 into Thai and assess its psychometric properties among Thai nurses.

Methods: A cross-sectional design was employed. The PES-5 was translated into Thai using a systematic forward and backward translation process to ensure conceptual and linguistic equivalence. Data were collected from 250 full-time registered nurses working in public hospitals under Thailand’s Ministry of Public Health via an online survey. Psychometric evaluation was conducted using Rasch model analysis, performed with Jamovi software (version 2.6.26). Internal consistency was assessed using Cronbach a and item-total correlation. Rasch analysis was used to examine item fit, response category functioning, and person separation reliability.

Results: The Thai version (T-PES-5) demonstrated excellent content validity (S-CVI = 1.00). Rasch analysis showed acceptable Infit and Outfit statistics (0.81-1.24 and 0.79-1.31, respectively), indicating good item fit. Cronbach a was 0.73, reflecting satisfactory internal consistency. The Wright map revealed a well-balanced item difficulty distribution with no evidence of floor or ceiling effects.

Conclusions: The T-PES-5 is a psychometrically sound instrument for evaluating the nursing practice environment in Thailand. Its brevity and validity make it particularly suitable for large-scale assessments in public healthcare settings, supporting efforts to improve work environments and, ultimately, patient care quality.

Incidence and Types of Cardiac Arrhythmias Detected by Telemetry Monitoring in Hospitalized Patients at a Tertiary Care Hospital

Sopita Areerob — 2026-01-26

Background: Cardiac arrhythmia constitutes a significant clinical complication among hospitalized patients, with elevated prevalence in individuals presenting with underlying cardiovascular pathology. Continuous telemetry monitoring provides real-time electrocardiographic surveillance, facilitating prompt arrhythmia detection and therapeutic intervention. Despite widespread clinical implementation globally, Thailand lacks standardized hospital guidelines governing telemetry monitoring utilization.

Objective: To determine the incidence, classification, and morphological characteristics of cardiac arrhythmias in patients subjected to continuous telemetry surveillance at a tertiary medical hospital in Thailand.

Methods: A cross-sectional study was conducted at Ramathibodi Hospital. The study comprised 331 hospitalized patients aged 18 years or older who received telemetry monitoring between June 2022 and December 2022. Clinical data were systematically extracted from electronic health records and subjected to descriptive statistical analysis.

Results: Among 331 monitored patients, cardiac arrhythmias were documented in 212 patients (64.05%). According to the American Heart Association classification criteria, most patients were categorized as class II (118 of 212 patients, 55.60%). Out of the 387 detected episodes, premature ventricular contractions constituted the most frequently observed arrhythmic pattern (34.37%), followed by premature atrial contraction (19.90%) and atrial fibrillation (15.76%). Conservative clinical observation represented the predominant management approach (41.69%). Hospital discharge constituted the primary indication for telemetry monitoring discontinuation (59.21%).

Conclusions: This study demonstrated a substantial incidence of cardiac arrhythmias under continuous telemetry surveillance, with premature ventricular contractions representing the most prevalent finding. These findings underscore the clinical utility of telemetry monitoring in hospitalized patients and support the development of standardized monitoring protocols in Thai healthcare hospitals.

Intraoperative Anxiety and Its Associated Factors Among Patients Undergoing Conscious Surgery for Closed-Leg Fracture

Xue Zhang — 2026-01-26

Background: Patients undergoing open reduction and internal fixation surgery frequently opt for spinal anesthesia, which preserves intraoperative consciousness. This conscious state may trigger significant anxiety during surgical procedures. Despite the clinical relevance of this phenomenon, intraoperative anxiety among conscious patients remains under-recognized in Chinese surgical populations. Many scholars have conducted extensive research on preoperative and postoperative anxiety levels. However, a study on the level of intraoperative anxiety and its’ related factors is still lacking. This knowledge gap motivated the current investigation.

Objectives: To examine the level of intraoperative anxiety and the relationship between gender, age, waiting time, surgical time and intraoperative anxiety among patients with closed-leg fracture undergoing conscious surgery.

Methods: A total of 112 participants were recruited during February 2025 to April 2025 by selecting samples as per the inclusion criteria and using random sampling. Research instruments include the demographic questionnaire and the Visual Analog Scale for Anxiety (VAS-A). Data were analyzed using descriptive statistics, the independent t test, and the Pearson correlation coefficient.

Results: The mean (SD) intraoperative anxiety was 6.3 (2.2), which indicates a clinically-relevant level of anxiety. There was a significant difference in the experience of intraoperative anxiety between female and male patients (t = -3.92, P < .001). Age, waiting time, and surgical time had a positive correlation with intraoperative anxiety among the patients undergoing conscious surgery (r = 0.221, P < .05; r = 0.307, r = 0.346, P < .001, respectively).

Conclusions: The findings provide a reference for healthcare providers to better understand the factors contributing to intraoperative anxiety of patients with closed-leg fracture undergoing conscious surgery, allowing for early identification of high-risk individuals, and targeted interventions, thereby preventing and alleviating intraoperative anxiety, reducing anxiety-related physiological response, minimizing complication risk, and promoting postoperative recovery.