Virgen Milagrosa University Foundation

Telemedicine has become a vital element of modern surgical practice, facilitating virtual consultations, intraoperative collaboration, and postoperative monitoring. One of its most innovative applications is remote proctoring, or teleproctoring—the real-time supervision and assistance of surgical procedures across distances. The COVID-19 epidemic has accelerated the impact of these technologies on surgical education, credentialing, and global access to specialized expertise. This narrative review synthesizes literature from 2005 to 2025 obtained from PubMed, ResearchGate, Web of Science, and Google Scholar. The emphasis includes telemedicine and remote proctoring in surgical care, education, and quality assurance. Chosen materials comprise original investigations, systematic reviews, and policy documents that pertain to technical platforms, clinical outcomes, educational applications, implementation issues, and regulatory considerations. Modern teleproctoring technologies include secure, low-latency, high-definition video broadcasts enhanced by augmented reality features and telestration capabilities. The available evidence, primarily from observational studies, confirms the approach's viability, cost-effectiveness, improved training efficiency, and high user acceptance across disciplines such as minimally invasive, robotic, and endoscopic surgery. However, inconsistencies in outcome measurements, a lack of randomized controlled trials, and varying legal frameworks restrict wider applicability. The safety profiles appear promising, yet data deficiencies remain. Telemedicine and remote proctoring are developing into integral components of surgical care. Essential future directions include the implementation of artificial intelligence solutions, the development of standardized outcome metrics, the execution of comparative research, the enhancement of cybersecurity measures, and the promotion of fair access in resource-constrained settings. When integrated within strong regulatory and ethical frameworks, remote proctoring has the potential to function as a fundamental pillar of efficient and interconnected global surgical practice.

This study explored the lived experiences of healthcare workers in Pangasinan regarding ethical dilemmas encountered in professional practice. Specifically, the study examined the ethical conflicts experienced by healthcare workers, the coping strategies used to manage these dilemmas, and the insights they developed through their experiences in healthcare settings. This study utilized a qualitative phenomenological research design to investigate the lived experiences of healthcare workers encountering ethical dilemmas in healthcare practice. Purposive sampling was employed to select participants who had direct experiences with ethical conflicts in healthcare settings. Semi-structured interviews were conducted, and the data were analyzed using Colaizzi’s phenomenological descriptive method. The findings revealed that healthcare workers commonly experience ethical dilemmas related to resource limitations, patient autonomy, end-of-life care, institutional pressures, confidentiality concerns, and financial constraints affecting patient care. Participants managed ethical conflicts through consultation with colleagues and supervisors, adherence to ethical guidelines, reflective practice, and open communication with patients and families. The study also highlighted the emotional and professional impact of ethical dilemmas, including moral distress, compassion fatigue, and emotional exhaustion, while demonstrating the importance of resilience, peer support, and ethics education. The study was limited to selected healthcare workers in Pangasinan and focused primarily on physicians and nurses. Future studies may include other healthcare professionals and broader geographic settings to further explore ethical dilemmas across diverse healthcare environments. Healthcare institutions may strengthen ethical decision-making and reduce moral distress by providing ethics education, establishing structured support systems, improving staffing conditions, and encouraging collaborative ethical discussions among healthcare professionals. Understanding healthcare workers’ ethical challenges may contribute to improved healthcare delivery, patient-centered care, and the development of supportive This study contributes to the growing body of literature on healthcare ethics by providing context-specific insights into the lived experiences of healthcare workers in provincial healthcare settings in the Philippines.

The rapid advancement of digital mapping technologies, including GNSS, GIS, drones, and computer-aided mapping software, has significantly transformed surveying practices worldwide. While these technologies offer increased efficiency, accuracy, and data management capabilities, the human experiences associated with transitioning from traditional to digital methods remain underexplored, particularly in the Philippine context. This qualitative phenomenological study examined the lived experiences of 10 surveyors in Region III, Philippines, focusing on their challenges, learning processes, shifts in work practices, and perceptions of professional identity during the adoption of digital mapping technologies. Data were collected through semi-structured interviews and analyzed using thematic analysis, revealing five major themes: initial resistance and uncertainty, learning curves and skill adaptation, shifts in work practices and efficiency, redefining professional identity, and acceptance and adaptation over time. Findings highlight that technological adoption is not merely a technical process but a complex human experience influenced by emotional, cognitive, and professional factors. The study offers insights for organizations, educators, and policymakers to support surveyors in effectively navigating digital transitions.

Introduction: Meningovascular neurosyphilis (MVNS) represents an uncommon manifestation of Treponema pallidum infection, potentially leading to stroke, cerebral edema, and elevated intracranial pressure. Cerebellar tonsillar herniation represents a rare yet critical complication with potentially life-threatening consequences. Timely diagnosis and intervention are critical to avert lethal consequences. Case Presentation: A 20-year-old female presented with headache, dizziness, and altered sensorium, which were preceded by a self-limiting genital lesion eight weeks prior. She exhibited disorientation without any focal neurological deficits. The MRI indicated a left thalamic infarct, while cerebrospinal fluid analysis validated the presence of meningovascular neurosyphilis. Intravenous ceftriaxone and corticosteroids were administered for her treatment. On the 14th day of hospitalization, the patient experienced a generalized seizure accompanied by a rapid deterioration in consciousness. Subsequent imaging revealed widespread cerebral edema and herniation of the cerebellar tonsils. Despite receiving supportive care, she ultimately died due to complications arising from brainstem compression and increased intracranial pressure. Conclusion: This case illustrates the significant consequences of MVNS resulting in infarction, cerebral edema, and tonsillar herniation in a young woman without a previous STD diagnosis. Early neuroimaging, cerebrospinal fluid analysis, and timely antimicrobial therapy are essential. The provision of IV penicillin and prompt surgical decompression are essential, particularly in resource-limited settings. Key Clinical Message: This case shows how a thalamic stroke caused by meningovascular neurosyphilis can quickly lead to cerebral edema and a tonsillar herniation. Neurological problems need to be diagnosed, treated, and decompressed surgically as soon as possible to avoid permanent damage.

The researchers used a convenience sampling method to qualitatively explore the communication barriers to pharmaceutical care among pharmacists working in rural health units of Pangasinan. Interviewing the participants yielded in-depth information about the study's objectives. The first theme, “Pharmaceutical Care Services: Their Scope and Delivery”, highlights the pharmaceutical care provided in rural communities, mentioned alongside the subthemes of medication administration, pharmaceutical consultations, consistent care and education, and healthcare collaborative efforts. The second theme, "Barriers to Effective Communication in Pharmaceutical Care," brought to light the communication barriers that disrupt pharmaceutical care, including lack of electronic devices, language barriers, technological difficulties, language preference, and lack of language proficiency. The third theme, "Rural Healthcare Communication and Delivery Challenges", highlights how these challenges negatively impact the enhancement of pharmaceutical care for patients, particularly through the subthemes of language translators, dialect varieties, comprehension challenges, and a shortage of pharmacists. These factors significantly disrupt the delivery of pharmaceutical care from pharmacists to patients. The fourth theme, "Communication's Effect on Pharmaceutical Care Services", includes subthemes such as medication errors, misinformation, slightly improved healthcare outcomes, and adherence to healthcare information. It also identifies areas that require consistent improvement. Lastly, the fifth theme, "Pharmacist-patient Communication Strategies and Healthcare Improvement", includes subthemes such as dedication to professionalism, establishing pharmacist-patient relationships, improved communication channels, and a team-based care model intervention that addresses communication challenges. When adopted, these interventions broadly structure the communication system and enhance pharmaceutical care services for patients in rural health units, as noted in the findings.