How Do Learners Receive Feedback on Note Writing? A Scoping Review.

PURPOSE: The literature assessing the process of note-writing based on gathered information is scant. This scoping review investigates methods of providing feedback on learners' note-writing abilities. METHOD: Scopus and Web of Science were searched for studies that investigated feedback on student notes or reviewed notes written on an information or data-gathering activity in health care and other fields in August 2022. Of 426 articles screened, 23 met the inclusion criteria. Data were extracted on the article title, publication year, study location, study aim, study design, number of participants, participant demographics, level of education, type of note written, field of study, form of feedback given, source of the feedback, and student or participant rating of feedback method from the included articles. Then possible themes were identified and a final consensus-based thematic analysis was performed. RESULTS: Themes identified in the 23 included articles were as follows: (1) learners found faculty and peer feedback beneficial; (2) direct written comments and evaluation tools, such as rubrics or checklists, were the most common feedback methods; (3) reports on notes in real clinical settings were limited (simulated clinical scenarios in preclinical curriculum were the most studied); (4) feedback providers and recipients benefit from having prior training on providing and receiving feedback; (5) sequential or iterative feedback was beneficial for learners but can be time intensive for faculty and confounded by maturation effects; and (6) use of technology and validated assessment tools facilitate the feedback process through ease of communication and improved organization. CONCLUSIONS: The various factors influencing impact and perception of feedback include the source, structure, setting, use of technology, and amount of feedback provided. As the utility of note-writing in health care expands, studies are needed to clarify the value of note feedback in learning and the role of innovative technologies in facilitating note feedback.

Spontaneous coronary artery dissection, a commonly overlooked etiology of acute coronary syndrome.

Spontaneous coronary artery dissection (SCAD) is a type of non-atherosclerotic coronary artery disease, initially thought to be uncommon but is now being increasingly recognized as a cause of acute coronary syndrome in females. The exact incidence of this remains unknown and most of these cases undergo emergent percutaneous intervention (PCI) due to concern for acute coronary syndrome (ACS). Prior studies have shown that PCI can be detrimental in these cases. It is important to recognize the possibility of SCAD in young female patients so that potentially harmful interventions, such as starting these patients immediately on heparin, use of thrombolytic therapy, and emergent PCI that can lead to worse outcomes, are avoided.

Multiple Hepatic Abscess from Parvimonas micra: An Emerging Gastrointestinal Microbe.

Parvimonas micra is an obligate anaerobic bacterium and a known commensal of the human oral cavity and gastrointestinal tract. It is rarely associated with infections outside the oral cavity. Recently it has been isolated as a causative agent in a variety of systemic infections, but it has never been previously identified to cause a hepatic abscess. We report a 90-year-old woman with multiple hepatic abscesses caused by P. micra.

Renal infarct: a rare disease due to a rare etiology.

Renal infarction is caused by profound hypoperfusion secondary to embolic/thrombotic occlusion of the renal artery or vasospasm of the renal artery. We present a case of a 54-year-old patient who presented with nausea, vomiting, and vague abdominal pain. He had frequent episodes of migraine headaches and he treated himself with as needed rizatriptan. CT scan of the abdomen showed renal cortical infarction. After extensive investigations, etiology of his renal infarct was deemed to be due to rizatriptan.