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BackgroundThe use of interactive patient scenarios has long been a valuable component of medical school curricula, as this type of learning facilitates empathy, comprehensive understanding, and cultural sensitivity.[1] The COVID-19 pandemic, however, has precipitated a shift to more virtual strategies to keep students, faculty, and patients safe.[2]ObjectivesTo evaluate second year medical students' (MS2s) perceptions on the use of live patient encounters during the teaching of the skin and rheumatology course (BMS 6635) using different teaching formats due to changes from the COVID-19 pandemic.MethodsFour to five patients with dermatologic, autoimmune, and musculoskeletal diseases volunteered to participate in an interactive teaching session with MS2s at the University of Central Florida College of Medicine. MS2s enrolled in BMS 6635 were asked to voluntarily complete a survey about their learning experiences using these patient cases. Students who did not respond to the survey were excluded. Data analysis using Chi Square testing was performed on survey responses obtained pre-pandemic as compared to those collected in academic years 2020-2021 and 2021-2022 during the COVID-19 pandemic.Results700 surveys were obtained after patient cases given in different formats. When the interactive patient cases were given in person before COVID-19, 93% of students enjoyed the cases and 95% of students believed that the cases were an appropriate learning experience in their education. When these cases were delivered virtually beginning in the academic year 2020-2021, however, students' enjoyment of these cases decreased to 86%, with 92% of students believing that the cases were an appropriate learning experience. This is a 7% and 9% decrease, respectively, from pre-pandemic years. During the academic year 2021-2022, use of a hybrid model, with students and faculty in-person and patients participating virtually, resulted in 81% of students enjoying the interactive patient cases and 83% of students believing that the cases were an appropriate learning experience. This was a 12% decrease from before the COVID-19 pandemic (p <.001) and a 5% and 9% decrease, respectively, from the previous year (p <.001) (Figure 1). 37% of students who had their cases in a completely virtual format preferred the interactive patient sessions to stay completely virtual, while 51% of students who participated in hybrid sessions during COVID-19 preferred the sessions to be completely virtual (p<.029) (Table 1).Table 1.Medical student survey responses comparing live patient encounters given in person, completely virtually, and a hybrid formatIn person pre-Covid (2016-2020)Completely virtual-Covid (2020-2021)Hybrid Format-Covid (2021-2022)Totalp-valueI enjoyed the Live Patient cases43993%9186%9881%628<.001*The Live Patient cases were an appropriate learning experience at this stage in my education44895%9792%10183%646<.001*The Live Patient cases helped me remember the diseases well for the exam9583%8075%8671%261.111Would you prefer the Live Patient sessions to be on Zoom?3937%6251%49.029** = Statistical significance defined as p<0.05Figure 1.Medical students' feedback on live patient cases given in different platforms before COVID-19 and during the COVID-19 pandemic.[Figure omitted. See PDF]ConclusionThe use of interactive patient cases in medical education has been met with positive feedback over the years and should continue to be used in medical education. This study showed that MS2s enjoyed the patient encounters more when delivered in-person vs a virtual or hybrid format. Careful consideration should be given to delivery format to optimize student learning and enjoyment.References[1] Spencer J, Blackmore D, Heard S, et al. Patient-oriented learning: a review of the role of the patient in the education of medical students. Med Educ. 2000;34(10):851-857. doi: 10.1046/j.1365-2923.2000.00779.x.[2] Rose S. Medical Student Education in the Time of COVID-19. JAMA. 2020;323(21):2131-2132. doi: 10.1001/jama.2020.5227.Acknowledgements:NIL.Disclosure of I terestsNone Declared.
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A narrative intended for science interns and scientists to overview regulatory pathways and federal perspectives pertinent to the complexity of nanoparticle systems and chaos precipitated by the COVID-19 pandemic. It elaborates on fundamental aspects of US FDA guidance on nanotechnology. It juxtaposes guidance on nanotechnology with the COVID-19 guidance documents to get a deeper understanding of “good practices” in the context of professional response in chaotic, complex, complicated, and simple systems. The narrative spirals in on practical consideration for experiential learning to be self-assured. © 2022 Elsevier Inc. All rights reserved.
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It is crucial to conjecture the consequences of the COVID-19 for an economy, to plan its policy and guidelines at present, and to prepare itself for the future. In the finance world it is suggested by health experts to use more and more digital financial services (DFSs). Thus in this paper, we will try to understand the impact of COVID-19 on DFS and digital financial inclusion in India. This research suggests that the impact of COVID-19 is negative on financial inclusion, whereas some DFS were impacted positively. While some DFS have faced the negative as well as neutral impact during this pandemic. Overall it is concluded that the impact on DFS is neutral to date, but with time and with the opening up of an economy, the status of DFS is expected to improve, which in turn will improve the status of digital financial inclusion in India in the future.
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Introduction: Following the first Covid-19 outbreak in March 2020, national BSG guidance1 called for high quality triage of endoscopy referrals in order to balance the individual need for endoscopy against the limited service capacity. Accordingly, we developed specific vetting criteria, organized a consultant-led triage system and assessed its performance in the higher urgency 2-week-wait (2WW) referrals. Aims & Methods: Five consultants developed a triage algorithm which would provide coloured urgency (Green, Yellow and Red in order of decreasing urgency) and a respective time window (2-4, 4-8 and 8-12 weeks, respectively) to endoscopy referrals. Vetting criteria were based on national guidance and criteria (BSG and NICE) and were supplemented by European guidance2 where applicable. Results: A total of 401 2WW referrals (53.6% females, mean age 62.3 years) were received over a 3.5-month study period. The commonest indication was upper gastrointestinal symptoms (39%), followed by anemia (18.2%), lower GI symptoms (16.7%) and rectal bleeding (14.5%). In total, 20 cases of neoplasia were identified among 391 2WW endoscopies, leading to a diagnostic yield of 5.1%. Our triage system reduced the number of high-urgency referrals by 65.6%. The new high-urgency group (Green code) led to a diagnostic yield for neoplasia of 10.9%, i.e. more than double compared to that of the 2WW pathway. Expanding our high-urgency group to include the Yellow code referrals would identify all cases of neoplasia and would defer almost 50% of the 2WW referrals with no missed diagnoses of cancer. FIT (fecal immunochemical testing) values ≥ 100 μg/g (Green code) and 4 to 99.9 μg/g (Yellow code) led to a neoplasia diagnosis in 25% and 3.5%, respectively. No case of lower GI neoplasia had normal FIT value. Conclusion: Our triage algorithm was particularly effective and safe to use during the Covid-19 outbreak. It reduced significantly the number of high urgency endoscopy referrals, increased the diagnostic yield for neoplasia and deferred safely all referrals in the lower urgency, Red code priority group. Specific vetting criteria, such as the FIT value and Edinburgh Dysphagia Score have high negative predictive value and their use should be generalized given the pressure imposed on the diagnostic services and the weaknesses of the existing triage systems and criteria.