Medical Campus Research Articles

How Well Do Medical Students at the Regional Medical Campus Match?: A 6-year Analysis at a Single Medical School.

ABSTRACT
 Introduction:
 Anecdotally, some students and faculty members alike have at times expressed concern that medical students who train at Regional Medical Campuses (RMC) will be disadvantaged in the National Residency Matching Program (NRMP), and may not achieve the same level of success as their peers at the main academic medical center. This project was undertaken to examine the validity of these concerns at the RMC affiliated with the Penn State Hershey College of Medicine (PSCOM).
 Methods:
 Results from the annual NRMP process were analyzed over a 6-year period (2014-2019), for both the main Hershey Campus (HC) and University Park Regional Campus (UPRC). Comparisons included the types of residencies selected, percent of students matching instate, percent matching in primary care specialties, and number having to participate in the supplemental offer and acceptance process (SOAP). All results were expressed as simple percentages.
 Results:
 During the study period, 819 students graduated from PSCOM (723 - Hershey Campus, 96 - UPRC). In total, 28 of the 723 Hershey Campus graduates (3.9%) and 1 of the 96 UPRC graduates (1%) went through the SOAP process. UPRC students were more likely to match into primary care specialties (44.8% (UPRC) vs 33.2% (Hershey Campus), defined as Medicine, Pediatrics, Family Medicine and Obstetrics-Gynecology, as well as stay within the state of Pennsylvania for their residency (34.4% - UPRC vs 31.7% - Hershey Campus). While the UPRC students more frequently matched into primary care specialties, several matched into highly competitive specialties, including ophthalmology, orthopedic surgery, otolaryngology, diagnostic radiology, and neurosurgery. 
 Conclusions:
 Concerns frequently expressed regarding a successful match for students studying at regional medical campuses are not supported by our findings. Compared to their main campus peers, the UPRC medical students have been equally successful in the NRMP match.

Begin with the End in Mind: Designing and Implementing an Effective System for Evaluation and Feedback of Learners in Regional Medical Campus Residency Settings

Developing an evaluation system within a medical education program can be daunting and confusing. The authors present a step by step approach, incorporating education theory, recent trends, and the many facets required by accreditation organizations.

Message from the Editor

Message from the Editor-in-Chief:
 It is with great excitement that I share with you that we have added an Associate Editor to our journal, Dr. Peter Nalin, Chair and Professor of Family Medicine and Biobehavioral Health at the University of Minnesota Medical School, Duluth Campus and Associate Dean for Rural Medicine for the University of Minnesota Medical School. Dr. Nalin has published in our journal and is well positioned to assist with our ongoing growth and development. Many thanks to Dr. Alan Johns who served in this role and helped to launch the journal. We will continue to honor his contributions by naming him as our Associate Editor Emeritus. Many thanks to our Editorial Board and their ongoing oversight and contributions to our journal.
 We invite you to consider submissions related to the COVID-19 pandemic and its impact on your campus. We have one perspective to share in this issue and would like to have an upcoming issue focused on COVID-19 impact. 
 Be safe. 
 Regards,Paula M. Termuhlen, MD
 Editor-in-Chief, Journal of Regional Medical Campuses

Post Exercise Change in Peak Expiratory Flow Rate and its Relation with Body Adiposity in Nepalese Settings

Background: The Queens College Step Test is used to determine aerobic fitness. Peak Expiratory Flow Rate (PEFR) is the maximum rate of forceful exhalation following full inspiration. PEFR primarily reflects bronchial airflow and depends on the voluntary effort and muscular strength of the individual. Studies that correlate ventilatory capacity with body fat percentage are rare in published literature in Nepalese settings. Body fat percentage is regarded as a better indicator of obesity recently. Hence, this study aims to find an association between post-exercise change in PEFR and body adiposity in the context of Nepal.
 Methods: A cross-sectional study was carried out from 20th July 2019 to 15th November in the laboratory of Clinical Physiology of Maharajgunj Medical Campus. Body fat percentage was measured by using OMRON BF 214. Pre-exercise PEFR of each subject was recorded by using Wright’s peak flow meter. Post-exercise PEFR was also recorded after three minutes of Queen’s College step test, which is the submaximal exercise test, and change in PEFR was calculated and correlated with body fat percentage.
 Result: The study showed a negative correlation of change in PEFR with body fat percentage (r=-0.324; P<0.001). A significant difference (P = 0.002) was observed between different quartiles of body fat percentage. A highly significant difference (P = 0.003) was noted with the first and fourth quartiles.
 Conclusion: Less ventilatory adjustment in response to exercise was noted in subjects with more body fat percentage compared to those with less body fat percentage.

Training Mentor-Mentee Pairs to Build a Robust Culture for Mentorship and a Pipeline of Clinical and Translational Researchers: The Colorado Mentoring Training Program.

The Colorado Mentoring Training program (CO-Mentor) was developed at the University of Colorado Anschutz Medical Campus in 2010, supported by the Colorado Clinical and Translational Sciences Institute. CO-Mentor represents a different paradigm in mentorship training by focusing equally on the development of mentees, who are valued as essential to institutional capacity for effective mentorship. The training model is unique among Clinical and Translational Science Award sites in that it engages mentors and mentees in an established relationship. Dyads participate in 4 day-long sessions scheduled throughout the academic year. Each session features workshops that combine didactic and experiential components. The latter provide structured opportunities to develop mentorship-related skills, including self-knowledge and goal setting, communication skills (including negotiation), "managing up," and the purposeful development of a mentorship support network. Mentors and mentees in 3 recent cohorts reported significant growth in confidence with respect to all mentorship-related skills assessed using a pre-post evaluation survey (P = .001). Mentors reported the most growth in relation to networking to engage social and professional support to realize goals as well as sharing insights regarding paths to success. Mentees reported the most growth with respect to connecting with potential/future mentors, knowing characteristics to look for in current/future mentors, and managing the work environment (e.g., prioritizing work most fruitful to advancing research/career objectives). CO-Mentor represents a novel approach to enhancing mentorship capacity by investing equally in the development of salient skills among mentees and mentors and in the mentorship relationship as an essential resource for professional development, persistence, and scholarly achievement.

Web Exclusive. Annals On Call - Surge Modeling for COVID-19.

[Figure: see text].

Variation of Arteries Forming Circle of Willis in Adult Human Cadavers

Introduction: Circle of Willis is a large arterial anastomosis between internal carotid and vertebrobasilar arterial system. It is the principal collateral channel for constant blood flow to brain. Any changes in its morphology may cause vascular insufficiency of variable severity. Knowledge about its anomalies may elucidate occurrence of cerebrovascular disorders, its presentation, treatment, prognosis and prevention. Methods: An observational study on 107 fresh cadavers was conducted at Maharajgunj Medical Campus from September 2016 to August 2017. After dissection of the scalp and removal of the vault and dura mater, the brain was obtained. Then the Circle of Willis was identified and observed for its completeness, symmetry, presence, origin and number of arteries forming it and the obtained data were documented, photographed and analyzed. Results: Out of 107 cadavers, variations were noted among 15 (14%): out of which 10 were male and 5 female. Twelve cadavers had single variation while 3 had two variations. Accessory anterior cerebral artery was found in 7 (38.90%), fetal origin of right posterior communicating artery in 2 (11.10%), fetal origin of left posterior communicating artery in 4 (22.20%), early bifurcation of left posterior cerebral artery in 1 (5.60%), variant anterior communicating artery in 2 (11.10%), fused anterior cerebral artery in 1 (5.60%) and aneurysm in 1(5.60%) subjects were found. Conclusion: Variations were noted among 15 cadavers (14%), 12 cadavers had single variation while 3 had two variations. The most common variation seen was accessory anterior cerebral artery found in 7 cadavers (38.90%). Most of the variations were found in midline anteriorly followed by right side.

Variation of Arteries Forming Circle of Willis in Adult Human Cadavers

Introduction Circle of Willis is a large arterial anastomosis between internal carotid and vertebrobasilar arterial system. It is the principal collateral channel for constant blood flow to brain. Any changes in its morphology may cause vascular insufficiency of variable severity. Knowledge about its anomalies may elucidate occurrence of cerebrovascular disorders, its presentation, treatment, prognosis and prevention.
 MethodsAn observational study on 107 fresh cadavers was conducted at Maharajgunj Medical Campus from September 2016 to August 2017. After dissection of the scalp and removal of the vault and dura mater, the brain was obtained. Then the Circle of Willis was identified and observed for its completeness, symmetry, presence, origin and number of arteries forming it and the obtained data were documented, photographed and analyzed.
 ResultsOut of 107 cadavers, variations were noted among 15 (14%): out of which 10 were male and 5 female. Twelve cadavers had single variation while 3 had two variations. Accessory anterior cerebral artery was found in 7 (38.90%), fetal origin of right posterior communicating artery in 2 (11.10%), fetal origin of left posterior communicating artery in 4 (22.20%), early bifurcation of left posterior cerebral artery in 1 (5.60%), variant anterior communicating artery in 2 (11.10%), fused anterior cerebral artery in 1 (5.60%) and aneurysm in 1(5.60%) subjects were found.
 ConclusionVariations were noted among 15 cadavers (14%), 12 cadavers had single variation while 3 had two variations. The most common variation seen was accessory anterior cerebral artery found in 7 cadavers (38.90%). Most of the variations were found in midline anteriorly followed by right side.

COVID-19 Q&A: Collaborating and coordinating keeps a zebrafish facility going.

Christine Archer, fish facility coordinator at the University of Colorado Anschutz Medical Campus, walks Lab Animal through her facility’s response to the ongoing coronavirus pandemic.

COVID-19 Lung Injury is Not High Altitude Pulmonary Edema.

Not applicable.

Web Exclusive. Annals On Call - COVID-19: Is Chloroquine the Answer?

Web Exclusives5 May 2020Annals On Call - COVID-19: Is Chloroquine the Answer?FREERobert M. Centor, MD, Alfred Hyoungju Kim, MD, PhD, and Jeffrey A. Sparks, MD, MMScRobert M. Centor, MDHuntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Search for more papers by this author, Alfred Hyoungju Kim, MD, PhDWashington University School of Medicine, St. Louis, Missouri (A.H.K.)Search for more papers by this author, and Jeffrey A. Sparks, MD, MMScBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.A.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/A20-0003 CME/MOC SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this episode of Annals On Call, Dr. Centor discusses the evidence that generated interest in the potential role of hydroxychloroquine in the treatment of COVID-19. Annals articles discussed include...A Rush to Judgment? Rapid Reporting and Dissemination of Results and Its Consequences Regarding the Use of Hydroxychloroquine for COVID-19: https://annals.org/aim/fullarticle/2764065/rush-judgment-rapid-reporting-dissemination-results-its-consequences-regarding-useUse of Hydroxychloroquine and Chloroquine During the COVID-19 Pandemic: What Every Clinician Should Know: https://annals.org/aim/fullarticle/2764199/use-hydroxychloroquine-chloroquine-during-covid-19-pandemic-what-every-clinicianAbout Annals On CallAnnals On Call focuses on a clinically influential article published in Annals of Internal Medicine. Dr. Robert Centor shares his own perspective on the material and interviews topic area experts to discuss, debate, and share diverse insights about patient care and health care delivery.For more information on Annals On Call and for more episodes, visit go.annals.org/OnCall. Comments0 CommentsSign In to Submit A Comment Dr Muhammad FarooqPhysician Internest & Rheumatologist18 April 2020 Well Explained Nicely explained & well summarised the outcomes of the current Trials on HCQ use as a Potential treatment & as a prophylaxis. Disclosures: No Author, Article, and Disclosure InformationAffiliations: Huntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Washington University School of Medicine, St. Louis, Missouri (A.H.K.)Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.A.S.)Disclosures: Dr. Centor has disclosed the following: Consultancy: DynaMed, MDCalc, Medscape, National Kidney Foundation, The Curbsiders. Employment: U.S. Department of Veterans Affairs. Dr. Kim has disclosed the following: Research grants/contracts: GlaxoSmithKline. Consultantship and speakers bureau: Exagen Diagnostics, GlaxoSmithKline. Dr. Sparks has disclosed the following: Research grants/contracts: National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Allergy and Infectious Diseases, Autoimmune Centers of Excellence, Rheumatology Research Foundation, Brigham Research Institute, the R. Bruce and Joan M. Mickey Research Scholar Fund. Consultantship: Bristol-Myers Squibb, Gilead, Inova, Janssen, Optum.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Deputy Editor, Statistics, reports that he has no financial relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.This article was published at Annals.org on 9 April 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUse of Hydroxychloroquine and Chloroquine During the COVID-19 Pandemic: What Every Clinician Should Know Jinoos Yazdany and Alfred H.J. Kim A Rush to Judgment? Rapid Reporting and Dissemination of Results and Its Consequences Regarding the Use of Hydroxychloroquine for COVID-19 Alfred H.J. Kim , Jeffrey A. Sparks , Jean W. Liew , Michael S. Putman , Francis Berenbaum , Alí Duarte-García , Elizabeth R. Graef , Peter Korsten , Sebastian E. Sattui , Emily Sirotich , Manuel F. Ugarte-Gil , Kate Webb , Rebecca Grainger , and Metrics Cited byRisk perception, public health interventions, and Covid-19 pandemic control in sub-saharan AfricaCOVID-19 Pandemic: Can Maintaining Optimal Zinc Balance Enhance Host Resistance? 5 May 2020Volume 172, Issue 9Page: OC1KeywordsCOVID-19ChloroquineDiagnostic techniquesDisclosureHydroxychloroquineMuscular dystrophiesResearch fundingResearch grantsRheumatologySkin diseases ePublished: 9 April 2020 Issue Published: 5 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.Loading ...

Synergistic Correlation between Dietary Patterns, Lifestyle and Hypertension among Medical School Population

Hypertension (High blood pressure) is responsible for 7.6 million deaths per annum worldwide (13.5% of the total), more than any other risk factors. Around 54% of stroke and 47% of coronary heart disease are attributable to high BP. The present study was conducted to find out how dietary patterns and lifestyle can affect or cause hypertension and its prevalence among the population on medical school campus. The cross‐sectional study involved a survey of 90 respondents aged 16 to 57 years using the random sampling technique. The results were based majorly on two factors i.e. diet and lifestyle. Considering the analysis on these factors, only 4.5% participants had high cholesterol intake, whereas 16.6% participants take heavy amounts of sugars,3.3% participants had high caffeine intake and 32% of population had high salt intake. Prevalence of smoking was 11.1% and heavy alcohol consumption was 4.07%. Contradictory to the expected results, only 6.7% population was found to be diagnosed by hypertension while 40–45% of people among the selected population were at risk of developing hypertension. 30.7% population did not have any exercise habits which is a risk factor leading to hypertension.Support or Funding InformationCommunity Health and Research of Spartan (CHARCOS), Spartan Health Science University School of Medicine, St. Lucia, West Indies

The Uterine Games: Using a Game Engine to Develop a 3D Digital Female Reproductive Tract to Aid in Anatomy Education

With reduced contact hours and increasing concern regarding inadequate anatomical knowledge, anatomy education in the medical curriculum must be robust and efficient. Although cadaveric dissection is the traditional approach to teaching anatomy, dissection has many limitations, such as high cost, time‐consuming labor, limited availability of cadavers, and lack of qualified instructors. To address this challenge, alternatives to cadaver‐based instruction, such as plastinates, are routinely used as supplemental teaching resources. By replacing water and adipose tissue with polymers, plastination allows the long‐term preservation of well‐dissected cadaveric specimens. Despite the advantages of plastination, use of plastinates may be limited by high production and maintenance costs. Currently, the Modern Human Anatomy Program at the University of Colorado Anschutz Medical Campus has one plastinate of the female reproductive tract, bisected to show the internal anatomy together with the external genitalia and urinary bladder. Although the plastinate was well‐received in a small‐sized graduate course, incorporating a singular plastinate in a large medical class is problematic. Thus, implementing a three‐dimensional (3D) digital model of a plastinate may be an effective method to accommodate large class sizes without compromising the physical specimen or adding substantial costs. The aim of this project was to iteratively design and develop a mobile application (app) depicting a 3D model of the plastinated female reproductive tract. A 3D surface model of the plastinate was digitally reconstructed using an Artec Space Spider 3D Scanner. Artifacts were smoothed and texture was refined in ZBrushCore 2018 and Autodesk Maya 2019. The model was packaged into a mobile app using a game engine, Unreal Engine 4 (UE4). Compared to other app development software, UE4 was chosen for its robust visualization of 3D models, cross‐platform deployment, and zero upfront costs. With online tutorials, UE4’s Blueprints visual scripting system is relatively simple to grasp, and the node‐based interface is a powerful approach for non‐programmers, allowing extreme flexibility without the need for coding. Utilizing this flexibility, the app was designed to promote self‐paced independent learning of the female reproductive tract and associated pelvic anatomy. Students can follow a pre‐determined learning module or freely navigate through highlighted and annotated structures on the bisected model. In addition to basic manipulation of the model, the app features interactive quizzes to encourage active learning. The app can also be used alongside the original plastinate to aid students in structure identification. By digitizing cadaver anatomy, the mobile app ensures a realistic and accurate representation of human anatomy and any anatomical variations or pathologies. Integrating supplemental resources, such as an interactive mobile app, may allow instructors to strengthen anatomy education and address barriers to cadaver‐based instruction. Further investigation is needed to evaluate the efficacy and educational value of the mobile app as a supplemental teaching resource for female pelvic anatomy.

PILONIDAL SINUS: SURGICAL EXCISION OF PILONDIAL SINUS AND SUTURING SKIN EDGE TO PRE-SACRAT FASCIA (PARTIAL CLOSURE)

Surgical treatment of pilonidal sinus is by surgical excision of sinus and partial closure by suturing skin to pre-sacral fascia. This study was carried out on 20 patient with pilonidal sinus admitted to surgical department in Kobry-El-Kobba Military Medical Campus. This patient was treated by surgical exciting of pilonidal sinus and partial closure of the wound by suturing skin edge to presacral fascia. This study covers the introduction and incidence, pathology, clinical presentationand different method in management of pilonidal sinus. This study proposes that excision of pilonidal sinus and partial closure of the wound by suturing skin edge to pre-sacral fascia, safe, with low recurrent rate- short hospital stay. No postoperative discomfort or food restriction and early ambulation and return to work. This study was done up on 20 young male troops “soldiers” patients with mean age 25 years admitted to surgical department, Kobry El-Kobba Military MedicalCampus, from January 2016 to December 2018, treated by suturing skin edge to pre sacral fascia, and study the effect of operation on patient convenience, infection, recurrence, bleeding postoperative, healing time, hospital stay and histopathological examination of specimens.

PILONIDAL SINUS: SURGICAL EXCISION OF PILONDIAL SINUS AND SUTURING SKIN EDGE TO PRE-SACRAT FASCIA (PARTIAL CLOSURE)

Surgical treatment of pilonidal sinus is by surgical excision of sinus and partial closure by suturing skin to pre-sacral fascia. This study was carried out on 20 patient with pilonidal sinus admitted to surgical department in Kobry-El-Kobba Military Medical Campus. This patient was treated by surgical exciting of pilonidal sinus and partial closure of the wound by suturing skin edge to presacral fascia. This study covers the introduction and incidence, pathology, clinical presentationand different method in management of pilonidal sinus. This study proposes that excision of pilonidal sinus and partial closure of the wound by suturing skin edge to pre-sacral fascia, safe, with low recurrent rate- short hospital stay. No postoperative discomfort or food restriction and early ambulation and return to work. This study was done up on 20 young male troops “soldiers” patients with mean age 25 years admitted to surgical department, Kobry El-Kobba Military MedicalCampus, from January 2016 to December 2018, treated by suturing skin edge to pre sacral fascia, and study the effect of operation on patient convenience, infection, recurrence, bleeding postoperative, healing time, hospital stay and histopathological examination of specimens.

Indigenizing Science and Reasserting Indigeneity in Research

1 Vanderbilt University, Nashville, Tennessee, USA. 2 Department of Science, Technology, Engineering, and Math, Turtle Mountain Community College, Belcourt, North Dakota, USA. 3 Division of Biomedical Informatics and Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 4 Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. *Correspondence to: Krystal S. Tsosie, e-mail: krystal.s.tsosie@gmail.com. KEY WORDS: native american, american indian, pacific islander, indigenous science, traditional ecological knowledge, indigenous knowledge, epistemologies, community-based participatory research, community engagement, research framework, gene drive, stem education. Human Biology, Summer 2019, v. 91, no. 3. doi: 10.13110/humanbiology.91.3.02. Copyright © 2020 Wayne State University Press, Detroit, Michigan 48201 introduction Indigenizing Science and Reasserting Indigeneity in Research Krystal S. Tsosie1,2 * and Katrina G. Claw3,4 Science,atitscore,isknowledgesystematically gained through repeated observations about the world around us. Indigenous people have always been scientists. As agronomists, Indigenous people of pre-Colombian Mexico domesticated maize over 9,000 years ago (Matsuoka et al. 2002). As astronomers, Polynesians studied constellations and movements of celestial bodies to become skilled sailors and navigators (Lewis 1972). In almost every scientifijic discipline throughout history, Indigenous people have contributed to our physical and biological understanding and have developed technologies that benefijit all. Imagine, then, how science today could be advanced if we empowered Indigenous approaches to the level of Western science. Indigenous people have multiple ways of knowing and varied traditional knowledge systems that are distinct from Western perspectives. These epistemologies are embedded in oral traditions , ceremonial practices, beliefs, and general knowledge from our ancestors. Thus, Indigenous science is the process by which Indigenous people construct and disseminate empirical knowledge of their environment. As approaches to gathering knowledge, Indigenous science may arise independently of Western science, but the two are not antithetical. Yet Indigenous science is often overshadowed and minimized by Western science. The latter is often seen by the dominant society as being more “objective,” whereas its counterpart might beviewedasanecdotal,imprecise,andvaluedonly by its interoperability with Western perspectives. This veneration of Western science has the efffect of undermining the embodied and relational ways of knowing developed over countless generations, passed down by elders to the next generation, and rooted in centuries of observational and experiential learning. Indigenous science is grounded in traditional knowledge, but it is perhaps the word “traditional” that seems to cause consternation and derision among non-Indigenous academics.The word itself is often used antonymously with “modern” and therefore implies that such concepts are of the past and incompatible with the contemporary world (Pierotti 2012). Perhaps we should instead think of “traditional knowledge” as knowledge that endures, or has been repeatedly tested and remained substantiated, as data points representing countless trials over time. Maybe scientists should reevaluate their perceptions of the word “traditional” and instead acknowledge and listen to expertise in Indigenous science. Hence, many biologists and conservationists are looking to traditional ecological knowledge (TEK), or Indigenous knowledge (IK) gained 000 ■ Tsosie and Claw through interacting with the environment, to provide solutions to climate change, deforestation, species extinction, and ecosystem degradation— problems arguably implicated by an overreliance on Western science. For instance, researchers were able to improve their population estimates of bowhead whales in Arctic Alaska by incorporating Iñupiat knowledge of whale behavior (Albert 2001; Popp 2018). Furthermore, elders from the Heiltsuk First Nation in British Columbia long recognized diffferences between coastal and inland gray wolves in their territory, which informed later genetic investigations comparing the two species (Stronen et al. 2014). As stewards of lands that encompass22%of Earth’ssurface,includingmuch of its biodiversity (Sobrevila 2008), Indigenous people, and IK approaches, are perhaps now more importantfortheplanet’ssustainabilityandfuture. LookingtoIndigenoussciencetofijindsolutions tosystemicissueswithoutconcernforthehealthof Indigenous knowledge keepers, however, is extractive . Indigenous people in the United States sufffer worse health outcomes and signifijicant barriers to health compared to non-Hispanic whites (JacobsWingo et al. 2016), and these health disparities may be further exacerbated as precision medicine moves forward (Martin et al. 2019) without proper attention to structural barriers to health that overburden these communities (Tsosie et al. 2019). Despite some attention over the years to explore themes of discrimination, racism, historical trauma, and cultural...

Scrub Club: A Medical Student‐Led Initiative That Uses Experiential Learning Opportunities in the Cadaver Laboratory to Introduce Pre‐Clerkship Medical Students to Surgery

IntroductionMost medical students have very little exposure to surgical specialties in their pre‐clerkship years, especially when compared to non‐surgical specialities; and bring very little knowledge of surgical skills to their surgical clerkship rotations. Second‐year medical students (Meds2022) at Schulich School of Medicine & Dentistry – Windsor Campus recognized this lack of early exposure to surgery as a potential barrier to their learning. Additionally, Schulich School of Medicine & Dentistry – Windsor Campus is a distributed medical campus (DMC). DMCs often have less engagement from surgeons compared to larger academic centres, making learning directly from a surgical mentor more challenging. In an attempt to address these student‐perceived gaps in their curriculum, a surgery interest group made up of Meds2022 students instituted an innovative club – the Scrub Club. Teaching models for early exposure to surgery have been previously implemented at other campuses, however none have been completely student‐directed or as multifaceted as the Scrub Club at a DMC.AimThe aim of Scrub Club is to develop experiential learning opportunities that will help introduce pre‐clerkship medical students to surgery using the on‐site cadaver laboratory.MethodsScrub Club members encouraged the development of surgical skills and knowledge amongst themselves, as well as their peers, by hosting regular experiential learning sessions in the cadaver laboratory. Experiential sessions included student‐led demonstrations on surgical anatomy, suturing, and knot tying using cadavers. Community surgeons were also brought in by Scrub Club members to lead simulated surgeries on cadavers.ResultsSince September 2019, the club has hosted two anatomy information sessions, one suturing session, and two simulated surgeries on cadavers. Simulated surgeries included an appendectomy, a prostatectomy, a nephrectomy, a bowel resection, and a splenectomy. During the physician‐led surgery simulations, each student was given an opportunity to assist, and to employ the skills/knowledge that they had acquired from previous sessions taught by their peers. Verbal feedback given by club members, as well as other medical student attendees, indicated that the sessions had a positive impact; and at least two students cited Scrub Club as the reason they felt comfortable performing suturing during observerships. Additionally, Scrub Club members felt that they were better able to demonstrate competencies important to the medical profession, such as leadership, collaboration, and communication, during these teaching sessions.Discussion and ConclusionThe members of Scrub Club were successfully able to develop and implement a variety of experiential learning opportunities using the cadaver laboratory at Windsor Campus. These opportunities have the potential to increase the level of engagement of pre‐clerkship students in surgical specialities, and to establish a basic surgical skillset that can be expanded upon in clerkship. The medical competencies developed were the unintentional benefits of the club.

It Takes a Village: Utilizing a Community-based Longitudinal Integrated Clerkship Model at a Regional Medical Campus to Provide the Core Emergency Medicine Clerkship Experience.

The objective was to evaluate the efficacy of a required emergency medicine (EM) experience embedded in a new community-based longitudinal integrated clerkship (LIC) for participating students and faculty. We developed and implemented a community-based LIC EM experience. The experience included 10 clinical shifts, one emergency medical services prehospital care shift, four didactic sessions, one reflection, and an emergency medicine simulation session. Students' outcomes were assessed using end-of-year surveys, focus groups, an emergency medicine subject examination, simulation performance, and clinical evaluations of the students by faculty. Faculty were recruited, underwent faculty development, and were evaluated by students. Faculty perceptions were gathered from a focus group and faculty retention rates were collected. Three cohorts of LIC students (total N=61) have completed their core emergency medicine experience in our community-based LIC. Among students, 76% to 95% rated the overall quality of teaching as very good or excellent and 66% to 100% rated the quality of learning in their community-based setting as very good or excellent. All students who passed the EM subject examination achieved the clinical competencies of the experience based on clinical evaluations. Among faculty, we have retained greater than 95% each year and they have reflected positively on their precepting experience. Implementing a required EM experience within a community-based LIC model can be an effective learning experience for students and perceived positively by community-based faculty. This model may offer an opportunity to expand clinical learning experiences in EM.

Understanding the Breadth and Depth of C-L Psychiatry: Assessing and Managing Delirium

Understanding the Breadth and Depth of C-L Psychiatry: Assessing and Managing Delirium

Web Exclusive. Annals On Call - Understanding the Spread of COVID-19.

Web Exclusives17 March 2020Annals On Call - Understanding the Spread of COVID-19FREERobert M. Centor, MD and David N. Fisman, MD, MPHRobert M. Centor, MDHuntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Search for more papers by this author and David N. Fisman, MD, MPHDalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (D.N.F.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/A20-0001 CME/MOC SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this episode of Annals On Call, Dr. Centor discusses the epidemiology of the novel coronavirus responsible for COVID-19 with Dr. David Fisman of the University of Toronto.Annals articles discussed include...Reporting, Epidemic Growth, and Reproduction Numbers for the 2019 Novel Coronavirus (2019-nCoV) Epidemic: https://annals.org/aim/fullarticle/2760912/reporting-epidemic-growth-reproduction-numbers-2019-novel-coronavirus-2019-ncovAbout Annals On CallAnnals On Call focuses on a clinically influential article published in Annals of Internal Medicine. Dr. Robert Centor shares his own perspective on the material and interviews topic area experts to discuss, debate, and share diverse insights about patient care and health care delivery.For more information on Annals On Call and for more episodes, visit go.annals.org/OnCall. Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Huntsville Regional Medical Campus, University of Alabama Birmingham School of Medicine, Birmingham, Alabama (R.M.C.)Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (D.N.F.)Disclosures: Dr. Centor has disclosed the following: Honoraria: Medscape. Dr. Fisman has disclosed no conflicts of interest.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.This article was published at Annals.org on 10 March 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoReporting, Epidemic Growth, and Reproduction Numbers for the 2019 Novel Coronavirus (2019-nCoV) Epidemic Ashleigh R. Tuite and David N. Fisman Metrics Cited byA study on usability and design parameters in face mask: Concept design of UVW face mask for COVID‐19 protection 17 March 2020Volume 172, Issue 6Page: OC1KeywordsCOVID-19Conflicts of interestDiagnostic techniquesDisclosureEpidemiologyHealth carePatients ePublished: 10 March 2020 Issue Published: 17 March 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.Loading ...