scholarly journals Medical Students and Patients Benefit from Virtual Non-Medical Interactions Due to COVID-19

2021 ◽  
Vol 8 ◽  
pp. 238212052110283
Author(s):  
Taylor M Coe ◽  
Trevor J McBroom ◽  
Sarah A Brownlee ◽  
Karen Regan ◽  
Stephen Bartels ◽  
...  
Keyword(s):  
Medical Students ◽  
Communication Skills ◽  
Patient Experience ◽  
Clinical Medicine ◽  
Organ Transplant ◽  
Medical Patient ◽  
Pilot Program ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Clinical Communication

Background: Patient care restrictions created by the COVID-19 pandemic constrained medical students’ ability to interact directly with patients. Additionally, organ transplant recipients faced increasing isolation due to the rise of telemedicine, the importance of social distancing and their immunosuppressed state. We created a pilot program to pair students with transplant patients for structured, virtual encounters and studied its impact on medical students and patients. Methods: In May 2020, medical students conducted virtual visits with patients via telephone or video conferencing. Patients and students were surveyed regarding their experiences and independent focus groups were conducted. The survey responses and focus group discussions were deidentified, transcribed, and analyzed for themes. Results: Ten participating students were in their first, second, or final year of medical school. The 14 patients were liver or kidney transplant recipients or kidney donors. All interactions lasted longer than 30 minutes, with 56% greater than 1 hour. Three themes emerged related to the student experience: improvement of their clinical communication skills, development of knowledge and attitudes related to organ transplantation and donation, and independent management of a patient encounter. Three themes related to the patient experience: appreciation of the opportunity to share their personal patient experience to help educate future physicians, a cathartic and personally illuminating experience and an opportunity to share the message of donation. Conclusions: This pilot program provided a novel opportunity for virtual student-patient interactions that was feasible, well-received, and mutually beneficial. The use of virtual non-medical patient experiences allowed for experiential learning during which students learned about both clinical medicine and enhanced their communication skills directly from patients. Additionally, patients were able to engage with medical students in a new way, as teachers of clinical interactions, and reported a high level of satisfaction in addition to deriving personal benefit.

scholarly journals Humoral Immune Response to SARS-CoV-2 Vaccination after a Booster Vaccine Dose in Two Kidney Transplant Recipients with Fabry Disease and Variable Secondary Immunosuppressive Regimens

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1412
Author(s):  
Lavinia Bernea ◽  
Oana R. Ailioaie ◽  
Nadine Benhamouda ◽  
Eric Tartour ◽  
Dominique P. Germain
Keyword(s):  
Fabry Disease ◽  
Organ Transplant ◽  
Vaccine Dose ◽  
Original Strain ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Success Rates ◽  
Kidney Transplant Recipients ◽  
Protection Measures ◽  
Renal Graft

The urgent need to fight the COVID-19 pandemic has accelerated the development of vaccines against SARS-CoV-2 and approval processes. Initial analysis of two-dose regimens with mRNA vaccines reported up to 95% efficacy against the original strain of the SARS-CoV-2 virus. Challenges arose with the appearance of new strains of the virus, and reports that solid organ transplant recipients may have reduced vaccination success rates after a two-dose mRNA vaccination regimen encouraged health authorities to recommend a booster in immunocompromised patients. Fabry disease is an X-linked inherited lysosomal disorder, which may lead to chronic end-stage renal disease. We report on two patients with advanced Fabry disease, renal graft and adjunctive immunosuppressive therapies who exhibited variable humoral vaccination-related immune responses against SARS-CoV-2 after three vaccine doses. The first patient developed mild COVID-19 infection, while the second patient did not seroconvert after three shots of an mRNA vaccine. Both cases emphasize that patients with Fabry disease and renal graft are susceptible to develop a weak response to COVID-19 vaccination and highlight the importance of maintaining barrier protection measures. Vaccination of family members should be encouraged to lower the risk of viral transmission to immunocompromised, transplanted patients, including vaccinated ones.

scholarly journals Effectiveness of clinical scenario dramas to teach doctor-patient relationship and communication skills

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yinan Jiang ◽  
Lili Shi ◽  
Jinya Cao ◽  
Liming Zhu ◽  
Yue Sha ◽  
...  
Keyword(s):  
Medical Students ◽  
Communication Skills ◽  
Patient Communication ◽  
Clinical Scenario ◽  
Patient Relationship ◽  
Doctor Patient Relationship ◽  
Clinical Communication ◽  
Doctor Patient Communication ◽  
Self Confidence ◽  
Chinese Medical Students

Abstract Background The doctor-patient relationship in China has deteriorated in recent years, and poor doctor-patient communication is one of the main reasons. How to effectively carry out doctor-patient communication training originated from the West among Chinese medical students still to be studied. In the past decade, Peking Union Medical College has adopted clinical scenario drama to teach doctor-patient relationship and clinical communication skills. The aim of this study was to introduce clinical scenario dramas and evaluate its effectiveness in promoting doctor-patient relationships and clinical communication skills through students’ self-perceptions in Chinese medical students. Methods This study was a retrospective, self-controlled study and conducted from March 2009 to October 2018. Doctor-patient relationship and communication skills training were administered to all sixth-year medical students, which involved lectures and various clinical scenario dramas. The program totaled 24 h, of which each class session was 3 h, with 8 sessions in total. All students were requested to complete an anonymous 5 likert self-rating survey including self-confidence in using communication skills and self-perceived learning attitude and ability before and at the end of the course. In addition, they were requested to evaluate the curriculum after completion of the course. Results Clinical scenario dramas helped students improve their self-confidence in clinical communication skills except for psychosomatic history taking (p < 0.05). The interests for participation in clinical scenario dramas were higher compared to attending lectures (4.39 ± 0.610 Vs 4.07 ± 0.831, p<0.01). Study participants were highly satisfied in the course setting, teaching instructors and content (4.61 ± 0.546, 4.65 ± 0.535, 4.63 ± 0.534). The self-evaluation results demonstrated that clinical scenario dramas improved the learning ability of medical students (p < 0.05). Conclusion The use of clinical scenario dramas was helpful in teaching doctor-patient communication skills.

scholarly journals Using multimedia to assist students with communication skills and biopsychosocial integration: An evaluation

2000 ◽  
Vol 16 (2) ◽  
Author(s):  
Teng Liaw ◽  
Gregor Kennedy ◽  
Mike Keppell ◽  
John Marty ◽  
Ruth McNair
Keyword(s):  
Medical Students ◽  
Communication Skills ◽  
Interface Design ◽  
Formative Evaluation ◽  
Evaluation Framework ◽  
Instructional Designers ◽  
Clinical Communication ◽  
Biopsychosocial Approach ◽  
The University ◽  
Facilitated Learning

<span>This paper reports on the development rationale and evaluation of a computer facilitated learning (CFL) package which aimed to assist medical students with their clinical communication skills and develop an integrated biopsychosocial approach to identifying a patient's problems. Using a formative evaluation framework developed at the University of Melbourne the CFL package, </span><em>Communicating with the Tired Patient,</em><span> underwent a three stage review. Initial evaluation consisted of both formal and informal conceptual and technical review by content experts, instructional designers and evaluators. The final stage of the evaluation involved the survey and observation of 110 medical students interacting with the package. Students were very positive about the instructional and interface design of the package and indicated that the package assisted with their understanding of issues associated with clinical communication. Nevertheless, a number of areas were highlighted where either the package or the learning environment could be modified or improved.</span>

scholarly journals 479. Real-world Evaluation of SARS-CoV-2 Monoclonal Antibodies in Solid Organ Transplant Recipients

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S341-S341
Author(s):  
Kristen Zeitler ◽  
Nicholas Piccicacco ◽  
Lyndsey Bowman ◽  
Jose Montero ◽  
Margarita Cancio ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Organ Transplant ◽  
Panel Member ◽  
Retrospective Chart Review ◽  
Editorial Board Member ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Abstract Background Patients with COVID-19 infection at highest risk for poor outcomes include immunocompromised patients, such as solid organ transplant (SOT) recipients. Monoclonal antibody (mAb) infusions were developed to promote passive immunity. Analysis of the first 200 patients who received SARS-CoV-2 mAb at our hospital showed a 27 % absolute reduction in hospitalization and emergency department (ED) visits. Understanding the role of SARS-CoV-2 mAb therapy in management of the SOT population is likely to inform decision making for these patients. Methods We conducted a retrospective chart review of SOT patients diagnosed with COVID-19 who received mAb therapy between 11/18/20 and 04/26/21. Patients were excluded if they were &lt; 18 years of age or if they weighed &lt; 40 kg. We compared those patients who were hospitalized or visited the ED within 29 days of mAb therapy to those who recovered without further visits to our hospital. Results A total of 50 SOT patients receiving mAb therapy were included in this analysis. Bamlanivimab was given to 33 patients, while 9 patients received bamlanivimab/etesevimab and 8 patients received casirivimab/imdevimab. Twelve (24 %) patients were hospitalized or visited the ED within 29 days of mAb therapy; 38 patients did not. These 2 groups did not significantly differ by age, gender, body mass index, time from SOT, or other risk factors for severe COVID-19 illness per FDA Emergency Use Authorization guidance. Both groups were primarily made up of kidney transplant recipients (66.7 % and 68.4 %, respectively). Significantly more patients in the hospitalization/ED group were receiving antimetabolites as part of their immunosuppression (IS) regimen prior to COVID-19 diagnosis (100 % vs 68.4 %, p = 0.047). Patients in the hospitalization/ED group received mAbs within a median of 6 days (IQR 3.8) of symptom onset compared to 4 days (IQR 4) (p = 0.006). Conclusion SOT recipients were more likely to be hospitalized or visit the ED due to COVID-19 after mAb if they were receiving antimetabolite IS or received mAb later after symptom onset. These data stress the importance of early mAb administration in all SOT patients, particularly in those on antimetabolite therapy. Disclosures Lyndsey Bowman, PharmD, Veloxis Pharmaceuticals (Advisor or Review Panel member, Speaker’s Bureau) Kami Kim, MD, Regeneron Pharmaceuticals Inc. (Scientific Research Study Investigator)Sanford Guide (Other Financial or Material Support, Editorial Board Member)

scholarly journals Assessing the training needs of medical students in patient information gathering; a qualitative study

2019 ◽  
Author(s):  
Conor Gilligan ◽  
Sonja Brubacher ◽  
Martine Powell
Keyword(s):  
Medical Students ◽  
Communication Skills ◽  
Medical Practice ◽  
Role Models ◽  
Teaching And Learning ◽  
Structured Interviews ◽  
Clinical Communication ◽  
Medical Interviewing ◽  
Medical Programs ◽  
And Training

Abstract Background Effective communication is at the heart of good medical practice but rates of error, patient complaints, and poor clinician job satisfaction are suggestive of room for improvement in this component of medical practice and education. Methods We conducted semi-structured interviews with experienced clinicians (n = 19) and medical students (n = 20) to explore their experiences associated with teaching and learning clinical communication skills and identify targets for improvements to addressing these skills in medical curricula. Results Interviews were thematically analysed and four key themes emerged; the importance of experience, the value of role-models, the structure of a consultation, and confidence. Conclusions The findings reinforce the need for improvement in teaching and learning communication skills in medicine, with particular opportunity to target approaches to teaching foundational skills which can establish a strong grounding before moving into more complex situations, thus preparing students for the flexibility required in medical interviewing. A second area of opportunity and need is in the engagement and training of clinicians as mentors and teachers, with the findings from both groups indicating that preparation for teaching and feedback is lacking. Medical programs can improve their teaching of communication skills and could learn from other fields s to identify applicable innovative approaches.

scholarly journals Strengthening student communication through pediatric simulated patient encounters

2014 ◽  
Vol 11 ◽  
pp. 21 ◽  
Author(s):  
Ryan Whitt ◽  
Gregory Toussaint ◽  
S. Bruce Binder ◽  
Nicole J. Borges
Keyword(s):  
Medical Students ◽  
Communication Skills ◽  
Family Members ◽  
Young Patients ◽  
Simulated Patient ◽  
Rank Test ◽  
Clinical Communication ◽  
Oral Feedback ◽  
Signed Rank ◽  
Signed Rank Test

As medical students enter the role of physician, clinical outcomes not only rely on their mastery of clinical knowledge, but also on the effectiveness in which they can communicate with patients and family members. While students typically have numerous opportunities to practice clinical communication with adult patients, such practice in pediatric settings is limited. This study examines if simulated patient (SP) encounters strengthen third-year medical students’ communication skills during the pediatrics clerkship. During 2011-2013, three SP encounters (comprising 3 pediatric scenarios) were incorporated into a pediatrics clerkship at one United States medical school to give students a safe venue to practice advanced communication with observation and direct feedback. Third-year medical students engaged in the scenarios and received both written and oral feedback from an evaluator observing the encounter. With IRB approval, students’ self-perceived confidence and abilities at performing the advanced communication skills were measured using an eightitem, Likert scale questionnaire administered pre and post the SP encounter. Pre- and post-questionnaires (n = 215; response rate, 96%) analyzed using a Wilcoxon-matched pairs signed-rank test demonstrated statistically significant increases in students’ perception of their confidence and abilities regarding their performance (P < 0.05; Bonferroni correction, P < 0.006). There was an increases in student confidence and self-perceived ability in: first, communicating with children and family members of young patients; second, managing confrontational situations involving parents; third, performing a thorough psychosocial history with an adolescent; and fourth, using Evidence Based Medicine to motivate parents.

scholarly journals Safety of Valganciclovir Dosed 450 MG Three Times Weekly for Cytomegalovirus Prophylaxis in Solid Organ Transplant Recipients Requiring Hemodialysis

2021 ◽  
Author(s):  
Danielle Ecabert ◽  
Christine Pham ◽  
Brett J Pierce ◽  
William L Musick ◽  
Duc T Nguyen ◽  
...  
Keyword(s):  
Renal Function ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Severe Neutropenia ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cmv Infection ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

Abstract Background Valganciclovir is the most commonly used antiviral for cytomegalovirus (CMV) prophylaxis in solid organ transplant recipients. However, there are limited clinical outcomes-supported data available to guide valganciclovir dosing in patients on hemodialysis (HD). This study aimed to assess the safety of our institution’s current dosing strategy of valganciclovir 450 mg three times weekly post-HD. Methods This was a single-center retrospective review of all adult non-kidney transplant recipients between May 2016 and June 2018. Patients with end stage renal disease requiring HD for &gt;28 days post-transplant receiving valganciclovir 450 mg three times weekly post-HD were matched with non-HD patients receiving valganciclovir prophylaxis dosed per renal function. The primary endpoints were incidence of leukopenia, neutropenia, and thrombocytopenia while on valganciclovir prophylaxis. Results A total of 465 non-kidney transplants were performed during the study period, with 37 patients included in the HD group who were matched to 111 control patients in the non-HD group. Liver transplant recipients comprised 84% and 72% of each group, with none being CMV D+/R-. The rates of leukopenia (51.4% vs. 51.4%, p = 1.00), severe neutropenia (ANC &lt;500 cells/µL, 15.8% vs. 14.0%, p = 0.85), and thrombocytopenia (24.3% vs. 20.7%, p = 0.64) were similar in both HD and non-HD groups. There were no cases of CMV infection while on valganciclovir prophylaxis in either group. Conclusions Valganciclovir 450 mg three times weekly was found to have similar rates of leukopenia, neutropenia, thrombocytopenia, and CMV infection in comparison to valganciclovir dosed per renal function in non-HD transplant recipients.

scholarly journals SARS-CoV-2-specific Humoral and Cell-mediated Immune Responses after Immunization with Inactivated COVID-19 Vaccine in Kidney Transplant Recipients (CVIM 1 Study)

2021 ◽  
Author(s):  
Jackrapong Bruminhent ◽  
Chavachol Sethaudom ◽  
Pongsathon Chaumdee ◽  
Sarinya Boongird ◽  
Sasisopin Kiertiburanakul ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Organ Transplant ◽  
Calcineurin Inhibitors ◽  
Neutralizing Antibody ◽  
Cell Mediated Immunity ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cell Responses ◽  
Clinical Trials Registry

Immunogenicity following inactivated SARS-CoV-2 vaccination among solid organ transplant recipients has not been assessed. Seventy-five patients (37 kidney transplant [KT] recipients and 38 non-transplant controls) received two doses, at 4-week intervals, of an inactivated whole-virus SARS-CoV-2 vaccine. SARS-CoV-2-specific humoral (HMI) and cell-mediated immunity (CMI) were measured before, 4 weeks post-first dose, and 2 weeks post-second dose. The median age of KT recipients was 50 years (IQR, 42 to 54) and 89% were receiving calcineurin inhibitors/mycophenolate/corticosteroid regimens. The median time since transplant was 4.5 years (IQR, 2 to 9.5). Among 35 KT patients, anti-RBD IgG titer after vaccination was not significantly different to baseline, but was significantly lower than in controls (7.8 [95%CI 0.2 to 15.5] vs 2,691 [95%CI 1,581 to 3,802], p<0.001) as well as the percentage of surrogate virus neutralizing antibody inhibition (2 [95% CI -1 to 6] vs 71 [95%CI 61 to 81], p<0.001). However, the mean of SARS-CoV-2 mixed peptides-specific T-cell responses measured by enzyme-linked immunospot assays was significantly increased compared with baseline (66 [95%CI 36 to 99] vs. 34 [95%CI 19 to 50] T-cells/10^6 PBMCs, p=0.02) and comparable to that in controls. Our findings revealed weak HMI and marginal CMI responses in fully vaccinated KT recipients receiving inactivated SARS-CoV-2 vaccine. (Thai Clinical Trials Registry, TCTR20210226002).

Sign in / Sign up

Export Citation Format

Share Document