A Randomized Controlled Trial of Simulation Training in Teaching Coronary Angiographic Views

IntroductionSimulation technology has an established role in teaching technical skills to cardiology fellows, but their impact on teaching trainees to interpret coronary angiographic (CA) images has not been systematically studied. The aim of this randomized controlled study was to test whether structured simulation training in addition to traditional methods would improve CA image interpretation skills in a group of novices to advanced medical trainees.MethodsWe prospectively randomized 105 subjects comprising of medical students (N=20), residents (N=68) and fellows (N=17) from the University of Arizona. Subjects were randomized into a simulation training group which received simulation training in addition to didactic teaching (n=53) and a control training group which received didactic teaching alone (n=52). The change in pre and post-test score (delta score) was analyzed by a two-way ANOVA for education status and training arm.ResultsSubjects improved in their post-test scores with a mean change of 4.6 ± 4.0 points. Subjects in the simulation training arm had a higher delta score compared to control (5.4 ± 4.2 versus 3.8 ± 3.7, p=0.04), with greatest impact for residents (6.6 ± 4.0 versus 3.5 ± 3.4) with a p=0.02 for interaction of training arm and education status.ConclusionsSimulation training complements traditional methods to improve CA interpretation skill, with greatest impact on novice trainees. This highlights the importance of incorporating high-fidelity simulation training early in cardiovascular fellowship curricula.

Development and Evaluation of Resident-Championed Point-of-Care Ultrasound Curriculum for Internal Medicine Residents

Introduction: Point-of-care ultrasound (POCUS) is a powerful clinical tool that has seen widespread adoption, including in Internal Medicine (IM), yet standardized curricula designed by trained faculty are scant. To address the demand for POCUS education at our institution, we created a resident-championed curriculum with support from skilled faculty across multiple specialties. Our objective was to teach postgraduate year (PGY)-3 IM residents the basics of POCUS for evaluation of the pulmonary, cardiac, and abdominal systems through resident-developed workshops. The goal of acquisition of these skills was for resident education and to inform decisions to pursue further patient testing. Methods: Three half-day workshops were created to teach residents how to obtain and interpret ultrasound images of the pulmonary, cardiac, and abdominal systems. Workshops were comprised of didactic teaching and practical ultrasound instruction with expert supervision of clinicians within and outside of IM. Residents were asked to complete a written survey before and after each workshop to assess confidence, knowledge, and likelihood of future POCUS use. Results: Across the three workshops (pulmonary, cardiac, and abdominal), 66 sets of pre- and post-workshop surveys (32 pulmonary, 25 cardiac, and 9 abdominal) were obtained and analyzed. Confidence in and knowledge regarding POCUS use increased significantly across all three workshops. Likelihood of future use increased in the cardiac workshop. Conclusions: We implemented a resident-championed POCUS curriculum that led to improved attitudes and increased knowledge of POCUS for PGY-3 IM residents.

Effectiveness of blended learning in pharmacy education: An experimental study using clinical research modules

Background &objectives Though there are studies to evaluate the effectiveness of blended learning in pharmacy education, most of them originate from USA and have used previous year students’ scores as control. Also there is less research in comparing use of self -regulated learning strategies between blended and other learning strategies. Primary aim was to evaluate the effectiveness of blended learning on knowledge score using clinical research modules. Secondary objective was designed to compare the use of self-regulated learning strategies between blended learning, web-based e-learning and didactic teaching. Materials and methods A prospective cluster randomized trial was conducted with didactic teaching as control and web-based e-learning and blended learning as interventions. The target population was final year Pharm D students. Outcome was assessed using a validated knowledge questionnaire, a motivated strategies for learning questionnaire and a feedback form. All statistical analyses were carried out using Statistical Package for Social Science (SPSS) Version 20. Results A total of 241 students from 12 colleges completed the study. Mean knowledge score of students in blended learning group was higher than those in the didactic teaching and web- based e- learning program (64.26±18.19 Vs 56.65±8.73 Vs 52.11±22.06,p<0.001).Frequency of use of learning strategies namely rehearsal, elaboration, organization and critical thinking was statistically significantly higher in the blended learning group compared to those of didactic and web-based e-learning group (p<0.05) But there were no statistically significant difference of motivational orientations between didactic and blended learning group except strategies of extrinsic goal orientation and self-efficacy. Students preferred blended learning (86.5%) over didactic and web-based e-learning. Conclusion Blended learning approach is an effective way to teach clinical research module. Students of blended learning group employed all motivational and learning strategies more often than students of the didactic and web- based e-learning groups except strategies of intrinsic goal orientation, task value, control of learning belief and help seeking.

Trends in Resin Composite Restoration Repair Teaching in Dental Colleges in Pakistan

Background The paradigm shift from replacement to repair of defective resin composite restorations to implement minimal intervention approaches has been popular. Therefore, the teaching of composite repair strategies is included in contemporary dental curricula across the globe. Methods A validated 18-item questionnaire pertaining to existing educational practices related to the teaching of defective composite restorations repair was acquired form dental colleges in Pakistan. Results The response rate was 63% and the majority of dental colleges (67%) reported that they have included the teaching of composite restorations repair in the curricula, where four colleges (33%) implemented only didactic teaching and eight colleges (66%) reported a combination of didactic teaching and clinical training. The composite repair indications taught included tooth substance conservation 100% (12), reduced cost to patient 84.3% (10) and dentist 100% (12), reduced iatrogenic pulpal damage 100% (12), and reduced chair side treatment time 91.3% (11), restoration-related defects (66% preferred repair), anterior tooth fracture from incisal/proximal margin (80% teach repair), and in case of posterior tooth cusp fracture (20% teach repair). Our results revealed that the choice of mechanical and adhesive substrate surface conditioning depended on case selection. Conclusion The teaching of defective composite restorations repair was less widespread and certain variations in teaching were identified. Nearly all dental colleges reported to incorporate current evidence of minimum invasive strategies of composite repair in curricula in future.

didactic teaching methodology to assist in the analysis of the economic impact on fuel prices commercialized in the Carajás region.

This research aims to analyze the economic impacts caused by the addition of the third digit after the comma in the prices of fuels commercialized in the Carajás region (Parauapebas, Canaã dos Carajás, Curionópolis e Serra dos Carajás) located in the southeast of Pará State, Brazil, and the professional categories chosen were UBER application drivers, who use gasoline with additives in their vehicles, sales representatives who use motorcycles and regular gasoline for their work and lastly, intercity van cooperative drivers who use regular diesel fuel. The results of the investigation highlighted that there was a total loss of 2,10 BRL, for the three categories of professionals for every 100 liters of fuel consumed, representing an economic impact of approximately 43% for S-10 diesel, 38% for regular gasoline and 19% for gasoline with additives. Furthermore, in the professional categories analyzed, it was observed that the greatest economic impact occurred for the group of inter-municipal van drivers, with an annual cost of 191,52 BRL. Subsequently, App drivers obtained 14,72 BRL of economic implication per year, and finally, with less annual impact, sales representatives with a cost of 2,72 BRL.

Changes in Family Medicine Clerkship Teaching Due to the COVID-19 Pandemic

Background and Objectives: On March 17, 2020, the Association of American Medical Colleges recommended temporary suspension of all medical student clinical activities due to the COVID-19 pandemic, which required a rapid development of alternatives to traditional teaching methods. This study examines education changes spurred by COVID-19. Methods: Data were collected via a Council of Academic Family Medicine Educational Research Alliance survey of family medicine clerkship directors. Participants answered questions about didactic and clinical changes made to clerkship teaching due to the COVID-19 pandemic, how positive the changes were, whether the changes would be made permanent, and how prepared clerkship directors were for the changes. Results: The response rate was 64%. The most frequent change made to didactic teaching was increasing online resources. The most frequent change made to clinical teaching was adding clinical simulation. Greater changes were made to clinical teaching than to didactic teaching. Changes made to didactic teaching were perceived as more positive for student learning than the changes made to clinical teaching. Clerkship directors felt more prepared for changes to didactic teaching than for clinical teaching, and were more likely to make the didactic teaching changes permanent than the clinical teaching changes. Conclusions: The COVID-19 pandemic caused nearly all clerkship directors to make changes to clerkship teaching, but few felt prepared to make these changes, particularly changes to clinical teaching. Clerkship directors made fewer changes to didactic teaching than clinical teaching, however, didactic changes were perceived as more positive than clinical changes and were more likely to be adopted long term.

A Scoping Review of Radiation Oncology Educational and Career-Planning Interventions in Undergraduate Medical Education

Radiation oncology (RO) teaching in undergraduate medical education (UME) is lacking worldwide with potentially detrimental effects on medical student career choices and patient care. The objective of this scoping review is to examine the extent of published literature describing RO educational and career-planning interventions in UME. Online databases were searched from respective dates of inception to June 2020 for articles that reported outcomes from RO educational and career-planning interventions in UME. Two independent reviewers screened entries for inclusion. Following full-text reviews, 25 articles were analyzed. Most interventions were a single session, involved clinical medical students, and were based in North America. Didactic teaching was most commonly used, though a majority included interactive learning in addition to or in place of didactic teaching. As expected, there was a heterogeneity of outcomes reported, and most studies collected data using surveys alone. Recurring topics included the multidisciplinary nature of oncology and psychosocial oncology. There was a paucity of studies reporting on formal mentorship programs and research programs. The data collated in this study can help develop new initiatives based on what has succeeded in the past. Areas that may benefit from future studies include mentorship programs, research programs, and interventions from outside North America.

Impact of Whatsapp in improving learning among 9th semester MBBS students

Background: Interactive Teaching learning can be used in clinical subjects like surgery for better participation of students as one-way didactic lectures do not involve active participation of students. WhatsApp is one of the most famous messaging services which everyone use and it is easy, cheaper, and faster. Objective: the purpose of the study was to study the impact of whatsapp in improving learning in general surgery among 9th semester medical students. Methods: This study was conducted among 9th semester MBBS students in Surgery department. Students were divided into group a (study group) and group b(control group) by a simple random sampling. Gastric cancer was discussed among students of both Groups through didactic teaching. after didactic teaching, only Group A students were exposed to social media type of learning, i.e., using WhatsApp, after the session a multiple-choice questionnaire having 10 MCQs was given to both groups and an additional poll was conducted among the Study-group students to assess their perception towards Whatsapp intervention. the mean score obtained by both the groups were compared with unpaired t test. P-value <0.05 is taken as statistically significant. Results: The mean (SD) score of the Study-group was 8.58(1.18) and the mean (SD) score of the Control-group was 5.41(1.32) and statistically significant difference was found between the two groups scores with a p-value less than 0.05 opinion poll found that the intervention of whatsapp among study group was effective. Conclusion: we observed that the usage of WhatsApp in addition to the didactic teaching was found advantageous and enhanced learning in undergraduate students