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    Optimizing Medical Education: Integrating Palpation and Radiologic Imaging in Simulation Labs
    (2024-03-21) Sankhavaram, Mira; Selby, Samuel; Mize, Will; Wieters, Matthew; Isa, Salman; Smith, Spencer; Papa, Frank
    Purpose: UNTHSC’s Regional Simulation Lab has created many opportunities for faculty to move beyond traditional, classroom-based approaches to an advanced, simulation-based learning environment. Unfortunately, there is minimal literature regarding the effective integration of distinct skills given that these sophisticated technologies can portray case scenarios that require the successful application of several skill sets. The investigators will utilize approximately 10 – 15 minutes of the two hours of time scheduled in the year two GI course, to support students in integrating the two primary skill sets introduced 'separately' earlier. This instructional activity will provide students an opportunity to simultaneously see CT and Ultrasound scans representing an abnormal abdominal finding while simultaneously palpating (on a high-fidelity abdominal simulator) the associated abnormal physical examination findings. Methods: UNTHSC utilizes a post-course evaluation tool collecting student feedback for continuous quality assurance of its curriculum. This year's post-course evaluation questions contain both a standardized set of questions and an additional set of questions designed to gather student opinions about how the course might be improved. Included in the survey were two sets of questions about the skills developed in this two-hour GI training activity. The first set of questions is about the adequacy of the time spent in: 1) Ultrasound training in isolation, 2) abdominal palpation training in isolation, 3) the simultaneous training of both Ultrasound and CT images, and palpation training. The second set of questions represents student opinion regarding the percentage of the two hours of instructional activity that should be spent with 4) Ultrasound training in isolation, 5) abdominal palpation training in isolation, and 6) simultaneous training in both Ultrasound and CT images, and palpation. Results: Our findings, based upon a survey of 99 students, reveal the value of integrating palpation with radiologic imaging more than performing either skill in isolation. The survey suggests that students would prefer spending about three times longer in the lab integrating these two skill sets compared to the original 15 minutes allocated. Conclusion: While traditionally topics in medical education are delivered to students in a piecemeal fashion, with the focus on mastering each skill in isolation before moving on to the next, this survey demonstrates that students value more opportunities to integrate various skills as they are first being introduced. This provides students with a more realistic understanding of how to use the resources they will have in the clinical setting to arrive at a diagnosis. This notion is further supported by the open-ended feedback solicited from the participants. In their comments, there is a strong desire for a more case-based approach to learning, in which students have the autonomy to work to solve a patient problem and dictate their diagnostic process in a more realistic, linear fashion rather than learning by simple demonstration and repetition. While more research is needed, these results demonstrate the value students place in integrating emerging simulation technology with pre-clinical medical education to help prepare students for their role in the clinical environment.
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    Resources and Opportunities Available for Allopathic and Osteopathic Medical Students Pursuing Otolaryngology: A Comprehensive Analysis
    (2024-03-21) Stucki, Brenton; Patel, Arpan; Judd, Dallin; Bruner, William
    Introduction: Otolaryngology, commonly known as Ear, Nose, and Throat (ENT), is a surgical subspecialty dedicated to addressing conditions of the head and neck. It is no surprise that matching into surgical subspecialties such as otolaryngology - head and neck surgery becomes more and more competitive each year. Data indicates that each year on average, students are performing at higher levels than years previous. This increase in competitiveness prompts the development of resources including specialty-specific information to be made more readily available to students. This review aims to identify key ENT organizations in the United States that may provide pivotal tools for medical students. Through an analysis of these organizations, this study reveals opportunities available to medical students through organizations such as research opportunities, conference scholarships, mentorship programs, and avenues for leadership roles. Furthermore, emphasizes the significance of research experience, leadership roles, academic performance, and compelling letters of recommendation, which are crucial in the application process. By focusing on these critical aspects, the primary aim is to highlight resources that can equip medical students with the necessary skills and experiences to apply for an ENT residency successfully.Methods:147 organizations were identified by the University of North Texas Health Science Center (UNTHSC) Gibson Library. A search conducted then by three independent researchers via Google Search contributed an additional 30 organizations. The combination of these sources resulted in a preliminary list of 177 organizations. Three duplicates were eliminated, thus decreasing the list to 174 unique organizations. The next stage of screening was predicated on the relevance of these organizations to the field of Otolaryngology. Three independent researchers excluded 129 entities sourced from the UNTHSC Gibson Library. Further reviews were conducted and a finalized cohort of fourteen national otolaryngology - head and neck surgery organizations were selected for comprehensive evaluation. Information regarding the following information was gathered and compiled for review and comparison: Organization Focuses on a Subspecialty of Otolaryngology, Organization Allows Both MD and DO Student Membership, Medical Student Cost to Join Organization, Annual Meeting, Research Presented at Annual Meeting, Medical Students can Present at Annual Meeting, Medical Student Registration Fee for Annual Meeting, Annual Meeting Registration / Travel Scholarships Available for Medical Students, Mentorship Available Within the Organization for Medical Students, Leadership Opportunities Available for Medical Students, Scholarships/Grants Available for Medical Students, Educational Material Available to Medical Students. Results: The comprehensive analysis highlighted resources and opportunities available for allopathic and osteopathic medical students pursuing otolaryngology. These entities offer numerous benefits, including research opportunities, educational materials, annual meetings, and access to subspecialties. These organizations can provide a competitive edge to medical students who take advantage of these benefits. Conclusion: In conclusion, this analysis underscores the vital support that professional organizations offer to medical students pursuing otolaryngology, highlighting the significance of mentorship, research opportunities, and educational materials. It urges medical students to actively engage with these organizations to enhance their career prospects in this field. However, identified gaps in mentorship, travel financial aid, and leadership roles point towards areas needing enhancement.
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    Impact of gross anatomy review on ultrasound learning in first-year medical students: A pilot study
    (2024-03-21) Robertson, Taylor; Reeves, Rustin; Meyer, Kimberly; Satsky Kerr, Marcel; Handler, Emma
    Introduction: Ultrasound (US) integration in undergraduate medical education (UME) has been a popular topic for the past decade. Current literature indicates ultrasound inclusion in UME is commonly integrated in gross anatomy instruction or clinical skills courses. US inclusion in gross anatomy focuses on overall anatomy understanding, whereas US in clinical skills courses focuses on the diagnostic application of medical imaging. Although there is plenty of literature demonstrating the benefits of US inclusion in gross anatomy, there is little research looking at the use of gross anatomy reviews prior to learning clinical ultrasound. Further, there is little research investigating how transferable gross anatomy identification is to ultrasound anatomy identification. Therefore, this study's purpose is to assess the effects of gross anatomy review prior to learning clinical ultrasound. Methods: 22 first year medical students interested in joining the ultrasound interest group (USIG), an extracurricular student group, participated in the study in the spring semester of 2023. There were four ultrasound imaging modules taught during the semester: cardiopulmonary, liver/biliary, E-fast, and musculoskeletal. Students were divided into two groups where they were required to participate in a pre-module quiz, attend the ultrasound instruction, then complete a post-module quiz and survey after the ultrasound instruction. The EXP group had to participate in an additional anatomy review prior to the ultrasound instruction session. Pre- and post-module quizzes contained gross anatomy structures of the relevant anatomy for the module, along with paired ultrasound images of that anatomical structure. The quizzes for each module were identical to each other allowing repeated measures. This allows for tracking students ability to transfer knowledge from gross anatomy identification to ultrasound anatomy identification. Groups switched treatments for each module, allowing equal exposure to both treatments. Quiz scores were compared within and between groups, setting significance level at p<0.05. Results: Both CON and EXP groups significantly improved in their performance from pre-quiz to post-quiz in all four sub-scores for Module 1 (p<.001 for overall; d=1.3, US; d=1.16 and transfer; d=1.34, p<.05 for anatomy; d=.51) and Module 4 (p<.001 for overall; d=1.1,and transfer; d=.74, p<.01 for anatomy; d=.67, and US; d=1.47). Significant increases were seen in three sub-scores for module 2 (p<.01 for overall; d=.77, and US; d=.65, p<.05 for transfer; d=.46). There were no significant increases in performance from pre-quiz to post-quiz in module 3. Looking at self-improvement between groups, the EXP group did show higher mean gains than the CON group and mild to moderate effect sizes, although these comparisons were not significant. The EXP group showed higher mean scores on post-quiz assessments for most sub-scores, including mild to moderate effect sizes, although none of these were significant. Conclusion: Ultrasound is a valuable tool in all areas of medicine, especially in anatomy learning. This study shows that a gross anatomy review does have a positive impact on student performance when learning US. Medical students learning US may receive benefit from a gross anatomy review to reintroduce previously learned material and further reinforce US instruction.
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    Demonstration of Steroid Atrophy From Chronic Topical Steroid Use in Various Fitzpatrick Skin Types
    (2024-03-21) Martinez, Maria Francesca Ysabelle; Du, Wenqin; Wong, Christopher; Hall, Marshall; Scheufele, Christian; Weis, Stephen
    Background: Topical steroids are commonly prescribed first-line medications for various inflammatory and autoimmune dermatologic conditions. Their widespread use raises the importance of proper use. Topical steroids have well-known side effects including skin atrophy, redness, striae, and telangiectasias. These side effects have not been well documented in patients of various skin tones. Primary care clinicians must recognize topical steroid side effects and their appearance in various skin tones. This paper will focus on representing skin atrophy, the most common steroid side effect, in a variety of Fitzpatrick skin types. Case Presentation: We present a series of images illustrating skin atrophy after prolonged topical steroid use on various Fitzpatrick skin types. The first case shows Fitzpatrick V skin with areas of erythema, hypopigmentation, and hyperpigmentation on the trunk. The second case presents thin skin with bright erythema and purpuric papules on the upper extremities of Fitzpatrick II skin. A third case showcases symmetric, parallel, linear, maroon dermal scars perpendicular to tension lines in the background of epidermal atrophy circum-anally and on the buttocks of Fitzpatrick IV skin. A fourth case exhibits Fitzpatrick III skin with shiny, thin skin and patches of hypopigmentation and telangiectasias on bilateral cheeks. The fifth case is a Fitzpatrick IV skin type with plaque psoriasis on the lower extremity and a background of skin thinning, hypopigmentation, and visible underlying vasculature from chronic topical steroid use. The final case represents Fitzpatrick VI skin with pyoderma gangrenosum, atrophied skin with overt hypopigmented patches adjacent to a cribriform scar. These cases feature the diverse presentations of skin atrophy on different Fitzpatrick skin types. Conclusion: Steroid atrophy is the most common side effect of chronic topical steroid use. Topical steroids are widely used for dermatologic conditions such as atopic dermatitis and plaque psoriasis. Steroids work to quell these inflammatory and autoimmune conditions and are overall tolerated well with proper use. Overuse of topical steroids is common and can cause known side effects of skin atrophy, erythema, striae, and telangiectasias. Recognition of steroid overuse requires knowledge of its presentation in various skin tones. In lighter skin types, atrophy is apparent with visible underlying vasculature and bright red erythema. In darker skin types, atrophy is more subtle and underlying vasculature may appear burgundy or maroon. Awareness of these differences in presentation will allow for quick recognition and immediate cessation of steroid use to prevent further side effects.
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    Exploring the Association Between Patient-Centered Communication and Awareness of Human Papillomavirus Vaccine: A Cross-sectional Study
    (2024-03-21) Akpan, Idara; Nhpang, Roi San; Webb, Nathaniel; Alkhatib, Sarah; Krenek, Brittany; Griner, Stacey; Thompson, Erika
    Purpose: Human papillomavirus (HPV) vaccination is effective in preventing anogenital and oropharyngeal cancers, including genital warts. The HPV vaccine is approved for individuals aged 9-45 years old and creates the opportunity for healthcare providers to educate parents, caregivers, and patients on the benefits of the vaccine. Effective provider-patient interactions promote collaboration, increase self-efficacy, and support decision-making. This study aimed to assess the association between patient-centered communication and patient awareness of the HPV vaccine. We also examined sociodemographic factors associated with HPV vaccine awareness. Methods: The sample population included adults aged 18-45 (n=1384) from the 2022 Health Information National Trends Survey (Cycle 6). The outcome variable was HPV vaccine awareness (yes/no), assessed by whether the respondent has ever heard of the cervical cancer vaccine or HPV shot. The primary predictor variable was patient-centered communication, and this was operationalized using the 7-item Patient-Centered Communication scale (PCC scale). The items assessed respondents’ experiences during their healthcare visits, such as the chance to ask questions, attention to their feelings, involvement in decision-making, time availability, clarity of information presented, comprehension of information, and help with uncertainty. The scale response options ranged from 1=Always to 4=Never. The association between patient-centered communication and HPV vaccine awareness was examined using weighted multivariable logistic regression, while controlling for age, sex, race, education attainment, marital status, health insurance status, and number of healthcare visits in the past 12 months. Results: The mean age of the sample population was 34.1 years (SD=7.2 years). Approximately 52.5% and 47.5% identified as women and men, respectively. Individuals identified as White non-Hispanic (56.2%), Black non-Hispanic (10.2%), Hispanic (19.6%), and Asian/Other non-Hispanic (14.0%). Approximately 40.4% of individuals had a college degree or higher, and 89.8% reported having health insurance coverage. Overall, 72.7% self-reported they had heard about the HPV vaccine. The PCC scale mean was 74.0 (range 0-100). Patient-centered communication was not statistically associated with HPV vaccine awareness. Compared to men, women had higher odds of HPV vaccine awareness (aOR=2.83; 95%CI=1.62-4.97). Individuals with some college (aOR=2.25; 95%CI=1.01-5.01) and college degree or higher (aOR=2.87; 95%CI=1.44-5.77) had higher odds of HPV vaccine awareness than those with less than a high school/12 years/high school diploma. Compared to individuals aged 18-26, individuals aged 27-45 had higher odds of HPV vaccine awareness (aOR=1.91; 95%CI=1.02-3.57). Black (aOR=0.24; 95%CI=0.12-0.49), Asian/Other (aOR=0.24; 95%CI=0.12-0.49), and Hispanic (aOR=0.36; 95%CI=0.21-0.59) individuals had lower odds of being aware of the HPV vaccine than whites. Conclusions: The absence of statistically significant relationship between patient-centered communication and HPV vaccine awareness underscores the need to investigate other factors that influence patient knowledge and decision-making regarding the HPV vaccine. Provider recommendation is one of the known strategies to address misconceptions and increase uptake of the HPV vaccine, particularly among populations who are at increased risk for HPV. However, individuals with limited or no access to healthcare may seek health information from other readily available sources. Exploring racial/ethnic disparities in HPV vaccine awareness is imperative, including identifying effective, evidence-based dissemination strategies that meet the information needs of diverse populations.
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    UNTHSC’s MedSci Program Prepares Students for Medical School Success
    (2024-03-21) Stafford, Suzanne; Schreihofer, Derek
    Purpose: It is well known that a medical school acceptance is difficult to obtain. The Association of American Medical Colleges’ most recent report of medical school acceptances shows that in 2021, a total of 62,443 students applied to U.S. medical schools, and 23,711 were accepted1. With a greater demand for seats than are available, admissions committees must determine who is or is not eligible for attending their program. The Texas College of Osteopathic Medicine (TCOM) has a class size generally seating 230–240 students from a pool of about 4,500–5,000 applicants2. For students whom the office of admissions feels could benefit from additional curriculum preparation, the University of North Texas Health Science Center (UNTHSC) offers a postbaccalaureate Master of Science in Medical Science. UNTHSC had its first Post-Baccalaureate Premedical Certification Program class in the fall of 2000 with a total of 7 students. The Medical Science master’s program was offered in 2005. The intent was to provide qualified, yet ultimately not accepted, applicants an opportunity to prepare for the rigors of medical school while improving their medical school application. In 2017, about 82% of the students who completed the program were successful in receiving either admission to a medical or dental school in the United States3. Currently, the program has grown to over 300 students and includes face-to-face and online cohorts. Methods: Our study examines the development and changes to the program over a 20-year period including curriculum and cohort size. We also examine the academic readiness of the TCOM-attending “MedSci” students to their non-MedSci classmates by comparing individual TCOM course GPAs and both COMLEX and STEP medical board examination passing scores. Results: Over the span of the program, the required courses have become more similar to the year 1 curriculum that TCOM offers. In 2021, the average TCOM GPA of former MedSci students was 86.61. The average GPA of their non-MedSci counterparts was 85.45. The general trend from 2015–2021 shows comparable scores for the MedSci students. For the 2021 COMLEX exam, 94.12% of MedSci students passed on their first attempt compared to the 97.62% of non-MedSci students. The average COMLEX 1 score for MedSci students was 559.83 compared to the non-MedSci average score of 546.92. Although not required, some students chose to take STEP 1, the first USMLE board examination. Of the MedSci students, 46 of 51 chose to take the exam with a first-time passing rate of 97.83% and an average score of 230.81. Of the non-MedSci students, 133 of 168 chose to take the exam with a first-time passing rate of 96.99% and an average score of 226.15. Conclusion: The MedSci program offered by UNTHSC allows students who were originally not accepted to medical school to match or exceed the academic expectations for medical students. 1Association of American Medical Colleges. (2021, December). 2021 Fall Applicant, Matriculant, and Enrollment Data Tables. 2TCOM admissions statistics. Texas College of Osteopathic Medicine. (2023, May 18). 3Medical science. School of Biomedical Sciences. (2024, February 2).
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    Presentations of Cutaneous Disease in Various Skin Pigmentations: Tinea Corporis
    (2024-03-21) Peddireddy, Navya; Van Alfen, Braden
    Background Tinea corporis, a superficial fungal skin infection, typically manifests as pruritic annular erythematous scaly plaques with central clearing. This condition can involve every body region. Here we present tinea corporis across various skin pigmentations. The goal is to highlight distinctions and similarities in light, medium, and dark skin tones, using the Fitzpatrick scale for stratification of skin types. We hope this can aid primary care clinicians in early recognition of this common condition. Case Information We present a series of cases illustrating the diverse manifestations of tinea corporis across different Fitzpatrick skin types. In Figure 2, a 28-year-old with Fitzpatrick I displays well-defined, scaly plaques on the inner thigh. Figure 3 features a 3-year-old of Fitzpatrick II with a large, poorly defined plaque on the right posterior thigh. A 33-year-old Fitzpatrick III male of showcases an erythematous, scaly plaque extending from the groin (Figure 4). Figure 5 presents a 15-year-old with Fitzpatrick IV, exhibiting well-demarcated erythematous plaques on the left arm with inflamed papules on the neck and arm. A 69-year-old female of Fitzpatrick V displays pink to violaceous plaques with hyperpigmentation and white/gray scales (Figure 6). These cases highlight the diverse clinical presentations that can be seen in different Fitzpatrick skin types. Conclusions Tinea corporis is a common superficial fungal infection of the skin that tends to be more prevalent in younger demographics and thrives in humid environments. Trichophyton rubrum is the most common dermatophyte culprit for this fungal infection. It can spread easily between different parts of the body, accentuating the need for comprehensive evaluations encompassing various anatomical areas. Diagnosis of tinea corporis across various skin tones involves recognizing the influence of age, environmental factors, and the Fitzpatrick scale on its clinical presentation. Variations can be observed in the degree of scaling and the amount of erythema. Bright red erythema is harder to distinguish in darker Fitzpatrick skin types (IV-VI). Instead, erythema may appear more hyperpigmented. Likewise, scale may be more easily seen in these skin types. Identifying tinea corporis in light, medium, and dark skin tones is crucial for early intervention. Confirmatory diagnostic procedures, such as KOH scrapings and fungal cultures from lesion swabs are valuable in confirming the presence of dermatophyte involvement.
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    The Importance of Investigative Primary Care Physicians in Managing Complex Genetic Disorders: A Case Study of Ehlers Danlos Syndrome and Its Vascular Complications
    (2024-03-21) Walker, Madelaine; Jain, Kunal
    INTRODUCTION: Ehlers Danlos Syndrome (EDS) is commonly thought of in relation to joint hypermobility, its most common feature, yet by no means its most concerning. EDS has several subtypes, some of which do not even present with hypermobility. Despite this seemingly simple and obvious symptom, EDS often presents with symptoms that are mistaken for other diseases, thereby prolonging the diagnosis of EDS for patients. Recent studies have identified life-threatening abnormalities common among patients presenting with EDS, inviting an investigation into whether this collagen disorder could be the underlying cause. This case study aims to review one instance of the associations found with this disease, contributing to the current literature regarding this investigation, improving diagnostic probability of this disease to minimize patient suffering, and furthering the research about uncommon genetic disorders. BACKGROUND: This case study surveys a 42-year-old female with EDS, Postural Orthopedic Tachycardia Syndrome (POTS), May Thurner Syndrome, Nutcracker Syndrome, Median Arcuate Ligament Syndrome (MALS), Polycystic Ovary Syndrome, and a host of other diagnoses. She reported a history of doctor visits starting at age 13, initially for abnormal uterine bleeding and then for gastrointestinal issues, prompting a diagnosis of Irritable Bowel Syndrome. She started having seizures and migraines in her twenties, and at age 39, she began to have spells of dizziness and collapsing that led to the diagnosis of POTS. Additionally during this time, she had severe right upper quadrant pain that led to her refusal to eat, causing subsequent weight loss. She obtained abdominal computed tomography angiography at age 41 that finally showed the following findings: Nutcracker Syndrome, May Thurner Syndrome, MALS, and an enlarged duodenum, all of which were missed on the reported nine computed tomography (CT) scans in the preceding two years. A friend with similar symptoms encouraged her to meet with a geneticist, who made encompassing diagnoses of Classical-like and Spondylodysplastic EDS. Experiencing difficulties finding a surgeon willing to perform external vascular grafting, the patient traveled overseas for her abdominal vascular compressions. Throughout her surgeries in life, she experienced complications due to her collagen disorder in which the sutures were not retained or her organs did not stay in place after positioning. The patient expressed frustration with the healthcare system in regards to her delayed EDS diagnosis. Currently, the patient is relieved that her primary care physician (PCP) closely follows her disease progression and responds to her concerns. CONCLUSION: Given the various symptoms associated with EDS, it can be challenging for PCPs to make this diagnosis, often leading them to refer patients to specialists for their various symptoms. Unfortunately, this can result in patients not receiving the proper treatment and preventive care, as specialists may only focus on specific aspects of the disease process, potentially worsening the patient's overall condition. Our case study aims to add to the pool of cases related to conditions associated with EDS. Additionally, it highlights the crucial role that PCPs play in diagnosing and managing patients with EDS, given the complex set of symptoms that require close follow-up.
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    Shaping Tomorrow’s Surgeons: Insights into PGY-1 Orthopaedic Training Across the United States
    (2024-03-21) Taft, Carter; Wong, Zachary; Rosenthal, Reece; Eaddy, Samuel
    Purpose Orthopaedic surgery residency offers valuable opportunities for first-year residents to diversify their medical training beyond their specific field. The American Board of Orthopaedic Surgery (ABOS) mandates a five-year residency program for board certification, wherein the initial year, termed postgraduate year one (PGY-1), the curriculum is variable. ABOS permits up to six months in orthopaedic surgery rotations, with the remaining six months offering various educational experiences. Among the non-orthopaedic surgery months, at least three must be dedicated to either general surgery, trauma surgery, plastic/burn surgery, surgical or medical intensive care, or vascular surgery. The additional three months can encompass a range of hospital services. This study examined the rotations included in residency programs across the nation to analyze trends in PGY-1 orthopaedic resident experiences. Methods This study gathered data from the Electronic Residency Application Service (ERAS) list of participating orthopaedic programs across the United States for the 2023 application cycle. Program-specific information regarding PGY-1 rotations, both in orthopaedic and non-orthopaedic fields, as well as matriculated residents was gathered by utilizing each program’s publicly available internet resources. Programs with inadequate information regarding these variables were excluded from the study. Individual rotations were primarily divided into “month” intervals, which were defined on a program-to-program basis. Results A total of 174 orthopaedic residency programs out of 201 participating programs with sufficient public data regarding PGY-1 curriculum were included in this study (86.6%). On average, these programs took 4.63 residents per application cycle.In assessing the ABOS requirement of 3 months of non-orthopaedic surgical rotations, the utilization rates among orthopaedic programs were as follows: intensive care (72.1%), plastics/burn care (67.4%), trauma (61%), general surgery (52.3%) and vascular (47.7%). The threshold of six months of orthopaedic surgery rotations was met by 90.11% of programs, with general orthopaedics, trauma, spine, and joints being the mostcommon subspecialties with an average of 4.1, 2.4, 1.2, and 1.6 months spent in these areas, respectively. Conclusions Among nationally accredited orthopaedic programs, notable differences exist in PGY-1 rotations. Our data revealed that within non-orthopaedic rotations, intensive care, plastics/burn care, and trauma were the most common, whereas general orthopaedics, trauma, and spine predominated within orthopaedic rotations. Understanding these curriculum differences in the first year of orthopaedic residency iscrucialto applicants as they navigate the intricacies of this highly technical field, marked by significant variability in training. Moreover, this information is valuable to current orthopaedic residents and program directors as they shape their program’s educational direction, ensuring that rotations are comprehensive and aligned with national trends. Future directions for our study include surveying program directors regarding the philosophy of their PGY-1 curriculum, aiming to better categorize the factors influencing educational design.
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    Breaking Barries, Building Bridges: Advancing Interprofessional Collaboration through Pediatric Critical Simulation
    (2024-03-21) Aldeeb, Sara; Olson, Zachary; McKeefer, Haley; Duginski, Christine
    Facilitating exposure of interprofessional collaboration in healthcare is a critical approach to fostering a seamless transition from academics to professional practice. In response, we present a collaborative effort between the student leaders of the Student Society of Health-System Pharmacists and the Texas College of Osteopathic Medicine (TCOM) Simulation Initiative for Medical Simulation (SIMS). Past research conducted at this university has identified the benefits of conducting interprofessional critical care simulation events between groups of student physicians and student pharmacists. During this third iteration of interprofessional simulation events, teams of student pharmacists and physicians worked together utilizing the Pediatric Advanced Life Support (PALS) algorithms to manage simulated medical emergencies of pediatric patients. The simulated cases included ventricular tachycardia and a critical condition status post-drowning case. The two main objectives of the collaboration included our primary objective of improving communication and teamwork skills through collaborative management of simulated pediatric medical emergencies. Our other key objective was enhancing the clinical decision-making abilities of student pharmacists and physicians. Specifically, how students can utilize the strengths of the other profession to help overcome the unique challenges presented during a simulated pediatric critical care scenario. We assessed our objectives by having our participants complete a pre-and post-simulation survey with unique questions for the student pharmacists and physicians. Each question was tied back to a primary concept and contained a 5-point Likert Scale statement. The responses were analyzed using a two-sided, unpaired T-test to determine the significance between our pre and post-survey results. A total of 48 students participated in the simulation event; 34 student physicians and 14 student pharmacists. These students were broken up into teams of 2-3 student pharmacists working collaboratively in teams with 5 student physicians. Each team utilized the PALS algorithms to manage the simulated cases. All ten student physicians and all four student pharmacist questions had an increase in average response when comparing our pre- and post-simulation surveys. However, due to a decrease in post-survey responses and our small sample size, six out of ten student physician questions and none of our student pharmacists questions had a statistically significant difference (p<0.05). Future studies incorporating a larger sample size and additional interprofessional professions may improve the statistical limitations. This study showed a significant improvement in student physicians’ understanding of pharmacists’ roles in critical scenarios. Specifically, this improved a better understanding of protocol timings involved in managing critically ill pediatric patients. The primary concepts that showed an improvement in this study included interprofessional communication, confidence in the ability to manage a critical care scenario, and the importance of an interprofessional approach to patient care. This study expanded upon past research which demonstrated the benefits of interprofessional educational simulations, by focusing on a special population; pediatrics. Increasing interprofessional collaboration in future simulated events, especially in special populations will undoubtedly broaden student knowledge and foster a seamless transition to professional practice.