Two Year Study of Aflibercept and Ranibizumab Intravitreal Therapy in Patients with Wet AMD

Background and objectives: The aim of this study was to evaluate the therapeutic results in patients with exudative AMD treated with ranibizumab and aflibercept intravitreal injections over a two-year observation period. Materials and methods: A retrospective observational study was conducted in a clinical hospital on a group of patients who randomly qualified for treatment with Aflibercept (group A) and Ranibizumab (group B) as part of the Polish National Health Fund Medical Program for exudative AMD. Group A consisted of 90 patients, and group B contained 54 patients. The choice of drug in a patient depended solely on the availability of the medication at the time. Before each injection, best corrected visual acuity (BCVA) on the ETDRS scale and central retinal thickness (CRT) were assessed using optical coherence tomography (OCT). Patients from both groups were treated in the first year of treatment with a rigid scheme of 3 doses of 2.0 mg Aflibercept (group A) and 0.5 mg Ranibizumab (group B) at monthly intervals, followed by 4 doses at bimonthly intervals. In the second year, a “pro re nata” scheme was applied. The aim was to evaluate changes in BCVA and CRT after three injections, after 7 injections (about 12 months), and after the second year of therapy (24 months) with reference to the baseline and to compare the effectiveness of the medications. The influences of the following factors were studied: age, gender, initial BCVA, and initial CRT, as well as the number of injections received. Results: No significant statistical differences were found between patients receiving Aflibercept and Ranibizumab therapy in terms of achieving improved visual acuity and reducing retinal thickness after two years of therapy. Conclusions: Both aflibercept and ranibizumab were found to be effective for treating exudative AMD.

Rapid Implementation of a Novel Embedded Senior Medical Student Program, as a Response to the Educational Challenges of COVID-19

As with many OECD countries, graduating medical students have been choosing specialist careers at a greater rate than ever before. Generalism in the form of family (general practice) and more generalist medical specialties have been trending down resulting in distributional geographic challenges. With the advent of COVID-19 in March 2020, medical schools and in particular the Joint Medical Program situated in a regional and rural area in NSW Australia had the unique opportunity to rethink the penultimate year curriculum when the previous rapid rotation model through numerous medical specialities became untenable. The need to vision a new practical pragmatic curriculum spurred a rapid revaluation of assessment, placement length and model with a pivot to an “embedded senior student placement” agnostic of discipline and supported by a competency-based learning portfolio. This article explores the barriers and enablers and identifies the potential elements of this type of placement which can be adapted to community and smaller rural sites. The positive student and supervisor experience also enabled an employment model to be woven into the students learning and ensured on hand medical student workforce for hospitals throughout the rural footprint. The capacity of these placements to celebrate variation in experience and support students to learn on the job have now caused a revision of the penultimate year with expectation of gains in students’ satisfaction and in employability. It has also opened up options to deliver and increase the inherent value of generalist placements with likely long term workforce benefit.

The impact of external academic accreditation of undergraduate medical program on students’ satisfaction

Background The external academic accreditation is a quality assurance and auditing process that focuses on the structure, process, and outcome of the education. It is an interrupting and highly demanding process in terms of effort, time, financial, and human resources. However, it is unclear in the literature how much of these external quality assurance practices impeded in the accreditation processes would reflect on the other end of the learning pathway, including student satisfaction. Methods A retrospective quantitative secondary data analysis, with a before-after comparison research design, was performed to evaluate external accreditation’s impact on students’ mean satisfaction score within two accreditation cycles at King Saud University (KSU)-Bachelor of Medicine, Bachelor of Surgery (MBBS) program. Results The overall average students’ satisfaction scores pre-and-post the first accreditation cycle were 3.46/5 (±0.35), 3.71 (±0.39), respectively, with a P-value of < 0.001. The effect of post first accreditation cycle was sustainable for a couple of years, then maintained above the baseline of the pre-first accreditation cycle until the pre-second accreditation cycle. Similarly, the overall average students’ satisfaction scores pre-and-post the second accreditation cycles were 3.57/5 (±0.30) and 3.70 (±0.34), respectively, with a P-value of 0.04. Compared to the first accreditation cycle, the improvement of the mean score of students’ satisfaction rates was not sustained beyond the year corresponding to the post-second accreditation cycle. Conclusion Both accreditation cycles were associated with an increased score in students’ satisfaction. The preparatory phase activities and navigation through the self-study assessment while challenging the program’s competencies are essential triggers for quality improvement practices associated with accreditation.

Development and Remodeling of Point-of-Care Ultrasound Education for Emergency Medicine Residents in Resource Limited Countries during the COVID-19 Pandemic

The administration of an accurate and effective POCUS course is a crucial tool in improving health education and thus the health care system in low- to middle-income countries. The development of the ultrasound curriculum in these countries during the pandemic era is a major challenge for medical educators. Therefore, this study aims to survey the learner experience after implementing the POCUS curriculum for first-year emergency medicine residents. All learners responded to the survey. Our results demonstrated that the ultrasound rotation and our ultra-sound learning materials were useful tools which showed a positive impact on POCUS knowledge for our learners. However, some obstacles of POCUS learning were identified to assist in closing faculty development gaps, including the availability of handheld devices, as well as the re-modeling of the ultrasound rotation course, which should be managed according to the feedback we received. This study demonstrated a clear need for constant updates in higher education, medical program development, accuracy of local learning materials, and the explosion of virtual and online learning platforms during this decade.

Medical Students’ Perception of the Educational Environment at College of Medicine: A Prospective Study with a Review of Literature

Dundee Ready Education Environment Measure (DREEM) inventory has been exhaustively used to evaluate the education environment (EE), especially in the health sector to identify the strengths and weaknesses of the program. This study was designed to investigate the medical students’ perceptions about the education environment (EE) of the College of Medicine (COM), Jeddah. This cross-sectional study was carried out on medical students and conducted between May and August 2020. A predesigned DREEM questionnaire written in English containing five subdomains was adopted to achieve the purpose of the study. A total of 220 students responded to the dispensed survey with a mean age of 21.97 (SD = 1.28). Male and female students represented 64.5% and 35.5% of the respondents, respectively, while most of them were in the fourth year of medical college (109, 49.5%), and the majority belonged to phase II (basic sciences) of the college (144, 65.4%). The overall total DREEM score for EE was 129.64 (SD = 31.81; 64.82%), and all the five subdomains of DREEM scored above 60% with the highest score by students’ academic self-perception (SASP) (21.22; 66.31%) and the lowest by students’ perception of learning (SPL) (30.16; 62.83%). Also, SASP2 was the highest scoring item with a mean of 3.13 (SD = 0.96), while SPA8 was the lowest with a mean score of 1.99 (SD = 1.38). We also compared our study with the available literature for contextual interpretations. The students’ assessment for EE of the medical program was positive; however, we identified a need for an improvement plan for six-weak scoring areas and one of the weak domains of DREEM i.e., students’ perception of teaching (SPT).

E-Learning as a Factor Optimizing the Amount of Work Time Devoted to Preparing an Exam for Medical Program Students during the COVID-19 Epidemic Situation

The COVID-19 pandemic had a huge impact on the learning and teaching processes, particularly in healthcare education and training, because of the principal position of the cutting-edge student–patient interaction. Replacing the traditional form of organization and implementation of knowledge evaluation with its web-based equivalent on an e-learning platform optimizes the whole didactic process not only for the unit carrying it out but, above all, for students. This research is focused on the effectiveness of the application of e-learning for computer-based knowledge evaluation and optimizing exam administration for students of medical sciences. The proposed approach is considered in two categories: from the perspective of the providers of the evaluation process, that is, the teaching unit; and the recipients of the evaluation process, that is, the students.

Residência Pedagógica espelhada na Residência Médica: formação de professores sob nova perspectiva?

INTRODUÇÃO: O programa de Residência Pedagógica é um modelo de formação profissional para cursos de licenciatura, sendo um programa integrado a Política Nacional de Formação de Professores, cujo intuito está no aperfeiçoamento prático por meio da inserção do acadêmico no ambiente escolar. Este programa surgiu com inspiração na Residência Médica, sendo esta uma modalidade de ensino de pós-graduação destinada a médicos já graduados, como forma de especialização clínica. OBJETIVO: Analisar as aproximações e distanciamentos entre o programa na área da Educação Física em relação ao programa da área médica a partir da percepção de coordenadores das áreas de uma universidade pública do Paraná. MÉTODOS: A pesquisa é caracterizada como de abordagem qualitativa, com foco no estudo de caso. Foram entrevistados 4 coordenadores de curso e de programa de residência vinculados aos cursos de Medicina e Educação Física. A análise dos dados foi baseada no princípio de categorização temática com foco na análise de conteúdo. RESULTADOS: Os resultados mostram que há diferenças significativas entre as propostas, tendo a residência médica uma formação em nível de pós-graduação enquanto a residência pedagógica uma formação inicial, isso reflete as definições estruturais e conceituais sobre a forma de inserção de tais modelos formativos no ambiente de atuação profissional. CONCLUSÃO: Conclui-se que o propósito de formação em licenciatura com base em modelos de residência profissional possibilitam novas experiências e caminhos, mas que ainda estão distantes do modelo ofertado na área médica.ABSTRACT. Mirrored Pedagogycal Residence in the Medical Residence: teacher training about new perspective?BACKGROUND: The Pedagogical Residency program is a model of professional training for undergraduate courses, being an integrated program the National Policy of Teacher Training, whose purpose is in practical improvement through the insertion of the academic in the school environment. This program was inspired by the Medical Residency, which is a graduate teaching modality for physicians already graduated, as a form of clinical specialization. OBJECTIVE: To analyze the approximations and distances between the program in the area of Physical Education in relation to the medical program in a public university in Paraná. METHODS: The research is characterized as qualitative, focusing on the case study. Four coordinators of courses and residency programs linked to medical and physical education courses were interviewed. Data analysis was based on the principle of thematic categorization with a focus on content analysis. RESULTS: The results show that there are significant differences between the proposals, with medical residency training at the graduate level while the pedagogical residency is an initial formation, this reflects the structural and conceptual definitions on the way of insertion of such formative models in the professional environment. CONCLUSION: It is concluded that the purpose of teacher training based on professional residency models enables new experiences and paths, but which are still distant from the model offered in the medical area.