ABSTRACT
Healthcare inequities are rampant in the USA. There is a lack of standardization for training medical students in providing care with cultural, racial, and ethnic humility. This innovation is the framework of an entrustable professional activity that can be utilized to address this vital issue.
ABSTRACT
Objective The coronavirus disease 2019 (COVID-19) pandemic has led to massive disruptions in medical education. In the fall of 2020, newly matriculated medical students around the country started medical school in a remote learning setting. The purpose of this study is to assess the impact of remote learning during the COVID-19 pandemic on academic performance and student satisfaction among first-year medical students. Methods The newest cohort of first-year medical students (class of 2024; n = 128) who completed their first basic science course, "Genes, Molecules & Cells (GMC)," using an adapted remote format was compared to the prior year's cohort (class of 2023; n = 122) of first-year medical students who were taught using traditional approaches. The items that were compared were numerical performance on exams and quizzes, study strategies, and course evaluation in GMC. Data were analyzed with a two-sided t-test and Pearson correlation coefficient. Students' perception of remote learning was also reported and results were obtained using a five-point Likert scale through anonymous surveys via E-value. Results No statistical difference was observed in students' performance on the midterm and final examinations between the two cohorts in both multiple-choice and written examinations. Mean multiple-choice question (MCQ) midterm students' performance in remote learning compared to traditional learning cohort was 75.9%, standard deviation (SD) 6.1 to 75.89%, SD 6.49, respectively. Mean MCQ final students' performance was 84%, SD 6.37 (class of 2024) to 85%, SD 8.78 (class of 2023). Students' satisfaction with their learning experience was similar among the two groups (class of 2024: mean = 4.61, SD 0.66; class of 2023: mean = 4.57, SD 0.68). Most students (70%) in the remote learning cohort had a positive opinion of remote learning. Of the students, 17% reported feeling disconnected, isolated, or not actively involved. Conclusions The results of this study demonstrate that not only is remote learning effective but that the students were also resilient in their adaptation to a new learning format. Our experience highlights the importance of including wellness solutions to mitigate the feeling of isolation and disconnection during remote learning.
ABSTRACT
Context: Intrasyringal hemorrhage was first described in literature in the renowned Lectures on Diseases of the Nervous System by Sir William Richard Gowers [Gowers W. A lecture on syringal haemorrhage into the spinal cord. Lancet [Internet]; 162(4180):993-997. [cited 2019 August 19]. Available from https://www.sciencedirect.com/science/article/pii/S0140673601362785]. The pathophysiology of this disease is a hemorrhage within a preexisting intramedullary fluid-filled cavity or hydrosyringomyelia in the spinal cord. Most common symptoms of this disease are numbness, weakness, paresthesia in the extremities and gait disturbances. Since first noted in 1903, there have been just fourteen confirmed cases of this disease reported in literature, making it extremely rare and difficult to study.Findings: Here we discuss a unique presentation of Gowers intrasyringal hemorrhage. The patient is a male in his late teens with no prior established neurological history. He presented at our institution four days post suspected injury with persistent mild left upper extremity numbness and weakness. The patient was admitted and underwent an MRI of the cervical spine without intravenous contrast. The imaging findings confirm subacute on chronic Gowers intrasyringal hemorrhage in the setting of a Chiari 1 malformation. This patient underwent neurosurgical intervention four months post initial presentation and had complete postoperative resolution of his interval non-progressive but persistent symptoms.Clinical relevance: This unique case suggests immediate surgical intervention may not always be necessary for treating Gowers intrasyringal hemorrhage.
