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Only two studies evaluated objective pain scores during extraction, and both studies reported lower pain scores in the articaine group. There is insufficient evidence to justify the statement that a single buccal infiltration of 4% articaine alone is sufficient for the extraction of primary molars. Further evidence is required to justify the claim that palatal infiltrations and IANB can be replaced with the use of 4% articaine single buccal infiltration for the extraction of primary molars in children.
Thyroid storm is a rare but life-threatening disease process that may be difficult to recognize and mimics other disease processes. It is critical for the emergency medicine clinician to be able to recognize thyroid storm in patients in order to effectively stabilize and treat them.
In this standardized patient case, learners were faced with a 17-year-old postpartum woman presenting to the emergency department with respiratory distress and altered mental status secondary to thyroid storm. The target learners were emergency department providers, including residents, medical students, and advanced practice practitioners. Providers were expected to identify signs and symptoms of thyroid storm and to initiate appropriate diagnostic workup and management of this complex patient. Debriefing followed the simulation using a debriefing guide and PowerPoint presentation.
Thirty-four learners participated in this simulation. All learners agreed or strongly agreed that the simulation case was relevant to their work, and 97% agreed or strongly agreed that it was effective in teaching thyroid storm management skills. Eighty-five percent felt that following the simulation, they would be confident in their ability to recognize thyroid storm in a postpartum patient and to recognize and manage respiratory distress and altered mental status in a postpartum patient.
Learners felt that this case was effective in teaching the skills necessary for caring for postpartum patients with respiratory distress and altered mental status. Future directions include conducting the simulation in situ to include multidisciplinary teams and increasing the learner pool to include OB/GYN residents.
Learners felt that this case was effective in teaching the skills necessary for caring for postpartum patients with respiratory distress and altered mental status. Future directions include conducting the simulation in situ to include multidisciplinary teams and increasing the learner pool to include OB/GYN residents.
Most interventions to date regarding breaking bad news focus on late-stage disease or disclosing a cancer diagnosis. Little attention has been given to delivery of chronic metabolic disease diagnoses such as prediabetes/type 2 diabetes.
Informed by the American Diabetes Association standards of care and formative research conducted by our research team, we developed this curriculum through the six-step approach to curriculum development. The curriculum consists of a 2- or 3-hour intervention that teaches medical decision-making, interpersonal communication, and clinical documentation in the context of prediabetes and type 2 diabetes followed by role-play and clinical practice.
Across three cohorts, 53 clinicians completed the curriculum. Across the three iterations, learners rated the curricular intervention as worthwhile and delivered at an appropriate level. In a community hospital setting, learners scored significantly higher on a knowledge check than did a control group of six clinicians (
< .001). Learners in the community hospital also indicated high response efficacy and self-efficacy. At the academic medical center, simulated patients indicated high measures on the Diabetes Health Threat Communication Questionnaire.
The moment of diagnosis presents a key opportunity to affect patients' perceptions of the disease. This curriculum guides clinicians in making the most of diagnosis delivery. Pairing of qualitative, patient-centered research alongside the iterative curriculum design process allows the curriculum to be adaptable and scalable to multiple settings and learner types.
The moment of diagnosis presents a key opportunity to affect patients' perceptions of the disease. This curriculum guides clinicians in making the most of diagnosis delivery. Pairing of qualitative, patient-centered research alongside the iterative curriculum design process allows the curriculum to be adaptable and scalable to multiple settings and learner types.
Virology is inherently challenging due to the sheer volume of information medical students are responsible for learning. Cognitive integration of this content is critical for early medical students to practice applying this knowledge to diagnostic problem-solving. Simulation offers learners engaging opportunities to practice cognitive integration. Plerixafor in vitro We developed a simulated clinic activity for first-year medical students consisting of standardized patient (SP) encounters representing viral infections.
Student small groups rotated through eight SP encounters during which they collected patient histories, reviewed physical exam findings, and developed a differential diagnosis and diagnostic plan for each case. The instructor debriefed students on the cases afterward. We assessed students' evaluation of the activity through online surveys.
Two hundred seventy-eight students participated in the simulated clinic in 2018 and 2019. Students rated the activity as very effective for learning about the infections rs learners an opportunity to solidify illness scripts for viral infections using an interactive, collaborative approach.
Substance misuse is a critical social and health care issue, and learning how to effectively screen for misuse and perform a brief intervention is useful for all health care professions. As an intercollegiate, interprofessional group, we developed a mechanism for delivering interprofessional education (IPE) using SBIRT (screening, brief intervention, and referral for treatment) as a tool to identify potential substance misuse.
A total of 1,255 students from nursing, pharmacy, medicine, physician assistant, social work, dietetics, and occupational therapy programs participated in the training and evaluation of this IPE experience over 2 academic years. The training incorporated asynchronous SBIRT training, in-person student role-plays, and a standardized patient (SP) interaction.
A significant majority of participants indicated that this IPE experience enhanced their interprofessional skills (91%), was useful for interprofessional development (79%), was relevant to their career (92%), and would benefit their clients (93%).
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