Planning for Active Learning in the Didactic Classroom.

Driven by the convergence of the exponential growth of medical knowledge and the dated medical education delivery system, educators in physician assistant (PA) programs are striving to create teaching practices that actively engage students, improve knowledge retention, and prepare students for a career that requires lifelong learning and reflection. The emphasis on professor-directed teaching and learning activities is shifting toward a more learner-centered approach. To incorporate appropriate active learning exercises into the PA classroom, instructors must plan, design, and execute pedagogically sound practices. In addition, instructors must find a concrete way in which to reflect on and refine their classroom exercises so that they can expand their teaching skills even while educating their students.

Pediatric lead exposure and the water crisis in Flint, Michigan.

Changing the source of the water supply to save money had the unintended consequence of exposing residents of Flint, Mich., to elevated lead levels in their drinking water. A study done at Flint's Hurley Children's Hospital demonstrated that the incidence of elevated blood lead levels of children living in the affected area nearly doubled after the change in the water source. This article reviews the recommendations for lead screening and for reporting, following, and treating children with blood lead levels greater than 5 mcg/dL.

Mild traumatic brain injury in a gymnast.

Primary care providers often are responsible for the initial evaluation and management plan of young patients with mild traumatic brain injury (mild TBI, also called concussion), and need to be familiar with new protocols and how to incorporate them into a patient's treatment plan. This article describes a patient who suffered a mild TBI and returned to sports too early, and discusses the appropriate protocols for managing concussion in children.

Informed Practice: Students' Clinical Experiences in the Undergraduate Phase of an Accelerated Physician Assistant Program.

This qualitative study explored the clinical experiences of students in an accelerated physician assistant (PA) program. The participants were either certified nursing assistants (CNAs) or emergency medical technicians-basic (EMTs-B). The study was designed to elicit (1) how the participants perceived their older patients and (2) how the participants' experiences might affect their own future communications, bedside manner, and clinical preparedness as PAs. This study used a focus group to explore students' clinical experiences before the graduate phase of their accelerated PA program. Five female and 2 male PA students (N = 7) participated in the study. All participants were 23 years old and worked as either a CNA or an EMT-B. Results fell into 2 basic themes: informing practice and forming relationships. Regarding the first theme, participants felt that their experience as entry-level health care providers allowed them to improve their communication skills and bedside manner and to provide greater comfort to patients. Regarding the second theme, participants gained appreciation for older people and began to recognize the knowledge deficits and learning needs of their patients. The results suggested that a student's clinical experience as a CNA or an EMT-B before entering a PA program has a positive effect on the student's personal and professional development. The participants acquired greater appreciation and respect for older patients and members of the health care team.

The influence of muscle action on heart rate, RPE, and affective responses after upper-body resistance exercise.

Ratings of perceived exertion (RPE) are routinely used to monitor, assess, and prescribe aerobic exercise. Heart rate (HR) is another measure used to evaluate exercise intensity. Additionally, affective responses to aerobic exercise have been studied and seem to be influenced by the intensity of the exercise. The perceptual, HR, and affective responses to resistance exercise have not been effectively established. The purpose of this study was to examine whether differences in affect, RPE, and HR exist among college-aged women (n = 31) performing three different modes of resistance training: concentric (CE), eccentric (EE), and traditional concentric/eccentric (TE) performed at varying resistances. The women were asked to complete four sessions of resistance training on variable resistance machines: chest press, seated row, overhead press, and biceps curl. The first session was used to establish the 10-repetition maximum (RM) load for each station. Subsequent sessions involved the execution of training in one of the three test conditions: CE, EE, or TE. The participants performed three sets of each lift at 80% 10-RM, 100% 10-RM, and 120% 10-RM. The data revealed lower RPE during EE than the other test conditions. Similarly, EE elicited more mild HR response than either CE or TE. This finding is potentially important for the establishment of training programs, especially for those individuals recovering from an illness, who had been previously sedentary, and who are involved in rehabilitation of an injury.