BackgroundDigital technologies increasingly shape postgraduate medical education, yet orthopedic and trauma training face unique challenges because of the tactile, procedurally focused skills involved. Digital tools partially address these needs, but gaps remain, particularly across diverse European contexts. ObjectiveOur primary aim was to quantitatively assess predictors of digital learning technology acceptance (e-learning, distance education, and virtual reality [VR] and augmented reality [AR]) among European orthopedic and trauma trainees, drawing on the technology acceptance model (TAM) and the unified theory of acceptance and use of technology (UTAUT) as conceptual guides. Specifically, we examined how perceived usefulness and perceived ease of use (TAM), alongside performance expectancy, effort expectancy, social influence, and facilitating conditions (UTAUT), related to trainees’ acceptance of digital technologies. These constructs guided variable selection and grouping, attitudinal scale design, and interpretation of how individual and contextual factors shape acceptance of digital learning tools in orthopedic training. Secondary aims were to describe adoption and attitude patterns, identify attitudinal trainee profiles, and examine contextual associations (eg, workplace type and national gross domestic product [GDP]). MethodsWe distributed a multinational survey via European trainee federations and used validated scales to assess digital competence and attitudes and gathered demographic data (n=217 across 29 European countries). We administered the questionnaire in English; however, respondents who self-reported English proficiency below the intermediate level were excluded from the analyses to minimize potential comprehension-related bias. The survey assessed digital experience, self-reported digital competence, and attitudes toward e-learning, distance education, and VR/AR, and collected detailed demographic and workplace data. Expert review, cognitive pretesting, and pilot testing ensured validity and clarity. Analytical methods included Wilcoxon tests, ANOVA, clustering, multinomial logistic regression, and factor analysis to ensure the reliability and validity of attitudinal measures. Resultse-Learning technologies were the most widely adopted, whereas VR/AR tools were less frequently used despite high average attitude ratings (mean 4.07, SD 0.88). Cluster analysis identified 3 distinctive groups—enthusiastic, supportive, and hesitant—that differed significantly in digital competence and acceptance profiles. Digital competence and national GDP emerged as significant predictors of group membership, consistent with TAM/UTAUT expectations that perceived capability and contextual facilitating conditions shape acceptance. Variation in attitudes was further associated with workplace type and regional resource disparities, underscoring the influence of contextual factors on technology adoption. ConclusionsEuropean orthopedic trainees show broad support for digital innovations, preferring VR/AR despite low use. Preliminary evidence supports digital competence as a key mediator of acceptance, with GDP and workplace disparities predicting profiles (hesitant vs enthusiastic). Competence-first strategies and targeted resource equity (eg, low-GDP subsidies), together with policy adjustments, may address regional disparities. Future longitudinal and multimethod studies are needed to test causal pathways implied by TAM and UTAUT and to evaluate the generalizability of these findings across specialties and educational contexts.
INTRODUCTION:Interstitial lung disease (ILD) contributes significantly to morbidity and mortality in connective tissue disease (CTD). Early detection and accurate diagnosis are essential for informing treatment decisions and prognosis in this setting. Clear guidance on CTD-ILD screening, however, is lacking. OBJECTIVE:To establish recommendations for CTD-ILD screening based on the current evidence. METHOD:Following an extensive literature research and evaluation of articles selected for their recency and relevance to the characterization, screening, and management of CTD-ILD, an expert panel formed by six pulmonologists from the Portuguese Society of Pulmonology, six rheumatologists from the Portuguese Society of Rheumatology, and six radiologists from the Portuguese Society of Radiology and Nuclear Medicine participated in a multidisciplinary discussion to produce a joint statement on screening recommendations for ILD in CTD. RESULTS:The expert panel achieved consensus on when and how to screen for ILD in patients with systemic sclerosis, rheumatoid arthritis, mixed connective tissue disease, Sjögren syndrome, idiopathic inflammatory myopathies and systemic lupus erythematous. CONCLUSIONS:Despite the lack of data on screening for CTD-ILD, an expert panel of pulmonologists, rheumatologists and radiologists agreed on a series of screening recommendations to support decision-making and enable early diagnosis of ILD to ultimately improve outcomes and prognosis in patients with CTD.
BACKGROUND:Climate change and environmental degradation pose significant threats to ecosystems and human well-being, leading to increased eco-anxiety, especially among young adults. Eco-anxiety, characterized by worry and fear about environmental issues, can affect mental health and behaviours. This study aims to explore the relationships between eco-anxiety, sociodemographic factors, experiences of climate events, pro-environmental behaviours, and life satisfaction in young adults. METHODS:A quantitative cross-sectional design was employed to examine the relationships between the variables mentioned above among young adults. The sample included university students from health science centres in Spain. Surveys were used to gather data on participants' eco-anxiety levels, sociodemographics, experiences with climate events, pro-environmental behaviours, and life satisfaction. RESULTS:The study revealed eco-anxiety differences among genders, with female participants experiencing greater personal impact anxiety. However, no differences were found among education or area of upbringing and residence, except that growing up/living in rural areas was associated with more behavioural symptoms of eco-anxiety. Direct and indirect experiences with climate events significantly influenced eco-anxiety levels, with direct experiences having a stronger effect. Linear regression models showed that different eco-anxiety dimensions had distinct relationships with pro-environmental behaviours and life satisfaction, with personal impact anxiety increasing pro-environmental behaviours and reduced affective/behavioural symptoms enhancing life satisfaction. Increased personal impact anxiety predicted higher levels of pro-environmental behaviours, whereas decreased affective and behavioural symptoms of eco-anxiety predicted higher life satisfaction. CONCLUSIONS:The findings suggest that eco-anxiety is a complex and multidimensional construct influenced by several factors, including direct and indirect psychosocial experiences related to climate events and information-seeking behaviours. Eco-anxiety is differently associated with pro-environmental behaviours and mental health variables, such as life satisfaction. Addressing eco-anxiety requires a multifaceted approach that considers its different dimensions and individual differences over time. Future research should explore these relationships longitudinally and include more diverse samples to enhance the generalizability of the findings.
