Toxicology Education Research Articles

The digital evolution in toxicology: pioneering computational education for emerging challenges

The educational landscape of toxicology is increasingly integrating computational methodologies due to ethical concerns about animal testing and advancements in biotechnological and data analysis tools. This paper examines the evolution and significance of the Toxicology in the 21st century (Tox21) initiative and its impact on computational toxicology education. It contrasts computational toxicology with traditional methods, highlighting the limitations of conventional approaches and the new perspectives offered by computational techniques. The study emphasizes the importance of incorporating computational toxicology into curricula, including case studies that demonstrate how this integration enhances students’ problem-solving abilities, real-time data analysis skills, and innovation capabilities. Furthermore, it outlines effective teaching content and methods, including software tools, online resources, and academic literature. The paper also addresses the challenges and limitations faced in this educational shift and explores prospects for advancing computational toxicology education. By documenting these developments, the study aims to clarify the current advancements in toxicology education and the preparedness of students to address global chemical safety challenges with innovative solutions.

The Current State of Veterinary Toxicology Education at AAVMC Member Veterinary Schools.

This study assessed the depth, breadth, and perception of toxicology education in curricula at Association of American Veterinary Medical Colleges (AAVMC) member veterinary schools. An online questionnaire was sent twice to all 54 AAVMC members and sent once to a veterinary toxicology list serve. The survey covered areas related to instructor demographics, the depth and extent of toxicology taught, and the respondent's perceptions of their student's ability to perform entrustable professional activities (EPA). Results were analyzed using descriptive statistics. Our survey resulted in a 44% response rate. All responding schools included toxicology in their curriculum, and it was a required course in 23 programs. Contact hours in stand-alone veterinary toxicology courses ranged from 14 to 45 h. Most respondents indicated that the current time allotted for toxicology was inadequate, despite indicating that most of their students could perform most EPAs autonomously. One exception related to the ability of students to analyze toxicology data. We found small variations in teaching methods and curriculum content. The results of our study can assist veterinary schools in evaluating their curricula to better prepare new graduates for the management of toxicology issues they may face in their veterinary careers.

Status of toxicology education in US Doctor of Pharmacy programs

Status of toxicology education in US Doctor of Pharmacy programs

Toxicology education in emergency medicine PA postgraduate programs.

Toxicology education in emergency medicine PA postgraduate programs.

Identifying the Gaps: Needs Assessment to Guide Development of a Dedicated Toxicology Curriculum for Emergency Medicine Residents

The American Board of Emergency Medicine identifies medical toxicology as an essential curricular element for emergency medicine (EM) residencies; however, access to medicaltoxicology education varies widely by institution. We hypothesized thatEM residents areuncomfortable with core toxicology content and would be interested in a dedicated toxicology curriculum. An electronic needs assessmentsurvey developed by experts in EM and medical toxicology was sent to residents and program leadership at nine EM programs participating in the Emergency Medicine Education Research Alliance (EMERA), a geographically diverse sampling ofacademic EM residency programs. We queried the presence of a current toxicology curriculum, interest in a dedicated toxicology curriculum, and comfort with core toxicology concepts for board examinations and in clinical practice. RESULTS: A total of 148 residents and 8facultyleadership completed the survey. Only 29% ofresidentrespondents felt comfortable with toxicology concepts, and only 66% of respondents reported access to a toxicology curriculum. Of those without a known toxicology curriculum, mostwere interested in a formal curriculum. Faculty respondents reported 6/8 programs offered a toxicology curriculum. Faculty at the two programs without a formal curriculum expressed interest in a dedicated curriculum. Emergency medicineresidents remain uncomfortable with the core toxicology content in clinical practice. The majority of residents without a known toxicology curriculum would be interested in a dedicated toxicology curriculum.

Toxicology and snakes in ptolemaic Egyptian dynasty: The suicide of Cleopatra.

The decadent Lagids'dynasty was especially interested in drugs and poisons meanwhile Alexandria became a prestigious center of learning and the first medical center of the ancient world. Scholars dedicated to toxicology would research in the famous Museion and the Hellenistic rulers of Alexandria and other kingdoms had court physicians specialized in pharmacology and venoms. As the last member of Ptolemaic Dynasty, Cleopatra VII inherited the throne and also the great inclination of Ptolemies towards medicine and science. In this city toxicological education seems to have had its most systematic development, and for Galen [1] "human and prompt executions' were made in Alexandria with the intervention of cobras". Attracted by the knowledge of venoms and poison, Cleopatra began to test them on condemned prisoners to see the different reactions produced in the body and found toxic limits. When she decided to commit suicide, the use of poison would make sense given the possibility to choose the best one to get a quick and relatively pain free death. Knowing that oral poisons would cause disturbances as painful spasms, nauseas, abdominal cramps and slow end, she presumably compared the major effects of venemous snakebites caused by the various species living in Egypt, specially three families: vipers, hydrophids and elapids. Cleopatra probably realized that viper bites generally produce violent local pain with inflammation, oedema, skin discoloration, pustules, vomiting and blood loss. With the cobra venom, hemotoxic or neurotoxic, instead, death could happen within half an hour, by respiratory failure and general paralysis without leaving any trace on the flesh, though. It has been said that Cleopatra used the cobra to kill herself because it would also make sense in terms of Egyptian mythology, being associated with the sacred uraeus worn by the pharaohs. However, there are several problems with this theory and some scholars recently argue it's more likely she would drank a cocktail of drugs or applied a toxic ointment, as Strabo suggested. Studying the different poisons and the snakes that she could have selected and the symptoms and consequences that they could produce in her body, we'll try to delve into her possible lucubrations and reflexions, weighing the difficulties in each case. Undoubtedly, the mysterious end of Cleopatra remains unsolved, offering a constant source of legends and theories. Keeping this in mind we will try to present the pros and cons of each of her possible decisions.

Development of virtual reality visualization model (VRVM) with relative spatiotemporality for visual contents in molecular toxicology education

Visualizing educational contents makes learning more efficient and effective especially in the area such as molecular toxicology, which is time consuming and intellectually taxing to learn. A design principle based on cognitive neuroscience was developed for spatiotemporality of information and optimized virtual reality (VR) for molecular toxicology. We modeled VR with the tricarboxylic acid (TCA) cycle, a major working mechanism of several toxic poisons such as fluoroacetate, malonate, arsenite, etc. to improve the effectiveness of education in molecular toxicology for better recall compared to traditional education methods. We devised an educational system and theoretical basis for virtual reality visualization model (VRVM), as integrated research in this area had been insufficient thus far. We found that VRVM has positive effects on learning and memory when teaching complex topics such as molecular toxicology in our previous study. This study has three main components: (1) construction of VR hardware/software (HW/SW) system; (2) creation of VR space design guide; and (3) verification of VRVM spatiotemporality. Consequently, we developed VRVM for the TCA cycle of toxicological mechanism to improve the study habits of medical students in the context of molecular toxicology studies. To continuously expand this approach for future educational applications, up-to-date findings in areas such as cognitive neuroscience and psychology for studying molecular toxicology should be incorporated to strengthen concepts, logic, and physical models of visualization.

2018 Lush Training Prize Winner: Laboratory of Education and Research in Pharmacology and Cellular Toxicology, LPCT Team, Brazil.

2018 Lush Training Prize Winner: Laboratory of Education and Research in Pharmacology and Cellular Toxicology, LPCT Team, Brazil.

Core competencies required by toxicology graduates in order to function effectively in a Poisons Information Centre: A Delphi study.

IntroductionThe availability of trained Medical Toxicologists in developing countries is limited and education in Medical Toxicology remains inadequate. The lack of toxicology services contributes to a knowledge gap in the management of poisonings. A need existed to investigate the core competencies required by toxicology graduates to effectively operate in a Poisons Information Centre. The aim of this study was to obtain consensus from an expert group of health care workers on these core competencies. This was done by making use of the Delphi technique.MethodologyThe Delphi survey started with a set of carefully selected questions drawn from various sources including a literature review and exploration of existing curricula. To capture the collective opinion of experts in South Africa, Africa and also globally, three different groups were invited to participate in the study. To build and manage the questionnaire, the secure Research Electronic Data Capture (REDCap) web platform was used.ResultsA total of 134 competencies were selected for the three rounds and in the end consensus was reached on 118 (88%) items. Panel members agreed that 113 (96%) of these items should be incorporated in a Medical Toxicology curriculum and five (4%) should be excluded.DiscussionAll participants agreed that effective communication is an essential skill for toxicology graduates. The curriculum can address this problem by including effective pedagogy to enhance oral and written communication skills.Feedback from panellists indicated that the questionnaires were country-specific and not necessarily representative of all geographical locations. This is an example of the ‘battle of curriculum design’ where the context in which the curriculum will be used, will determine the content.ConclusionThe Delphi method, based on three iterative rounds and feedback from experts, was effective in reaching consensus on the learning outcomes of a Medical Toxicology curriculum. The study results will ultimately improve education in Medical Toxicology.

Medical Toxicology Education and Global Health: It is Still a World of Limited Resources in Low- and Middle-Income Countries

Medical Toxicology Education and Global Health: It is Still a World of Limited Resources in Low- and Middle-Income Countries

Key point sessions, a knowledge sharing method in clinical toxicology education

Medical management, is a team work and the nature of clinical toxicology is multidisciplinary. Internal organs problems following intoxications are included in field of internal medicine; similar problems in poisoned children brings pediatric medicine into the arena. The emergency nature of many acute intoxications, the legal problems of poisoned patients, respiratory assist in unconscious cases or need to sedate sever agitation in some intoxicated patients on the contrary, require the expertise of emergency medicine, forensic medicine, and anesthesiology, respectively. Multidisciplinary nature of clinical toxicology is a valuable point; so that, incorporating various medical specialties, gives great power to clinical toxicology groups. On the other hand, this diversity in specialties leads to a variety of viewpoints on dealing with poisoned patients. The key point sessions have been held in Mashhad CTD for the past 18 months and considering the wide range of topics, the need to continue these sessions in the coming years is quietly felt.

Status of clinical toxicology education and ethics in medical care of poisoned patients in the Islamic Republic of Iran and a comparison with other countries.

Clinical toxicology is not recognized as a clinical speciality in Iran. After the chemical war gas attack by the Iraqi army against the Iranian troops in the 1980s, health professionals and Iranian authorities noticed the importance of this field in clinical medicine. Collaboration between the clinical toxicologists and toxicologists of pharmacy schools resulted in the establishment of the Iranian Society of Toxicology and Poisonings in 1991 and the National Board of Toxicology in 1993. Clinical toxicology fellowship was also formed as a joint collaboration between the toxicology and internal medicine boards in 2010. Medical doctors who specialized in clinical medicine are eligible to take the entrance examination of the fellowship. In spite of the advancement of clinical toxicology and increased number of acute poisonings and drug abuse, undergraduate teaching in this field is still lacking and being taught as part of the forensic medicine curriculum since 1952. There is a lack of an efficient national poison information and control centre (s) in Iran, and no action plan and practical efforts have been done for poisoning prevention. Therefore, the number of drug abuse and acute poisonings has increased over the past four decades and induced cultural, social and health problems. According to Iranian legal medicine organization reports, poisoning is the second-most occurring cause of unnatural death. The suicidal attempt is the most common method of acute poisoning in adults. Suicidal attempt including self-poisoning is not accepted in the Islamic point of view, and thus self-poisoning is mostly neglected and may not be treated appropriately in time in some regions of Iran. Accidental poisoning in children is also common in Iran and estimated to be between 20000 and 25000 cases annually over the recent years. In addition, social, cultural and economic problems have induced more health problems such as drug abuse and addiction even in children. Adulterated opium to lead for economic gaining has produced thousands of cases of lead poisoning over the past few years in nearly all opium addicts, which is still a major health problem in Iran. Ban on alcoholic beverages leads some people to make their own home-made spirits, which is unfortunately contaminated with methanol. Thousands of cases of methanol poisoning and even some epidemics have occurred over the past four decades in some parts of the country. Lack of availability of essential antidotes such as succimer and fomepizole has been a major problem for the effective treatment of poisoned patients. Despite the well-known fact that cases of poisoning and drug overdose constitute a significant proportion of hospital admissions in some developing countries, clinical toxicology education and medical care of the poisoned patients are lacking. Therefore, policymakers and health authorities should realize the importance of toxicology in clinical medicine. The Iranian Ministry of Health, medical care and Medical Education should implement clinical toxicology courses for medical students; establish effective national poisons information and control centres and advance clinical toxicology services for appropriate management of poisoned patients to improve public health and the overall health policy goals.

Toxicology education in emergency medicine: an assessment and pilot study

Accreditation Council for Graduate Medical Education (ACGME)-accredited emergency medicine programs have no formal requirements regarding training and education in medical toxicology. From review of previously published survey data less than two-thirds of emergency medicine residencies had formalized access to teaching with toxicologists. To evaluate capacity for toxicology education at ACGME-accredited emergency medicine residency programs, assessment of satisfaction in toxicology education and receptiveness to tele-education modalities. Secondarily to determine feasibility of a pilot web education toxicology program. A survey was conducted in 2015 to evaluate toxicology education capacity, satisfaction with current toxicology education, and technological capabilities of emergency medicine residencies (n = 167). We reviewed websites of non-responding residency programs to determine access to toxicology education. A pilot web-conference-based toxicology education program followed with one residency. Of programs that completed the survey (n = 35, 21%), 77% offered a toxicology rotation for trainees and 60% had an American Board of Medical Toxicology (ABMT)-certified Toxicologist on staff. Programs dissatisfied with toxicology education did not have a toxicology fellowship or an ABMT-certified toxicologist. Participants in the pilot educational program favorably rated the usefulness of the technology, effectiveness of the lecture, value of the subject, and educational value. Barriers exist to implementation of web education. Access to toxicology education through a clinical rotation or medical toxicologist is not consistently available among emergency medicine residency programs, which may indicate programs lacking a toxicologist have lower levels of satisfaction. Successful components of the pilot educational program could be disseminated, but further standardization is indicated.

Michael Dourson tapped to lead EPA chemical program

Michael Dourson, President Donald J. Trump’s pick to head the Environmental Protection Agency’s office that oversees commercial chemicals and pesticides, is a board-certified toxicologist with decades of experience in risk assessment. Dourson’s close ties to the chemical industry, however, have some environmental groups raising concerns about potential conflicts of interest. Dourson is a professor in the Risk Science Center at the University of Cincinnati College of Medicine. Before joining the university in 2015, he directed the Cincinnati-based nonprofit consulting firm Toxicology Excellence for Risk Assessment (TERA), which he founded in 1995. Dourson also held several positions at EPA from 1980 to 1995. Well known in the toxicology community, Dourson has served on numerous U.S. government panels and toxicology journal editorial boards. He has also held multiple positions for the American Board of Toxicology, Society of Toxicology, Society for Risk Analysis, and Toxicology Education Foundation. Dourson...

Course constructions: A case-base of forensic toxicology

Forensic toxicology education in China is limited by insufficient teaching methods and resources, resulting in students with adequate theoretical principles but lacking practice experience. Typical cases used as teaching materials vividly represent intoxication and provide students with an opportunity to practice and hone resolving skills. In 2013, the Department of Forensic Pathology at Zhongshan School of Medicine began to construct top-quality courses in forensic toxicology, with its first step, creating a base containing typical cases of intoxication. This essay reviews the construction process of said cases-base, which is intended to set an example of forensic toxicology education.

Evaluating the Knowledge Base and Current Training of Paramedics in the Southwest United States in Assessing and Managing Toxic Alcohol Exposures

Introduction Toxic alcohol overdose poses a problem in patients who are suffering from the toxicological consequences of toxic alcohol exposure and front line emergency care providers, such as paramedics, need to be well versed in assessing patients, identifying specific toxicities, and implementing appropriate therapies. Objectives The aim of this research was to identify the current knowledge base of paramedics to recognise key clinical, pathophysiological and treatment features of toxic alcohol poisoning. Additionally, the emphasis in training and education of paramedics in terms of the level of importance assigned to toxic alcohol emergencies was evaluated. Methods The study was conducted as an anonymous online survey. Demographic data, timed choice and open-ended questions were collected to evaluate knowledge and identify gaps in toxic alcohol poisoning training by paramedics. The survey link was sent out to emergency medical services (EMS) organisations and individual paramedics in the southwest United States. Bivariate analysis via Pearson correlation coefficient (PCC) was used to compare variables. Results Eighty paramedics participated in the survey, with 60 (75%) participants completing all questions. Respondents were able to identify common sources of toxic alcohol exposure to varying degrees with 58% for methanol and 89% for ethylene glycol. Data indicated that a lack of knowledge of the underlying pathophysiology was related to missing education (PCC <0.05) in toxicology. Education appears to have been insufficient in regards to recognising and treating toxic alcohol exposure. A majority of respondents (68.6%) believed that assessment and treatment of toxic alcohol poisoning is an important component of their training. Conclusions Although symptom recognition for toxic alcohol poisoning is present in most EMS providers, pharmacological intervention and treatment approaches were often not known. The results indicate that there is a need for educators and curriculum builders to include additional coverage of topics of toxicological importance such as the anion gap and toxic alcohol assessment, pathophysiology and treatment.

日本毒性学会の国際貢献、毒性学の変遷－薬学教育の立場－

日本毒性学会の国際貢献、毒性学の変遷－薬学教育の立場－

Knowledge and Confidence of Emergency Clinicians in Managing Toxicological Presentations

Background: Acute poisonings are common presentations to emergency departments (EDs) worldwide and require rapid assessment. Consultant emergency physicians (EPs) faced with various toxicological presentations must initiate rapid investigations and empirical management. This study aimed to determine emergency department doctors’ level of knowledge and confidence in toxicological presentations, and factors that predicted these outcomes. Methods: Target participants included members of the Australasian College for Emergency Medicine (ACEM) and readers of the emergency medicine website, “Life in the Fast Lane”. The survey was distributed electronically via the ACEM bulletin and posted on Life in the Fast Lane. A survey was designed based on toxicology multiple choice questions (MCQs). The questionnaire comprised 59 items: 10 demographic items; 20 items about confidence; 28 MCQs assessing knowledge of common and serious toxicological presentations. Results: There were 467 consenting respondents from 31 countries, with most residing in Australia (306/467, 66%). Respondents comprised similar proportions of consultant emergency physicians (196/467, 42.0%), and trainees (197/467, 42.2%). Almost two-thirds (292/467; 62.1%) had received formal training in toxicological emergencies, while a third (166/467, 35.5%) had participated in a relevant conference or workshop. A total of 284/339 (83.8%) participants completing all items achieved a knowledge test score >50%. More than 65% incorrectly answered questions on pharmacology of serotonin syndrome and lithium toxicity, and more than half incorrectly answered questions on use of 12 lead ECG in toxicology, calcium channel antagonist or tricyclic antidepressant toxicities. Predictors of overall knowledge for toxicology were receipt of formal toxicology education, and clinicians’ experience and seniority. Conclusion: The knowledge and confidence of doctors working in emergency departments is varied, yet correlated. Emergency medicine training programs should consider the benefit of reviewing current toxicological education, including the provision of further educational support to regional and rural hospitals.

History of Japanese Society of Toxicology.

Founded in 1981, the Japanese Society of Toxicology (JSOT) has grown into an organization of nearly 3,000 members working together to advance the nation's scientific knowledge and understanding of toxicology through the implementation of planning that ensures a systematic and efficient expenditure of energies and resources, and is closely aligned with a strategy for accomplishing the Society's long-range plans. To promote public education in toxicology, the Society organizes public lectures during each year's annual meeting. Other activities include hosting scientific conferences, promoting continuing education, and facilitating international collaboration. Internally, the JSOT operates five standing committees: General Affairs, Educational, Editorial, Finance, and Science and Publicity to handle its necessary relationships. To bestow official recognition, the Society established its Toxicologist Certification Program in 1997, and has certified 536 members as Diplomat Toxicologists (DJSOT) as of May 1, 2016. Furthermore, on the same date, 43 JSOT members were certified as Emeritus Diplomats of the JSOT (EDJSOT). The Society has launched two official journals, the "Journal of Toxicological Sciences (JTS)" in 1981 and "Fundamental Toxicological Sciences (Fundam. Toxicol. Sci.)" in 2014. As for participation in the international organizations, the JSOT (then known as the Toxicological Research Group) joined the International Union of Toxicology as a charter member in 1980, and became a founding member of the Asian Society of Toxicology at its inauguration in 1994. Into the future, the JSOT will continue working diligently to advance knowledge and understanding of toxicology and secure its place among the interdisciplinary fields of science, humane studies, and ethics.

Toxicology in Asia--Past, present, and future.

The Asian Society of Toxicology (ASIATOX), which consists of the seven national toxicology member societies of Japan, Korea, China, Taiwan, Thailand, Singapore, and Iran, now boasts of more than 3,000 members from a variety of industries, academia, and regulatory organizations. ASIATOX congresses are spaced three years apart and rotated among the member societies. In 1995, ASIATOX joined the International Union of Toxicology (IUTOX) as a regional society, and now serves as the scientific voice of toxicology in Asia under the IUTOX umbrella. Since its inauguration, the society has worked diligently to handle matters deemed essential to promoting the vision set fourth by its founders. Future perspectives of ASIATOX include the establishment of education and training programs, and the certification and accreditation of toxicologists. As the leading voice of toxicology in Asia, the society seeks to extend knowledge of toxicological issues to developing nations in Asia based on the following missions and goals: (1) to provide leadership as a worldwide scientific organization that objectively addresses global issues involving the toxicological sciences, (2) to broaden the geographical base of toxicology as a discipline and profession to all countries of the world, and (3) to pursue capacity building in toxicology, particularly in developing countries, while utilizing its global perspective and network to contribute to the enhancement of toxicology education and the career development of young toxicologists.