RESUMO
BACKGROUND: The unique characteristics of the millennial generation has promulgated changes in the workplace and in academia. A lack of national standards necessitates that anesthesia faculty create educational content for anesthesia clerkships. Assessing expectations before an anesthesia rotation would provide data to accommodate millennial medical students' needs and preferences for learning. METHODS: A 16-question survey using Qualtrics software was created, with input from millennial medical students, to query preclinical medical students at the Oakland University William Beaumont School of Medicine on their educational expectations of an anesthesia clerkship. RESULTS: Seventy-four surveys were completed, with 34 (46%) of 74 from first-year and 40 (54%) of 74 from second-year medical students. Daily feedback (44 [59%] of 74) and written exams (43 [58%] of 74) were preferred methods of evaluation. No lectures, observing in an operating room, and performing procedures on real patients were the preferred format for instruction. Two (23 [31%] or 74) to 3 (33 [45%] of 74) weeks was the preferred duration of an anesthesia rotation. CONCLUSIONS: This study demonstrates that millennial medical students have preconceived educational expectations of an anesthesia clerkship, and identifies learning preferences that differ from the implemented anesthesia curriculum currently described in the literature.
RESUMO
Coronary artery vasospasm (CAVS) plays an important role in acute chest pain syndrome caused by transient and partial or complete occlusion of the coronary arteries. Pathophysiology of the disease remains incompletely understood, with autonomic and endothelial dysfunction thought to play an important role. Due to the dynamic nature of the disease, its exact prevalence is not entirely clear but is found to be more prevalent in East Asian and female population. Cigarette smoking remains a prominent risk factor, although CAVS does not follow traditional coronary artery disease risk factors. Many triggers continue to be identified, with recent findings identifying chemotherapeutics, allergens, and inflammatory mediators as playing some role in the exacerbation of CAVS. Provocative testing with direct visualization is currently the gold-standard for diagnosis, but non-invasive tests, including the use of biomarkers, are being increasingly studied to aid in the diagnosis. Treatment of the CAVS is an area of active research. Apart from risk factor modification, calcium channel blockers are currently the first line treatment, with nitrates playing an important adjunct role. High-risk patients with life-threatening complications should be considered for implantable cardioverter defibrillator (ICD), although timing criteria for escalated therapy require further investigation. The role of pharmaceuticals targeting oxidative stress remains incompletely understood.
