Compassionate end-of-life care matters deeply for patients and their caregivers, but studies cont... more Compassionate end-of-life care matters deeply for patients and their caregivers, but studies continue to demonstrate ways in which physicians fall short. Despite specific training during medical school, many patients report lack of empathy in their providers with respect to end-of-life conversations. This is likely because empathy is simply hard to teach. Numerous activities have been tried to combat the decline in empathy during medical training with little to moderate success. However, virtual reality, which allows users to viscerally experience anything from another person’s point of view, could be a game changer for building empathy within medicine. This type of perspective-taking has previously shown to improve understanding, reduce biases, facilitate empathy, and promote prosocial behaviors. In this pilot study, virtual reality was used to allow students to “become a patient” virtually embodying their daily activities, symptoms, and interactions with caregivers. Using the Embodied Labs modules, first-year medical students were able to experience first-hand having a terminal illness, being told no further treatments are available and witnessing loved ones’ reactions. Data generated through surveys and reflections indicated a high level of place illusion, plausibility, and embodiment of users. This high level of immersion generated an increase in comfortability with talking about end-of-life issues, produced a better understanding of what patients and their families experience, and promoted a change in the way students would approach clinical skills. Analysis of reflections indicated a high level of empathy for the patient and his family members. Overall, the activity was highly received by students as a valuable learning activity. As such, we propose that virtual reality could be a useful pedagogical tool to facilitate empathy and clinical skills within medical education.
Ключевые слова: восстановление нарушенных прав и свобод человека и гражданина, государственный ор... more Ключевые слова: восстановление нарушенных прав и свобод человека и гражданина, государственный орган, ежегодный доклад, защита прав человека, омбудсмен, правоприменительная практика, рассмотрение жалоб, уполномоченные по правам человека в субъектах Российской Федерации.
Empathetic care giving is associated with improved patient satisfaction, compliance and outcomes;... more Empathetic care giving is associated with improved patient satisfaction, compliance and outcomes; clinical competence, career satisfaction, and burnout reduction; as well as diminished medical errors and litigation claims. Unfortunately, recent studies have shown erosion in empathy and compassion across the health professions. Virtual reality shows promise as a teaching tool to combat this decline as it has been dubbed the ultimate empathy machine, allowing users to vividly and viscerally experience any situation from any perspective. Embodied Labs allows users to virtually walk in the shoes of different patients, experiencing symptoms, family dynamics, support networks and various components of the health care systems. We have demonstrated that the high level of immersion and presence afforded by these virtual labs are effective pedagogical tools to increase understanding, comfortability, compassion and empathy within various populations including informal caregivers, high school s...
Specialized training in ocular ultrasound is not a focus for most emergency medicine residencies,... more Specialized training in ocular ultrasound is not a focus for most emergency medicine residencies, despite the fact that it allows physicians to quickly and accurately identify ocular pathology and prioritize emergency ophthalmological consultations. Therefore, we tested the value of utilizing normal and pathologic ocular ultrasound phantoms as a training tool for residents. Twenty emergency medicine residents were given a pre-test including written and practical skills diagnosis of ocular phantom pathologies, a short video on common ocular pathologies, practice time with the phantoms and a post-test including written and scanning components. Residents were then asked to complete an overall evaluation of the learning activity. After didactic and hands-on training with phantoms, residents demonstrated a significant increase in knowledge, skills and preparedness for diagnosing real patients with ocular pathologies. Overall, the phantoms allowed residents an unrestricted opportunity to practice and refine their technique. This study provided a framework for teaching emergency medicine residents the basics of ocular US through a brief didactic and practical intervention using novel ocular pathology US phantoms. Our curriculum resulted in both objective and subjective improvement in residents' performance and understanding of ocular US. Medical education • Ocular ultrasound • Point-of-care ultrasound (POCUS) • Ultrasound phantom * Donald Byars
With roughly 83.56 million confirmed cases and 1.82 million confirmed deaths in 2020,1 COVID-19 h... more With roughly 83.56 million confirmed cases and 1.82 million confirmed deaths in 2020,1 COVID-19 has impacted ways of life worldwide, including transforming the educational landscape. Multiple stakeholders have been involved in managing the educational response to COVID-19, including executive boards and faculty. Less explored is the role of student leadership and its influences on an institution’s response to COVID-19. One example of student leadership in the United States medical education context is that of class president. Typically, the medical school class president, elected by their peers, helps lead the Student Government Association as an inductee and is responsible for ensuring class leadership functionality and efficiency while serving as a liaison between students and the administration. As the chief class officer, the class president sets the agenda and establishes the order of business for the medical student class Executive Council (vice president, secretary, treasurer...
Empathy is the basis of a patient-physician relationship; however, this is being lost by students... more Empathy is the basis of a patient-physician relationship; however, this is being lost by students throughout medical training. Immersive virtual reality that allows individuals to viscerally experience anything from another person’s point of view has the potential to reverse the erosion of empathy and improve clinical practices.
Fulminant idiopathic intracranial hypertension is a rare presentation of idiopathic intracranial ... more Fulminant idiopathic intracranial hypertension is a rare presentation of idiopathic intracranial hypertension in which visual decline occurs within 4 weeks of initial symptom presentation. Idiopathic intracranial hypertension usually presents with headaches, visual disturbances, and in women who are overweight. We present a case of idiopathic intracranial hypertension in which a female patient presented with rapid, severe vision loss within 8 days of symptom presentation and no other idiopathic intracranial hypertension symptoms. This case highlights a rare presentation of Fulminant idiopathic intracranial hypertension and the need for a quick diagnosis and treatment to preserve vision.
Drawing as a pedagogical tool in anatomy has been shown to be effective at increasing knowledge a... more Drawing as a pedagogical tool in anatomy has been shown to be effective at increasing knowledge and engaging students. Therefore, a three-dimensional drawing activity of the dural venous sinuses was implemented to increase knowledge of the structures and improve understanding of their spatial orientation and drainage. Students were given a pre-test, listened to a lecture, performed the activity, and completed a post-test. For this activity, students working in pairs were given markers and white swim caps and instructed to draw the sinuses on their partner's swim cap with anatomical accuracy. Results from the post-test revealed a significant increase in knowledge related to the structure and drainage of the dural venous sinuses. Students found that drawing was an effective way to learn anatomical structures and strongly agreed that translating a two-dimensional picture into a three-dimensional drawing improved their understanding of anatomical orientation. Overall, this was a quick, effective activity utilizing three-dimensional drawing to solidify the understanding of the dural venous sinuses.
Throughout the medical education continuum, some students encounter difficulty in meeting academi... more Throughout the medical education continuum, some students encounter difficulty in meeting academic or professional standards that leads to remediation or dismissal. Termination of a student without due process may lead to litigation by deprivation of a student's property or liberty interest. This article outlines the concept of procedural and substantive due process as applied to litigated student dismissal cases in undergraduate and graduate medical education. Determination of the amount of due process owed is based on whether the dismissal is academic or nonacademic. The decision to dismiss a student where the entire student record has been reviewed, due process provided, and the institution complied with its own policies is usually upheld by the courts in litigation.
Journal of the American College of Radiology : JACR, Jan 26, 2016
From its inception as a tool for prototype development in the early 1980s, three-dimensional (3-D... more From its inception as a tool for prototype development in the early 1980s, three-dimensional (3-D) printing has made inroads into almost every sector of industry, including health care. Medical applications range from extra- and intracorporeal orthopedic devices to complex, temporal reconstructions of patient-specific anatomy that allow operative planning and education. In the contemporary climate of personalized medicine, the utility of tangible 3-D models extrapolated directly from patient imaging data seems boundless. The purpose of this review is to briefly outline the development of 3-D printing, discuss its applications across the many medical and surgical specialties, and attempt to address obstacles and opportunities facing radiology as this technology continues to be integrated into patient care.
The matricellular extracellular matrix protein thrombospondin-1 (TSP1)stimulates focal adhesion d... more The matricellular extracellular matrix protein thrombospondin-1 (TSP1)stimulates focal adhesion disassembly through a sequence (known as the hep I peptide) in its heparin-binding domain. This mediates signaling through a receptor co-complex involving calreticulin and low-density lipoprotein (LDL)receptor-related protein (LRP). We postulate that this transition to an intermediate adhesive state enhances cellular responses to dynamic environmental conditions. Since cell adhesion dynamics affect cell motility,we asked whether TSP1/hep I-induced intermediate adhesion alters cell migration. Using both transwell and Dunn chamber assays, we demonstrate that TSP1 and hep I gradients stimulate endothelial cell chemotaxis. Treatment with focal adhesion-labilizing concentrations of TSP1/hep I in the absence of a gradient enhances endothelial cell random migration, or chemokinesis,associated with an increase in cells migrating, migration speed, and total cellular displacement. Calreticulin-null...
Compassionate end-of-life care matters deeply for patients and their caregivers, but studies cont... more Compassionate end-of-life care matters deeply for patients and their caregivers, but studies continue to demonstrate ways in which physicians fall short. Despite specific training during medical school, many patients report lack of empathy in their providers with respect to end-of-life conversations. This is likely because empathy is simply hard to teach. Numerous activities have been tried to combat the decline in empathy during medical training with little to moderate success. However, virtual reality, which allows users to viscerally experience anything from another person’s point of view, could be a game changer for building empathy within medicine. This type of perspective-taking has previously shown to improve understanding, reduce biases, facilitate empathy, and promote prosocial behaviors. In this pilot study, virtual reality was used to allow students to “become a patient” virtually embodying their daily activities, symptoms, and interactions with caregivers. Using the Embodied Labs modules, first-year medical students were able to experience first-hand having a terminal illness, being told no further treatments are available and witnessing loved ones’ reactions. Data generated through surveys and reflections indicated a high level of place illusion, plausibility, and embodiment of users. This high level of immersion generated an increase in comfortability with talking about end-of-life issues, produced a better understanding of what patients and their families experience, and promoted a change in the way students would approach clinical skills. Analysis of reflections indicated a high level of empathy for the patient and his family members. Overall, the activity was highly received by students as a valuable learning activity. As such, we propose that virtual reality could be a useful pedagogical tool to facilitate empathy and clinical skills within medical education.
Ключевые слова: восстановление нарушенных прав и свобод человека и гражданина, государственный ор... more Ключевые слова: восстановление нарушенных прав и свобод человека и гражданина, государственный орган, ежегодный доклад, защита прав человека, омбудсмен, правоприменительная практика, рассмотрение жалоб, уполномоченные по правам человека в субъектах Российской Федерации.
Empathetic care giving is associated with improved patient satisfaction, compliance and outcomes;... more Empathetic care giving is associated with improved patient satisfaction, compliance and outcomes; clinical competence, career satisfaction, and burnout reduction; as well as diminished medical errors and litigation claims. Unfortunately, recent studies have shown erosion in empathy and compassion across the health professions. Virtual reality shows promise as a teaching tool to combat this decline as it has been dubbed the ultimate empathy machine, allowing users to vividly and viscerally experience any situation from any perspective. Embodied Labs allows users to virtually walk in the shoes of different patients, experiencing symptoms, family dynamics, support networks and various components of the health care systems. We have demonstrated that the high level of immersion and presence afforded by these virtual labs are effective pedagogical tools to increase understanding, comfortability, compassion and empathy within various populations including informal caregivers, high school s...
Specialized training in ocular ultrasound is not a focus for most emergency medicine residencies,... more Specialized training in ocular ultrasound is not a focus for most emergency medicine residencies, despite the fact that it allows physicians to quickly and accurately identify ocular pathology and prioritize emergency ophthalmological consultations. Therefore, we tested the value of utilizing normal and pathologic ocular ultrasound phantoms as a training tool for residents. Twenty emergency medicine residents were given a pre-test including written and practical skills diagnosis of ocular phantom pathologies, a short video on common ocular pathologies, practice time with the phantoms and a post-test including written and scanning components. Residents were then asked to complete an overall evaluation of the learning activity. After didactic and hands-on training with phantoms, residents demonstrated a significant increase in knowledge, skills and preparedness for diagnosing real patients with ocular pathologies. Overall, the phantoms allowed residents an unrestricted opportunity to practice and refine their technique. This study provided a framework for teaching emergency medicine residents the basics of ocular US through a brief didactic and practical intervention using novel ocular pathology US phantoms. Our curriculum resulted in both objective and subjective improvement in residents' performance and understanding of ocular US. Medical education • Ocular ultrasound • Point-of-care ultrasound (POCUS) • Ultrasound phantom * Donald Byars
With roughly 83.56 million confirmed cases and 1.82 million confirmed deaths in 2020,1 COVID-19 h... more With roughly 83.56 million confirmed cases and 1.82 million confirmed deaths in 2020,1 COVID-19 has impacted ways of life worldwide, including transforming the educational landscape. Multiple stakeholders have been involved in managing the educational response to COVID-19, including executive boards and faculty. Less explored is the role of student leadership and its influences on an institution’s response to COVID-19. One example of student leadership in the United States medical education context is that of class president. Typically, the medical school class president, elected by their peers, helps lead the Student Government Association as an inductee and is responsible for ensuring class leadership functionality and efficiency while serving as a liaison between students and the administration. As the chief class officer, the class president sets the agenda and establishes the order of business for the medical student class Executive Council (vice president, secretary, treasurer...
Empathy is the basis of a patient-physician relationship; however, this is being lost by students... more Empathy is the basis of a patient-physician relationship; however, this is being lost by students throughout medical training. Immersive virtual reality that allows individuals to viscerally experience anything from another person’s point of view has the potential to reverse the erosion of empathy and improve clinical practices.
Fulminant idiopathic intracranial hypertension is a rare presentation of idiopathic intracranial ... more Fulminant idiopathic intracranial hypertension is a rare presentation of idiopathic intracranial hypertension in which visual decline occurs within 4 weeks of initial symptom presentation. Idiopathic intracranial hypertension usually presents with headaches, visual disturbances, and in women who are overweight. We present a case of idiopathic intracranial hypertension in which a female patient presented with rapid, severe vision loss within 8 days of symptom presentation and no other idiopathic intracranial hypertension symptoms. This case highlights a rare presentation of Fulminant idiopathic intracranial hypertension and the need for a quick diagnosis and treatment to preserve vision.
Drawing as a pedagogical tool in anatomy has been shown to be effective at increasing knowledge a... more Drawing as a pedagogical tool in anatomy has been shown to be effective at increasing knowledge and engaging students. Therefore, a three-dimensional drawing activity of the dural venous sinuses was implemented to increase knowledge of the structures and improve understanding of their spatial orientation and drainage. Students were given a pre-test, listened to a lecture, performed the activity, and completed a post-test. For this activity, students working in pairs were given markers and white swim caps and instructed to draw the sinuses on their partner's swim cap with anatomical accuracy. Results from the post-test revealed a significant increase in knowledge related to the structure and drainage of the dural venous sinuses. Students found that drawing was an effective way to learn anatomical structures and strongly agreed that translating a two-dimensional picture into a three-dimensional drawing improved their understanding of anatomical orientation. Overall, this was a quick, effective activity utilizing three-dimensional drawing to solidify the understanding of the dural venous sinuses.
Throughout the medical education continuum, some students encounter difficulty in meeting academi... more Throughout the medical education continuum, some students encounter difficulty in meeting academic or professional standards that leads to remediation or dismissal. Termination of a student without due process may lead to litigation by deprivation of a student's property or liberty interest. This article outlines the concept of procedural and substantive due process as applied to litigated student dismissal cases in undergraduate and graduate medical education. Determination of the amount of due process owed is based on whether the dismissal is academic or nonacademic. The decision to dismiss a student where the entire student record has been reviewed, due process provided, and the institution complied with its own policies is usually upheld by the courts in litigation.
Journal of the American College of Radiology : JACR, Jan 26, 2016
From its inception as a tool for prototype development in the early 1980s, three-dimensional (3-D... more From its inception as a tool for prototype development in the early 1980s, three-dimensional (3-D) printing has made inroads into almost every sector of industry, including health care. Medical applications range from extra- and intracorporeal orthopedic devices to complex, temporal reconstructions of patient-specific anatomy that allow operative planning and education. In the contemporary climate of personalized medicine, the utility of tangible 3-D models extrapolated directly from patient imaging data seems boundless. The purpose of this review is to briefly outline the development of 3-D printing, discuss its applications across the many medical and surgical specialties, and attempt to address obstacles and opportunities facing radiology as this technology continues to be integrated into patient care.
The matricellular extracellular matrix protein thrombospondin-1 (TSP1)stimulates focal adhesion d... more The matricellular extracellular matrix protein thrombospondin-1 (TSP1)stimulates focal adhesion disassembly through a sequence (known as the hep I peptide) in its heparin-binding domain. This mediates signaling through a receptor co-complex involving calreticulin and low-density lipoprotein (LDL)receptor-related protein (LRP). We postulate that this transition to an intermediate adhesive state enhances cellular responses to dynamic environmental conditions. Since cell adhesion dynamics affect cell motility,we asked whether TSP1/hep I-induced intermediate adhesion alters cell migration. Using both transwell and Dunn chamber assays, we demonstrate that TSP1 and hep I gradients stimulate endothelial cell chemotaxis. Treatment with focal adhesion-labilizing concentrations of TSP1/hep I in the absence of a gradient enhances endothelial cell random migration, or chemokinesis,associated with an increase in cells migrating, migration speed, and total cellular displacement. Calreticulin-null...
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