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Independent Study Projects

Cover page of Implementing bilingual labor & delivery education modules for the centering pregnancy  curriculum at Chula Vista Medical Plaza

Implementing bilingual labor & delivery education modules for the centering pregnancy curriculum at Chula Vista Medical Plaza

(2019)

The aim of this project was to create supplemental education modules to assist in the labor and delivery sessions, Sessions 5 and 6, of the CenteringPregnancy curriculum hosted at Chula Vista Medical Plaza in order to allow participants that are monolingual in Spanish to better understand the processes of labor and delivery. The activities already in place from the curriculum made assumptions about patient understandings of their own anatomy, what uterine contractions are, and stages of labor. By designing education tools that were more visual, barriers in language that prevent understanding of educational content could be overcome. Most importantly, participants could feel empowered in their pregnancies by understanding the physiological changes their bodies would experience during labor and delivery.

Cover page of Using high-fidelity simulation to teach neurological emergency and neurocritical care skills: A systematic review of the literature

Using high-fidelity simulation to teach neurological emergency and neurocritical care skills: A systematic review of the literature

(2019)

This article analyzes the current available literature on high-fidelity simulation as an educational tool in teaching acute neurology and neurocritical care skills to trainees. Twenty-five studies were found to be published in peer-reviewed journals. While every study had a common target of educating learners on appropriate acute neurology evaluation, diagnosis, and management, there exists significant heterogeneity in the chosen topics, implemented procedures, and assessments of learner outcomes. Overall findings suggest that there is considerably significant evidence for the effectiveness and utility of simulation-based education when it comes to the teaching of acute and critical neurological emergencies to trainees and even practicing providers. Existing literature is summarized, current trends are discussed, and recommendations for areas of future research are included.

Cover page of Investigation of enrichment programs at juvenile detention facilities in San Diego County

Investigation of enrichment programs at juvenile detention facilities in San Diego County

(2019)

Enrichment activities are known to enhance youth development, and are especially beneficial for at-risk youth who have not consistently had the social capital to receive such enrichment throughout the critical periods of their development. The National Institute of Justice has published many studies demonstrating the benefit of enrichment activities for disadvantaged youth. Enrichment activities promote self-esteem and sense of discipline and well-being, which impacts mental health and risk taking behaviors such as substance abuse. With the goal of achieving the aforementioned impact, juvenile detention centers offer enrichment programs as part of the rehabilitation process. My goal for this project was to further investigate the availability, equity and impact of such programs on mental health outcomes for at risk youth, I completed a needs assessment. The following needs assessment report summarizes my findings.

Cover page of Anesthesia student survival guide

Anesthesia student survival guide

(2019)

At UC San Diego medical school, third year medical students’ exposure to Anesthesia is often as part of a two-week selective during their surgery rotation. Students are told to read up on Miller or Bareish (not for the faint of heart) to understand the foundational knowledge for the rotation. Fourth year medical students often feel like there should be a concise introductory document to help students before the rotation. This document is to provide a brief introduction to the field of anesthesia and ensure students feel more prepared prior to the rotation. This document is intended to be modified and altered as other students find the information outdated or irrelevant to the Anesthesia rotation.

Cover page of Development of an organotypic slice culture protocol and proof of cultured sample viability

Development of an organotypic slice culture protocol and proof of cultured sample viability

(2019)

Ischemia reperfusion injury is a major cause of morbidity and mortality worldwide. A better understanding of the cardioprotective effects of anesthetics is needed to open up opportunities for research in a variety of medical fields such as internal medicine, geriatrics, cardiology, surgery and anesthesiology. Furthermore, a better understanding of the mechanism of pre- and post- conditioning of anesthetics may lead to the development of novel cardioprotective therapeutics for older patients who are in need of cardiac surgery. This project takes a novel approach towards the study of cardiac tissue in vivo. Previously, human samples were obtained from patient surgeries. This approach presented the scientific community with several problems. First, the samples were scarce and difficult to obtain. Second, the experiments and the time available was very limited due to the viability of the tissue. New approaches include the culturing of cardiac myocytes. However, the lack of the microenvironment present in isolated cardiac cells makes it difficult to compare experimental results with those performed on adult heart tissue. Our approach involves using a vibratome to create slices of cardiac tissue with a preserved microenvironment to establish baseline parameters for mouse heart, with the hopes of replicating these experiments in human tissue. The ability to culture and study in vitro slices of human heart tissue will increase research output from difficult to obtain and limited human tissue samples.

Cover page of Fertility preservation and decisional regret in young breast cancer survivors: a longitudinal analysis

Fertility preservation and decisional regret in young breast cancer survivors: a longitudinal analysis

(2019)

Fertility is important to young breast cancer survivors (YBCS). Treatment for breast cancer increases the risk of infertility. Fertility preservation prior to breast cancer treatment aims to improve options for fertility post-treatment. Fertility preservation decisions are challenging for YBCS. In retrospective cohort studies, YBCS that underwent fertility preservation experienced less decisional regret after primary cancer treatment. Objectives and hypotheses: to assess longitudinal changes in decisional regret on fertility preservation following breast cancer diagnosis; to determine if fertility concerns and fertility preservation treatment decisions are related to decisional regret.

Cover page of Warm Handoff: Fact or Fiction?

Warm Handoff: Fact or Fiction?

(2019)

1. Compare characteristics of patients in which a BHP was involved in any manner in apatient’s visit to those who did not have any BHP involvement in their visit.

2. Compare follow-through rates after referral to psychotherapy for patients who didversus did not have a warm handoff (i.e., face-to-face interaction with a BHP) at the timeof the patient’s visit to a PCP

Cover page of Reducing opioid doses prescribed from a pediatric emergency department

Reducing opioid doses prescribed from a pediatric emergency department

(2019)

Background: opioid overdose and abuse have reaches epidemic rates in the United States. Legitimate prescriptions are a large source of opioid misuse in adults and adolescents. The goal of this quality improvement project was to reduce opioid exposure from our pediatric emergency department (ED).

Cover page of A clinical survey evaluating the most common factors influencing a parental decision of vaccine refusal, and whether a correlation exists between vaccine refusal and the degree of trust in pediatricians

A clinical survey evaluating the most common factors influencing a parental decision of vaccine refusal, and whether a correlation exists between vaccine refusal and the degree of trust in pediatricians

(2019)

The practice of vaccine delay and refusal has recently held the attention of the medical community, most notably due to outbreaks of vaccine preventable diseases. It is a loaded subject both for parents/guardians and pediatricians; to the point of pediatricians being more likely to dismiss families who refuse vaccinations for their children. Within the field of pediatrics, this is a topic that poses a threat to the physician-patient relationshp. Studies have shown an increase in vaccine refusals in the last decade; therefore, further examination of the reasons behind this decision remains key in better understanding what drives this decision when made by some parents and guardians. This survey will attempt to cite the most common reasons for this decision directly from parents/guardians, as well as to examine if there is any significant difference between the degree of trust in pediatricians amonst parents/guardians who refuse or delay vaccines when compared to non-refusing parents/guardians. The ultimate goal of such a survey will be to better understand the "why" behind parental vaccine delay and refusal. Ultimately it is unquestioned that both sides want the best for the child and patient; the hope of this survey is to better understand the gap between the two sides.

Cover page of Implementation of an educational exercise to enhance clinical reasoning in third year medical students

Implementation of an educational exercise to enhance clinical reasoning in third year medical students

(2019)

Clinical reasoning (CR) is essential to a physician's practice of medicine. Although there have clear efforts to incorporate CR into the pre-clinical curriculum at UCSD-SOM, there is a lack of formal CR education during rotations. Thus, the Clinical Reasoning Exercise (CRE) was designed for third year medical students on the inpatient internal medicine service. The CRE is an educational exercise that provides step-by-step guidance through the diagnostic process by utilizing three principles--problem representation, diagnostic schema, and illness scrips. Supplementary materials include narrated PowerPoint/YouTube tutorials (for both students and faculty) as well as an example completed CRE for student reference. The CRE was piloted with six students rotating the Veteran's Association (VA) in February 2019. Students were met in small groups (2-3) to review general aspects and logistics. After the one-month long inpatient rotation, students were sent the link to an anonymous survey. The overall respondent rate was 66% (N=4/6). All four students reported completing one CRE during the 4-week block. Overall, students felt the CRE was a useful exercise that helped educate them on CR/CR principles and helped them systematically approach a clinical problem. However, there was a mixed response as to whether the CRE should be implemented in the future curriculum. The students' main concerns included increasing the number of requirements for the rotation and redundancy with a pre-existing requirement. Going forward, the CRE itself will need to be modified and its position in the curriculum closely reassessed. In addition, a larger sample size is needed to adequately obtain generalizability to the remainder of the third-year class.