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Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30809
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Browsing Education by Author "Jackson, Garrett"
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Item Incorporating Medical Students into the Development of Age Friendly Healthcare Systems through Quality Improvement Projects(2022) Thompson, Sadie; Miller, Cassidy; Jackson, Garrett; Hadley, Lesca; Gibson, John; Severance, JenniferPurpose: The world is aging. Health systems are often not prepared for the number or complexity of geriatric patients. Caring for this vulnerable population through age-friendly health systems is imperative for our future. With the universal lack of geriatricians, family physicians primarily care for the elderly population and are therefore ideally placed to lead changes to improve the lives of geriatric patients. The Rural Osteopathic Medical Education (ROME) Program partnered with UNTHSC's Center for Geriatrics to create geriatric-focused quality improvement projects (QIPs) for medical students to complete in their family medicine clerkships. Methods: Two cohorts of ROME students interviewed rural family physicians regarding the needs of their geriatric patient population. Students then partnered with the physician to develop geriatric QIPs which were implemented in the clinics. Following the conclusion of the projects, students were surveyed about their experience implementing geriatric QIPs during their clerkships. Results: In the first cohort, 100% of students stated that they were better able to analyze, collect, and communicate data about quality improvements in practice. 100% of students in this cohort stated that they would integrate QIPs into their practices. In the second cohort, 76% of students stated that they were better able to analyze and collect data for QIP. In this cohort, 71% of the students stated that they would actively integrate QIPs into their practices. 67% of the family physicians strongly agreed that QIPs were useful to their practice. Conclusions: Students identified best practices to address the health needs and concerns of older adults and their caregivers. The QIPs improved care for the elderly in addition to providing experience in implementing quality improvement methods that can be used in the students' future medical practices. Incorporating medical students into QIPs in family medicine clinics is valuable for the patients, students, and physicians.Item Unfixed Cadavers as an Adjunct to the Texas College of Osteopathic Medicine POCUS Curriculum(2022) Thomas, Alexander; Son, Min Ji; Jackson, Garrett; Oh, James; Terlizzese, Taylor; Banh, Debini; Burrows, Jack; Quach, Shanon; Vedantam, RahulPURPOSE: Point of care ultrasound (POCUS) continues to grow in its application across all primary care settings due to its wide ranging use and high level of patient safety, especially during medical procedures and aiding in diagnostic accuracy. Advanced technological capabilities in conjunction with affordability gives handheld ultrasound devices the ability to acquire higher quality videos and real time images that are conducive for teaching. Due to these factors, many medical schools are incorporating the use of POCUS into their curricula, including the Texas College of Osteopathic Medicine (TCOM). POCUS is introduced in year 2 as a part of the SIM Lab to help promote development of clinical skills and reasoning. This is implemented via a two-part process in which, alongside systems classes, students complete Sonosim modules that teach about using POCUS on various organ systems. Students then, as part of a skills lab, are aided by student teaching assistants and faculty on proper screening technique utilizing a student volunteer. One key limitation, however, is the fact that the majority of the student volunteers are healthy medical students, which makes it harder to screen for pathology. Due to this limitation, the use of fresh, unfixed cadavers could be a useful adjunct to allow students to further sharpen their POCUS skills while simultaneously seeing pathology in real time. METHODS: A total of 27 unfixed, de-identified cadavers were scanned with a handheld Butterfly iQ+ probe. Sixteen body systems were screened: ocular, thyroid, carotid/internal jugular vein (IJV), brachial plexus, heart, kidneys, pancreas, gallbladder, liver, aorta and the inferior vena cava (IVC), femoral artery and vein, knee, popliteal vessels, uterus, scrotum, and shoulder. RESULTS: Of the 16 body systems, we were able to consistently capture anatomical and pathological images in 8. The body systems that we saw in more than 70% of the screened cadavers include: ocular, thyroid, carotid/IJV, brachial plexus, liver, knee, scrotum, and shoulder. An ultrasound-skilled physician reviewed the images obtained from the cadavers and concluded that for certain body systems the images acquired were indiscernible from anatomy obtained from live patients. Additionally, pathologies discovered in unfixed cadavers were similar to the pathologies seen in live patients. These pathologies include: vitreous detachment, thyroid nodule, liver cyst, hydrocele, and others. CONCLUSION: Ultrasound on unfixed cadavers can be a useful adjunct to the current TCOM ultrasound curriculum. Using cadavers allows room for error and cadavers often have common pathology throughout their system that are rare in healthy student volunteers. Prospective studies should include assessing more body systems and introducing procedures that parallel the current SIM lab curriculum. Additionally, creating artificial pathologies in cadaveric models should be explored to broaden the scope of application.Item UTILIZING UNFIXED CADAVERS IN MEDICAL STUDENT ULTRASOUND TRAINING FOR NORMAL SCROTAL ANATOMY(2022) Jackson, Garrett; Oh, James; Gibson, John; Grieb, Gavin; Banh, Debini; Son, Min Ji; Thomas, Alexander; Quach, Shanon; Terlizzese, Taylor; Abella, MatthewPoint-of-care ultrasound (POCUS) continues to become more widespread due to its range of use, low cost, and extremely high level of patient safety. It is imperative that we train medical professionals to utilize this tool in its fullest capacity as its diagnostic accuracy varies drastically with the skill and experience of the provider. Many programs recognize this discrepancy and have begun implementing POCUS earlier in training within medical school curricula. Despite these efforts, training across the broad application of POCUS continues to be underutilized in anatomy that is less accessible due to reservation amongst peers and patients. Testicular and scrotal anatomy is one of these sensitive areas that is lacking in early hands-on training. Ultrasound remains the first-line modality in the evaluation of scrotal disease. For emergent etiologies of acute scrotal pain or swelling, timing largely determines prognosis; any delay in care significantly increases risk of tissue necrosis, compromising the fertility of the patient. A solid foundation in acquiring and visualizing normal scrotal anatomy on the human body is an essential first step in creating the adept POCUS provider. Utilizing fresh, unfixed cadavers as ultrasound screening specimens for scrotal anatomy may be a feasible option for initiating early training in scrotal POCUS. Supported by the Willed Body Program, cadavers were screened with hand-held Butterfly iQ+ ultrasound devices by members of the ultrasound teaching assistant cohort of 3rd and 4th year TCOM students. Ultrasound acquired images and clips were reviewed and evaluated by a trained faculty member. Of the images obtained 17 out of 20 cadavers (85%) adequately visualized pertinent structures of scrotal anatomy in the absence of significant imaging artifacts. The Butterfly iQ+ ultrasound provided excellent quality images with minimal artifacts; the scrotum is an easily accessible organ that avoids the early processes of decomposition which can obscure image acquisition. However, given the lack of blood flow, color and power doppler settings were unable to be adequately utilized. These settings are crucial in the diagnosis of certain scrotal pathologies such as epididymitis, varicocele, testicular torsion and orchitis. In conclusion, the provider's first time obtaining and assessing scrotal anatomy on a human body should not be in a time-limited, emergent situation. Fresh, unfixed cadavers can provide a means for closing the gap in providing scrotal anatomy training at the medical school level and ultimately elevate patient care. Benefits to this approach include: increased diagnostic and visualization skills of normal structures, augmented visuo-spatial and tactile probe-handling skills, enhanced ability to compensate for artifact and variations in anatomy, and practice handling the patient with professionalism and care. Future projects could include using cadavers to artificially replicate pathologic conditions for advanced training in diagnostic and procedural skills.