Medical Education Commons^™

Intravenous Estrogen Is Not Proven Effective For Abnormal Uterine Bleeding: Guidelines Are Based On Flawed Evidence, Stephen Simmer

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of: DeVore GR, Owens O, Kase N. Use of intravenous Premarin in the treatment of dysfunctional uterine bleeding--a double-blind randomized control study. Obstet Gynecol. 1982 Mar;59(3):285-91.

This appraisal identifies significant statistical irregularities in the study. A reworking of the study's statistics leads to a conclusion different from that put forth by the authors of this paper: intravenous estrogen therapy is not, in fact, significantly more effective compared to placebo therapy for the cessation of acute abnormal uterine bleeding.

Inhaled Glucocorticoid Use Produces A Small But Important Impact On Adult Height, Nabaa Zalzala, Sharon Im

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of: Kelly HW, Sternberg AL, Lescher R, et al. Effect of inhaled glucocorticoids in childhood on adult height. N Engl J Med. 2012;367(10):904-912. doi:10.1056/NEJMoa1203229.

From The Editors, Anthony M. Provenzano B.A., John Dawdy B.Sc., Mhs

Clinical Research in Practice: The Journal of Team Hippocrates

Welcome to the inaugural issue of Clinical Research in Practice: The Journal of Team Hippocrates.

2015 January 20 - Medical Student Education Committee Retreat Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

Complex Care Curriculum: Autonomic Dysreflexia, Jimmy Beck, Rebekah Conroy

E-Learning Modules

Children with special health care needs (CSHCN) are increasingly prevalent in US hospitals. The pediatric hospitalist is often the primary provider of inpatient care for these patients. However, exposure to this patient population during training varies from provider to provider. No published educational curricula are specific to the inpatient care of this population. The purpose of this project is to build a multi-modal educational curriculum for providers with the overall goal of improving inpatient care for this at-risk population.

This curriculum is primarily composed of a series of topic-specific learning modules. Asynchronous learning modules, utilized appropriately, can augment learning by …

Active Management Of The Third Stage Of Labor By Skilled Birth Attendants In A Rural Regional Hospital In Southern Ethiopia: A Qualitative Case Study, Marcella J. Gowan

Doctor of Education (EdD)

In Ethiopia, as in many developing countries, postpartum hemorrhage (PPH) is the leading cause of maternal mortality. PPH can be prevented through a three-step practice called active management of the third stage of labor (AMTSL), which can be learned by a skilled birth attendant (SBA). However, most SBAs have not adopted AMTSL into practice. The purpose of this case study was to investigate the use of AMTSL among SBAs in a rural regional hospital in southern Ethiopia. Six theoretical propositions and a conceptual framework were designed to guide the research and analysis. In-depth interviews were conducted with SBAs who worked …

Transforming Health Professions' Education Through In-Country Collaboration: Examining The Consortia Between African Medical Schools Catalyzed By The Medical Education Partnership Initiative, Zohray Talib, Elsie Kiguli-Malwadde, Hannah Wohltjen, Millard Derbew, Yakub Mulla, David Olaleye, Nelson Sewankambo

Medicine Faculty Publications

Background African medical schools have historically turned to northern partners for technical assistance and resources to strengthen their education and research programmes. In 2010, this paradigm shifted when the United States Government brought forward unprecedented resources to support African medical schools. The grant, entitled the Medical Education Partnership Initiative (MEPI) triggered a number of south-south collaborations between medical schools in Africa. This paper examines the goals of these partnerships and their impact on medical education and health workforce planning.

Methods Semistructured interviews were conducted with the Principal Investigators of the first four MEPI programmes that formed an in-country consortium. These …

Sci Pop Talks! Presenter Guidelines, Kiyomi D. Deards, Raychelle Burks

University of Nebraska-Lincoln Libraries: Faculty Publications

Presenter guidelines for the nUniversity of Nebraska-Lincoln (UNL) Sci Pop! Talks series.

Attitudes Towards An Evidence-Based Clinical Decision Support Tool To Reduce Exposure To Ionizing Radiation, Raymond Zakhari

Faculty Publications and Presentations

Patients who suffer minor brain injuries experience unnecessary ionizing radiation in the form of a non-contrast head CT scan despite the dearth of evidence supporting standard CT scans for all brain injuries. Exposure to ionizing radiation increases the incidence of certain types of cancer. This evidence-based practice change project assesses the attitude of clinicians towards evidence-based clinical decision support tools, specifically the Canadian CT head rule. The use of highly sensitive clinical decision support tools is supported in the literature to help healthcare providers mitigate the risk associated with unnecessary use of CT scan imaging studies. The project was conducted …

Implications Of Epigenetic Variability Within A Cell Population For "Cell Type" Classification, I. Tabansky, J. N.H. Stern, D. W. Pfaff

Journal Articles

Here, we propose a new approach to defining nerve "cell types" in reaction to recent advances in single cell analysis. Among cells previously thought to be equivalent, considerable differences in global gene expression and biased tendencies among differing developmental fates have been demonstrated within multiple lineages. The model of classifying cells into distinct types thus has to be revised to account for this intrinsic variability. A "cell type" could be a group of cells that possess similar, but not necessarily identical properties, variable within a spectrum of epigenetic adjustments that permit its developmental path toward a specific function to be …

Cultural Norms Of Clinical Simulation In Undergraduate Nursing Education, Susan G. Mcniesh

Faculty Publications

Simulated practice of clinical skills has occurred in skills laboratories for generations, and there is strong evidence to support high-fidelity clinical simulation as an effective tool for learning performance-based skills. What are less known are the processes within clinical simulation environments that facilitate the learning of socially bound and integrated components of nursing practice. Our purpose in this study was to ethnographically describe the situated learning within a simulation laboratory for baccalaureate nursing students within the western United States. We gathered and analyzed data from observations of simulation sessions as well as interviews with students and faculty to produce a …

The Effect Of In Situ Simulation On Teamwork Attitudes In Nursing Students, Janice Kaye Fuson

Nursing Theses and Capstone Projects

Nursing students are not adequately trained in teamwork principles. Positive teamwork has been identified by governmental and accrediting bodies of healthcare to be an essential element in patient safety. TeamSTEPPS© is a program developed by the Department of Defense adapted to healthcare as a cost effective method to change the culture of healthcare organizations. A capstone project that implemented in situ simulation using a TeamSTEPPS© tool was conducted in a rural North Carolina nursing program. Eighteen students participated in the simulation and completed a pre and post TeamSTEPPS© Teamwork Attitude Questionnaire. Mean scores were noted to be considerably lower post …

Evaluating Chain-Of-Command Self-Efficacy Through High Fidelity, Student-Directed, Obstetrical Simulation, Michelle Mcewen-Campbell

Nursing Theses and Capstone Projects

The purpose of this quasi-experimental capstone project was to evaluate the impact of high fidelity, student-directed, obstetrical simulation upon chain-of-command self-efficacy of baccalaureate nursing students. The convenience sample, composed of 48 junior nursing students, was randomly divided into four simulation groups, and then further randomly divided into active or observational status. Active participants planned interventions and participated in high fidelity obstetrical simulations related to patient safety and chain-of-command initiation. Active and observational students participated in a combined debriefing session. A pretest posttest design utilizing the General Self-Efficacy Scale (GSES) was utilized to measure chain-of-command self-efficacy in relation to both active …

The Impact Of Simulation-Based Learning Experience On Student Satisfaction, Perceived Self-Confidence, And Anxiety, Michelle Britt Warren

Nursing Theses and Capstone Projects

Nurse educators are faced with the challenges of facilitating student learning in shorter time frames along with decreasing student opportunities to further their learning experiences in real-world clinical situations (LaFond & Van Hulle Vincent, 2012; Smith & Barry, 2013). There is an identifiable need for safe environments where students can practice and apply the knowledge they have learned in the didactic component of the course to the clinical situations (LaFond & Van Hulle Vincent, 2012; McClure & Gigliotti, 2012). The capstone project, "The impact of simulation based learning experience on student satisfaction, perceived self-confidence and anxiety" examined the implementation of …

Do You Understand What I Mean? How Cognitive Interviewing Can Strengthen Valid, Reliable Study Instruments And Dissemination Products, Anne Hofmeyer, Brenda H. Sheingold, Ruth Taylor

Nursing Faculty Publications

It is now well accepted that working in research teams that span universities, jurisdictions and countries can be rewarding and economically prudent. To this end, investigators collaborate in the pursuit of knowledge to address human and societal problems and translate results into local and global contexts. This implies that investigators need to develop study instruments that are fit for purpose and strategically manage issues arising from geographical, linguistic and cultural diversity. A proven method is cognitive interviewing to pre-test the study materials to ensure clarity and relevance in the study population. This paper describes the steps taken to increase the …

Fusion, 2015, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Further Expansion Of Nested E-Modules To Address Anatomical Knowledge Retention In Medical Students Entering The Obstetrics And Gynecology Clinical Rotation, Abigail Armstrong, Jill A. Krapf, Kirsten Brown, Gisela Butera, Ellen F. Goldman, Rosalyn A. Jurjus

GW Research Days 2015

Previous work has shown that a curriculum that included computer-based teaching modules (“e-modules”) improved retention of preclinical concepts of gross anatomy, as medical students transitioned to the third-year OBGYN clerkship. However, data showed that deficiencies still remained in areas not addressed by the curriculum. Two of these areas were microscopic anatomy and embryology, where retention scores were 4% and 38%, respectively (Jurjus et al., unpublished). Based on this research, an expanded series of e-modules will be created to target these anatomical topics that still require improvement, specifically in microscopic anatomy and embryology: 1) Ultrasound in Pregnancy using Embryological Knowledge 2) …

Improving Anatomical Knowledge Through Interactive Modules On The Ob/Gyn Clinical Clerkship, Artin Galoosian, Jill A. Krapf, Kirsten Brown, Gisela Butera, Ellen F. Goldman, Rosalyn A. Jurjus

Anatomy and Regenerative Biology Faculty Posters and Presentations

The goal of this study is to evaluate the impact of a newly designed interactive method of teaching clinically relevant anatomy to medical students on the OB/GYN clerkship. A 20-question multiple-choice exam was administered to 143 consenting third-year medical students at the beginning and end of each OB/GYN rotation. Students participated in a skills lab with preparatory e-modules that linked anatomy to clinical applications during each rotation. Topics included perineal muscle anatomy (laceration), anterior abdominal wall anatomy (cesarean section), vulvovaginal and uterine anatomy (IUD), and pelvic organ, vasculature, and neural anatomy (hysterectomy). Mean scores improved significantly after the nesting of …

Use Of Team-Based Learning Pedagogy For Internal Medicine Ambulatory Resident Teaching, S. Balwan, A. Fornari, P. Dimarzio, J. Verbsky, R. Pekmezaris, J. Stein, S. Chaudhry

Journal Articles

BACKGROUND: Team-based learning (TBL) is used in undergraduate medical education to facilitate higher-order content learning, promote learner engagement and collaboration, and foster positive learner attitudes. There is a paucity of data on the use of TBL in graduate medical education. Our aim was to assess resident engagement, learning, and faculty/resident satisfaction with TBL in internal medicine residency ambulatory education. METHODS: Survey and nominal group technique methodologies were used to assess learner engagement and faculty/resident satisfaction. We assessed medical learning using individual (IRAT) and group (GRAT) readiness assurance tests. RESULTS: Residents (N = 111) involved in TBL sessions reported contributing to …

Not For Industry Only: Medical Students And Office-Based Academic Detailing The Pivot (Pregnant Women Influenza Vaccine Optimization Team) Initiative, D. A. Blitz, J. R. Mallen, T. G. Kwiatkowski, J. M. Rabin, Y. D. Dlugacz, R. A. Silverman

Journal Articles

Academic detailing is a method of educational outreach that utilizes individualized encounters with physicians to broach specific medical issues in an evidence-based and quality-driven manner. Medical students utilized the matter of influenza vaccination during pregnancy as a lens through which to explore the methods of academic detailing in a community setting. Structured and customized dialogues between North Shore-LIJ affiliated obstetricians and Hofstra North Shore-LIJ medical students were conducted regarding the disparity between the proportion of providers that recommend the vaccine and the percentage of pregnant women being vaccinated annually. Ultimately the project aimed to increase vaccine-carrying rates throughout office based …

Neutralizing Antibodies Against West Nile Virus Identified Directly From Human B Cells By Single-Cell Analysis And Next Generation Sequencing, K. Tsioris, N. T. Gupta, A. O. Ogunniyi, R. M. Zimnisky, F. Qian, Y. Yao, X. Wang, J. N. Stern, R. Chari, J. C. Love, +8 Additional Authors

Journal Articles

West Nile virus (WNV) infection is an emerging mosquito-borne disease that can lead to severe neurological illness and currently has no available treatment or vaccine. Using microengraving, an integrated single-cell analysis method, we analyzed a cohort of subjects infected with WNV - recently infected and post-convalescent subjects - and efficiently identified four novel WNV neutralizing antibodies. We also assessed the humoral response to WNV on a single-cell and repertoire level by integrating next generation sequencing (NGS) into our analysis. The results from single-cell analysis indicate persistence of WNV-specific memory B cells and antibody-secreting cells in post-convalescent subjects. These cells exhibited …

The Use Of Peer Video Via M-Learning To Teach Essential Nursing Skills, Elizabeth Hall Carver

Nursing Theses and Capstone Projects

The purpose of this project was to compare adding an additional educational intervention (the use of an instructional peer video on a mobile device) to standard practice in the skills lab to teach the skill of male and female urinary catheterization and the removal of a urinary catheter. The project had a quasi-experimental design, without control, and utilized a convenience sample of 31 pre-licensure nursing students. Failure rates at skills evaluation were compared between the previous semester A (fall 2014) and semester B (spring 2015). Semester B was subdivided into two groups, with approximately half in the traditional instructional B1 …

Improving Attitudes Toward Interdisciplinary Collaboration Between Nursing And Medical Students In Simulation, Kristy H. Williams

Nursing Theses and Capstone Projects

This capstone project assessed whether a curriculum change for senior nursing students could have an impact on improving attitudes toward physician-nurse collaboration. A convenience sample of 60 senior level nursing students and eight residents were enrolled in the study. The nursing students and residents participated in a high-fidelity simulation scenario, and were given a pretest and posttest using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. There was strong evidence (t= -1.971, p=.05) that the attitudes of physician-nurse collaboration improved for nursing students through a simulation based scenario with residents. The confidence interval for the difference was (-0.22, 0.002). Although …

Book Review: Where No Doctor Has Gone Before: Cuba’S Place In The Global Health Landscape, Curt Stilp

Faculty Publications - College of Medical Science

Robert Huish, Assistant Professor at Dalhousie University, Department of International Development Studies, presents an overview of the Cuban health system, the Cuban medical education system, and the government’s effort to provide care beyond its borders. This is a practical book that gives the historical background of how Cuba has survived decades of economic sanctions to become one of the world leaders in universal health care. The author examines the different aspects of Cuban health care using credible evidence and a variety of sources including the author’s own experiences in Cuba learning how health care and medical education is delivered.

Promoting Faculty Scholarship - An Evaluation Of A Program For Busy Clinician-Educators, S. Reader, A. Fornari, S. Simon, J. Townsend

Journal Articles

BACKGROUND: Clinician educators face barriers to scholarship including lack of time, insufficient skills, and access to mentoring. An urban department of family medicine implemented a federally funded Scholars Program to increase the participants' perceived confidence, knowledge and skills to conduct educational research. METHOD: A part-time faculty development model provided modest protected time for one year to busy clinician educators. Scholars focused on designing, implementing, and writing about a scholarly project. Scholars participated in skill seminars, cohort and individual meetings, an educational poster fair and an annual writing retreat with consultation from a visiting professor. We assessed the increases in the …

Developing A Long-Term Care Dental Training Program: A Maryland Experience, American Dental Association

Action for Dental Health

No abstract provided.

Integrating Social Justice For Health Professional Education: Self-Reflection, Advocacy, And Collaborative Learning, Lena Hatchett, Nanette Elster, Katherine Wasson, Lisa Anderson, Kayhan Parsi

Journal of Health Ethics

Justice as fair and equal treatment for all is one of the core visions for health professional education to reduce racial and economic health disparities in bioethics, nursing and medicine. However, the current reality of deeply entrenched structural inequities across race, class, gender, and social privilege make it a challenge for students to become aware of practical health equity solutions. This paper illustrates how faculty and students can build their understanding of health equity solutions in health professional education through self-reflection, self-direction, advocacy, and collaborative learning opportunities. We provide lessons learned and teaching resources from nursing, medicine, and law.

Generational Conflicts Among Vietnamese Americans In The Health Care Decision Making Process, Georgie D. Nguyen

Journal of Health Ethics

In the U.S. there are approximately 1.3 million Vietnamese Americans. This group faced multiple problems after their immigration to the U.S. after the Fall of Saigon. While some easily acculturated within this group, others such as the older generation suffered difficulty doing so. The purpose of this article is to address concerns regarding the health care decision making process among the Vietnamese community and its importance to helping health care providers understand why there is a high mortality rate within this group.

Simulation In Assisting Nurses To Better Recognize Early Signs Of Clinical Deterioration Of Patients, Loretta Elder

Doctor of Nursing Practice Projects

The need to enhance the knowledge and skills of nurses caring for patients who exhibit signs of clinical deterioration has been validated in the literature. The literature has further supported the registered nurse as the key individual expected to recognize signs of clinical deterioration in the patient. The use of simulation as an effective teaching strategy has been well documented in the literature. The purpose of the project was to use simulation as an educational intervention to increase nurse knowledge, self-confidence, and competency when caring for patients exhibiting signs of clinical deterioration. The findings of this project are supported by …

Improving A Curriculum Through Incremental Changes Based On Programmatic Assessment Results, Batoul Senhaji-Tomza, Suzanne R. Soliman, Paramita Basu

Touro College of Pharmacy (New York) Publications and Research

Objectives: To describe implementation of incremental curriculum changes aimed at addressing identified gaps via subjective and objective programmatic assessment in a 2 + 2 curriculum.

Method: After low first-time NAPLEX pass rates for two consecutive class years, subjective and objective assessment of a 2 + 2 curriculum was conducted. The curriculum was benchmarked to the other existing 2 + 2 program. Other assessments that occurred include: intensive course content review, course credit number versus instructional time audit, vertical and horizontal topical sequence revision in the clinical, basic sciences and social and behavioral course sequences, faculty/student feedback and focus groups; outside …