Ultrasound Curriculum Integration Review and a Survey of its Utility in Regional Medical Campuses

to guide procedures. As the technology becomes more portable and affordable, schools have increasingly utilized this technology in training physicians. Ultrasonography may be especially useful in rural settings to fill the limitations that rural hospitals have in terms of imaging. The mission of many regional medical campuses is to train physicians to work in rural or underserved communities. Given this goal, we wanted to explore how regional medical campuses are utilizing ultrasound preclinically and determine the best approach for developing a standardized ultrasound curriculum, keeping regional medical campus resources in mind. A literature review of medical schools’ preclinical ultrasound curriculum was completed, and information was collected regarding curriculum programming, faculty, assessment, and student feedback. Based on data from this search, a fourteen question Qualtrics survey was sent out to regional medical campuses with questions regarding the use of ultrasound in their own preclinical curriculum. Of the 11 campuses that responded, 10 (90.9%) indicated that they include ultrasound in their curriculum. Respondents from nine of these schools progressed through the survey and information regarding topics covered in ultrasound curriculum, teachers of curriculum, patients used, ultrasound equipment used, and assessment of student knowledge all varied among medical campuses. The data suggested that regional medical campuses are focusing on similar aspects of ultrasound curriculum however, a standardized curriculum does not currently exist to ensure that all students are receiving similar ultrasound training.

Process Evaluation of the Regional Referral Clinical Pathway for Home-Based Palliative Care and Outreach Program: A Questionnaire Survey of the Medical Staff and Bereaved Families

Background: The purpose of this study was to clarify how the Regional Referral Clinical Pathway for Home-based Palliative Care (RRCP-HPC) and an outreach program by a palliative care team (PCT) lead to an improvement in the outcome. Design and Methods: We conducted questionnaire surveys using the mailing method involving the regional medical staff involved in cancer patients introduced to the PCT of a single hospital, as well as bereaved families. The questionnaire was prepared through interviews with the medical staff and bereaved families. Subsequently, factor analysis was performed to identify factor structures and calculate the correlation coefficient with each outcome. Results: For the questionnaire survey involving the medical staff, responses were collected from 119 regional medical institutions and 84 regional medical staff. The response rate per institution was 51.3%. Similarly, for the questionnaire survey involving bereaved families, the response rate was 42.4%. For the survey involving the medical staff, 6 factors, such as “improved awareness of an interdisciplinary team,” were extracted. For the survey involving the bereaved families, 4 factors, such as “improvement of communications between patients and healthcare professionals,” were extracted. There were significant (≥moderate) correlations between these factors and all outcomes. Conclusion: In this study, we clarified the process of achieving palliative care until death at home without difficulties using the outreach program and RRCP-HPC. The results suggest the importance of improving communications. The outreach program and RRCP-HPC may have contributed to palliative care at home without difficulties through an improvement in communications.

Clinical characteristics and prognosis in patients with urosepsis from intensive care unit in Shanghai, China: a retrospective bi-centre study

Background The purpose of this study was to retrospectively analyze clinical characteristics and prognostic risk factors of urosepsis patients admitted to two intensive care units in Shanghai, China. Methods Clinical data from patients diagnosed with urosepsis were retrospectively retrieved and analyzed from ICU in two regional medical centers from January 2015 to December 2019. Results Two hundred two patients were included in the subsequent analysis eventually, with an average age of 72.02 ± 9.66 years, 79.21% of the patients were female and the mortality rate of 15.84%.The proportion of patients with chronic underlying diseases such as diabetes and hypertension was relatively high (56.44, 49.50%, respectively), and the incidence of shock was also high (41.58%) correspondingly. The most common pathogen isolated was Escherichia coli (79.20%), of which the extended-spectrumβ-lactamases (ESBLs)(+) accounted for 42.57%. In multivariate analysis, the strongest predictors for death were mechanical ventilation (OR 7.260, 95% CI 2.200–23.963; P = 0.001),chronic kidney disease (CKD) (OR 5.140, 95% CI 1.596–16.550; P = 0.006), APACHE II score (OR 1.321, 95% CI 1.184–1.473; P < 0.001) and lactate (OR 1.258, 95% CI 1.037–1.527; P = 0.020). Both APACHE II score and lactate had the ideal predictive value, with the area under the ROC curve (AUC) of 0.858 and 0.805 respectively. Conclusion The patients with urosepsis were characterized by a higher proportion of female, older age, more percentage of comorbidities in this region, and patients with ESBLs (+) Escherichia coli infection were more prone to shock. Mechanical ventilation, comorbidity with CKD, APACHE II score and lactate were independent risk factors for death in urosepsis patient, but lactate level and APACHE II score had better predictive value for prognosis.

Sustainable Hospital Management by a Cross SWOT Analysis in a Medium-Sized Hospital

The medical working environment in small and medium-sized hospitals is becoming more intense, and the coronavirus epidemic has threatened the hospital management base in Japan. To establish the future sustainable management of hospitals using internal and external environmental data, a cross SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis may be a very useful tool. A cross SWOT analysis considers four strategies: an offensive strategy (SO), a confrontation strategy (ST), a strengthening strategy (WO) and a defense strategy (WT). Here, using a cross SWOT analysis, we consider the future direction of an older medium-sized hospital as one case. The most important issue is to balance the interests of hospital management with those of patients. As a sustainable strategy for this purpose, we forecast the medical situation in the Fukuoka-Itoshima Medical Area, including the Fukuoka-Nishi area in Japan, and the future profitability of a medium-sized hospital for the next 30 to 40 years. Based on the data, we used a cross SWOT analysis to analyze the current situation at the hospital and formulated measures to realize innovations at the hospital that respond to the needs of patients and the community. According to this analysis, for the future sustainable management as a hospital, we should plan to become a more community-based by increasing our capacity to treat elderly inpatients and outpatients with cardiovascular, gastrointestinal and respiratory diseases and to increase the number of beds dedicated to community comprehensive care. Furthermore, through close cooperation with highly specialized and advanced medical institutions, we need to create a new type of regional medical cooperation that can bridge the gap between regional medical care and advanced medical care. We also need to open a cardiovascular-rhythm center and a gastrointestinal endoscopy center and establish an appropriate working system for staff. The future direction for this older hospital should include plans for relocation and reconstruction, considering the balance between expected changes in income and expenses. In conclusion, we performed a cross SWOT analysis with SO, ST, WO and WT. The analysis can be a very useful tool for planning the future direction of hospitals using internal and external environmental data, and our older hospital should eventually be able to achieve sustainable developmental innovations by rebuilding while working on various strategies.

Empirical Study on Medical Information and Communication Technology System in Dentistry in Southeast Asia

In the field of dentistry, diagnoses based on data obtained using medical imaging modalities such as digital panoramic radiography and cone beam computed tomography (CBCT) have been widely recommended for advanced dental care. In Lao People’s Democratic Republic (Laos), there are place where advanced dental imaging devices are available in only one university dental hospital. The establishment of an information and communication technology (ICT) system has been expected as telemedicine system, for sharing medical imaging data among medical institutions in Laos. Recently, regional medical cooperation using telemedicine has been developed in Japan, and medical imaging data have been provided and shared among medical institutions, by using a mobile tablet terminal application. Therefore, we have carried out the empirical research on the telemedicine system with the university in Laos. The technologies and research results from our project will be presented in this chapter.

COVID-19 in children in Odisha state, India: a retrospective review

We retrospectively analysed the swab samples tested for COVID-19 from 7 March 2020 to 17 August 2021 at the Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, Odisha. 553 763 nasopharyngeal swabs were collected from individuals suspected with COVID-19 in Odisha state. 75 190 (13.6%) samples were positive by reverse transcription-PCR. There were 5988 (8%) cases in children and young people under 18 years old. Odisha reported 996 153 COVID-19 cases which resulted in 6985 deaths in adults and 36 in children and young people under 18 years old.

Energizing scholarly activity in a regional medical campus

Implication Statement Medical education is increasingly delivered at distributed sites away from Academic Health Sciences Centres. The Council of Ontario Faculties of Medicine recommends schools develop resources and metrics to foster regional campus scholarly activity. Opportunities for distributed program trainees must support learning core skills in research and critical appraisal to comply with medical school accreditation standards and to develop their interests and skills in scholarly work for their future medical careers. We describe a scholarly activity program that is a template for distributed campuses or regional teaching sites seeking to increase learner and faculty engagement and research productivity.

COVID-19 Impact on Regional Medical Campus Education: Student Perspectives

Due to social distancing precautions and the desire to protect clinical learners, the COVID-19 pandemic forced medical schools everywhere to implement more distanced and virtualized learning in their educational curriculums. More specifically, at the University of Kansas School of Medicine-Salina, a regional medical campus, the impact of some of these changes were also seen and felt. The purpose of this study was to investigate the downstream effects of these curriculum changes from the perspectives and opinions of medical students attending a regional medical campus. To explore the study purpose, a mixed-methods, cross-sectional study that used an online survey with closed and open-ended questions was used. Additionally, because of unique curriculum characteristics depending on the year of the student, 1st and 2nd year students (phase I) were asked slightly different questions than students in their 3rd and 4th years (phase II). Closed-ended questions asked students about lecture experience, clinical learning development and time, study time, exam performance, collaborative learning experiences, and socialization/interactions with colleagues. Students answered in range of -3 to +3, negative numbers meaning a detrimental impact (or decrease in study time), and positive numbers being beneficial impact (or increase in study time). Open-ended questions asked students about improvements that could be made, unique class circumstances during the pandemic and any other relevant impact not covered in closed-ended questions. For phase I students, lecture experience, study time and exam performance resulted in no impact. However, collaborative learning and socialization with colleagues did result in a detrimental impact that was significant. For phase II learners, clinical skills development, time spent in clinical skills development and socialization with colleagues were detrimentally impacted. However, the amount of time spent on studying increased and exam performance benefited. These findings suggest that pandemic-related curriculum changes impact learners differently depending on the phase of medical they are in. There are no conflicts of interest by either of the authors. This study has been approved by the University of Kansas Medical Center Institutional Review Board.

SWOT Analysis of the Universiti Sains Malaysia Medical Educationists’ Preparations to Make a Regional Medical Education Hub: A Qualitative Study

The aim of this study was to analyse the strengths, weaknesses, opportunities and threats that describe the current circumstances of medical educationists in the School of Medical Sciences in Universiti Sains Malaysia (USM), particularly towards preparing themselves for becoming a regional hub in medical education. A total of 21 documents, including nine strategic management records, three department meeting documents and nine researchers’ observation journals were engaged in this study. The gained data were clustered by themes for each of the four categories which were strengths, weaknesses, opportunities and threats regarding medical educationists in the USM. High motivation and interest of the lecturers, interest in writing, presence of medical background, experienced in clinicals, experienced in management, presence of good health status, presence of postgraduate medical education and the presence of international students were designated as strengths of medical educationists. Presence of personal challenges, a majority of young lecturers and a majority with no PhD were stated as weaknesses of medical educationists. Positive support from family, strong support from the top administration to the medical education department, positive attention to individual instructors, two instructors having a PhD, supportive cadre, positive international perception to the department of medical education and large opportunities for research and school-provided grants were indicated as opportunities for medical educationists. Financial issues and facilities were expressed as threats to medical educationists. Consistent with the positive mode to move forward, there is a good chance for the USM medical faculty to become a medical education hub.