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Scholarly Works (3 results)

  • Article
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 23, Issue 4.1 (2022)

Learning Objectives: To use online simulation to teach disaster triage skills to medical students.

Background: Practicing disaster triage teaches skills of rapid patient evaluation. Triage simulation (with structured debriefing) results in improved accuracy in pediatric residents and improved confidence in medical students. Screen-based simulation of disaster triage improved triage accuracy in prehospital providers, and virtual reality (VR) simulation improved medical student triage skills. Few studies have evaluated online simulation to teach disaster triage skills to medical students.

Design: In May 2021, 15 final-year medical students engaged with online simulation to practice triaging respiratory disease outbreak patients. Students submitted personal reflections and participated in a faculty-led debrief. In October 2021, 9 additional students participated.

Outcomes: 14/15 students completed an anonymous post-course survey. Students found the exercise “very” or “extremely” helpful for learning, on a 5-point Likert scale, with a mean of 4.4 (SD+/- 0.8). Students rated their pre-exercise competency as “beginner” or “proficient” on a 4-point rubric (mean of 1.5). Most students rated their post-exercise competency as “proficient” (mean 2.8). Average increase in self-reported competency was 1.3 points, yielding a large effect size (Cohen’s d). 8/9 October students rated the simulation a 4.6 on a 5-point Likert scale (5 = extremely helpful for learning).

Strengths: This module overcomes resource limitations of live and VR simulation, and can be completed asynchronously anywhere.

Limitations: Participants need internet access. The debrief requires a facilitator skilled in disaster triage and debriefing. Assessment of effectiveness included neither triage accuracy/speed, nor comparability to live simulation/VR.

Feasibility and transferability: This innovation is freely accessible online. Future development will allow learners to select their experience level, for simplified or complex cases. Open source code allows anyone to develop their own adaptation.

    Cover page: Online simulation effectively teaches introductory disaster triage skills to medical studentsCreative Commons 'BY' version 4.0 license
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2022)
    Introduction  During a time of increased interest in physician well-being, this study benchmarks current work life, home life, and burnout scores for ophthalmology medical student directors (MSD), associate program directors (APD), and program directors (PD). Methods  An anonymous cross-sectional survey was disseminated through the Association of University Professors of Ophthalmology (AUPO) listserve, with queries regarding leadership positions, work time allotment, extracurricular activities, family life, and burnout. Answers were analyzed descriptively through Fisher's exact test, Kruskal-Wallis test, and Poisson regression models. Results  Nineteen percent of listed MSD, 15% of APD, and 29% of PD queried responded to the survey. MSD, APD, and PD are statistically similar in terms of work and home life, with the exception of time spent performing administrative tasks for the position. PD spend more time on administrative tasks, and are paid more. All groups score positively on burnout surveys. Conclusion  This benchmarking survey demonstrates that MSD, APD, and PD are intensively involved in both their work and home lives, with a seemingly high correlation of sense of worth both personally and in their careers.
      Cover page: Ophthalmology Medical Student Directors, Associate Residency Program Directors, and Program Directors: A Benchmarking Study of Work and Life Metrics
      • Article
      • Peer Reviewed
      UC Davis Previously Published Works (2011)
      Loss of CXCL12, a leukocyte localizing cue, from abluminal surfaces of the blood-brain barrier occurs in multiple sclerosis (MS) lesions. However, the mechanisms and consequences of reduced abluminal CXCL12 abundance remain unclear. Here, we show that activation of CXCR7, which scavenges CXCL12, is essential for leukocyte entry via endothelial barriers into the central nervous system (CNS) parenchyma during experimental autoimmune encephalomyelitis (EAE), a model for MS. CXCR7 expression on endothelial barriers increased during EAE at sites of inflammatory infiltration. Treatment with a CXCR7 antagonist ameliorated EAE, reduced leukocyte infiltration into the CNS parenchyma and parenchymal VCAM-1 expression, and increased abluminal levels of CXCL12. Interleukin 17 and interleukin 1β increased, whereas interferon-γ decreased, CXCR7 expression on and CXCL12 internalization in primary brain endothelial cells in vitro. These findings identify molecular requirements for the transvascular entry of leukocytes into the CNS and suggest that CXCR7 blockade may have therapeutic utility for the treatment of MS.
        Cover page: CXCR7 influences leukocyte entry into the CNS parenchyma by controlling abluminal CXCL12 abundance during autoimmunity
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