scholarly journals Promotion of knowledge transfer and retention in year 2 medical students using an online training exercise

2021 ◽  
Author(s):  
Lucy V. Rosby ◽  
Henk G. Schmidt ◽  
Gerald J. S. Tan ◽  
Naomi Low-Beer ◽  
Silvia Mamede ◽  
...  
Keyword(s):  
Medical Students ◽  
Knowledge Transfer ◽  
Online Training ◽  
Far Transfer ◽  
Near Transfer ◽  
Training Exercise ◽  
X Ray ◽  
Transfer And Retention ◽  
Chest X Ray ◽  
Mean Time

AbstractIt was recently shown that novice medical students could be trained to demonstrate the speed-to-diagnosis and diagnostic accuracy typical of System-1-type reasoning. However, the effectiveness of this training can only be fully evaluated when considering the extent to which knowledge transfer and long-term retention occur as a result, the former of which is known to be notoriously difficult to achieve. This study aimed to investigate whether knowledge learned during an online training exercise for chest X-ray diagnosis promoted either knowledge transfer or retention, or both. Second year medical students were presented with, and trained to recognise the features of four chest X-ray conditions. Subsequently, they were shown the four trained-for cases again as well as different representations of the same conditions varying in the number of common elements and asked to provide a diagnosis, to test for near-transfer (four cases) and far-transfer (four cases) of knowledge. They were also shown four completely new conditions to diagnose. Two weeks later they were asked to diagnose the 16 aforementioned cases again to assess for knowledge retention. Dependent variables were diagnostic accuracy and time-to-diagnosis. Thirty-six students volunteered. Trained-for cases were diagnosed most accurately and with most speed (mean score = 3.75/4, mean time = 4.95 s). When assessing knowledge transfer, participants were able to diagnose near-transfer cases more accurately (mean score = 2.08/4, mean time = 15.77 s) than far-transfer cases (mean score = 1.31/4, mean time = 18.80 s), which showed similar results to those conditions previously unseen (mean score = 0.72/4, mean time = 19.46 s). Retention tests showed a similar pattern but accuracy scores were lower overall. This study demonstrates that it is possible to successfully promote knowledge transfer and retention in Year 2 medical students, using an online training exercise involving diagnosis of chest X-rays, and is one of the few studies to provide evidence of actual knowledge transfer.

scholarly journals Case series: Point-of-Care Ultrasound Conducted by Medical Students During their First Clinical Rotation Changes Patients’ Primary Diagnosis and Management

2021 ◽  
Vol 9 (1) ◽  
pp. 15-20
Author(s):  
Re'em Sadeh ◽  
Tomer Gat ◽  
Omer Kaplan ◽  
Tzvika Porges ◽  
Lior Zeller ◽  
...  
Keyword(s):  
Medical Students ◽  
Point Of Care ◽  
Case Series ◽  
Medical Schools ◽  
Point Of Care Ultrasound ◽  
Additional Contribution ◽  
Clinical Rotation ◽  
X Ray ◽  
First Case ◽  
Chest X Ray

Background: As point-of-care ultrasound (POCUS) becomes a standard of care procedure, medical schools around the world have started to seek the integration of POCUS courses into their curricula. This puts medical students in a unique position as they are trained in an area in which many physicians lack knowledge. This case series provides a glimpse into the capabilities of POCUS even when used by medical students. Methods: Fourth-year medical students at Ben-Gurion University of the Negev performed numerous POCUS exams during their first clinical rotation at Soroka University Medical Center in Israel. All students completed a course in basic POCUS training and were evaluated in a brief practical exam before entering their first clinical rotation. Four of the cases in which the students took part are presented in this case series. Results: The POCUS exam in the first case discovered pulmonary embolism in addition to the diagnosis of Cushing disease. In the second case, endocarditis could have been diagnosed three days earlier had a POCUS exam been performed. Case 3 demonstrates the additional contribution of POCUS to the decision-making process carried out by physicians and its superiority in quantifying and diagnosing pleural effusion compared to chest X-Ray. Case 4 indicated that POCUS is preferable over chest X-ray and auscultation for the diagnosis of pulmonary edema. Conclusion: This case series may emphasize the capabilities POCUS has when utilized in the standard physical examination and the importance of incorporating POCUS instruction in medical schools for new physicians to acquire this skill.

scholarly journals Comparative effectiveness of a mnemonic-use approach vs. self-study to interpret a lateral chest X-ray

2017 ◽  
Vol 41 (4) ◽  
pp. 518-521 ◽  
Author(s):  
Michael Thompson ◽  
Dallin Johansen ◽  
Russell Stoner ◽  
Allison Jarstad ◽  
Robert Sorrells ◽  
...  
Keyword(s):  
Medical Students ◽  
Imaging Study ◽  
Lateral View ◽  
Frontal View ◽  
Chest Film ◽  
X Ray ◽  
Self Study ◽  
Lateral Film ◽  
Chest X Ray ◽  
Lateral Chest

The chest X-ray is the most commonly performed medical imaging study; however, the lateral chest film intimidates many physicians and medical students. The lateral view is more difficult to interpret than the frontal view but provides important information that is either not visible or not as evident on frontal view, and inability to read it may lead to missed diagnoses and more expensive imaging. The objective of this study was to assess a novel mnemonic-based approach to teaching medical students to proficiently read a lateral film using a prospective pilot study. A clinical faculty radiologist taught two groups of second-year medical students to read a lateral chest X-ray. One group learned a novel mnemonic-based method (MUM), and the other cohort performed directed web-based self-study (STMM). Each cohort was given a pre- and postassessment, and their performance was analyzed. A total of n = 29 students participated with n = 14 being taught the mnemonic method. The MUM group significantly ( P = 0.001) improved their score vs. the STMM group This study demonstrates students can quickly and effectively learn to read a lateral chest film using this novel mnemonic.

scholarly journals Assessment of final-year medical students’ performance in diagnosing critical findings on chest X-ray

2021 ◽  
Author(s):  
Osama Samara ◽  
Saif Aldeen AlRyalat ◽  
Lna Malkawi ◽  
Mo’ath Bani Ali ◽  
Areej Kilani ◽  
...  
Keyword(s):  
Medical Students ◽  
X Ray ◽  
Chest X Ray

Learning to diagnose X-rays: a neuroscientific study of practice-related activation changes in the prefrontal cortex

Diagnosis ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerome I. Rotgans
Keyword(s):  
Prefrontal Cortex ◽  
Medical Students ◽  
Response Time ◽  
Diagnostic Accuracy ◽  
Test Phase ◽  
Learning Phase ◽  
X Rays ◽  
Far Transfer ◽  
Near Transfer ◽  
System 2

Abstract Objectives Medical expertise manifests itself by the ability of a physician to rapidly diagnose patients. How this expertise develops from a neural-activation perspective is not well understood. The objective of the present study was to investigate practice-related activation changes in the prefrontal cortex (PFC) as medical students learn to diagnose chest X-rays. Methods The experimental paradigm consisted of a learning and a test phase. During the learning phase, 26 medical students were trained to diagnose four out of eight chest X-rays. These four cases were presented repeatedly and corrective feedback was provided. During the test phase, all eight cases were presented together with near- and far-transfer cases to examine whether participants’ diagnostic learning went beyond simple rote recognition of the trained X-rays. During both phases, participants’ PFC was scanned using functional near-infrared spectroscopy. Response time and diagnostic accuracy were recorded as behavioural indicators. One-way repeated measures ANOVA were conducted to analyse the data. Results Results revealed that participants’ diagnostic accuracy significantly increased during the learning phase (F=6.72, p<0.01), whereas their response time significantly decreased (F=16.69, p<0.001). Learning to diagnose chest X-rays was associated with a significant decrease in PFC activity (F=33.21, p<0.001) in the left dorsolateral prefrontal cortex, the orbitofrontal area, the frontopolar area and the frontal eye field. Further, the results of the test phase indicated that participants’ diagnostic accuracy was significantly higher for the four trained cases, second highest for the near-transfer, third highest for the far-transfer cases and lowest for the untrained cases (F=167.20, p<0.001) and response time was lowest for the trained cases, second lowest for the near-transfer, third lowest for the far-transfer cases and highest for the untrained cases (F=9.72, p<0.001). In addition, PFC activity was lowest for the trained and near-transfer cases, followed by the far-transfer cases and highest for the untrained cases (F=282.38, p<0.001). Conclusions The results suggest that learning to diagnose X-rays is associated with a significant decrease in PFC activity. In terms of dual-process theory, these findings support the notion that students initially rely more on slow analytical system-2 reasoning. As expertise develops, system-2 reasoning transitions into faster and automatic system-1 reasoning.

Tuberculosis: Diagnostic Challenges in Rural Africa

Praxis ◽  
2019 ◽  
Vol 108 (15) ◽  
pp. 991-996
Author(s):  
Ngisi Masawa ◽  
Farida Bani ◽  
Robert Ndege
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
X Ray ◽  
Molecular Tests ◽  
Rural Settings ◽  
Chest X Ray ◽  
Screening Questions ◽  
Rural Africa ◽  
Tb Diagnostics ◽  
Strip Test ◽  
Urine Strip

Abstract. Tuberculosis (TB) remains among the top 10 infectious diseases with highest mortality globally since the 1990s despite effective chemotherapy. Among 10 million patients that fell ill with tuberculosis in the year 2017, 36 % were undiagnosed or detected and not reported; the number goes as high as 55 % in Tanzania, showing that the diagnosis of TB is a big challenge in the developing countries. There have been great advancements in TB diagnostics with introduction of the molecular tests such as Xpert MTB/RIF, loop-mediated isothermal amplification, lipoarabinomannan urine strip test, and molecular line-probe assays. However, most of the hospitals in Tanzania still rely on the TB score chart in children, the WHO screening questions in adults, acid-fast bacilli and chest x-ray for the diagnosis of TB. Xpert MTB/RIF has been rolled-out but remains a challenge in settings where the samples for testing must be transported over many kilometers. Imaging by sonography – nowadays widely available even in rural settings of Tanzania – has been shown to be a useful tool in the diagnosis of extrapulmonary tuberculosis. Despite all the efforts and new diagnostics, 30–50 % of patients in high-burden TB countries are still empirically treated for tuberculosis. More efforts need to be placed if we are to reduce the death toll by 90 % until 2030.

Task-Switching Training and Transfer

2018 ◽  
Vol 32 (3) ◽  
pp. 106-130 ◽  
Author(s):  
Zsófia Anna Gaál ◽  
István Czigler
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Cognitive Training ◽  
Task Switching ◽  
Difficulty Level ◽  
Training Procedure ◽  
Far Transfer ◽  
Near Transfer ◽  
Related Potentials ◽  
Transfer Tasks

Abstract. We used task-switching (TS) paradigms to study how cognitive training can compensate age-related cognitive decline. Thirty-nine young (age span: 18–25 years) and 40 older (age span: 60–75 years) women were assigned to training and control groups. The training group received 8 one-hour long cognitive training sessions in which the difficulty level of TS was individually adjusted. The other half of the sample did not receive any intervention. The reference task was an informatively cued TS paradigm with nogo stimuli. Performance was measured on reference, near-transfer, and far-transfer tasks by behavioral indicators and event-related potentials (ERPs) before training, 1 month after pretraining, and in case of older adults, 1 year later. The results showed that young adults had better pretraining performance. The reference task was too difficult for older adults to form appropriate representations as indicated by the behavioral data and the lack of P3b components. But after training older adults reached the level of performance of young participants, and accordingly, P3b emerged after both the cue and the target. Training gain was observed also in near-transfer tasks, and partly in far-transfer tasks; working memory and executive functions did not improve, but we found improvement in alerting and orienting networks, and in the execution of variants of TS paradigms. Behavioral and ERP changes remained preserved even after 1 year. These findings suggest that with an appropriate training procedure older adults can reach the level of performance seen in young adults and these changes persist for a long period. The training also affects the unpracticed tasks, but the transfer depends on the extent of task similarities.

Lingual Dystonia Treated with Botulinum Toxin - A Case Report

1970 ◽  
Vol 24 (2) ◽  
pp. 75-78
Author(s):  
MA Hayee ◽  
QD Mohammad ◽  
H Rahman ◽  
M Hakim ◽  
SM Kibria
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
X Ray ◽  
Medical College ◽  
Lingual Dystonia ◽  
History Of ◽  
Chest X Ray

A 42-year-old female presented in Neurology Department of Sir Salimullah Medical College with gradually worsening difficulty in talking and eating for the last four months. Examination revealed dystonic tongue, macerated lips due to continuous drooling of saliva and aspirated lungs. She had no history of taking antiparkinsonian, neuroleptics or any other drugs causing dystonia. Chest X-ray revealed aspiration pneumonia corrected later by antibiotics. She was treated with botulinum toxin type-A. Twenty units of toxin was injected in six sites of the tongue. The dystonic tongue became normal by 24 hours. Subsequent 16 weeks follow up showed very good result and the patient now can talk and eat normally. (J Bangladesh Coll Phys Surg 2006; 24: 75-78)

Hubungan antara Luas Lesi pada Foto Toraks Penderita TB Paru Dewasa yang Memiliki Riwayat Diabetes Melitus dengan Indeks Massa Tubuh di Rumah Sakit Hasan Sadikin Bandung

2016 ◽  
Vol 1 (3) ◽  
pp. 138-144
Author(s):  
Ina Edwina ◽  
Rista D Soetikno ◽  
Irma H Hikmat
Keyword(s):  
Chest Radiograph ◽  
Chi Square ◽  
Pulmonary Tb ◽  
X Ray ◽  
Consecutive Sampling ◽  
Close Relationship ◽  
Chi Square Test ◽  
Chest X Ray ◽  
The Relationship ◽  
Diabetes Melitus

Background: Tuberculosis (TB) and diabetes mellitus (DM) prevalence rates are increasing rapidly, especially in developing countries like Indonesia. There is a relationship between TB and DM that are very prominent, which is the prevalence of pulmonary TB with DM increased by 20 times compared with pulmonary TB without diabetes. Chest X-ray picture of TB patients with DM is atypical lesion. However, there are contradictories of pulmonary TB lesion on chest radiograph of DM patients. Nutritional status has a close relationship with the morbidity of DM, as well as TB.Objectives: The purpose of this study was to determine the relationship between the lesions of TB on the chest radiograph of patients who su?er from DM with their Body Mass Index (BMI) in Hasan Sadikin Hospital Bandung.Material and Methods: The study was conducted in Department of Radiology RSHS Bandung between October 2014 - February 2015. We did a consecutive sampling of chest radiograph and IMT of DM patients with clinical diagnosis of TB, then the data was analysed by Chi Square test to determine the relationship between degree of lesions on chest radiograph of pulmonary TB on patients who have DM with their BMI.Results: The results showed that adult patients with active pulmonary TB with DM mostly in the range of age 51-70 years old, equal to 62.22%, with the highest gender in men, equal to 60%. Chest radiograph of TB in patients with DM are mostly seen in people who are obese, which is 40% and the vast majority of lesions are minimal lesions that is equal to 40%.Conclusions: There is a signifcant association between pulmonary TB lesion degree with BMI, with p = 0.03

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