Examining Clinical Readiness and Performance of Students on Clinical Education Experiences: Is There an Influence From Virtual Learning?

Supplemental Digital Content is Available in the Text. Introduction.: Peer simulation is a mechanism to enhance clinical reasoning and determine clinic readiness of Doctor of Physical Therapy students. In 2020, coursework that was traditionally face-to-face (F2F) was conducted completely online at many universities. Therefore, the purpose of this study was to examine if students who completed a stand-alone virtual simulation course presented with the same readiness and performance on their first full-time clinical education experience (CEE) as compared with students who completed the course during the previous 2 years in the traditional F2F format. Review of Literature.: Prior to the COVID-19 pandemic, literature focused on virtual learning explored hybrid methods of delivering physical therapy education. There are limited studies exploring the impact of virtual learning on clinical performance of DPT students. Subjects.: One hundred eight students completed their first full-time CEE during this 3-year period, with 34 having a virtual preparation and 74 having F2F coursework. Twelve of the clinical instructors (CIs) who had supervised students both virtually and in the previous 2 years were included in survey data analysis to compare cohorts. Methods.: This study used final Clinical Performance Instrument (CPI) data to compare objective ratings of student performance from CIs as well as a standardized survey of student clinical readiness based on 22 items previously published. Both instruments were used to compare students from the class of 2022 (virtual cohort) to those from the previous 2 years (F2F cohort). Independent sample t tests were used to examine group differences in perceptions of student readiness and CPI data for compiled professional practice and patient management constructs. Results.: Clinical Performance Instrument data revealed lower mean scores of students in all areas of performance in the virtual cohort as compared with F2F, but none of the differences reached statistical significance. For the clinical readiness survey, CIs rated students from the virtual cohort lower than prior students in overall readiness, as well as psychomotor, cognitive, and affective skill domains, including safety and accountability. However, none of the mean score differences reached statistical significance. Discussion and Conclusion.: Although there was no statistical difference in scores on the CPI or perception of clinic readiness by CIs, students from the virtual cohort consistently scored lower on both instruments. Transition of students from F2F coursework for psychomotor skills to virtual formats should transpire with caution. As students transition back to traditional learning environments, programs should evaluate the effectiveness of various teaching methods to ensure excellence in physical therapist education.

Short Communication: Restrictions in care following the COVID-19 pandemic severely impacted Machado-Joseph disease patients: a study in the Azores Islands, Portugal.

This qualitative study describes how the restrictions imposed by the COVID-19 pandemic impacted on Machado-Joseph disease (MJD) patients and their care, in the island of São Miguel (the Azores, Portugal). In-person semi-structured interviews were conducted with 11 participants, including patients, family members, healthcare professionals, and care providers. Main findings highlighted the key role played by the local association in psychosocial and healthcare for MJD patients and families, and the adverse effects on their care following the onset of the COVID-19 pandemic. In particular, hindered access to the day-care centre increased isolation and had a negative impact on mental health and disease progression. For persons with a progressive and severe neurological disease, there is no "back to normal." Future restrictive measures ensuing need to be accompanied by a careful definition of daily care routines for patients.

CRISPR-Cas13-Mediated Knockdown of Regulator of G-Protein Signaling 8 (RGS8) Does Not Affect Purkinje Cell Dendritic Development.

CRISPR-Cas13 technology is rapidly evolving as it is a very specific tool for RNA editing and interference. Since there are no significant off-target effects via the Cas13-mediated method, it is a promising tool for studying gene function in differentiating neurons. In this study, we designed two crRNA targeting regulator of G-protein signaling 8 (RGS8), which is a signaling molecule associated with spinocerebellar ataxias. Using CRISPR-Cas13 technology, we found that both of crRNAs could specifically achieve RGS8 knockdown. By observing and comparing the dendritic growth of Purkinje cells, we found that CRISPR-Cas13-mediated RGS8 knockdown did not significantly affect Purkinje cell dendritic development. We further tested the role of RGS8 by classical RNAi. Again, the results of the RNAi-mediated RGS8 knockdown showed that reduced RGS8 expression did not significantly affect the dendritic growth of Purkinje cells. This is the first example of CRISPR-Cas13-mediated gene function study in Purkinje cells and establishes CRISPR-Cas13-mediated knockdown as a reliable method for studying gene function in primary neurons.

Impact of COVID-19 on vasooclusive crisis in patients with sickle cell anaemia.

OBJECTIVES: The study aimed to assess COVID-19 impact on the morbidity and mortality of vasooclusive crisis (VOC) in sickle cell anaemia (SCA) patients. METHODS: A prospective cohort study of 100 SCA patients; 50 with COVID-19 (COVID group) and 50 without (non-COVID group). All patients signed written informed consent. RESULTS: The COVID group had a significantly higher VOC episode median per year; 3 (IQR,1-6) vs 2 (IQR,2-12) (P < 0.05). The need for hospitalisation was similar in both groups. The non-COVID group had more history of culture-proven infection (P = 0.05). The COVID-group had more osteonecrosis (P < 0.05), splenic sequestration, splenomegaly and hepatic crisis (P = 0.05, 0.006, 0.02; respectively) and significantly higher (P < 0.05) symptoms of fever, cough, fatigue, abdominal pain and anosmia. Mean haemoglobin, lymphocyte subset, platelets, and reticulocytes were reduced in both groups, while lactate dehydrogenase and ferritin levels were significantly elevated. In the COVID group, the rise in white blood cell count, reticulocyte percentage, platelets and ferritin was subdued (P < 0.05). Two patients in the COVID group and 3 in the non-COVID group died; there was no statistically significant difference in mortality. CONCLUSIONS: Although COVID-19 may have triggered the onset of VOC, it did not significantly influence VOC-related morbidity or mortality in this SCA cohort.

[COVID-19 and STEMI]. / COVID-19 et SCA ST.

The COVID-19 pandemic had an unexpected impact on cardiovascular emergencies, particularly STEMI. The France PCI registry and other studies around the world have highlighted a significant decrease in myocardial infarctions arriving at hospital. This decrease is mainly related to patients' fear of coming to the hospital and being contaminated. Although the STEMI revascularisation time targets (<120min) are often difficult to achieve in normal times, they were almost impossible to achieve in periods of lockdown because of the many obstacles. Longer delays and longer total ischemic time have led to excess mortality, especially in the regions most affected by the epidemic. Recommendations for the management of STEMI during the COVID-19 period have thus been issued by the scientific societies. STEMI in patients with COVID-19 often have an uncommon clinical presentation, and the absence of coronary obstruction on angiography is frequent. Their prognosis is very poor. Only public information campaigns and an organisation adapted to the management of coronary emergencies during epidemics can try to limit their effects and avoid aggravating an already fragile health situation in the future.