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Objective: We implemented a four-day intensive clinical orientation program in 2004 for cardiology fellows to compare the change in self-assessed confidence of fellows before versus after the orientation. Background: The transition from an internal medicine residency to a cardiology fellowship can be challenging. There has been limited research on the use of orientation programs to ease this transition. Methods: New fellows in 2006 and 2007 (N = 13) were prospectively queried immediately before, immediately after, and six months after orientation about their confidence and their support for the orientation program. We retrospectively queried fellows who began their fellowships in 2004 and 2005 (N = 12) by asking them to complete the same questionnaire based on what they recalled feeling immediately before, immediately after, and six months after orientation. Responses to each question were based on a Likert scale from 1 to 7, and a total confidence score was calculated. Retrospective and prospective data were pooled, and nonparametric paired analyses were performed.Results: Twenty-five fellows were enrolled. Fellows’ confidence scores increased after the orientation from 20 to 36 (p<0.01). A significant increase was sustained after six months. In addition, at all time points, the fellows supported the orientation program. Conclusion: An intensive clinical orientation program improved new cardiology fellows’ confidence. Support for this program was high, and the findings support con- tinuation and further development of the program.

Background Sesamoiditis is a common inflammatory condition affecting the sesamoid bones at the plantar aspect of the first metatarsophalangeal joint (1MTPJ). However, there are currently no recommendations or clinical guidelines to support podiatrists in their assessment or management of sesamoiditis. The aim of this study was to explore the views of podiatrists in Aotearoa New Zealand on their approaches to the assessment and management of patients with sesamoiditis. Methods This qualitative study included focus group discussions with registered podiatrists. Focus groups took place online via Zoom and were guided by a detailed focus group question schedule. The questions were designed to encourage discussion around assessment approaches used in the diagnosis of sesamoiditis and the treatment tools used to manage patients with sesamoiditis. Focus groups were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to analyse the data. Results A total of 12 registered podiatrists participated in one of three focus groups. Four themes were constructed relating to the assessment of sesamoiditis: (1) obtaining a patient history; (2) recreating patient symptoms; (3) determining contributing biomechanical factors; and (4) ruling out differential diagnoses. Seven themes were constructed relating to the management of sesamoiditis: (1) consideration of patient factors; (2) patient education; (3) cushioning of the sesamoids to allow more comfortable weightbearing of the 1MTPJ; (4) pressure redistribution and offloading of the sesamoids; (5) immobilisation of the 1MTPJ and sesamoids; (6) facilitating efficient sagittal plane motion during gait; (7) referring to other health professionals to find different ways to treat or manage patient symptoms. Conclusion Podiatrists in Aotearoa New Zealand demonstrate an analytical approach in the assessment and management of patients with sesamoiditis based on their clinical experience and knowledge of lower limb anatomy. A range of assessment and management techniques are selected based on the practitioners personal preferences, as well as the patient’s social factors, symptomology, and lower limb biomechanics.