Dataset Information

Thrombotic Microangiopathy Team-Based Learning Module for Second-Year Medical Students.

ABSTRACT: Introduction:Thrombotic microangiopathy (TMA) syndromes are a diverse group of disorders characterized by microangiopathic hemolytic anemia (intravascular hemolysis and presence of peripheral blood schistocytes) and thrombocytopenia. Prompt diagnosis is crucial to inform management and improve patient outcome. Clinical and laboratory manifestations of these various disorders overlap, making diagnosis difficult. My colleagues and I developed a team-based learning (TBL) module for second-year medical students in their hematology course block. Methods:Students attend a 1-hour lecture on hemolytic anemia in their standard course curriculum and are given two articles to read outside of class in preparation for the TBL. Total out-of-class preparatory time is 30 minutes. The TBL runs for 1 hour, and students participate in groups of eight. Materials associated with this TBL include the lecture on hemolytic anemia, individual and group readiness assurance test questions, and application exercises. Explanations for all answers are provided for instructors. Results:Surveys indicated students enjoyed the TBL and felt that after participation, their ability to diagnose a TMA was improved. They felt that the number of questions in the session was appropriate to time allowed and that the preparatory articles provided a sufficient level of understanding to participate in the TBL. Some commented they would have liked more time to complete the application exercises, so instructors could consider increasing the allotted time to 1.5 hours. Discussion:Based on the success of this TBL, we plan to develop additional modules for the course and investigate other measures of academic success after implementation.

SUBMITTER: Murphy M

PROVIDER: S-EPMC6342151 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Thrombotic Microangiopathy Team-Based Learning Module for Second-Year Medical Students.

Murphy Martina M

MedEdPORTAL : the journal of teaching and learning resources 20170210

<h4>Introduction</h4>Thrombotic microangiopathy (TMA) syndromes are a diverse group of disorders characterized by microangiopathic hemolytic anemia (intravascular hemolysis and presence of peripheral blood schistocytes) and thrombocytopenia. Prompt diagnosis is crucial to inform management and improve patient outcome. Clinical and laboratory manifestations of these various disorders overlap, making diagnosis difficult. My colleagues and I developed a team-based learning (TBL) module for second-y ...[more]

PMID: 30800742

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Project description:A ubiquitous dilemma in medical education continues to be whether and how to integrate research competencies into the predoctoral curriculum. Understanding research concepts is imbedded in the six core competencies for physicians, but predoctoral medical education typically does not explicitly include research education. In an effort to quickly report academic research findings to the field, this is the second in a series of articles reporting the outcomes of a research education initiative at one college of osteopathic medicine. The first article described the competency model and reported baseline performance in applied understanding of targeted research concepts. This second article reports on the learning outcomes from the inaugural year of a course in basic biomedical research concepts.This course consisted of 24 total hours of classroom lectures augmented with web-based materials using Blackboard Vista, faculty moderated student presentations of research articles, and quizzes. To measure changes in applied understanding of targeted research concepts in the inaugural year of the course, we administered a pretest and a posttest to second year students who took the course and to first year students who took an informatics course in the same academic year.We analyzed 154 matched pretests and posttests representing 56% of the 273 first and second year students. On average, the first year (53) and second year students (101) did not differ in their mean pretest scores. At posttest the second year students showed significant improvement in their applied understanding of the concepts, whereas the first year students' mean posttest score was lower than their mean pretest score.This biomedical research course appears to have increased the second year students' applied understanding of the targeted biomedical research concepts. This assessment of learning outcomes has facilitated the quality improvement process for the course, and improved our understanding of how to measure the benefits of research education for medical students. Some of the course content and methods, and the outcome measures may need to be approached differently in the future to more effectively lay the foundation for osteopathic medical students to utilize these concepts in the clinical setting.

Project description:BackgroundThrombotic microangiopathy (TMA) is an important complication associated with several diseases that are rare and life-threatening. TMA is common to thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). TTP is defined by a severe deficiency of ADAMTS13, and early treatment is associated with good prognosis. The diagnosis of HUS can be difficult due to the potential multiple etiologies, and the best treatment option in most cases is not well-established yet. The implementation of a multidisciplinary team (MDT) could decrease the time to diagnosis and treatment for HUS and may improve the outcomes of these patients.ObjectiveTo determine the impact of MDT on morbidity and mortality [death or chronic renal replacement therapy (CRRT) requirements], incidence and response time [(RT) defined as the period between hospital admission and the first day of direct therapy administration], length of stay at an intensive care unit (ICU-LOS) and total hospitalization (T-LOS) were also assessed.MethodsWe compared a pre-MDT implementation period (from January/2008 to May/2016) versus post-MDT period (from May/2016 to December/2016). The screening TMA diagnosis was made according the following criteria: hemolytic anemia, thrombocytopenia and acute renal damage and without ADAMTS13 deficiency. An online chat was implemented to provide instant medical information.ResultsTwenty-eight patients were included. The incidence changed from 2.3 cases/pre-MDT: (all cases: n = 18) to 10 cases/year post-MDT (all cases: n = 10). Two patients died in pre-MDT and post- MDT (11% versus 20%, P = 0.60). From pre-MDT, the number of patients who required CRRT by post-MDT decreased from 7 (39%) to 0, P = 0.03. Similarly, RT, ICU-LOS and T-LOS [median(p25-p75)] decreased from 10 (2-12) days to 0.5 (0-1.5) days, P = 0.04, from 16 (9-30) days to 10 (4-13) days, P = 0.01 and from 33 (22-53) days to 16 (12-32) days, P < 0.01, respectively.ConclusionMDT implementation was associated with a greater number of patients who meet TMA criteria. A decrease in the RT and T-LOS periods were observed and associated with better outcomes in these patients.

Dataset Information

Thrombotic Microangiopathy Team-Based Learning Module for Second-Year Medical Students.

Publications

Thrombotic Microangiopathy Team-Based Learning Module for Second-Year Medical Students.

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