The endocrine module: An integrated course for first‐year medical students combining lecture‐based and modified problem‐based curricula

At the University of Miami School of Medicine, a 2‐week endocrine course, designed to combine the desirable aspects of conventional lecture‐based and modified problem‐based curricula, has been offered to first‐year medical students for 7 years. It is team taught and integrates several basic science and clinical disciplines. Independent learning, problem‐solving activities, and small‐group conferences are emphasized. Each conference period is moderated by two or three faculty members, one or two representing the basic sciences and one representing clinical endocrinology. The course has been well received by the students, and the faculty have enjoyed teaching in this fully integrated format.     

Development of a problem‐based obstetrics and gynecology curriculum for 3rd‐year medical students

Many medical schools have introduced problem‐based learning (PBL) in the traditional “basic science”; years, but there has not been a great movement to connect PBL methodology with clinical teaching.

An attempt to integrate PBL and the clinical component of a 3rd‐year course was undertaken by the Department of Obstetrics and Gynecology, University of Toronto. Evaluations of the preparation, introduction, process, and outcomes were undertaken, using qualitative and survey methodology. Analysis of data revealed that logistics, attitudes of faculty and students, and the degree of faculty preparation were the major influences on the perceived success of the project.     

The role of medical students’ training and community placement as a tool to enhance medical education in Canada

We are currently witnessing unprecedented crises on an international scale linked to synthetic opioid overdose fatalities. While most governments and health policy makers have focused mainly on combating the current crises through harm reduction strategies, little focus has been given to the role and training of future doctors in evidence-based practices of harm reduction and addiction medicine. Therefore, enhancing medical student’s training in the implementation of addiction medicine, and the establishment (or expansion) of medical students, residents and post-fellows’ community placement—via partnerships with organizations that provide specialized care to patients struggling with mental health and addiction—would strongly improve the health and well-being of marginalized populations.     

Pediatric registered nurses as preceptors for 3rd‐year medical students: A program to enhance the pediatric inpatient experience

Background: Pediatric clinical clerkships often include inpatient rotations with limited direct patient exposure and little input from experienced registered nurses (RNs).

Purpose: We sought to enhance medical student education by increasing direct patient contact and the frequency of performing basic pediatric caregiving skills through an RN preceptor program.

Methods: We designed a prospective, controlled teaching interaction utilizing surveys during a children's hospital inpatient rotation. Medical students were matched with an RN during one 8‐hr shift (Ns) or acted as controls (Cs). Results: Forty‐seven Ns and 46 Cs participated. Ns performed all tasks surveyed significantly more often, including changing diaper, giving bottle‐feedings, measuring blood pressure and temperature, and giving medications. Direct daily patient interaction was 3 hr for Ns versus 1.7 hr for Cs. Ninety‐six percent of Ns and 100% of RNs felt the program was worthwhile.

Conclusions: A 1‐day interaction significantly increased direct pediatric experiences. It was well accepted and promoted a heightened awareness of the crucial nursing roles on the medical team.     

Should we keep pushing for a spirometer in every doctor's office?

Professional societies have encouraged primary care providers to conduct spirometry testing for the detection of chronic obstructive pulmonary disease (COPD). In spite of this effort, the success rate is unacceptably low. Simple flow-sensing spirometers have technical flaws that can cause misreadings, and they are rarely checked for accuracy. When spirometry is performed by an experienced technologist, and when payment is made on the criterion of quality, the success rate for adults and school-aged children can be as high as 90%. But testing remains a challenge for younger children and the elderly. Regular feedback for the technologist about their testing results is essential. Even with an accurate spirometer, an able patient, and a skilled technologist, the ordering physician may wrongly interpret the data. Use of spirometry in primary care will continue to be problematic unless high quality testing is tied to reimbursement. Using FEV(1) or peak flow measurements to rule out airway abnormality in the majority of patients, followed by referral for more sophisticated studies in those remaining, may be the best approach. Respiratory therapists should engage in this effort.     

Development of a research elective program for first‐ and second‐year medical students

A Research Elective Program (REP) was designed to foster medical students’ investigative skills within the context of a research project. The REP enabled students to identify a research question, perform a literature review, design and implement a study, and draw conclusions based on their observations. The REP was divided into first‐ and second‐year courses and comprised 368 hr (17%) of the total curriculum time. Seventy‐two students submitted a written report on their project at the conclusion of each course. Advantages of the REP included opportunities for students to interact with a faculty member over an extended time period, to investigate an in‐depth question of their choosing, and to publish their findings in appropriate refereed journals. The objectives of the REP were fulfilled to the extent that new knowledge, understanding of the investigative process, and informatics skills were acquired by the students. The program was an effective and positive learning experience for the majority of students.     

Adherence‐related questioning by fourth‐year medical students interviewing ambulatory diabetic patients

Patient adherence is one determinant of the success of medical therapy, but little is known about the extent to which health professionals routinely assess adherence. This study evaluated the extent of patient adherence assessment by senior medical students in an outpatient diabetes clinic. The number of adherence questions students asked was low in all areas of the patients’ diabetes regimen. The number of questions asked did not relate to patients’ clinical status or their self‐reported regimen adherence. Findings suggest a need for systematic attention to adherence issues in physician education.     

Imaging‐based planning for spine surgery

The planning of decompressive and reconstructive spine surgery is based on clinical findings and diagnostic imaging. The evaluation of segmental instability, but also of the risk of destabilization following a needed decompression of the spinal canal and/or neural foramina make complex spine surgery a challenge, bearing in mind the risk of failures in case of an inadequate operation. The insufficient correlation between imaging and clinical symptoms originating from the spine and its nerve roots has been frustrating for some decades. This review focuses on the new upright, dynamic‐kinetic, i.e., “functional” MRI and its ability to detect load‐ and motion‐dependent disc herniations, stenosis, instabilities, and combinations of these pathologies not seen during recumbent imaging.     

Practice‐based Research Network Research Good Practices (PRGPs): Summary of Recommendations

Introduction

Practice‐based research networks (PBRNs) conduct research in community settings, which poses quality control challenges to the integrity of research, such as study implementation and data collection. A foundation for improving research processes within PBRNs is needed to ensure research integrity.

Methods

Network directors and coordinators from seven U.S.‐based PBRNs worked with a professional team facilitator during semiannual in‐person meetings and monthly conference calls to produce content for a compendium of recommended research practices specific to the context of PBRNs. Participants were assigned to contribute content congruent with their expertise. Feedback on the draft document was obtained from attendees at the preconference workshop at the annual PBRN meeting in 2013. A revised document was circulated to additional PBRN peers prior to finalization.

Results

The PBRN Research Good Practices (PRGPs) document is organized into four chapters: (1) Building PBRN Infrastructure; (2) Study Development and Implementation; (3) Data Management, and (4) Dissemination Policies. Each chapter contains an introduction, detailed procedures for each section, and example resources with information links.

Conclusion

The PRGPs is a PBRN‐specific resource to facilitate PBRN management and staff training, to promote adherence to study protocols, and to increase validity and generalizability of study findings.     

Nursing students’ genomics literacy: Basis for genomics nursing education course development

This study aimed to investigate the genomics literacy of Finnish and Filipino nursing students as a basis for developing a genomics nursing education course. This is a cross-sectional online survey using the 31-item Genomic Nursing Concept Inventory, IBM SPSS version 27, and item-analysis. A total of 245 nursing students participated in the study; 75% reported that they had not completed any genetics-genomics courses. The GNCI scores ranged from 2 to 31 total correct answers out of a total possible score of 31. The GNCI mean score of the Finnish cohort (9.53; SD = 3.48; 36% correct) was significantly lower compared to the Filipino cohort (16.21; SD = 9.74, 58% correct). These results show that the genomics literacy of nursing students in Finland and the Philippines is weak, particularly in human genome homogeneity and genotype-phenotype association concepts. We recommend designing effective genetic and genomic educational programs and updating the nursing curricula.