Thrombotic Microangiopathy Team-Based Learning Module for Second-Year Medical Students.
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ABSTRACT:
SUBMITTER: Murphy M
PROVIDER: S-EPMC6342151 | biostudies-literature | 2017 Feb
REPOSITORIES: biostudies-literature
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Project description:IntroductionA frequently encountered complaint in primary care, pain has a variety of causes and treatments. To reduce mortality, the Centers for Disease Control released guidelines on opioid prescribing in 2016. Taking those guidelines into account, this team-based learning (TBL) module for third-year medical students on their family medicine clinical clerkship serves as an introductory application for treatment of nociceptive and neuropathic pain.MethodsStudents accessed preparticipation reading material online 1 week before the session. After students had been arranged into groups for the 1-hour module, each student completed an individual readiness assessment test (iRAT). Next, each group completed the group readiness assessment test (gRAT) using Immediate Feedback-Assessment Technique cards to give its answers. To complete the more complex learning objectives, groups answered the multiple-choice team application (tAPP) questions.ResultsOver 2 years, this module was administered to more than 400 students. Average iRAT scores were approximately 80% and gRAT scores nearly 100%. Groups scored approximately 70% on the tAPP questions. Students rated the module on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree) and provided individual comments. The course always received a score of at least 4, as well as consistent positive feedback.DiscussionThe module can easily be embedded into a preexisting clinical clerkship didactic series. It can also serve as a platform on which to build additional TBL modules following a more longitudinal course and more in-depth skills development in pain management.
| S-EPMC7880255 | biostudies-literature
Project description:IntroductionThe underlying immune mechanisms of renal diseases are complex, and medical students benefit from learning these complexities in the setting of team-based learning (TBL), where they can apply foundational immunologic concepts to clinical problems.MethodsThis immune-mediated renal disease TBL module focusing on glomerular disease was delivered over a period of 2 consecutive years in an integrated cardiovascular, pulmonary, and renal block within the second semester of the first year of medical school. Each class consisted of 53 students, for a total of 106 students. The TBL module consisted of a seven-question individual and team readiness assurance test (iRAT and tRAT) and two clinically relevant team application activities. Following the TBL module, students completed an 18-item survey that collected information on student perspectives of engagement.ResultsFor the 2-year period, the iRAT average scores were 73% and 74%, and the tRAT average scores were 100% and 99%, respectively. The survey assessing student perceptions of engagement yielded positive feedback.DiscussionIn summary, this TBL module effectively integrates the foundational and clinical sciences to teach higher-order concepts in immunology and renal disease pathogenesis to medical students.
| S-EPMC8674152 | biostudies-literature
Project description:IntroductionTeam-based learning (TBL) is an instructional method utilized by the University of Alabama School of Medicine to facilitate collaboration and integration of concepts introduced in undergraduate medical training. This TBL was created for the Gastrointestinal module and facilitates understanding of anatomy of the retroperitoneal space, posterior abdominal wall, and neurovasculature of the abdomen. This module integrates topics from abdominal anatomy, radiology, and clinical decision-making for medical students.MethodsPrior to the TBL, students were provided with a set of learning objectives and three instructional video podcasts. During the in-class portion of the activity, learners completed the readiness assurance phase, which consisted of individual and team assessments. During the application phase, teams of five to six students collaborated on multiple-choice questions centered on the presentation, diagnosis, surgical intervention, and palliation of a patient with pancreatic cancer. TBL sessions were cofacilitated by an anatomist and a physician.ResultsSince the TBL's institution in 2014, medical students have consistently performed better on the readiness assurance test in teams rather than individually. On a 5-point Likert scale, over 90% of students in the 2016 (M = 4.12) and 2017 (M = 4.20) Gastrointestinal modules agreed or strongly agreed on an end-of-course evaluation that the TBL activity was effectual for learning.DiscussionIn a medical climate that continues to rely heavily on cross-sectional imaging, early integration of gross anatomy and cross-sectional anatomy is essential and can facilitate acclimation to the clinical years. This TBL would be a valuable addition to other undergraduate medical programs.
| S-EPMC6342382 | biostudies-literature
Project description:In medical and healthcare-related education, case-based learning (CBL) is a teaching strategy that uses clinical cases to engage students in active learning using course concepts to solve important problems. Here we describe the design and implementation of a CBL module to teach first year medical students about the human immunodeficiency virus (HIV), acute retroviral syndrome, clinical progression to acquired immunodeficiency syndrome, HIV diagnostics, assays used to assess stage of disease and response to antiretroviral treatment, and highly active antiretroviral therapy. A team of basic science and clinical faculty in the disciplines of microbiology, immunology, infection prevention and control, clinical medicine, pharmacology, and medical ethics collaboratively designed the CBL module. The results of a questionnaire indicated that the students found the CBL case interesting, engaging, and a useful educational strategy for linking basic science concepts to important clinical problems. In our experience, the CBL promoted student synthesis of basic science concepts across disciplines and engaged learners in the application of basic science knowledge to address significant real-world clinical problems.
| S-EPMC6067042 | biostudies-literature
Project description:IntroductionCancer screenings are key preventive services that patients receive in primary care. Health care professional students are generally taught about major society guidelines and U.S. Preventive Services Task Force recommendations for cancer screenings. Unfortunately, students and novice providers may view these influential recommendations as a rule book by which to provide care. Experienced providers recognize that not every patient fits neatly into clinical guidelines. Appropriate use of cancer screening entails an understanding of patient preferences, patient-specific health factors, and screening risks and associated pitfalls.MethodsThis 2-hour team-based learning (TBL) session immerses learners in three challenging patient scenarios that are designed to stimulate nuanced discussion of cancer screening using controversial cases. The scenarios encompass the following cases: (1) a 68-year-old man actively seeking prostate cancer screening, (2) a heavy smoker with psychiatric illness and alcoholism being considered for lung cancer screening, and (3) a 42-year-old woman seeking to become pregnant who inquires about breast cancer screening.ResultsThe materials were originally designed for fourth-year students on an ambulatory medicine rotation. Our students universally viewed this activity as a high-quality presentation applicable to their careers. They strongly agreed that the cases facilitated a deeper understanding of the nuances of cancer screening.DiscussionThis TBL encourages learners to critically appraise cancer screening guidelines and apply them to real-life examples. It is applicable for learners who understand the complexities of patient care but still suffer from a guidelines-are-rules mentality.
| S-EPMC6338177 | biostudies-literature
Project description:IntroductionCurrent medical education promotes enhanced integration of various disciplines and early exposure to clinically relevant topics. Against this background, we have developed a team-based learning (TBL) module for medical students in the preclerkship period that integrates embryology, anatomy, and radiology of the head and neck region.MethodsThe module, which includes prereading assignments, readiness assurance tests, and an application exercise, focuses on the development of the head and neck region. Students were asked to consolidate their knowledge of the topic-acquired as part of their regular curriculum-and to apply this knowledge to cases of cervical cysts and cleft lip/palate.ResultsThe TBL module was developed for a class of 234 students. The students performed well in the TBL module. Although many students perceived the session as time-consuming, the majority of students evaluated it as relevant for their understanding of the course material and a valuable adjunct to their course.DiscussionTo our knowledge, as of this writing, no TBL modules have been published that focus on the integration of complex embryological topics with anatomy and radiology and that are suitable for medical students at the beginning of their education. Therefore, the presented TBL module fills a gap in material available to educators in the field.
| S-EPMC6440433 | biostudies-literature
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.
| S-EPMC2914734 | biostudies-other
Project description:IntroductionThe team-based learning (TBL) instructional strategy promotes learning and retention, enhances student engagement, allows for a deeper understanding of foundational and applied concepts, and helps students' develop lifelong learning skills. The autonomic nervous system (ANS) TBL was created for first-year medical students in the Neuroscience 1 course at Oakland University William Beaumont School of Medicine.MethodsThe module covered the pathophysiology of ANS-related diseases and therapeutic agents that impact ANS function. By the conclusion of the module, students were able to diagnose different disease processes of the ANS, identify potential complications, and formulate appropriate management strategies. Four faculty members used backward design to create the ANS TBL. The preparatory assignment included reviewing content from previous didactic lectures and consolidating key information in provided tables. Key concepts were evaluated with readiness assurance tests. All application exercises adhered to the 4 S's.ResultsOver the course of 2 years, the class averages for the individual readiness assurance test were 79.8% and 87.6%. The class averages for the team readiness assurance test and application exercises were similar across both years. Course evaluations revealed that students found the TBL relevant and valuable.DiscussionSimilar TBL modules available on MedEdPORTAL are not integrated to include different aspects of the basic and clinical sciences. This ANS TBL was used to help students integrate several essential concepts, including neuroanatomy, neurophysiology, neuropharmacology, and clinical neurology. Students were very enthusiastic and engaged throughout the ANS TBL as it contained relevant case-based scenarios with questions that were meaningful for clinical practice.
| S-EPMC6440417 | biostudies-literature
Project description:IntroductionAs medical students transition from didactic courses to clinical rotations, they will frequently encounter patients with cirrhosis and ascites. It is paramount that they have a firm foundation of how to diagnose ascites and perform a proper diagnostic workup in order to understand the etiology and therefore the proper management. This module is designed as a group-based, interactive learning workshop for those transitioning students.MethodsThe session begins with the students obtaining a pertinent history of a standardized patient case. The students are then divided into four groups and rotate through four stations: physical examination, diagnostic studies, paracentesis, and ascitic fluid analysis. Each station is designed for up to 10-12 students and typically lasts 20 minutes. After all of the students have rotated through each station, they reconvene to review ascites management, case conclusions, and summary. The total time allocated for this module is 125 minutes for 40-48 students.ResultsPostmodule evaluations by the students showed a high level of satisfaction and improvement in the students' fund of knowledge and clinical skills. Evaluations completed by the students after each workshop revealed more than 95% either agreeing or strongly agreeing with the learning objectives being clear, the learning materials being effective, overall satisfaction with the learning material and teaching, and having a better understanding of the evaluation, diagnosis, and management of ascites.DiscussionThrough this team-based interactive module, students obtain clinical and hands-on experience that better prepares them for their clinical rotations.
| S-EPMC6342229 | biostudies-literature
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.
| S-EPMC6214549 | biostudies-literature