Increase In Medical Knowledge Research Articles

Knowledge and belief in the times of COVID-19: A comparative analysis of epistemicity in English newspaper discourse of two stages of the pandemic.

This paper sets forth a quantitative analysis of expressions of epistemicity, a category covering the expression of commitment to the information transmitted and comprising epistemic modality and evidentiality, in a corpus of 400 newspaper articles from The Guardian concerning the COVID-19 pandemic. 200 articles were written in April 2020; the other 200 were written between January and April 2022, after massive vaccination and an extraordinary increase in medical knowledge. The analysis distinguishes between a number of subtypes of epistemic expressions and three kinds of authorial voice. The results show that the April 2020 articles contain more epistemic expressions, of both weak commitment (might, perhaps, apparently…) and strong commitment (know, clearly, surely…), which suggests a greater need to distinguish the known from the unknown in this period, due to the pervasive state of uncertainty. The analysis has social implications, since it gives readers an opportunity to appreciate the careful assessments of epistemicity found in the corpus and therefore to consider the convenience of obtaining information from quality media. These social implications, together with the methodology of the analysis, contribute to the potential of the paper for pedagogical applications.

(062) Identifying the Comfort Level and Understanding of Female Anorgasmia in Medical Students Following an Interactive Online Medical Educational Module in Female Anorgasmia

Abstract Introduction Sexuality is an important aspect of a woman's health; however, in the United States, it is estimated that 10 to 42% of women suffer from female anorgasmia [1]. Despite the high prevalence of female orgasmic disorders, many women are reluctant to discuss it with their providers due to anxiety or embarrassment. They will only voice this issue after direct clinical inquiry. Healthcare professionals frequently under screen for anorgasmia in patients [2]. There is good evidence that sexual health education increases providers’ confidence in screening for sexual dysfunction and ultimately improves the quality of life for their patients. Yet, historically, there has been a lack of medical student education and training on female sexual dysfunction [3]. To address this gap, we created a medical student online training module focused on female anorgasmia. Objective Our primary goals are to obtain preliminary data on: the baseline medical student knowledge of female anorgasmia, the effectiveness of our female anorgasmia module, and the feasibility of assessing the module in an academic setting. We hypothesize that our female anorgasmia module will increase students' knowledge and comfort in addressing and screening for anorgasmia in a clinical setting. Methods We obtained IRB approval. A REDcap database was created to collect and record results. Students were recruited through email and class-based group messaging services. Through pre and post-surveys, we assessed participants’ baseline comfort in screening for anorgasmia and evaluated changes in their comfort after completion of the module. Results Of 24 participants in the study, 11 completed all components and were used to assess the pre and post-responses. Our baseline responses showed 54% of medical students were slightly or not comfortable screening for anorgasmia. 27% were slightly comfortable screening for decreased desire. Our post module responses showed statical improvement in both comfort in screening for desire (p = .03) and orgasm (p = .01). An increase in medical knowledge surrounding anorgasmia was seen but not statically significant. Conclusions Our pilot study revealed over half of medical student participants at baseline had no or little comfort in screening for anorgasmia. Our module improved participants’ comfort in screening for anorgasmia. It also showed an increase in medical knowledge surrounding anorgasmia. Additionally, participants gained statically significant comfort in screening for desire. While our initial results are promising, we cannot attribute them to our entire population due to the small sample size. Of the 24, 11 participants completed all components needed to assess the module (demographics, the pre-module survey, the module, and the post-module survey. We plan to reevaluate our REDcap survey, assessment instructions and hope to provide incentives to our participants to maximize our completion rate. An additional study with a larger sample size is necessary to better assess the effectiveness of the module. Disclosure No

Initial report on special operations clinical training at a civilian academic medical center.

Military-civilian partnerships for combat casualty care skills training have mostly focused on traditional, combat surgical team training. We sought to better understand US Special Forces (SF) Medics' training at West Virginia University in Morgantown, West Virginia, a Level 1 trauma center, via assessments of medical knowledge, clinical skills confidence, and technical performance. Special Forces Medics were evaluated using posttraining medical knowledge tests, procedural skills confidence surveys (using a 5-point Likert scale), and technical skills assessments using fresh perfused cadavers in a simulated combat casualty care environment. Data from these tests, surveys, and assessments were analyzed for 18 consecutive SF medic rotations from the calendar years 2019 through 2021. A total of 108 SF Medics' tests, surveys, and assessments were reviewed. These SF Medics had an average of 5.3 years of active military service; however, deployed experience was minimal (73% never deployed). Review of knowledge testing demonstrated a slight increase in mean test score between the precourse (80% ± 14%; range, 50-100%) when compared with the postcourse (82% ± 14%; range, 50-100%). Skills confidence scores increased between courses, specifically within the point of injury care ( p = 0.09) and prolonged field care ( p < 0.001). Technical skills assessments included cricothyroidotomy, chest tube insertion, and tourniquet placement. This study provides preliminary evidence supporting military-civilian partnerships at an academic Level 1 trauma center to provide specialty training to SF Medics as demonstrated by increase in medical knowledge and confidence in procedural skills. Additional opportunities exist for the development technical skills assessments. Therapeutic/Care Management; Level IV.

INCREASING MEDICATION SAFETY AWARENESS IN RURAL OLDER ADULTS

Abstract Compared to urban populations, rural residents have a higher incidence of chronic diseases and poorer health outcomes. Most medications in the United States are consumed by older adults who are more susceptible to adverse drug events due to the presence of multiple chronic conditions and physiologic changes in the body. This community-based project evaluated the impact of an interdisciplinary medication education intervention on medication knowledge and adherence to medications and refills. The study was a quasi-experimental pretest/posttest design with a convenience sample. The project was marketed via a multi-media approach. Most participants reported learning of the event at a senior center. Each participant received a private educational session for their specific medications with a nurse practitioner, pharmacist, or pharmacy resident. Forty-nine older adults participated in the study with 48 (97.9%) completing both the pretest and posttest. The average age of participants was 71.4 years and the average number of medications per participant was 5.4. There was a statistically significant difference in the adherence to medication and refills subscale score (p = .003). There was no statistically significant difference in the medication knowledge subscale (p = .192), however, the scores did trend upward indicating an increase in medication knowledge. Forty-four (89.8%) participants reported they were more comfortable understanding their medication since participating in the program and 48 (98%) reported they would recommend the program to others. The results of this study suggest community-based outreach medication educational programs can increase adherence to medication and refills for older adults residing in rural areas.

International medical students’ perspectives on factors affecting their academic success in China: a qualitative study

BackgroundThe number of international students who choose China as their destination for quality medical education is rising, particularly those from developing countries, but little is known about their adaptation and educational experiences at Chinese universities. This study explored the factors that these students perceived to have influenced their academic success.MethodsSemi-structured interviews were conducted with international students (N = 40) from developing countries from September 2020 to January 2021. Participants were graduates or in their second, third, fourth, fifth, or sixth academic year in two university medical schools. Interviews were audio-recorded, transcribed, and analyzed using a thematic analysis approach.ResultsThe participants chose China to study medicine based on cost, teaching resources, quality of medical education, recommendation, and safety factors. They considered an increase in medical knowledge, clinical skills and communication skills as an indicator of academic success. Positive factors affecting academic success were the support system (family, friends, seniors) and campus resources (library, laboratories, extra-curricular activities, scholarship). Negative factors were (i) issues affecting learning (English language barrier), adjusting to the medical education system in China, learning difficulties, failing exams, internship difficulties, problems with online learning during the pandemic, (ii) sociocultural issues (lacking knowledge of the Chinese language, challenges in daily life, perceived discrimination, interpersonal relationships), (iii) wellbeing issues (physical and mental health issues), and (iv) other challenges (climate, food, finance, scholarship). The influence of teachers, administrators and classmates was perceived as both positive and negative.ConclusionsFactors affecting the academic success of international medical students at Chinese universities are multi-faceted. It is the collective responsibility of the host society, universities, teachers, administrators, classmates, families, and students themselves to address these factors in order to support and help students achieve academic success. Findings in our study support recommendations to improve teachers’ English language skills and pedagogy and to invest in administrators’ professional development. They also suggest that greater awareness of students’ sociocultural and mental challenges and optimizing the positive influence of classmates could strengthen student support and better address student academic difficulties. The English proficiency and prior academic performance of international students should be considered during recruitment. Given the rapid growth in international MBBS programs in China, further research on the experiences of international students in China’s medical programs is needed.

The Magnetic Resonance Safety Officer (MRSO) Role

The transition toward value-based payment models increases focus on the radiologist's direct impact on hospital-provided patient care. Radiology trainees understand inpatient hospital workflows and decision-making paradigms and are well positioned to interface directly with hospital physicians regarding clinical decision making related to diagnostic imaging and/or image guided interventions. A radiology resident-led project with internal medicine residents focused on Clinical Decision Support was designed, implemented, and reviewed, with the objectives of educating clinical teams and positively impacting patient care.During the 2017-2018 academic year, senior radiology residents (PGY-5) led weekly rounds with medicine residents rotating through inpatient floor units. During these rounds, they discussed indications for and types of hospital inpatient imaging studies, exchanged clinical information, directed further imaging workup, and taught the essentials of image interpretation. Participating medical residents’ degree of radiology-awareness and opinions were systematically surveyed at the conclusion of the academic year. Thirty-four out of a total of 161 (21%) Internal Medicine residents responded to the survey. Thirty one percent of these residents could identify an instance where radiology-led rounds altered patient management and 94% acknowledged an increase in medical knowledge. Sixty-one percent believed evidence-based choice for imaging orders was enhanced by attending radiology-led rounds and 64% developed a better understanding of resources available to guide image ordering. Forty-nine percent of residents made suggestions to their Internal Medicine attending physician or more senior trainee or otherwise applied something learned during radiology-led rounds and 42% cancelled or ordered a study based on what they learned or discussed in radiology rounds. Thirty-nine percent of medicine residents stated that these rounds changed their perception of the role of the radiologist and 75% expressed the desire to see increased participation by radiologists in their daily workflow. Radiology resident-led educational medicine rounds promote cross-specialty collaboration, further educate trainees, and directly affect patient management. It is therefore valuable for radiology trainees to directly engage in the teaching of other medical providers, to enhance their own consultative skill set, promote face-to-face interactions with other physicians, and to directly impact patient care.

Ultrasound's Impact on Preclinical Medical Student Neurology Unit Grades: Findings After 2 Years.

Ultrasound is a valuable tool for anatomy education, but limited evidence exists for using ultrasound to teach neuroanatomy and neurophysiology. Previous work demonstrated a potential increase in medical knowledge in preclinical medical students participating in a neurology ultrasound workshop, however, without comparison to a control group. After 2 years, we assessed how a neurology ultrasound workshop affected the medical knowledge of participating preclinical medical students compared to a traditional curriculum control group. This quasiexperimental study compared academic performance of ultrasound workshop participants to nonparticipant classmates. The primary outcome was the overall neurologic disorders unit total score. An analysis of covariance was conducted to test for statistically significant differences while controlling for the average quiz score. A total of 360 medical students were included in the study. The intervention group (n=57) showed no significant difference in the total unit score (F=3.206; P=.074), with averages for the control and experimental groups being 87.3% ± 5.0% and 88.4% ± 4.8%, respectively. Additionally, anatomy practical scores and written final examination scores were not significantly different between groups (F=1.035; P=.310; F = 2.035; P=.155). Participation in a neurologic disorders ultrasound workshop did not appear to be correlated with improved curricular performance in our cohort. Further research should continue to assess ultrasound workshops in other organ systems to elucidate the relationship between learning ultrasound and the impact on medical school academic performance.

Johannes Juda Groen (1903-1990): A Forgotten Visionary in the History of Medical Education.

Beyond the increase in medical knowledge and biotechnology during the last decades, doctors have adopted professional norms that would have been considered heretical only two generations ago. The changes transpired between the 1970s and 1990s, and generated controversies between those who upheld the traditional values of patient care, and those who welcomed the new professional norms. Professor Dr Johannes Juda Groen (1903–1990) predicted and promoted some of these changes. As early as the 1940s through the 1960s, he recognized the need to teach interviewing skills and advocated an orientation to patients, rather than to diseases; he supported decision-making based on evidence, rather than on personal experience and pathophysiologic rationale; and he demonstrated that psychosocial determinants predict, rather than only correlate with, disease. These views led to confrontations with the medical establishments in the Netherlands and in Israel. Still, many of his colleagues recognized the value of his contributions. The author, for one, admires Groen’s commitment in challenging the prevailing clinical wisdom after the end of World War 2, and his courage in opposing the views of his colleagues.

Benefits of medication charts provided at transitions of care: a narrative systematic review

ObjectivesParticularly at transitions of care points information concerning current medication tends to be incomplete. A medication chart that contains all essential information on current therapy is likely to be a...

Face-to-Face: Resident-led Radiology Medicine Rounds Facilitate Evidence-based Processes for Clinical Decision Support

BackgroundThe transition toward value-based payment models increases focus on the radiologist's direct impact on hospital-provided patient care. Radiology trainees understand inpatient hospital workflows and decision-making paradigms and are well positioned to interface directly with hospital physicians regarding clinical decision making related to diagnostic imaging and/or image guided interventions. A radiology resident-led project with internal medicine residents focused on Clinical Decision Support was designed, implemented, and reviewed, with the objectives of educating clinical teams and positively impacting patient care. Materials and MethodsDuring the 2017-2018 academic year, senior radiology residents (PGY-5) led weekly rounds with medicine residents rotating through inpatient floor units. During these rounds, they discussed indications for and types of hospital inpatient imaging studies, exchanged clinical information, directed further imaging workup, and taught the essentials of image interpretation. Participating medical residents’ degree of radiology-awareness and opinions were systematically surveyed at the conclusion of the academic year. Thirty-four out of a total of 161 (21%) Internal Medicine residents responded to the survey. Thirty one percent of these residents could identify an instance where radiology-led rounds altered patient management and 94% acknowledged an increase in medical knowledge. Sixty-one percent believed evidence-based choice for imaging orders was enhanced by attending radiology-led rounds and 64% developed a better understanding of resources available to guide image ordering. Forty-nine percent of residents made suggestions to their Internal Medicine attending physician or more senior trainee or otherwise applied something learned during radiology-led rounds and 42% cancelled or ordered a study based on what they learned or discussed in radiology rounds. Thirty-nine percent of medicine residents stated that these rounds changed their perception of the role of the radiologist and 75% expressed the desire to see increased participation by radiologists in their daily workflow. Radiology resident-led educational medicine rounds promote cross-specialty collaboration, further educate trainees, and directly affect patient management. It is therefore valuable for radiology trainees to directly engage in the teaching of other medical providers, to enhance their own consultative skill set, promote face-to-face interactions with other physicians, and to directly impact patient care.

Investigating Fatigue and Exercise Intolerance in a University Immunology Clinic

The last 20 years have seen dramatic increases in medical knowledge that have changed the way that we look at various clinical disorders. One of these advances has been the appreciation that metabolism is a critical part of the functioning of every cell, tissue and organism. Metabolism is defined in the Oxford dictionary as “the chemical processes that occur within a living organism that maintain life”.

Halting dehumanization in medicine

Dehumanization in medicine extends beyond doctor–patient relationship and affects the whole health-care system. It affects the physician himself who has become more of a doctor-machine. The constant expansion of medical information, the objective approach, and the compulsion to remain in touch with evidence-based updates, takes the physician away from the patient. Much of the increase in medical knowledge is downstream (body dimension), whereas the primary cause may remain the same upstream (mental and spiritual dimensions). In the conventional body medicine, there is little requirement for empathy and a persistent demand for use of the analytic mind. Intuitive approach being efficacious, fundamental, and creative, is able to connect the physician to inner joy but is neglected. The “quantum-aware” approach, where there is balanced consideration of all the three components: body, mind-body and mind-body-spirit medicine, allows the physician to be competent, intuitive, creative and empathetic. Health-care delivery and the process of medical education are modified accordingly.The following core competencies are addressed in this article: Patient care, Medical knowledge, Interpersonal and communication skills, Systems-based practice.

Impact of learners’ role (active participant-observer or observer only) on learning outcomes during high-fidelity simulation sessions in anaesthesia: A single center, prospective and randomised study

AimThe increasing use of high-fidelity simulation is limited by the imbalance between the growing number of students and the human resources available in such a way that all residents cannot play a role during scenarios. The learning outcomes of observers need to be studied. MethodsThis prospective randomised study was approved by the institutional review board. Anaesthesia residents attending a one-day training session were enrolled. In each of the four scenarios, three residents played an active role while others observed in a separate room. All participants attended debriefing sessions. Residents were randomised between active participant-observer group (AP-O group) and observer group (O group). A similar questionnaire was distributed before, immediately after the session and after three months and included self-reported assessment of satisfaction, medical knowledge (noted 0–16), and non-technical skills. ResultsA hundred and four questionnaires were analysed. Immediately after the simulation, a significant increase in medical knowledge was recorded but was higher in the AP-O group (6 [5–8] to 10 [8–11]/16) than in the O group (7 [5–8] to 9 [7–10]/16). High scores for non-technical skills were similarly observed in both groups. Satisfaction was high in both groups but was higher in the AP-O group (9 [8–9] versus 8 [8–9]/10, P=0.019). Decay of knowledge was observed for most main outcomes at three months. ConclusionThis study suggests an immediate improvement of learning outcomes for both roles after immersive simulation but some learning outcomes may be better for residents engaged as players in scenarios.

Fundamentals for an Osteopathic Obesity Designed Study: The Effects of Education on Osteopathic Medical Students' Attitudes Regarding Obesity.

Obesity is a major health concern in the United States, and its prevalence continues to rise. Although it is a common health issue, many people, including health care professionals, are biased against people with obesity. To determine whether a comprehensive obesity curriculum presented to students in medical school can positively influence their attitudes toward obesity. The study was designed around a comprehensive educational obesity curriculum at Touro University College of Osteopathic Medicine-CA, involving the classes of 2013 through 2018. A survey to assess student attitudes toward obesity was distributed to first-year students before the curriculum, directly after completion, and each year after until graduation (graduating classes of 2015 through 2018). Second- and third-year medical students in 2011 (graduating classes of 2014 and 2013), who did not complete the curriculum, were given an examination to establish baseline values and served as the control group. The obesity curriculum consisted of lectures delivered during the first and second year of medical school and case study simulations during the third year. Knowledge gained from the curriculum was assessed with a multiple-choice examination, and bias was assessed using the Fat Phobia Scale. A total of 718 first- through fourth-year students were included. Students who completed the first year of the obesity curriculum (n=528) showed significantly greater medical knowledge regarding obesity-related epidemiology, pathogenesis, biochemistry, pathophysiology, and metabolic factors; nutrition, diet, physical activity, self-control, and behavior modification; pharmacologic and nonpharmacologic interventions; and associated chronic disorders, based on their multiple-choice examination scores compared with the control group. The examination scores indicated significant increases in medical knowledge compared with the precurriculum cohort after the curriculum (OMS I students: 130 [72.4%]; 133 [92.6%]; 133 [91.1%]; 132 [89.0%]; vs control: 105 [47.2%]; 134 [52.6%], respectively [P<.01]). In all 4 years observed, there was a significant reduction in bias among first-year medical students after obesity curriculum (before: 3.65, 3.76, 3.57, 3.61, and after: 3.47, 3.38, 3.34, 3.37, respectively) (P<.05). The reduction in bias was also significantly sustained throughout the fourth year. A comprehensive obesity curriculum throughout medical school resulted in an improvement in students' attitudes toward and knowledge of obesity.

Impact of online toxicology training on health professionals: the Global Educational Toxicology Uniting Project (GETUP)

Objective: The Global Educational Toxicology Uniting Project (GETUP), supported by the American College of Medical Toxicology, links countries with and without toxicology services via distance education with the aim to improve education. Due to the lack of toxicology services in some countries there is a knowledge gap in the management of poisonings. We describe our experience with the worldwide delivery of an online introductory toxicology curriculum to emergency doctors and other health professionals treating poisoned patients.Methods: We delivered a 15-module introductory Internet-based toxicology curriculum to emergency doctors and health professionals, conducted from August to December 2016. This Internet-based curriculum was adapted from one used to teach emergency residents toxicology in the United States. Modules covered themes such as pharmaceutical (n = 8), toxidromes (n = 2) and agrochemicals (n = 5) poisoning. Participants completed pre-test and post-test multiple choice questions (MCQs) before and after completing the online module, respectively, throughout the course. We collected information on participant demographics, education and training, and perception of relevance of the curriculum. Participants gave feedback on the course and how it affected their practice.Results: One hundred and thirty-six health professionals from 33 countries participated in the course: 98 emergency doctors/medical officers, 25 physicians, eight pharmacists/poisons information specialists, two toxicologists, two medical students and one nurse. Median age of participants was 34 years. Median number of years postgraduate was seven. Ninety (65%) had access to either a poisons information centre over the phone or toxicologist and 48 (35%) did not. All participants expected the course to help improve their knowledge. Overall median pre-module MCQ scores were 56% (95%CI: 38, 75%) compared to post-module MCQ scores median 89% (95% CI: 67, 100%) (p < .0001).Conclusions: Our participants demonstrated an increase in medical knowledge based on performance on MCQs. An online toxicology curriculum is an effective way to deliver education to health professionals treating poisoned patients and can help to bridge the knowledge gap and change practice in developed and developing countries.

Implementation of Educational Module to Improve Cervical Length Measurement Quality Among Obstetrical Residents [6B

INTRODUCTION: Proper techniques for measuring cervical length (CL) are imperative for obtaining accurate measurements. We sought to evaluate resident physician knowledge of proper methodology/criteria for CL evaluation. A second aim was to assess resident performance of proper CL measurements before and after formal education based on Cervical Length Education and Review (CLEAR). METHODS: Following IRB exemption, OB/GYN residents completed a pre- and post-test, and participated in image procurement before and after a formal training module. Education included a review given by a perinatologist and viewing of a CLEAR lecture. Residents collected three cervical length images on five different patients who presented for evaluation of preterm labor. Images collected prior to and following the educational module were assessed for quality and adherence to established CLEAR criteria by a perinatologist, graded on a point system and assigned a pass or fail score. These results, as well as the pre- and post-test scores were analyzed with paired t test and Wilcoxon signed rank test. RESULTS: Fifteen residents completed image procurement, training and testing. Adherence to proper CL measurement techniques improved after implementation of a formal educational module as significantly more images achieved pass status (6% prior to and 26% post training, P=.005). Additionally, an increase in medical knowledge was reflected by a significantly higher mean percentage on the posttest 92.9 (95% CI 90.7–95.1) vs the pretest 65.7 (95% CI 60.6–71.4), P<.001. CONCLUSION: Implementation of formal CL training using CLEAR resources improved the quality of CL images obtained by residents as well as their medical knowledge.

Emerging Trends in the Epidemiological Pattern of Head and Neck Cancers in Lagos, Nigeria.

Background:Unfortunately, despite an increase in medical knowledge, survival rates of head and neck cancers (HNCs) have not been observed to improve greatly. This is true, especially in tumors located in obscure primary sites or late presentation.Aim:The purpose of this study is to assess the epidemiologic pattern of HNCs and to evaluate its emerging trends and patterns in Lagos state.Subjects and Methods:A retrospective study was conducted from 2003 to 2013 that analyzed histologically diagnosed cases of HNC at the Pathology Departments of the two tertiary teaching hospitals in Lagos. Data analysis was performed using the Statistical Package for the Social Sciences (version 20) statistical software.Results:One thousand and eighty-three cases of head and neck malignancies were recorded. A female: male ratio of 1.01:1 was reported with mean age of 39.6 (standard deviation 21.1) years. The oral cavity was the most affected anatomic site (21.2%, 230/1083) in the period under review. Malignant epithelial tumors accounted for 72% (779/1083) of cases seen. Carcinomas were the most common histological variant seen (67%, 726/1083) and squamous cell carcinoma accounted for 58% (421/726) of carcinomas recorded. Oral cavity malignancies (21.8%, 118/540) were the most common in males while thyroid malignancies (28.5%, 155/543) were the most seen in females. In children (≤15 years), the most common histologic findings were carcinomas (42.3%; 77/182) and retinoblastomas (23.6%; 43/182).Conclusion:Epithelial malignancies were the most common malignancy in the study, and the oral cavity appears to be the increasingly predominant site for HNCs. A changing pattern in gender predominance, age distribution, and frequency with histological variants and anatomical sites was also observed in this study.

Simulation of cardiac emergencies with real patients.

Simulation training with manikin simulators for medical emergencies is increasingly used in medical training. The assessment of a manikin, in particular history and examination, is very different to that of a real patient. We sought to combine aspects of traditional simulation training with the assessment of real hospital in-patients. In-patients who had recently experienced a cardiac emergency were asked to recall their symptoms as if they were still present. Medical students assessed these patients in the role of foundation year-1 (FY1) doctors, supervised by core medical trainee (CMT) doctors, and were encouraged to formulate a differential diagnosis and initial management plan. The students filled in a questionnaire prior to, immediately after and 1 week after each simulation session. This included a self-assessment of confidence in managing cardiac emergencies, as well as knowledge-based questions on aspects of assessment and management of cardiac emergencies. We sought to combine aspects of traditional simulation training with the assessment of real hospital in-patients Confidence in managing cardiac emergencies was initially low, but significantly increased after one simulation training session (p < 0.001). This increase was sustained on re-assessment 1 week after the training session (p < 0.001). In addition to the increase in confidence, a significant and sustained increase in knowledge score was also observed (p < 0.001). Simulation training with real patients led to an immediate and sustained increase in self-assessed confidence. There was also an increase in medical knowledge of the assessment and management of cardiac emergencies. This simulation technique is inexpensive, easily reproducible and can be used to complement learning from traditional simulation training with manikins.

Evaluation of the UCLA department of medicine Malawi global health clinical elective: lessons from the first five years.

In 2008, the UCLA Department of Medicine established a three-week clinical elective in Malawi, Africa, for Medicine and Medicine/Pediatrics residents. We sought to determine whether the elective resulted in improved medical knowledge, alterations in career trajectory, and whether the opportunity for the elective influenced selection of UCLA for residency. A 29-question survey was distributed to all graduates of the elective from 2009-2013. Surveys were distributed to 40 individuals, with 33 responses (82.5%). Thirty-one participants (93.9%) reported increased medical knowledge and 24 participants (72.7%) reported the rotation altered their career trajectory. Among the 23 residents who came to UCLA after the elective was established, 13 (56.5%) stated it had an influential role in their selection of UCLA for residency. The Malawi elective resulted in self-reported increases in medical knowledge, alterations in career trajectory, and has played an important role in attracting individuals to UCLA for residency.

De extractie door de eeuwen heen

The University Museum of the University of Utrecht houses within its walls a dentistry collection. A range of dental instruments is on display here which have been used through the ages to deliver people from toothaches. A long time passed, however, before instruments for tooth extraction had been developed which, with the benefit of anatomical knowledge, could effectively grasp teeth. In the middle of the 19th century, general anaesthetics were (re) discovered and that represented an enormous breakthrough. The 'tooth operator' was finally able to treat the patient in a relaxed manner. That opened up a world of medical possibilities. Musclemen who could restrain the patient were no longer necessary and in surgical treatments time became a much less pressing factor. From the beginning of the 20th century, the increase in medical knowledge also made huge advances possible, and the possibilities for dental treatment multiplied.