Physician Assistant Students' Knowledge of Zika Virus: A Pilot Study.

OBJECTIVE: The aim of this study was to assess physician assistant students' knowledge about the screening, transmission, management, and prevention of Zika virus infection. BACKGROUND: It is important for health care providers in the United States to recognize the symptoms of Zika so that they can screen, diagnose, and or treat persons exposed to or infected by the virus. Physician assistant students, on completion of their educational program and passing their board examinations, provide care for patients in primary care or specialty settings where they may treat patients who either have the virus or post-virus exposure. METHODS: A convenience sample of 37 students enrolled in a physician assistant studies program in the Midwestern United States completed an in-person self-administered paper-and-pencil questionnaire that tested their knowledge about Zika virus infection. RESULTS: All the respondents knew that the disease is of viral origin; however, only 89% knew that mosquitoes were the natural host. Primary modes of transmission were identified as sexual contact and blood transfusion (47% and 44% of respondents respectively); 47% incorrectly identified amniotic fluid as a transmission mode. More than half (61%) knew that health care providers should ask pregnant women about any possible virus exposure before and during pregnancy at each prenatal visit. Most respondents knew that muscle/joint pain (67%) was one of the symptoms of Zika infection, but only 39%, 25%, and 19% also identified low-grade fever, maculopapular rash, and conjunctivitis respectively as other symptoms. Some participants incorrectly identified antivirals (44%) and nonsteroidal anti-inflammatory medications (36%) rather than the recommended treatments of pain relief (30%) and fever relief (42%) medications for clinical management of the disease.

Active Shooter: What Would Health Care Students Do While Caring for Their Patients? Run? Hide? Or Fight?

OBJECTIVE: The aim of this study was to explore the clinical decisions that health care students would make if faced with an active shooter event while providing patient care. METHODS: A cross-sectional study design was used to survey 245 students from 6 different professional programs. Participants read 4 case-based scenarios, selected 1 of 4 actions in a multiple-choice format, and responded to an open-ended question. Demographic questions asked whether participants had been a victim of violence and whether they have taken a certified active shooter course. Statistical analysis included descriptive statistics and chi-square testing. RESULTS: For each case, most students chose "patient-centric" versus "provider-centric" actions (range: 66%-94% and 4%-17%, respectively). The gender of the patient made no difference in actions. Those who attended a certified active shooter course tended to act with more "provider-centric" concerns than those who did not take such a course. CONCLUSION: A significant majority of interprofessional health care students, when presented with specific case-scenarios, declared they would act to protect themselves and their patients during an active shooter event. This "patient-centric" attitude transcends the oversimplified "Run-Hide-Fight" axiom and must be addressed by all health care educational institutions.

START versus SALT Triage: Which is Preferred by the 21st Century Health Care Student?

IntroductionWhile the art and science of disaster triage continue to evolve, the education of the US health care student in matters pertaining to disaster preparedness and response remains stifled. Unfortunately, these students will be assuming major decision-making responsibilities regarding catastrophes that will be complicated by climate change, nuclear threats, global terrorism, and pandemics. Meanwhile, Sort, Assess, Life-Saving Interventions, Treatment, and/or Transport (SALT) triage is being advocated over the globally popular Simple Triage and Rapid Treatment (START) algorithm for multiple reasons: (1) it's an all-hazard approach; (2) it has four medical interventions; and (3) it has an additional triage color for victims with non-survivable injuries.Hypothesis/ProblemAs present-day threats become more ominous and health care education emphasizes the needs of vulnerable populations and palliative care, the authors hypothesize that, when given a choice, health care students will prefer SALT triage. METHODS: A convenience sample of 218 interprofessional, disaster-naïve health care students received just-in-time, unbiased education on both START and SALT triage systems. Students then completed a survey asking them to decide which triage system they believe would be most effective in their community. RESULTS: A total of 123 health care students (56.4%) preferred SALT while 95 (43.6%) preferred START; however, only the physician assistant students showed a statistically significantly preference (28 versus six, respectively; P=.042). Interestingly, there was also a statistically significant difference in preference by gender (Chi-square=5.02; P=.025) of the observed distribution versus expected distribution in SALT and START. The females preferred SALT (61.0%) while the males preferred START (55.9%).Among those who preferred START, START being easier to learn was the most important reason cited. Among those who preferred SALT, the most important reason cited was that the number of patient triage categories seemed more logical, comprehensible, and consistent with traditional medical care. CONCLUSION: While SALT's preference among females and physician assistant students was based on the addition of medical interventions and the provision of palliative care, START's preference was related to expediency. Based on this research, incorporating disaster concepts into US health care students' curricula encourages thoughtful consideration among the future health care leaders about the most effective approach to triage care. It is critical that further research be completed to determine, without reservation, which triage system will not only save the most lives but provide the most humane care to victims.Fink BN, Rega PP, Sexton ME, Wishner C. START versus SALT triage: which is preferred by the 21st century health care student? Prehosp Disaster Med. 2018;33(4):381-386.