Procedural Fundamentals for Medical Students: Institutional Outcomes of a Novel Multimodal Course.

RATIONALE AND OBJECTIVES: There is a gap in current medical student education pertaining to procedural skills' exposure and acquisition. The aim of this study is to evaluate the institutional experience of a novel medical student procedural course and its impact on procedural confidence. MATERIALS AND METHODS: This is a single-center prospective study performed at a public medical school and its associated tertiary care medical center between June 2020 and January 2021. This study was deemed exempt by our Institutional Review Board and was performed with participant consent. The multimodal course developed by the radiology department consisted of four didactic lectures, four simulation sessions, and a minimum of 16 clinical rotation hours with the department's vascular access team. Primary outcomes were assessed by comparing participant pre and post course surveys including twenty-five 5-point Likert scaled questions. RESULTS: Twenty-five self-selected students completed the course in its entirety. The curriculum and the corresponding survey analysis were stratified into sections by procedure modality. An increase in participant confidence to a moderate or greater level was observed when comparing pre and post course survey data for each procedure: vascular access (4% vs 52%, p < 0.01), thoracentesis (8% vs 48%, p < 0.01), paracentesis (8% vs 72%, p < 0.01), lumbar puncture (4% vs 44%, p < 0.01), and bone marrow biopsy (0% vs 48%, p < 0.01). CONCLUSIONS: The creation of a medical-student-centric procedural course is feasible and fills a potential gap in undergraduate medical education. This study demonstrated that a comprehensive multimodal course, designed to include didactic, simulation and clinical experiences, increases participant exposure to, participation with, and confidence in bedside procedural performance abilities.

Knee Cartilage Defect Characteristics Vary among Symptomatic Recreational and Competitive Scholastic Athletes Eligible for Cartilage Restoration Surgery.

OBJECTIVE: To determine whether there are differences by sport or competitive level in symptomatic knee cartilage defects among recreational, high school, or collegiate competitive athletes undergoing initial arthroscopic knee surgery who meet criteria for cartilage restoration surgery. DESIGN: Three hundred recreational (n = 172) and high school or collegiate competitive athletes (n = 128) younger than 40 years and body mass index (BMI) <35 kg/m2 (63% male, mean age 24.3 years, SD 7.1; mean BMI 25.7 kg/m2, SD 3.7) with Outerbridge grade 2 or higher symptomatic cartilage defects who underwent arthroscopic knee surgery were identified. The independent relationship between sporting activity or competitive level and cartilage defect location, size, severity, and symptom chronicity were assessed by multivariate regression analysis. RESULTS: Full-thickness defects were present in 24% of competitive athletes and 31% of recreational athletes (P = 0.21). There was a trend toward an independent association with competitive level and high-grade (3 or 4) multicompartment disease (adjusted odds ratio [aOR] 3.99, 95% confidence interval 0.84-18.8; P = 0.08) or isolated anterior compartment defects (aOR 2.00, 95% CI 0.86-4.62, P = 0.10) but not isolated medial or lateral defects. High-grade defect size was similar among recreational and competitive athletes (P = 0.71). High-grade lateral defect prevalence differed by sport (running 24%, basketball 23%, soccer 18%, football 5%; P = 0.02) but not medial or anterior defect prevalence. CONCLUSIONS: Among recreational and high school or collegiate competitive athletes with symptomatic cartilage defects who meet criteria for cartilage restoration, competitive athletes may have higher risk of high-grade anterior and multicompartment defects but no difference in defect size.