Palmermiles0531
The Prune-Belly syndrome (PBS) is a rare pathology predominating in male infants, classically manifesting with the triad including aplasia of the abdominal wall muscles, dilatation of the urinary tract, and testicular abnormalities. We report and discuss the case of a full-term male newborn, in whom clinical examination at birth revealed abdominal wall muscle hypoplasia, cryptorchidism, urinary tract dilatation and renal failure. The diagnosis was made based on physical assessment, abdominal ultra-sonographic imaging, and blood sampling of urea and creatinine. For such cases, the recommended surgical management usually consists in a sequential surgical intervention including urinary tract reconstruction, abdominoplasty, and orchidopexy. However, these could not be practiced in due time in our patient, who died on the seventh day of life because of kidney failure. The prognosis of infants with Prune-Belly syndrome may be improved by quality antenatal follow-up, to enable the early diagnosis and preparation for prompt surgical intervention.Self-assessments conducted by individuals when taken together (grouped) provide valid and accurate measures of learning outcomes of the group. This is useful for program evaluation. Grouped self-assessments are simple to understand and construct, easy to implement, relatively accurate, and do not require extensive and complex pre-post testing measures. However, group self-assessments have the potential to be misused. To examine how group self-assessments have been used in medical education, we conducted a search of journal articles published in 2017 and 2018 from eight prominent medical education journals. Twenty-seven (n = 27) articles that used self-assessments for program evaluation were selected for data extraction and analysis. We found three main areas where misuse of self-assessments may have resulted in inaccurate measures of learning outcomes measures of "confidence" or "comfort", pre-post self-assessments, and the use of ambiguous learning objectives. To prevent future misuse and to build towards more valid and reliable data for program evaluations, we present the following recommendations measure competence instead of confidence or comfort; use pre-test self-assessments for instructional purposes only (and not for data); ask participants to do the post-intervention self-assessments first followed by retrospective pre-intervention self-assessments afterwards; and use observable, clear, specific learning objectives in the educational intervention that can then be used to create the self-assessment statements.
International health experiences (IHEs) are popular among medical learners and provide a valuable learning experience. IHE participants have demonstrated an increased intention to care for underserved populations in the future, but what is its actual impact on practice? This study evaluates the effect of postgraduate IHE participation on the future careers of clinicians regarding their work among underserved populations.
We conducted a systematic review and meta-analysis of peer-reviewed articles comparing the populations served by physicians who had participated in an IHE with those of physicians who had not participated in an IHE.
764 titles were scanned, 28 articles were reviewed, with an eventual 3 studies of fair-good or good quality identified. These addressed physicians' service to domestic underserved populations, and also addressed future service in a low- or middle-income country (LMIC). Meta-analysis demonstrated a statistically-significant increase in service by IHE graduates to domestic underserved populations (OR = 2.12; CI = 95%; P = 0.03). selleck chemicals The certainty of the evidence was low due to limitations in study design (non-randomised studies) and inconsistency in effects.
Participation in an IHE may cause an increase in care for domestic underserved populations in future clinical practice, though further research from high quality randomised trials is needed to increase the certainty of the effect. Further study is needed to establish whether there is a similar effect with increased future service in a LMIC setting.
Participation in an IHE may cause an increase in care for domestic underserved populations in future clinical practice, though further research from high quality randomised trials is needed to increase the certainty of the effect. Further study is needed to establish whether there is a similar effect with increased future service in a LMIC setting.
Clinical placements are essential for applied learning experiences in health professions education. Unfortunately, there is little consensus on how best to prepare learners for the transition between academic and clinical learning. We explored learners' perceptions of hospital-based orientation and resulting preparedness for clinical placement.
Sixty-three learners participated in a total of 18 semi-structured focus groups, during their clinical placements. Data were analyzed thematically.
We organized learners' perceptions of hospital-based orientation that support their preparedness for placement into three themes (1) adequate
orientation for learner acquisition of organization acumen and (2) clinical preceptor training to support
and (3)
components.
Thoughtful attention to hospital-based orientation can support learners in transitioning from academic to clinical learning. Hospital organizations should attend to all three components during orientation to better support learners' preparedness for clinical learning.
Thoughtful attention to hospital-based orientation can support learners in transitioning from academic to clinical learning. Hospital organizations should attend to all three components during orientation to better support learners' preparedness for clinical learning.
Previous literature has explored the underrepresentation of women in surgery. However, this research has often been quantitative or limited by considering only the perspectives and experiences of women at more advanced career stages. Here, we use a qualitative methodology and a sample of women and men across the career continuum to identify the role that gender plays in the decision to pursue a surgical career.
We audio-recorded and transcribed semi-structured interviews conducted with 12 women and 12 men ranging in their level of medical training from medical students to residents to staff surgeons. We used Braun and Clarke's six-step approach to thematic analysis to analyze the data, maintaining trustworthiness and credibility by employing strategies including reflexivity and participant input.
Our findings suggested that the characteristics of surgery and early exposure to the profession served as important factors in participants' decisions to pursue a surgical career. Although not explicitly mentiocommended.
Although transition from residency to practice represents a critical learning stage, there is a paucity of literature to inform local curriculum development and implementation.
To describe local curriculum development for
(TTP) for use within a competency-based medical education model, including important content and suitable teaching and assessment strategies.
We reviewed the literature to construct a definition and develop initial curriculum content for TTP. We then gathered local residency program directors' views on TTP content, teaching, and assessment via online survey and an international educational conference workshop.
We identified 21 important TTP content areas in the literature and analyzed 35 survey responses, representing 33 residency programs. Survey participants viewed
, and
as the three most important content areas. Views on content importance varied by program. For teaching and assessment strategies, most respondents preferred assessing what residents could do, providing real-life practice opportunities, and offering workplace-based assessments.
TTP curricula implementation should reflect nationally set, specialty-specific curriculum elements; locally developed priority content; and assessment and teaching strategies. Individual learner needs and imminent practice context should guide faculty approaches to curriculum delivery.Résumé.
TTP curricula implementation should reflect nationally set, specialty-specific curriculum elements; locally developed priority content; and assessment and teaching strategies. Individual learner needs and imminent practice context should guide faculty approaches to curriculum delivery.Résumé.
Physicians often avoid discussing patients' religious and spiritual concerns, even though most patients (i.e., 50-94%) want integrated care. To address this gap, medical students interviewed a Standardized Patient (SP) who was upset because the daughter did not confront her fiancée about converting to Orthodox Judaism. link2 Students reflected on how their own religion and spirituality affected engaging with their patient.
With a 97% response rate, 231 first-year medical students responded to open-ended questions about their patient encounter. For this quantitative content analysis, we used inductive reasoning, identifying three themes (1) impact of students' own religion on their comfort, (2) change in comfort, and (3) their learning. We used deductive reasoning to compare qualitative results from half of the students who began the curriculum with a questionnaire about their own spirituality with the other students completing afterwards.
Most students said being religious positively influenced their comfort, whether they were also Orthodox Jewish or from a different religion. Among uncomfortable students (6.5%), some attributed this to not being religious. Some students (4.8%) grew more comfortable discussing the religious issue, and 18.2% became uncomfortable due to lacking knowledge of Orthodox Judaism and the awkwardness of the topic. link3 Students who had completed the questionnaire beforehand gave more comments about connecting with their patients than students who completed the questionnaire afterwards (X
=11.047, p<.001).
Students' own religion influenced their comfort with discussing religious concerns, with some feeling more connected and others becoming uncomfortable. This finding helps inform medical educators about teaching mind-body-spirit care.Résumé.
Students' own religion influenced their comfort with discussing religious concerns, with some feeling more connected and others becoming uncomfortable. This finding helps inform medical educators about teaching mind-body-spirit care.Résumé.
The transgender (trans) population is one of the most underserved in health care. Not only do they face discrimination and stigma from society as a whole, they also have difficulty accessing transition-related care, leading to adverse outcomes such as suicide. We aimed to increase understanding on how our current postgraduate education system contributes to a lack of care for trans patients.
Our study consisted of 11 semi-structured interviews conducted in 2016 with residents in the following specialties family medicine (3), endocrinology (3), psychiatry (3), and urology (2). We used Framework Analysis to qualitatively analyze our data.
Residents described a lack of trans care education in the core curriculum, in part due to a lack of exposure to experts in this area. They also expressed discomfort when dealing with trans patients, due to inexperience and lack of knowledge. Furthermore, residents in each specialty had false assumptions that other specialties had sufficient knowledge and expertise in trans care.
