Case-based Module Research Articles

Case-Based Peer Teaching for Pain Medicine Fellows: A Curriculum for Diverse Residency Backgrounds.

Pain medicine is an advanced medical subspecialty incorporating trainees from diverse primary disciplines. A curriculum that does not assess or promote the trainees' differential expertise developed from their primary specialties may silo instead of promoting collaborative learning in a multidisciplinary subspecialty. We created a Kern-guided curriculum for the pain medicine fellowship utilizing case-based modules and a novel note-taking and knowledge-sharing format. Nine faculty-led, case-based modules of increasing complexity were developed based on pain medicine competency content. Pain medicine fellows were instructed to actively designate prior and new knowledge into four categories: Prior knowledge that is accurate and relevant, inaccurate prior knowledge, new knowledge gained from peers, and new knowledge for all trainees. After each case study, each fellow acknowledged "new knowledge gained from peers" and prepared a brief teach-back of "new knowledge for all trainees" at the beginning of the next session. Fellow participants were assessed for their reactions to the curriculum via anonymized surveys. The curriculum was implemented at a single institution pain medicine fellowship from 2021 to 2023. At the end of this curriculum, 90% of participants reported improved knowledge retention through participating in this case-based curriculum compared to the traditional didactic format, and 80% participants reported increased respect for their peers. We created a novel note-taking and knowledge-sharing platform, anchored by a well-established case-based educational strategy, to improve the learning environment and knowledge retention for multidisciplinary trainees with heterogeneous baseline knowledge.

Training and Sustaining: Training and Learning Collaborative Outcomes Across a Statewide Network for Early Autism Diagnosis.

The objective of this study was to describe the development of a primary care professional (PCP) autism diagnosis training model and to report on outcomes related to PCP training and sustained engagement in a longitudinal learning collaborative. We developed Accelerating the Diagnosis of Autism with Primary care Training (ADAPT), a training program to prepare PCPs to develop independent competency in evaluation of autism in children aged 14 to 48 months. ADAPT includes didactic and case-based modules and practice-based coaching delivered by an expert diagnostic specialist; after training, PCPs participate in a longitudinal learning collaborative. Aligned with competency-based medical education standards, measures of autism evaluation knowledge and diagnostic competency are collected. From 2021 to 2023, 13 PCPs completed ADAPT didactic and practicum training to reach competency in independent autism evaluation. Clinicians demonstrated significant improvement in total autism knowledge after didactic training (p = 0.02). Scoring agreement on an autism observational assessment tool between clinicians and expert diagnosticians improved over case observations and practicum evaluations. Similarly, PCPs demonstrated improved evaluation competence, moving on average from Advanced Beginner to Competent Performer as rated by expert diagnosticians. After training, PCPs attended 57% of monthly learning collaborative sessions. Training PCPs to deliver autism evaluations for young children as part of tiered community-based models of care is a promising solution to address access and waitlist challenges. ADAPT is an intensive, standardized PCP training model that results in achievement of independent competency and sustained engagement in autism evaluation. Effectiveness-implementation studies are needed to ensure scalability and sustainability of training models.

143 Training & Sustaining: Training and learning collaborative outcomes across a statewide network for early diagnosis of children with autism

OBJECTIVES/GOALS: Community-based primary care autism diagnostic models are one promising solution to delays in autism diagnosis. Our objective is to describe the development and report on outcomes related to primary care professional (PCP) training and sustained engagement in a longitudinal learning collaborative across a statewide network for autism diagnosis. METHODS/STUDY POPULATION: We developed ADAPT (i.e., Accelerating the Diagnosis of Autism with Primary care Training), a training program to prepare PCPs to develop independent competency in evaluation of autism in children ages 14-48 months. ADAPT includes didactic and case-based modules and expert practice-based coaching delivered by a diagnostic specialist; following training PCPs participate in a longitudinal learning collaborative. Aligned with competency-based medical education standards, measures of autism evaluation knowledge and diagnostic competency are collected. RESULTS/ANTICIPATED RESULTS: To date, 13 PCPs have completed ADAPT didactic and practicum training reaching competency in independent autism evaluation. Clinicians demonstrated significant improvement in total autism knowledge following didactic training (p=.02). There was an overall trend toward increased scoring agreement on an autism observational assessment over case observations and practicum evaluations. Similarly, PCPs demonstrated improved evaluation competence, moving on average from Advanced Beginner to Competent Performer as rated by expert trainers. Following training, PCPs attended 57% of monthly learning collaborative sessions. DISCUSSION/SIGNIFICANCE: Training PCPs to deliver autism evaluations as part of community-based models of care is a promising solution to address access and waitlist challenges. ADAPT is an intensive, standard PCP training model which results in achievement of independent competency and sustained engagement in in autism evaluation.

Evidence supporting a virtual case-based module to improve cognitive foundation for the management of laparoscopic appendectomy

Evidence supporting a virtual case-based module to improve cognitive foundation for the management of laparoscopic appendectomy

Abusive Pediatric Burns Module in the Child Abuse Pediatrics Curriculum for Physicians (CAP-CuP).

Child abuse pediatrics is an underrepresented area of medical education. To date, the available teaching materials about child abuse in MedEdPORTAL do not address burn injury, and the available materials about burn injury do not address child abuse. We created an interactive, case-based module on abusive pediatric burns to fill this educational gap. The abusive pediatric burns module was presented to a hybrid audience at a 45-minute emergency medicine grand rounds at Mayo Clinic. Participants completed a pre- and postmodule assessment to measure their confidence and knowledge pertaining to abusive pediatric burns. Fifty-six attendees, from an audience primarily composed of emergency medicine physicians but also including some multidisciplinary individuals, participated in the module. The median confidence level in assessing pediatric burns for abuse showed a modest increase from 4 (interquartile range [IQR]: 2-6) to 6 (IQR: 5-8), and the proportion of participants answering knowledge questions correctly increased for every question: 18% versus 45%, 41% versus 100%, 59% versus 84%, and 72% versus 100%. Qualitative feedback from the audience was favorable. This interactive, case-based module about abusive pediatric burns was successfully administered to an audience at emergency medicine grand rounds. Increases in confidence and knowledge were observed, and positive qualitative feedback was received.

Evidence for a case-based module in the low-resource setting to teach ectopic pregnancy management

Evidence for a case-based module in the low-resource setting to teach ectopic pregnancy management

An asynchronous web-based intervention for neurosurgery residents to improve education on cost-effective care

ObjectiveTo gauge resident knowledge in the socioeconomic aspects of neurosurgery and assess the efficacy of an asynchronous, longitudinal, web-based, socioeconomics educational program tailored for neurosurgery residents. MethodsTrainees completed a 20-question pre- and post-intervention knowledge examination including four educational categories: billing/coding, procedure-specific concepts, material costs, and operating room protocols. Structured data from 12 index cranial neurosurgical operations were organized into 5 online, case-based modules sent to residents within a single training program via weekly e-mail. Content from each educational category was integrated into the weekly modules for resident review. ResultsTwenty-seven neurosurgical residents completed the survey. Overall, there was no statistically significant difference between pre- vs post-intervention resident knowledge of billing/coding (79.2 % vs 88.2 %, p = 0.33), procedure-specific concepts (34.3 % vs 39.2 %, p = 0.11), material costs (31.7 % vs 21.6 %, p = 0.75), or operating room protocols (51.7 % vs 35.3 %, p = 0.61). However, respondents’ accuracy increased significantly by 40.8 % on questions containing content presented more than 3 times during the 5-week study period, compared to an increased accuracy of only 2.2 % on questions containing content presented less often during the same time period (p = 0.05). ConclusionsBaseline resident knowledge in socioeconomic aspects of neurosurgery is relatively lacking outside of billing/coding. Our socioeconomic educational intervention demonstrates some promise in improving socioeconomic knowledge among neurosurgery trainees, particularly when content is presented frequently. This decentralized, web-based approach to resident education may serve as a future model for self-driven learning initiatives among neurosurgical residents with minimal disruption to existing workflows.

Curriculum Innovations: "Eye"-ing Enhanced Educational Methods for Neurology Trainees: Pilot of an Online, Case-based Neuro-ophthalmology Interactive Workshop.

Common and potentially life-threatening neurologic conditions often present with neuro-ophthalmologic manifestations. Given the growing shortage of neurologists, and specifically neuro-ophthalmologists, it is important that students who will be at the front lines of these complaints are comfortable assessing such patients. We developed a neuro-ophthalmology learning intervention composed of an interactive workshop that discussed novel, online case-based modules. We assessed (1) the subjective and objective improvement in the understanding of neuro-ophthalmologic manifestations of common neurologic conditions and (2) satisfaction with the educational tool. The objectives of this study were to identify and describe common neuro-ophthalmologic manifestations of neurologic conditions, to explain the differential diagnosis, diagnostic workup, and evidence-based treatment of common neuro-ophthalmologic conditions, and to use interactive, case-based discussion to foster an enjoyable, student-focused e-learning environment via the 20/20 SIM platform. Our study team, composed of ophthalmology and neurology faculty, developed cases for 5 common and high-stake neurologic conditions with neuro-ophthalmologic manifestations and published them on 2020SIM.com. The cases served as the basis of our educational intervention, a 1-hour virtual interactive workshop for neurology clerkship students. Students completed optional, anonymous pretests and posttests and an exit survey to assess subjective and objective neuro-ophthalmology knowledge improvement and satisfaction with the educational tool. A total of 145 students participated; 86% (n = 125), 70% (n = 102), and 61% (n = 88) completed at least part of the pretest, posttest, and exit survey, respectively. The mean knowledge score increased from 7.5 to 8.5/10, p = 0.00014. Students reported a subjective increase in knowledge of neuro-ophthalmology (70%, n = 62) and wished to see a similar learning tool for other specialties (92%, n = 81). More than half (64%, n = 56) enjoyed the workshop, approximately three-quarters (73%, n = 64) preferred the interactive session to traditional didactics, and almost all (92%, n = 81) students recommended the learning sessions in the future. Medical students experienced subjective and objective improvement in their understanding of neuro-ophthalmologic manifestations of common neurologic conditions. In addition, they rated the intervention favorably in relation to traditional didactics and recommended a similar platform in other specialties. The integration of interactive online learning tools, such as the SIM platform, into curricular workshops may offer a favorable and effective strategy to increase exposure to topics with less curricular time.

Beyond Skin Deep: case-based online modules to teach multidisciplinary care in dermatology among clerkship students

BackgroundCanadian medical schools offer limited clinical dermatology training. In addition, there is a lack of educational resources that are designed specifically for clerkship students that focus on the multidisciplinary nature of dermatology.ObjectivesAfter developing case-based educational resources to address the lack of clinical exposure and learning of multidisciplinary care in dermatology, this study aimed to evaluate the educational intervention and gather feedback for future module development.MethodsTen online interactive dermatology case-based modules involving 14 other disciplines were created. Medical students (n = 89) from two Canadian schools were surveyed regarding perceptions of the existing dermatology curriculum. Among 89 students, 46 voluntarily completed the modules, and a survey (a five-point Likert scale ratings) including narrative feedback was provided to determine an improvement in dermatology knowledge and understanding of multidisciplinary care.ResultsAmong 89 surveyed students, only 17.1% agreed that their pre-clerkship dermatology education was sufficient and 10.2% felt comfortable managing patients with skin conditions in a clinical setting. Among 46 students, 95.7% of students agreed that the modules fit their learning style (4.17 ± 0.73 on Likert scale) with positive narrative feedback. 91.3% agreed or strongly agreed that the modules enhanced their dermatology knowledge (4.26 ± 0.61). 79.6% of students agreed that the modules helped with understanding the multidisciplinary nature of dermatological cases (3.98 ± 0.81). Student comfort to manage skin conditions increased 7.7 times from 10.2% to 78.3% post-module.ConclusionsClerkship students had limited knowledge of dermatologic conditions; the case-based modules were able to successfully address these deficits and assist students in understanding the multidisciplinary nature of dermatology.

Efficacy of an Introductory Nail Disorder Learning Module to Supplement the Medical School Curriculum: Experience from One United States Medical School

Introduction: Dermatologic and systemic conditions affecting nails are common, but nail pathology education in medical school curricula is limited. We created and evaluated the efficacy of a case-based module on nail pathologies in a medical student cohort from one well-respected US medical school. Methods: We developed a module consisting of five cases: melanonychia, onychomycosis, nail psoriasis, Beau’s lines/onychomadesis, and apparent leukonychia. Participants completed a pre-module questionnaire prior to completing the module and another questionnaire directly following completion. Results: Sixty-two clinical medical students completed the pre-module questionnaire, the module, and the post-module questionnaire. 59.68% of participants reported they had evaluated 1–5 patients with nail findings. However, 43.55% of study participants denied receiving any lectures on nail pathologies in their medical education. On average, the module took 13.73 min to complete. Student-reported confidence in both identifying and treating common nail disorders significantly increased from to pre- to post-module responses for both identification (p < 0.001) and treatment (p < 0.001) of common nail pathologies. Discussion/Conclusion: Nail findings are prevalent in all medical specialties, and improved medical student education on nail pathologies is necessary. Our introductory, case-based module on pathologies is an effective way to improve student confidence in identifying and treating nail disorders.

Impact of interactive multi-media learning for physicians in musculoskeletal education – a pilot study

BackgroundThe aim of this educational study was to investigate the use of interactive case-based modules relating to the screening and identification of early-stage inflammatory arthritis in both online technology (OLT) and paper (PF) formats with identical content.MethodsForty learners from family medicine or rheumatology residency programs were recruited. Content pertaining to a “Sore Hands, Sore Feet” (SHSF) and Gait Arms Legs Spine (GALS) screening tool modules were selected, reviewed and developed based on a validated curriculum from the World Health Organization and Canadian Curriculum for MSK conditions. Both the SHSF module and GALS screening tool were assessed via a randomized control trial. Assessments were completed during an orientation with all learners; then prior to the intervention (T1); at the end of the module (T2) and 3 months following the modules (T3) to assess retention. Focus groups were conducted to determine learners’ satisfaction with the different learning formats. Baseline data was collated, and analysis performed after randomization into the PF (control) and OLT (experimental) groups. Repeated measures ANOVA was used for statistical analyses.ResultsForty participants were recruited and randomized into the PF or OLT group (n = 20 each). At 3 months, there were n = 31 participants for SHSF (PF n = 19, OLT n = 12) and n = 32 for GALS (PF n = 19, OLT n = 13). There was no significant difference between the OLT and PF groups in both analyses. A significant increase in scores from Pre- to Post-Module in SHSF (F (1, 18) = 24.62. p < .0001) and GALS (F (1, 30) = 40.08, p < .0001) were identified to suggest learning occurred with both formats. The repeated measures ANOVA to assess retention revealed a significant decrease in scores from Post-Module to Follow-up for both learning format groups for SHSF (F (1, 29) = 4.68. p = .039), and GALS (F (1, 30) = 18.27. p < .0001) suggesting 3 months may be too long to retain this educational information.ConclusionsBoth formats led to residents’ ability to screen, identify and initially manage inflammatory arthritis. The hypothesis is rejected because both OLT and PF groups demonstrated significant learning during the process regardless of format. It is important to emphasize that from T1 (pre-module) to T2 (post-module), the residents demonstrated learning regardless of group to which they were assigned. However, learning retention declined from T2 (post-module) to T3 (three-month follow-up). Regular review of knowledge may be required earlier than 3 months to retain information learned. This study may impact educational strategies in MSK health.Trial registrationThis study did not involve “patients” rather learners and as such it was not registered.

Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students.

Primary care nurse practitioners (NPs) receive little sleep education in graduate programs but are often first-line providers for patients presenting with sleep-related symptoms. A pre-/postevaluation study was conducted using asynchronous, case-based sleep education modules in a cohort of primary care NP students enrolled in a single academic institution's nursing master's degree program. Six virtual, case-based modules addressed adult sleep health and disorders, prioritized based on prevalence and primary care presentation. Kirkpatrick Training Evaluation Model guided outcome selection. Descriptive and paired comparative analyses were conducted. Participants were first-year NP students (n = 149; 88% female; 82% ≤ 35 years of age) in an adult primary care program that included psychiatric/mental health track. Participants reacted positively to course delivery methods and content. Insomnia was endorsed by 87% as most relevant to practice with healthy sleep (88%) and obstructive sleep apnea (50%) also frequently endorsed as practice relevant. Posttest knowledge scores significantly improved for all modules (P < .001). Self-rated confidence for future practice application was high. This novel asynchronous, virtual curriculum met Kirkpatrick levels 1 and 2 (positive reaction and knowledge transfer) in NP students who predicted an impact on their practice (Kirkpatrick level 3). Studies are needed to assess the benefits of increasing primary care NP knowledge in sleep medicine on quality of care and access to care (Kirkpatrick level 4). Future use of this novel sleep curriculum in other professional curricula, new-to-sleep clinical researchers, and practicing primary care providers may further potentiate care quality and sleep care access. Sawyer AM, Saconi B, Lyons MM, etal. Case-based, asynchronous sleep education outcomes among primary care nurse practitioner students. J Clin Sleep Med. 2022;18(10):2367-2376.

Deconstructing Ableism in Health Care Settings Through Case-Based Learning.

IntroductionPatients with disabilities face health disparities, and providers with disabilities confront professional roadblocks and institutional bias. Yet their experiences are often excluded from medical education, and few case studies address culturally humble care for those with disabilities.MethodsWe created two 1-hour case-based modules on disability and ableism from patient and provider perspectives. Modules were piloted in June 2020 and presented at two conferences in April 2021. Modules included a prereading, introductory disability presentation, and facilitated case discussions. Sessions were evaluated with pre- and/or postsession surveys. Modules were rated on 5-point Likert scales for educational value, professional growth contribution, and interactive/engaging design.ResultsParticipants rated the patient and provider modules 4.5, 4.4, and 4.4 and 4.5, 4.4, and 4.5 for the three categories, respectively. Participants noted that the sessions were insightful and validating and improved their understanding of ableism and the importance of disability curricula. There were significant improvements in participants’ perceptions of ability to discuss ableism's impacts, recognize barriers, identify resource/support gaps for trainees, and advocate. A total of 171 participants completed our modules, with survey response rates of 38% (60 out of 160) and 48% (77 out of 160) for one conference and a postsurvey response rate of 64% (seven out of 11) for the second.DiscussionDesigned for health care trainees, providers, administration, and staff, our sessions introduced concepts of ableism, accommodation, and health care barriers. Our results suggest the modules can contribute to professional growth, understandings of ableism, and participants’ disability advocacy tool kit.

Addressing the Opioid Crisis: A Dynamic Case-Based Module Set for Interprofessional Educators, Learners, and Clinicians.

IntroductionIn 2017, the opioid crisis was declared a public health emergency in the United States. The CDC has called for a multifaceted, collaborative approach to address the opioid epidemic. Though many resources have been made available for provider education, much of what has been published to date has focused narrowly on specific contexts and/or has become outdated.MethodsTo address the need for more up-to-date and broad-based training, we designed a dynamic, module-based curriculum aligned with the 2016 CDC Opioid Prescribing Guideline. The three-part module set addresses safe opioid prescribing, recognizing and treating opioid use disorders, and opioids and pain management. Each module contains interactive content and assessments and culminates in case-based applications. The modules provide an anchor point for supplemental activities that can be utilized in various contexts.ResultsAs of May 2021, we recorded 3,529 module completions (≥80% performance on module assessments). A 6-month follow-up survey revealed that the majority of respondents had used the strategies they had learned to improve their prescribing practice and believed they had improved outcomes for patients.DiscussionThe modules and supplementary resources can be used by clinicians and educators to combat the opioid epidemic with best practices in patient care and by meeting many state licensure requirements. Included supplemental resources are ideal for learners, providing a comprehensive understanding of the opioid crisis as well as tools for medication-assisted treatment that create capacity to immediately address these issues once learners become fully licensed.

Preservice science teachers\u2019 emerging pedagogy of mobile game integration: a tale of two cohorts improvement study

In the context of the current teacher education program in Thailand, Technology Pedagogical and Content Knowledge (TPACK) framework is formally recognized as essential qualities of knowledge for a highly qualified preservice teacher in today’s education. TPACK has been attracted to educational researchers for preparing preservice science teachers nationwide. In this study, TPACK was employed for restructuring a preservice science teacher education course with mobile game technology, which was offered in two consecutive semesters with a total enrollment of 115 student teachers in the first cohort and 94 student teachers in the second cohort. A pedagogic module of Mobile Game-based Inquiry Learning in Science (MGILS) has been designed and created in two settings, a usual separated and integrated case-based TPACK support module, and then implemented with the first and second cohort respectively in general science teacher education program at a Rajabhat University of Thailand. They were measured TPACK in terms of four constructs, namely, (a) technological knowledge (TK), (b) technological content knowledge (TCK), (c) technological pedagogical knowledge (TPK), and (d) technological pedagogical content knowledge (TPCK). Considering both qualitative and quantitative data analysis from two cohorts, the results showed preservice science teachers’ incremental TPACK improvement from the implementation of the usual separated and integrated case-based TPACK support module of MGILS. Based on the results of MGILS intervention, it seems to indicate the alleged superiority of the integrated case-based TPACK support over the usual separated TPACK support. The deficits in the use of MGILS module are identified, and possible improvements to enhance TPACK in the mobile game are proposed.

Increasing Medical Student Exposure to Pathology by Creating an Integrated Rotation During Surgery Clerkship

Following a nationwide trend, the University of Michigan Medical School has restructured its curriculum to facilitate integration of basic science curricula and early inclusion of clinical experiences, resulting in a truncation of a 19-month didactic-based preclinical curriculum to 13 months. Because preclinical didactic and lab sessions formed the bulk of pathology contact hours, the curriculum overhaul significantly reduced student exposure to pathologists. This reduction in exposure may decrease student understanding of how pathology integrates into the larger picture of healthcare delivery and could also decrease the pipeline of students interested in pursuing pathology as a career choice. To ameliorate these concerns, a mandatory 1-week rotation through the Pathology Department was integrated into the surgery clerkship. This brief report outlines the process of creating a new, unique pathology rotation for surgery clerkship students that includes observation in autopsy and surgical pathology sign-out, small group sessions focused on foundational concepts in microbiology, chemistry, and transfusion medicine, and access to online case-based modules. Available qualitative student feedback indicates that students appreciate how this rotation granted them a “behind the scenes” look at pathology but also noted that the fast pace of clinical sign-out sessions and length of small group sessions were suboptimal for student learning. This feedback and future survey data will serve as a platform on which curricular improvements can be made to enhance the learning environment for both learners and educators.

Effectiveness of Immersive Virtual Reality on Orthopedic Surgical Skills and Knowledge Acquisition Among Senior Surgical Residents

Video learning prior to surgery is common practice for trainees and surgeons, and immersive virtual reality (IVR) simulators are of increasing interest for surgical training. The training effectiveness of IVR compared with video training in complex skill acquisition should be studied. To evaluate whether IVR improves learning effectiveness for surgical trainees and to validate a VR rating scale through correlation to real-world performance. This block randomized, intervention-controlled clinical trial included senior (ie, postgraduate year 4 and 5) orthopedic surgery residents from multiple institutions in Canada during a single training course. An intention-to-treat analysis was performed. Data were collected from January 30 to February 1, 2020. An IVR training platform providing a case-based module for reverse shoulder arthroplasty (RSA) for advanced rotator cuff tear arthropathy. Participants were permitted to repeat the module indefinitely. The primary outcome measure was a validated performance metric for both the intervention and control groups (Objective Structured Assessment of Technical Skills [OSATS]). Secondary measures included transfer of training (ToT), transfer effectiveness ratio (TER), and cost-effectiveness (CER) ratios of IVR training compared with control. Additional secondary measures included IVR performance metrics measured on a novel rating scale compared with real-world performance. A total of 18 senior surgical residents participated; 9 (50%) were randomized to the IVR group and 9 (50%) to the control group. Participant demographic characteristics were not different for age (mean [SD] age: IVR group, 31.1 [2.8] years; control group, 31.0 [2.7] years), gender (IVR group, 8 [89%] men; control group, 6 [67%] men), surgical experience (mean [SD] experience with RSA: IVR group, 3.3 [0.9]; control group, 3.2 [0.4]), or prior simulator use (had experience: IVR group 6 [67%]; control group, 4 [44%]). The IVR group completed training 387% faster considering a single repetition (mean [SD] time for IVR group: 4.1 [2.5] minutes; mean [SD] time for control group: 16.1 [2.6] minutes; difference, 12.0 minutes; 95% CI, 8.8-14.0 minutes; P < .001). The IVR group had significantly better mean (SD) OSATS scores than the control group (15.9 [2.5] vs 9.4 [3.2]; difference, 6.9; 95% CI, 3.3-9.7; P < .001). The IVR group also demonstrated higher mean (SD) verbal questioning scores (4.1 [1.0] vs 2.2 [1.7]; difference, 1.9; 95% CI, 0.1-3.3; P = .03). The IVR score (ie, Precision Score) had a strong correlation to real-world OSATS scores (r = 0.74) and final implant position (r = 0.73). The ToT was 59.4%, based on the OSATS score. The TER was 0.79, and the system was 34 times more cost-effective than control, based on CER. In this study, surgical training with IVR demonstrated superior learning efficiency, knowledge, and skill transfer. The TER of 0.79 substituted for 47.4 minutes of operating room time when IVR was used for 60 minutes. ClinicalTrials.gov Identifier: NCT04404010.

On-board Clutch Slippage Detection and Diagnosis in Heavy Duty Machine

In order to reduce unnecessary stops and expensive downtime originating from clutch failure of construction equipment machines; adequate real time sensor data measured on the machine in combination with feature extraction and classification methods may be utilized.This paper presents a framework with feature extraction methods and an anomaly detection module combined with Case-Based Reasoning (CBR) for on-board clutch slippage detection and diagnosis in heavy duty equipment. The feature extraction methods used are Moving Average Square Value Filtering (MASVF) and a measure of the fourth order statistical properties of the signals implemented as continuous queries over data streams. The anomaly detection module has two components, the Gaussian Mixture Model (GMM) and the Logistics Regression classifier. CBR is a learning approach that classifies faults by creating a new solution for a new fault case from the solution of the previous fault cases. Through use of a data stream management system and continuous queries (CQs), the anomaly detection module continuously waits for a clutch slippage event detected by the feature extraction methods, the query returns a set of features, which activates the anomaly detection module. The first component of the anomaly detection module trains a GMM to extracted features while the second component uses a Logistic Regression classifier for classifying normal and anomalous data. When an anomaly is detected, the Case-Based diagnosis module is activated for fault severity estimation.

Serology Curriculum For Residents Using Online, Case-Based Simulation Modules

Abstract Introduction/Objective Although serology concepts are a frequent exam topic for Pathology trainees, serology education remains challenging, in part, because serologic test performance occurs in different laboratories (immunology, microbiology, or chemistry.) Serology education topics may be eclipsed by larger concerns of the laboratory where serology resides. To evaluate the utility and advantages of online modules as adjuncts to other education modalities used during a standalone serology rotation, we developed a one-week curriculum in which residents were given four case-based vignettes to discuss with faculty, eight online case-based simulation modules, and bench time in the laboratory performing serological tests (RPR, VDRL, hepatitis, and HIV). Methods The online modules are housed within an e-learning portal. Residents were asked to print certificate of completion for eight assigned modules. Residents were offered an anonymous survey of the rotation between one week and up to 2 months after completing the rotation. Results Twenty-three first-year residents (spanning a 3-year period) completed the online modules, and 10 (43.5%) completed the survey. The average percentage of correct answers ranged from 73% for the HIV module to 88% for the hepatitis B module. The number of residents with scores below 80% was highest for EBV and Cryptococcus modules (8 and 9 scoring &amp;lt;80% respectively) and lowest for hepatitis B and toxoplasmosis modules (2 and 3 respectively). On the survey, residents stated they had repeated the online modules between 1 and 4 times, averaging between 1 and 2 attempts. Although there was no specific module rated as most enjoyable, the toxoplasmosis and EBV modules were picked by 3 out of 10 residents as his or her favorite. There was no consensus on which module was subjectively easiest or most difficult, nor which was least enjoyed. The majority of the residents (7/10) found the modules helpful and all ten residents stated that they “learned more” after completion of the modules because they reinforced (6/10) concepts important to serologic testing. Conclusion The online, case-based simulation modules are effective additions to a serology curriculum that includes case-based discussions and time in the laboratory performing tests. The online modules are effective because they provide additional structure and reinforce learning within the serology curriculum.

Remote Assessment of Video-Recorded Oral Presentations Centered on a Virtual Case-Based Module: A COVID-19 Feasibility Study.

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has resulted in the suspension of our pediatric clerkship, which may result in medical student skill erosion due to lack of patient contact. Our clerkship has developed and assessed the feasibility of implementing a video-recorded oral presentation assignment and formative assessment centered on virtual case-based modules.MethodsThis retrospective study examined the feasibility of providing a remote formative assessment of third-year medical student video-recorded oral presentation submissions centered on virtual case-based modules over a one-week time period after pediatric clerkship suspension (March 16th to 20th, 2020). Descriptive statistics were used to assess the video length and assessment scores of the oral presentations.ResultsTwelve subjects were included in this study. Overall median assessment score [median score, (25th, 75th percentile)] was 5 (4,6), described as “mostly on target” per the patient presentation rating tool.ConclusionPatient-related activities during the pediatric clerkship were halted during the COVID-19 pandemic. This study demonstrated the possibility of remotely assessing oral presentation skills centered on virtual case-based modules using a patient presentation tool intended for non-virtual patients. This may prepare students for their clinical experiences when COVID-19 restrictions are lifted. Future studies are needed to determine if suspended clerkships should consider this approach.