Hands-on Sessions Research Articles

Hands-On Workshops Improve Emergency Department Physicians' Self-Reported Understanding of Pediatric Hand Injuries.

The aims of this study were to assess emergency department (ED) physician perception of hand injuries and improve their understanding and confidence in treating these injuries. Combined didactic and hands-on workshops for ED physicians were developed and run by a team of medical students, plastic surgeons, and ED physicians. The workshops consisted of a short review by a hand surgeon followed by hands-on sessions involving radiograph assessment, administration of local anesthetic, closed reduction, and splinting. Two sessions, 6 months apart, were provided. The workshops were evaluated using preworkshop and postworkshop questionnaires to assess the following domains: confidence and competence in treating hand injuries, knowledge of basic hand injury care, and feedback on the intervention itself. Fifty physicians participated in the workshops. After the workshops, physician recognition of hand fracture reduction as a critical skill increased. Self-efficacy ratings of fracture assessment, administration of local anesthetic, performing a reduction, and applying postreduction immobilization increased. Median scores on knowledge-testing questions also increased postintervention from 73.3% (95% confidence interval, 70.2-78.5) to 86.7% (95% confidence interval, 79.3-86.2) (P < 0.05). Finally, physicians reported that they found the intervention educational, useful, and important, and approximately 90% of participants indicated they intended to change their practice based on this intervention. Knowledge sharing between specialists and generalists through combined didactic and hands-on workshops is an effective and well-received method of refining physician knowledge and increasing confidence in treating subspecialty-specific clinical presentations.

Point-of-Care Ultrasound for Family Medicine Residents: Attitudes and Confidence.

Point-of-care ultrasound (POCUS) is increasingly being incorporated into family medicine residency training. Attitudes towards POCUS among family medicine residents (FMRs) are largely unknown, and confidence levels with performing and interpreting POCUS exams are also unknown among this group of learners. Our aim was to evaluate FMRs' attitudes and confidence levels before and after the implementation of a new POCUS curriculum. Study participants included FMRs in all postgraduate years (ie, PGY1-PGY3) at the University of New Mexico (UNM) Family Medicine Residency Program. Our intervention was a yearlong implementation of a new POCUS curriculum based on the American Academy of Family Physicians POCUS curriculum guidelines. Our interventions included hands-on training sessions for both FMRs and faculty along with a resource website. We assessed attitudes and confidence levels with various POCUS exams using a pre- and postintervention survey. Overall, FMRs felt significantly more confident in their ability to perform and interpret a point-of-care ultrasound after the implementation of POCUS curriculum. There was no significant difference in participants' expectations of their use of POCUS during or after residency. Overall, this study provides evidence that the implementation of a POCUS curriculum that includes hands-on and didactic training is associated with increased confidence in utilizing POCUS among FMRs.

Virtual Reality Human-Human Interface to Deliver Psychotherapy to People Experiencing Auditory Verbal Hallucinations: Development and Usability Study.

BackgroundDigital technologies have expanded the options for delivering psychotherapy, permitting for example, the treatment of schizophrenia using Avatar Therapy. Despite its considerable potential, this treatment method has not been widely disseminated. As a result, its operability and functionality remain largely unknown.ObjectiveWe aimed to study the usability of a therapeutic virtual reality human–human interface, created in a game engine.MethodsParticipants were psychiatric hospital staff who were introduced to the therapeutic platform in a hands-on session. The System Usability Scale (SUS) was employed for evaluation purposes. Statistical evaluation was conducted using descriptive statistics, the chi-square test, analysis of variance, and multilevel factor analysis.ResultsIn total, 109 staff members were introduced to the therapeutic tool and completed the SUS. The mean SUS global score was 81.49 (SD 11.1). Psychotherapists (mean 86.44, SD 8.79) scored significantly higher (F2,106=6.136; P=.003) than nursing staff (mean 79.01, SD 13.30) and administrative personnel (mean 77.98, SD 10.72). A multilevel factor analysis demonstrates a different factor structure for each profession.ConclusionsIn all professional groups in this study, the usability of a digital psychotherapeutic tool developed using a game engine achieved the benchmark for an excellent system, scoring highest among the professional target group (psychotherapists). The usability of the system seems, to some extent, to be dependent on the professional background of the user. It is possible to create and customize novel psychotherapeutic approaches with gaming technologies and platforms.Trial RegistrationClinicaltrials.gov NCT04099940; http://clinicaltrials.gov/ct2/show/NCT04099940

Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of in situ Simulation as a Learning Technique.

IntroductionHyperbaric chambers and underwater environments are challenging and at risk of serious accidents. Personnel aiming to assist patients and subjects should be appropriately trained, and several courses have been established all over the world. In healthcare, simulation is an effective learning technique. However, there have been few peer-reviewed articles published in the medical literature describing its use in diving and hyperbaric medicine.MethodsWe implemented the curriculum of the Master’s degree in hyperbaric and diving medicine held at the University of Padova with emergency medicine seminars created by the faculty and validated by external experts. These seminars integrated traditional lectures and eight in situ simulation scenarios.ResultsFor the hyperbaric medicine seminar, simulations were carried out inside a real hyperbaric chamber at the ATIP Hyperbaric Treatment Centre, only using air and reproducing compression noise without pressurization to avoid damages to the manikins. The four scenarios consisted of hyperoxic seizures, pneumothorax, hypoglycemia, and sudden cardiac arrest. Furthermore, we added a hands-on session to instruct participants to prepare an intubated patient undergoing hyperbaric oxygen treatment with a checklist and simulating the patient transfer inside and outside the hyperbaric chamber. The diving medicine seminar was held at the Y-40 The Deep Joy pool in Montegrotto Terme (Italy), also involving SCUBA/breath-hold diving (BHD) instructors to rescue subjects from the water. These diving medicine scenarios consisted of neurologic syndrome (“taravana/samba”) in BHD, drowning of a breath-hold diver, pulmonary barotrauma in BHD, and decompression illness in a SCUBA diver.ConclusionWith this experience, we report the integration of simulation in the curriculum of a teaching course in diving and hyperbaric medicine. Future studies should be performed to investigate learning advantages, concept retention, and satisfaction of participants.

An Interprofessional Senior Medical Student Preparation Course: Improvement in Knowledge and Self-Confidence Before Entering Surgical Training.

PurposeSenior medical students are variably prepared to begin surgical training; and a national curriculum was established through the American College of Surgeons to better prepare senior medical students for surgical training. The purpose of our course is to prepare senior medical students to more effectively enter surgical training programs. We recently enhanced our independently developed surgical training preparation course by increasing exposure to surgical anatomy, medical physiology, surgical skills, and point-of-care ultrasound. We evaluated the impact of our interprofessional training course to increase confidence and readiness among senior medical students entering surgical training.MethodsThe course focused on pre- and post-operative patient care, surgical anatomy, human physiology, and bedside ultrasound. Didactic lectures in anatomy, human physiology, and bedside ultrasound were provided prior to all hands-on simulated patient care sessions and mock surgical procedures. To evaluate our interprofessional curriculum, we administered pre- and post-course surveys, pre- and post-course knowledge tests, and a final surgical anatomy laboratory practical examination to 22 senior medical students who were enrolled in the course. All students created a final surgical anatomy presentation.ResultsThe students demonstrated a 100% pass rate in surgical anatomy. The knowledge test, which included assessment of knowledge on perioperative surgical decision making, human physiology, and bedside ultrasound, demonstrated an average improvement of 10%. Statistically significant improvements in median confidence values were identified in 10 of 32 surveyed categories, including surgical skills (p < 0.05); 84% of student goals for the course were achieved. The medical students’ surveys confirmed increased confidence related to the use of point-of-care ultrasound, teamwork experience, and basic surgical skills through small group interactive seminars and surgical simulation exercises.ConclusionOur preparation for surgical training course resulted in high student satisfaction and demonstrated an increased sense of confidence to begin surgical training. The 10% improvement in medical student knowledge, as evaluated by a written examination, and the significant improvement in confidence level self-assessment scores confirms this surgery preparation course for senior medical students successfully achieved the desired goals of the course.

Paramedic-performed Prehospital Point-of-care Ultrasound for Patients with Undifferentiated Dyspnea: A Pilot Study.

IntroductionThoracic ultrasound is frequently used in the emergency department (ED) to determine the etiology of dyspnea, yet its use is not widespread in the prehospital setting. We sought to investigate the feasibility and diagnostic performance of paramedic acquisition and assessment of thoracic ultrasound images in the prehospital environment, specifically for the detection of B-lines in congestive heart failure (CHF).MethodsThis was a prospective observational study of a convenience sample of adult patients with a chief complaint of dyspnea. Paramedics participated in a didactic and hands-on session instructing them how to use a portable ultrasound device. Paramedics assessed patients for the presence of B-lines. Sensitivity and specificity for the presence of bilateral B-lines and any B-lines were calculated based on discharge diagnosis. Clips archived to the ultrasound units were reviewed and paramedic interpretations were compared to expert sonologist interpretations.ResultsA total of 63 paramedics completed both didactic and hands-on training, and 22 performed ultrasounds in the field. There were 65 patients with B-line findings recorded and a discharge diagnosis for analysis. The presence of bilateral B-lines for diagnosis of CHF yielded a sensitivity of 80.0% (95% confidence interval [CI], 51.4–94.7%) and specificity of 72.0% (95% CI, 57.3–83.3), while presence of any B-lines was 93.3% sensitive (95% CI, 66.0–99.7%), and 50% specific (95% CI, 35.7–64.2%) for CHF. Paramedics archived 117 ultrasound clips of which 63% were determined to be adequate for interpretation. Comparison of paramedic and expert sonologist interpretation of images showed good inter-rater agreement for detection of any B-lines (k = 0.60; 95% CI, 0.36–0.84).ConclusionThis observational pilot study suggests that prehospital lung ultrasound for B-lines may aid in identifying or excluding CHF as a cause of dyspnea. The presence of bilateral B-lines as determined by paramedics is reasonably sensitive and specific for the diagnosis of CHF and pulmonary edema, while the absence of B lines is likely to exclude significant decompensated heart failure. The study was limited by being a convenience sample and highlighted some of the difficulties related to prehospital research. Larger funded trials will be needed to provide more definitive data.

Musculoskeletal Anatomy and Clinical Skills Combine to Deliver a Pandemic Safe Curriculum

Introduction The pandemic of 2020 presented an opportunity to evaluate options for changing the delivery of the anatomy curriculum to first year medical students. We describe the integration of small group anatomy and clinical skills sessions to accomplish this. Objective Albany Medical College switched to a completely virtual curriculum during March 2020. However, learning anatomy requires more than just lectures and small group conversations. Both clinical skills and anatomy courses require a hands-on curriculum. Although the lecture portion of these courses can be delivered virtually, the hands-on sessions contribute to the students’ ability to see and experience three-dimensional integration. Materials 1). Lectures in both Anatomy and Clinical Skills, 2). 3-D Anatomy modules using the Toltec Virtual Human Dissector platform, 3). Anatomical prosections, 4). Virtual cases, using the SECTRA Table platform, and 5). Clinical Skills sessions with ultrasound demonstrations. Methods In the fall semester of 2020, the first-year class of 145 was randomly divided into 6 groups of about 24 students. During the musculoskeletal theme, there were 8 anatomy lab sessions and 4 clinical skills sessions. On days with corresponding clinical skills sessions, a group of 24 students came to the lab for a one-hour review of the anatomy on prosected specimens and Sectra Table cases. Several structures were tagged in each cadaver and students were provided with a key. This allowed for self-assessment and a chance to apply knowledge gained from lectures and 3-D anatomy directly to real anatomy. Faculty rotated to address questions and to quiz the students on the anatomy topics. Each group spent one hour in the anatomy lab and then immediately rotated to the clinical skills session. The emphasis in the clinical skills portion was the connection between musculoskeletal anatomy and function, along with physical exam maneuvers. Each session began with a demonstration highlighting an aspect of musculoskeletal ultrasound to correlate anatomy with 2-D imaging. Faculty rotated to address questions and provide demonstrations of maneuvers when indicated. Results There were no differences in exam scores when compared to previous classes for either anatomy or physical diagnosis topics. Conclusion Student feedback revealed the correlation of anatomy followed by clinical skills helped them better understand the anatomy and connection to the physical exam without the risks of exposure to large groups of students. Significance The new curriculum demonstrates that we can still teach the material and deliver the content in an effective manner despite the limitations of the COVID pandemic. Implication: The success of this model resulted in new and preferred structure of these classes.

Diversity and Inclusion: A Review of Effective Initiatives in Surgery

Surgery lacks women and racial minorities that are underrepresented in medicine (UIM). This systematic review evaluates interventions used to promote diversity in surgery. The PubMed (MEDLINE), EMBASE, and Cochrane databases were searched for studies (1) describing interventions for increasing UIM and gender diversity, (2) within surgery, and (3) targeting any learner prior to residency. Nine surgical specialties were searched: general, neurosurgery, plastics, orthopedics, otolaryngology, urology, cardiothoracic, vascular, and ophthalmology. Of the 982 studies identified, 16 were included. Awards, clerkships, and workshops were each described by three studies; awards funded research or travel to national meetings, clerkships referred to a third- or fourth-year rotation that provided exposure to surgery, and workshops were hands-on skills sessions for learners. Two studies proposed a holistic review of residency applications, which involves emphasizing an individual's attributes and life experiences rather than strictly academics. Two studies detailed a longitudinal mentoring program comprised of mentorship throughout medical school plus opportunities for research, lectures, and workshops. One study described a combination of interventions and the remaining 2 presented interventions that were characterized as "other." Longitudinal mentoring programs significantly increased the likelihood of women and UIM applying to surgical residency, while holistic review significantly increased the numbers of women and UIM being interviewed and ranked by residency programs. One award increased the number of female residents matriculating into surgical residency. Clerkships significantly increased the number of women applying to surgical residency. The mere mention of diversity initiatives on a program's website was associated with more female surgical residents, but not UIM residents. Workshops led to a higher, but not statistically significant, proportion of women applying to surgery. Holistic review and longitudinal mentoring programs are the most effective interventions for increasing UIM and female representation among surgical trainees.

Big Data in Conservation Genomics: Boosting Skills, Hedging Bets, and Staying Current in the Field.

A current challenge in the fields of evolutionary, ecological, and conservation genomics is balancing production of large-scale datasets with additional training often required to handle such datasets. Thus, there is an increasing need for conservation geneticists to continually learn and train to stay up-to-date through avenues such as symposia, meetings, and workshops. The ConGen meeting is a near-annual workshop that strives to guide participants in understanding population genetics principles, study design, data processing, analysis, interpretation, and applications to real-world conservation issues. Each year of ConGen gathers a diverse set of instructors, students, and resulting lectures, hands-on sessions, and discussions. Here, we summarize key lessons learned from the 2019 meeting and more recent updates to the field with a focus on big data in conservation genomics. First, we highlight classical and contemporary issues in study design that are especially relevant to working with big datasets, including the intricacies of data filtering. We next emphasize the importance of building analytical skills and simulating data, and how these skills have applications within and outside of conservation genetics careers. We also highlight recent technological advances and novel applications to conservation of wild populations. Finally, we provide data and recommendations to support ongoing efforts by ConGen organizers and instructors-and beyond-to increase participation of underrepresented minorities in conservation and eco-evolutionary sciences. The future success of conservation genetics requires both continual training in handling big data and a diverse group of people and approaches to tackle key issues, including the global biodiversity-loss crisis.

At-home hands-on surgical training during COVID19: proof of concept using a virtual telementoring platform.

IntroductionSurgeons in practice have limited opportunities to learn new techniques and procedures. Traditionally, in-person hands-on courses have been the most common means for surgeons to gain exposure to new techniques and procedures. The COVID19 pandemic caused a cessation in these courses and left surgeons with limited opportunities to continue their professional development. Thus, SAGES elected to create an innovative hands-on course that could be completed at home in order to provide surgeons with opportunities to learn new procedures during the pandemic.MethodsThis course was initially planned to be taught as an in-person hands-on course utilizing the Acquisition of Data for Outcomes and Procedure Transfer(ADOPT) method 1. We identified a virtual telementoring platform, Proximie Ltd(London, UK), and a company that could create a model of an abdominal wall in order to perform a Transversus Abdominis Release, KindHeart™(Chapel Hill, NC, USA). The course consisted of pre-course lectures and videos to be reviewed by participants, a pre-course call to set learning goals, the hands-on telementoring session from home, and monthly webinars for a year.ResultsThe ADOPT hands-on hernia course at home was successfully completed on October 23rd of 2020. All participants and faculty were successfully able to set up their model and utilize the telementoring platform, but 15% required assistance. Post course-surveys showed that participants felt that the course was successful in meeting their educational goals and felt similar to prior in-person courses.ConclusionsSAGES was successfully able to transition and in-person hands-on course to a virtual at-home format. This innovative approach to continuing professional development will be necessary during the times of the COVID19 pandemic, but may be a helpful option for rural surgeons and others with travel restrictions in the future to continue their professional development without the need to travel away from their practice.

Scientific method for improvement and student success: Plan-Do-Study-Act.

Are you curious what STEM students find to be barriers to their own success? Do you have anything in your courses or research laboratory environments that you would like to improve? In this hands-on session you will learn how to use the basic principles of improvement science, specifically a branch called Networked Improvement Communities (NIC), to identify ideas that you think might produce the improvement you seek. You will be guided through setting up a Plan-Do-Study-Act (PDSA) cycle to test your change idea on a rapid timescale in your own local environment. The First2 Network (https://first2network.org) is a growing statewide alliance that aims to improve student success and retention in STEM fields, using the NIC framework. First-generation and other underrepresented students are at the center of the work, and we invite all students at the conference to join in and share their own experiences and perspectives with faculty members during this session. First2 Network, a National Science Foundation INCLUDES Alliance, is supported by NSF award numbers HRD-1834569, 1834575, 1834586, 1834595, and 1834601.

A corpus-aided discovery learning (CADL) approach to teaching collocations in TEFL settings

Despite the progress made in the field of corpus linguistics, the use of corpora is relatively scarce in language pedagogy (Krieger, 2003). However, the effectiveness of using corpus-based activities in teaching English has been supported by researchers (Vannestal and Lindquist, 2007). This paper discusses the potential of using a corpus-aided discovery learning (CADL) approach in TEFL settings, particularly in teaching collocations (i.e. habitual cooccurrences of lexical items). There is consensus that the study of collocations is vital for developing language skills and fostering fluency and accuracy (e.g. Biber et al.,1999; McEnery & Wilson, 2001; McAlpine & Myles, 2003) since competence in a language undoubtedly involves collocational knowledge (Herbst, 1996: 389). Evidently, learners’ knowledge of collocations is quite important (Kita and Ogata, 1997: 230) and is needed for effective sentence generation (Smadja and McKeown, 1990) and avoidance of errors (McAlpine and Myles, 2003: 75). In this paper, we argue that using a CADL approach and involving learners in corpus-based activities in the study of collocations would extend their lexicon. To support this argument, the researchers initiated an experiment applying a CADL approach to the teaching of vocabulary, particularly collocations, in the Faculty of Education, Tanta University, Egypt. 20 third-year students were introduced to the BNC[1] web and were given a hands-on session on how to use the BNC. Then, learners were asked to look at the concordances of the most frequent 10 nouns in the BNC, namely: ‘time’, ‘people’, ‘way’, ‘years’, ‘year’, ‘work’, ‘government’, ‘day’, ‘man’, and ‘world’; to decide which adjectives most frequently occur with these nouns; to extract collocates for each noun; and to discuss their findings with their colleagues. This is followed by a number of exercises in which students use the collocates they have found. The aim of the study, or as Chambers (2007) and Mukherjee (2004) call it ‘task’, is to ‘popularise’ the work with corpus data in TEFL settings. Hence, language learners would not rely solely on the teacher but would deal with corpora on their own under the teacher's guidance and find out about language patterning and the behaviour of words and phrases in an ‘autonomous’ way (Bernardini, 2002: 165).

Point-of-care ultrasonography for the diagnosis of testicular torsion: a practical resident curriculum.

BackgroundPrompt Doppler ultrasonography to aid in diagnosis is often key to managing testicular torsion, but there may be delays in access; a faster, more widely available alternative is point-of-care ultrasonography (POCUS). The purpose of this study was to develop and evaluate a scrotal POCUS curriculum for urology and emergency medicine residents.MethodsContent experts in urology, emergency medicine and diagnostic imaging collaborated in a modified Delphi method to design a practical didactic curriculum for scrotal POCUS for the identification of testicular torsion. Training included 3 online video teaching modules and a 1-hour hands-on teaching session with standardized adult patients. We evaluated participants’ competency in scrotal POCUS using a validated scale. We assessed participants’ knowledge, comfort and confidence in performing scrotal POCUS before and after the intervention and at 3 months.ResultsTwenty-four urology (n = 12) and emergency medicine (n = 12) residents participated in the curriculum. After hands-on practice, 23 participants (96%) were deemed competent at scrotal POCUS. Pre–post testing showed significant improvement in knowledge (mean score 63% v. 80%, p < 0.001), comfort (mean Likert score 0.6 v. 3.6, p < 0.001) and confidence (mean Likert score 1.0 v. 2.1, p < 0.001) after the intervention. These effects were maintained at the 3-month assessment.ConclusionThe scrotal POCUS curriculum was effective and acceptable to both urology and emergency medicine residents. The findings suggest that scrotal POCUS can be learned effectively through a short hands-on session and didactic instruction.

Towards the adoption of virtual reality training systems for the self-tuition of industrial robot operators: A case study at KUKA

Interest is growing around Virtual Reality training systems (VRTSs), which started to be considered as a credible option to train companies’ workforce. Although the efficacy of VRTSs as a fancy alternative to traditional learning material used by trainers in their lectures has already been proved, their effectiveness as self-learning tools not requiring human instructors is still controversial, since experiments carried out within established training programmes are still rare. This paper reports the results of a user study aimed to investigate how an immersive VRTS designed to train industrial robot operators on light maintenance tasks actually compares to the training practice based on in-class and hands-on sessions that is adopted worldwide by an international company. After the training, study participants were evaluated by company's instructor while performing the taught task autonomously on a real robot. Obtained results showed that the effectiveness of the devised VRTS in making the trainees able to successfully complete the task was comparable to that of the traditional training. It was also found that there is still room for improvement, e.g., on virtually training interaction with physical tools and equipment, as well as on emulating and fortifying aspects of human trainer-trainee social dynamics.

Application of a bioinformatics training delivery method for reaching dispersed and distant trainees.

Many initiatives have addressed the global need to upskill biologists in bioinformatics tools and techniques. Australia is not unique in its requirement for such training, but due to its large size and relatively small and geographically dispersed population, Australia faces specific challenges. A combined training approach was implemented by the authors to overcome these challenges. The “hybrid” method combines guidance from experienced trainers with the benefits of both webinar-style delivery and concurrent face-to-face hands-on practical exercises in classrooms. Since 2017, the hybrid method has been used to conduct 9 hands-on bioinformatics training sessions at international scale in which over 800 researchers have been trained in diverse topics on a range of software platforms. The method has become a key tool to ensure scalable and more equitable delivery of short-course bioinformatics training across Australia and can be easily adapted to other locations, topics, or settings.

Student led outreach workshops to promote basic life support.

To provide basic life support training to the staff, students and faculty of higher educational institutions in urban areas through pre-trained medical students, and to record the qualitative impact of community training on student facilitators. The mixed-method quasi-experimental study was conducted at the Foundation University, Islamabad, Pakistan, in collaboration with the Higher Education Commission of Pakistan from 2015 to 2018. Trained volunteer medical students were divided into teams to visit and provide hands-on basic life support training to 15 educational institutions in Rawalpindi and Islamabad with each batch having 45-50 participants. The participants completed pre- and post-training questionnaires, whereas the trainers went through post-training, semi-structured interviews. Quantitative analysis of pre and post-training responses was done using SPSS 21. Qualitative assessment of the impact of learning experience was done through constant comparative analysis of transcripts. There were 120 volunteers and 675 participants subjects. The participants' knowledge about basic life support showed significant improvement (p<0.001) post-training. There were two main recurring themes identified in the interviews; an opportunity to improve self-confidence, and technical skill. Hands-on training sessions conducted by pre-trained medical students not only resulted in an improvement in Basic Life Support knowledge of the participants, but also had a substantial impact on student trainers' self-confidence and technical skills.

Impact of School-Based Oral Health Education on Vietnamese Adolescents: A 6-Month Study.

We have evaluated the impact of a school-based intervention on oral health knowledge, behaviours, and oral health status of adolescents in Vietnam. This 6-month study included 462 adolescents aged 12 years from four selected schools in Hue City, Vietnam. The intervention group received a 15-min lecture by a dentist and hands-on session on mouth observation and toothbrushing skills. The control group did not engage in any educational activities during the follow-up period. Data were collected at baseline and 6 months through a survey questionnaire and clinical examination. The Debris Index was used for dental plaque; the Papillary, Marginal, Attached gingiva index for gingivitis; and the Decayed, Missing, and Filled Teeth index (World Health Organization modification) for dental caries. Difference-in-difference analysis was used to compare changes between the groups. After 6 months, the control tended to show decreased toothbrushing frequency and increased dental plaque accumulation. The participants in the intervention group showed improved oral health knowledge (p < 0.01), behavior (p < 0.05), and hygiene (p < 0.001) compared to the control group. However, the intervention did not improve dental caries and gingivitis. A single school-based oral health education program can help adolescents improve oral health knowledge and prevent the deterioration of short-term oral health behavior and hygiene.

Efficacy of implementing intermittent STOP THE BLEED® reviews on long term retention of hemorrhage control skills of first year medical students.

Some medical schools integrate STOP THE BLEED® training into their curricula to teach students howto identify and stop life threatening bleeds; these classesthat are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention ofhemorrhage control skills and improving perceived confidence. First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4min STOP THE BLEED® review video (intervention group) or a "distractor" video (control group) at 4 week intervals. After the 12weeks, the students were asked to complete an 11item survey. Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median=21.4 points vs. control group median=16.8 points). Intermittent review videos for STOP THE BLEED® training improved medical students' confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.

Teaching Skin Cancer Detection to Medical Students Using a Dermoscopic Algorithm.

Early detection of melanoma skin cancer improves survival rates. Training family physicians in dermoscopy with the triage amalgamated dermoscopic algorithm (TADA) has high sensitivity and specificity for identifying malignant skin neoplasms. In this study we evaluated the effectiveness of TADA training among medical students, compared with practicing clinicians. We incorporated the TADA framework into 90-minute workshops that taught dermoscopy to family physicians, primary care residents, and first- and second-year medical students. The workshop reviewed the clinical and dermoscopic features of benign and malignant skin lesions and included a hands-on interactive session using a dermatoscope. All participants took a 30-image pretest and a different 30-image posttest. Forty-six attending physicians, 25 residents, and 48 medical students participated in the workshop. Mean pretest scores were 20.1, 20.3, and 15.8 for attending physicians, resident physicians and students, respectively (P<.001); mean posttest scores were 24.5, 25.9, and 24.1, respectively (P=.11). Pre/posttest score differences were significant ( P<.001) for all groups. The medical students showed the most gain in their pretest and posttest scores. After short dermoscopy workshop, medical students perform as well as trained physicians in identifying images of malignant skin lesions. Dermoscopy training may be a valuable addition to the medical school curriculum as this skill can be used by primary care physicians as well as multiple specialists including dermatologists, gynecologists, otolaryngologists, plastic surgeons, and ophthalmologists, who often encounter patients with concerning skin lesions.

Comprehensive residency-based point-of-care ultrasound training program increases ultrasound utilization in the emergency department.

Point-of-care ultrasonography (POCUS) is a prompt and simple tool for the urgent diagnosis and treatment of patients in the emergency department (ED). We developed a comprehensive residency-based POCUS training program for ED residents and determined its effect on ultrasound utilization in the ED.We conducted a retrospective cohort study in the ED of a university-affiliated medical center, to evaluate a centralized residency-based POCUS training course for ED residents, which included 12 core ultrasound applications, from July 2017 to June 2018. Each application comprised a combined lecture and hands-on practice session that lasted for 2 hours. Pre-tests and post-tests, including still image and video interpretation, were performed. The use of POCUS (number of ultrasound studies performed divided by the number of patients each resident saw in 1 year) among ED residents, before and after the POCUS training course (July 2016–June 2017 and July 2018–June 2019), was calculated and analyzed using the Wilcoxon signed-rank test.Sixteen residents participated and completed the entire training course. The post-test score was significantly better than the pre-test score, by a median of 12 points (P = .04). Utilization of POCUS among the ED residents increased significantly, from 0.15 ultrasound studies per patient per year to 0.41 ultrasound studies per patient per year (P < .01), after completion of the entire training course. Increased POCUS scanning percentages over the cardiac tissue, soft tissue, abdominal region, vascular system, procedural guidance, and ocular regions were also noted after providing the curriculum.Conducting a comprehensive POCUS education program may enhance POCUS utilization among residents in the ED.