Student evaluation of a Learning Enhancement in Anatomy Program (LEAP) during the COVID-19 pandemic: A retrospective study

Background and Objective@#The pandemic acted as an accelerator for the development of online teaching formats in anatomy and histology worldwide. The authors introduce a bridging program that reinforces the knowledge and understanding of gross and correlative anatomy and histology acquired in a virtual environment in preparation for its future clinical application. The study aims to evaluate the Learning Enhancement in Anatomy Program (LEAP) conducted among first-year medical students at the College of Medicine, University of the Philippines Manila. @*Methods@#This descriptive cross-sectional study aims to determine the initial experience of implementing a learning enhancement program and assess areas for its improvement. An internally validated questionnaire was given to students after the program to gauge students’ reactions (Kirkpatrick Level 1 evaluation). Pre- and post-tests were administered to evaluate knowledge acquisition (Kirkpatrick Level 2 evaluation). Short-term behavioral peer evaluation (Kirkpatrick Level 3 evaluation) was also instituted. @*Results@#One hundred fifty-two (152) students participated in the study. General reactions from students to the LEAP were consistently positive, with a steady majority of the students rating ‘5’ or a ‘Strongly Agree’ to positive statements regarding the program. Higher ratings for more traditional teaching methods, such as cadavers, formalinized specimens, and bones, compared to virtual systems were apparent. However, inter-student variation in preference for teaching modalities was observed. All stations of the LEAP were evaluated satisfactorily, with most gross anatomy stations rated higher than histology stations. A significant increase was noted in the total post-test scores compared to pre-test scores. This improvement in test scores was observed in the anatomy and histology subcategories and in six of the seven organ system modules. Perceived behavioral outcomes were also generally positive. @*Conclusion@#The LEAP is a worthwhile endeavor, garnering overwhelmingly positive reactions and a significant improvement in test scores. Future studies are necessary to fine-tune teaching and training in a blended learning environment.

Risk factors and interventions: Fournier gangrene in a tertiary hospital: A 10-year experience

@#<p style="text-align: justify;"><strong>Objective.</strong> The study aimed to describe the patient demographic characteristics, clinical factors, surgical interventions, and quality of care parameters in non-survivors and survivors of Fournier's gangrene (FG).</p><p style="text-align: justify;"><strong>Methods.</strong> A total of 131 cases of Fournier's gangrene (FG) were included in a retrospective chart review in the Philippine General Hospital over 10 years using the Department of Surgery research database. We collected data for various direct and derived variables from the identified population. The primary outcome was mortality rate, while other factors studied were genital and colorectal manipulation, bowel diversion, laboratory parameters (white blood cell count, creatinine, hemoglobin).</p><p style="text-align: justify;"><strong>Results.</strong> The mortality rate was 15%. Diabetes mellitus was common comorbidity among patients with Fournier's disease. The following were statistically more common in the non-survivor group: female sex, concomitant bowel diversion surgery. Admission data in the non-survivor group showed a lower serum hemoglobin, a higher serum creatinine, and an increased percentage of patients with an abnormal white blood cell count; these did not statistically differ between cohorts, however. The median time to first antibiotic infusion was six hours. The median time to surgery was 13 hours.</p><p style="text-align: justify;"><strong>Conclusions.</strong> Among patients with Fournier's gangrene, the proportion of women and those undergoing bowel diversion was higher in those who did not survive. The time of infusion of antibiotics or time to surgery did not differ significantly between survivors and non-survivors.</p>

Genitourinary involvement in colorectal cancer: pre-operative diagnostic utility of CEA, computed tomography and cystoscopy in predicting surgical involvement

OBJECTIVE@#This study aims to describe the demographics, clinical characteristics of patients, and the sensitivity and specifity of the clinical, laboratory, radiologic, diagnostic parameters in detecting histopathologically-proven urinary tract involvement in primary colorectal cancer patients referred to the urology service in the Philippine General Hospital. @*METHODS@#This was a retrospective, cross-sectional study. The study included patients referred to the Division of Urology from the Division of Colon, Rectal and Anal Surgery January 1, 2018 to December 31, 2018. All patients diagnosed with colorectal malignancy and referred to the Urology service were included in the study, including their cystoscopy, axial tomography, CEA and symptom assessment scores.@*RESULTS@#Fifty-eight patients were included in the study and, 43% were rectal cancers and 33% were sigmoid cancers. Sensitivities and specificities were as follows. Symptoms 40%, 84%, Cystoscopy, 45%, 100%; Axial tomography 75%, 79%. Surgical involvement correlated with histopathologic involvement with a specificity of 52%. CEA did not discriminate between cohorts of positive or negative involvement.@*CONCLUSION@#Cystoscopy, axial tomography and symptom assessment had high positive predictive values. All diagnostics had low negative predictive values when taken in isolation. Surgical assessment correlated with histopathologic findings in half of the population. CEA did not discriminate between those with surgical involvement and those without. A multi-modality assessment strengthens detection of surgical involvement preoperatively.