Design and evaluation of an interprofessional education workshop series for preclinical and prelicensure health professional students.

BACKGROUND: There are a variety of designs and implementation strategies reported for interprofessional education (IPE); however, most of these descriptions lack robust evaluations of interprofessional (IP) outcomes. INTERPROFESSIONAL EDUCATION ACTIVITY: An IPE Workshop Series was implemented for preclinical and prelicensure students in eight health professions, consisting of four sessions: health professionals' roles and responsibilities (1A); introduction to patient safety (1B); IP diabetes management (2A); and IP pain management in the opioid epidemic (2B). For Workshops 2A and 2B, student perceptions of IPE were measured using the validated Students Perceptions of Interprofessional Clinical Education Revised Version 2 and IP team care plans were assessed with a rubric. Five hundred twenty-seven students attended all four workshops and completed all surveys. Student perceptions of IPE and collaboration were significantly increased after completing the IPE Workshop Series. Most teams met or exceeded expectations on the diabetes team care plans for collaboration, addressing patient concerns, and gaps in care; however, most teams needed improvement on addressing additional workup and management. The pain management team care plans were below expectations for most teams. DISCUSSION: Student perceptions of IP collaboration increased and were maintained longitudinally indicating a positive impact on this IPE outcome; however, performance on team care plans did not meet faculty expectations suggesting areas for improvement in the design and evaluation for this outcome. IMPLICATIONS: These findings reinforce the importance of evaluation to ensure IPE curricula are achieving IP outcomes, notably, utilizing validated instruments and incorporating faculty assessments that are appropriately leveled for learners.

Candida albicans Immunotherapy for Verrucae Plantaris.

BACKGROUND: Verrucae plantaris is a viral disease caused by human papilloma virus that is commonly seen in the office setting and is often challenging to treat owing to its high recurrence rate and recalcitrant profile. Candida albicans intralesional injections have been hypothesized to incite an immunogenic response toward the virus. METHODS: We report on the immunotherapeutic effect of intralesional injection of C albicans into plantar verrucae with a retrospective medical record analysis of 80 patients. Using a luer-lock syringe, 0.1 to 0.3 mL of C albicans antigen was injected into either the first known lesion or the largest lesion. RESULTS: The success rate of intralesional C albicans, defined as total clearance of the lesion, was 65%, which may be underestimated because patients lost to follow-up were included in the 35% failure rate. It was also found that female patients with a previous tissue-destructive treatment process were more than four times more likely to respond to C albicans therapy, whereas this effect was less pronounced in the male patient population. CONCLUSIONS: These results indicate that a series of intralesional injections of C albicans is an effective and efficient method of treatment for verrucae plantaris.

Lower extremity neurological evaluation of the older patient.

The phrase "lower extremity neurological evaluation" is a misnomer. The evaluation focuses on deficits that manifest in the lower extremity, but the expert knowledge of the competent examiner may indicate that the cause is remote from the lower limbs. Moreover, the skilled examiner must evaluate the patient in toto to determine the etiology of any abnormalities manifesting in the lower extremities. For these reasons and others, the neurological evaluation of the older patient is of particular importance and should be performed routinely.

Stability of the offset V osteotomy: effects of fixation, orientation, and surgical translocation in polyurethane foam models and preserved cadaveric specimens.

Polyurethane foam models and cadaver specimens were used to examine the stability of the offset V first metatarsal osteotomy. Uniform osteotomies were performed in all specimens by using a specially designed jig. Specimens in the polyurethane foam model series (n = 10) varied with respect to fixation type, fixation orientation, and degree of lateral translocation of the osteotomy. All specimens were loaded to failure in an Instron testing machine (Instron, Canton, MA). The plantar wing-pin (Kirschner wire) osteotomy group showed statistically significantly greater stiffness (P =.0119) and load at failure (P =.0027) than the dorsal wing-pin group. Cadaveric offset V specimens received the same amount of capital fragment lateral translocation but had different fixation types and orientations. Using the identical protocol as the models, the cadaveric dorsal wing-screw group showed statistically significantly less displacement at failure than the plantar wing-screw, plantar wing-pin, and dorsal wing-pin groups (P =.0262). The dorsal wing-pin group with a synthetic tension band showed a statistically significant greater stiffness (P =.0054) and peak load at failure (P =.0004) compared with the dorsal wing-pin group without the tension band. The most stable offset V construct in the polyurethane foam model was the plantar wing-pin group. The preserved cadaveric specimens yielded different results. The cadaveric dorsal wing-pin group with the synthetic tension band showed superior stability compared with all other non-tension-band groups. These results indicate the importance of tension band effects provided by capsular and ligamentous structures, which are typically ignored in surgical optimization research.