Training the next generation of community-engaged physicians: a mixed-methods evaluation of a novel course for medical service learning in the COVID-19 era.

BACKGROUND: Medical school curricula strive to train community-engaged and culturally competent physicians, and many use service learning to instill these values in students. The current standards for medical service learning frameworks have opportunities for improvement, such as encouraging students to have more sustainable and reciprocal impact and to ingrain service learning as a value to carry throughout their careers rather than a one-time experience. PEDS 220: A COVID-19 Elective is a Stanford University course on the frontlines of this shift; it provides timely education on the COVID-19 pandemic, integrating community-oriented public health work to help mitigate its impact. METHODS: To analyze our medical service learning curriculum, we combined qualitative and quantitative methods to understand our students' experiences. Participants completed the Course Experience Questionnaire via Qualtrics, and were invited to complete an additional interview via Zoom. Interview transcripts were analyzed using an interactive, inductive, and team-based codebook development process, where recurring themes were identified across participant interviews. RESULTS: We demonstrate through self-determination theory that our novel curriculum gives students valuable leadership and project management experience, awards strong academic and community-based connections, and motivates them to pursue future community-engaged work. CONCLUSIONS: This educational framework, revolving around students, communities, and diversity, can be used beyond the COVID-19 pandemic at other educational institutions to teach students how to solve other emergent global health problems. Using proven strategies that empower future physicians to view interdisciplinary, community-engaged work as a core pillar of their responsibility to their patients and communities ensures long-term, sustainable positive impact. TRIAL REGISTRATION: N/A.

Applying Kern's Six Steps to the Development of a Community-Engaged, Just-in-Time, Interdisciplinary COVID-19 Curriculum.

Universities and medical schools often work towards operationalizing their shared mission of facilitating community-engaged work independently. Based on their experience teaching the COVID-19 Elective course at Stanford University School of Medicine, the authors proposed a novel solution for universities and medical schools to achieve an interdisciplinary collaboration within a diverse student population by creating targeted, project-based, and community-engaged courses for addressing emergent health needs. In this article, the authors discuss their curriculum, which was created using Kern's six-step approach for curriculum development, to address emergent health needs related to the novel coronavirus pandemic. The curriculum provides an opportunity for universities and medical schools to advance community health, educate students across the medical and non-medical education continuum, and foster interdisciplinary cooperation.

Association of Lateral Crural Overlay Technique With Strength of the Lower Lateral Cartilages.

IMPORTANCE: The lateral crural overlay technique is a powerful technique for altering nasal tip projection and rotation. By overlapping and thus shortening the lateral crura, the nasal tip is shortened and rotated upward, thus decreasing projection and increasing rotation. There is no data to show the association of this technique with the strength of the lower lateral cartilage. Strengthening of the lower lateral cartilages would presumably lead to resistance to external nasal valve collapse and improved airway. OBJECTIVE: In this cadaver study, we set out to determine the differences in the strength and resilience of the lateral crura after performing lateral crural overlay using 2 different techniques. DESIGN, SETTING, AND PARTICIPANTS: Seven individual lower lateral cartilages were harvested from 6 cadavers for analysis. Each of the 7 cartilages was included sequentially in 3 test groups in the following order: a preprocedure group (preP), a postprocedure group (postP) in which the lateral crural overlay technique was performed, and a postprocedure with glue group (postPG) in which cyanoacrylate glue was added to the postP cartilages to simulate cartilage healing. A force gauge was used to measure the force required to deflect the lower lateral cartilages distances from 1 to 6 mm. MAIN OUTCOMES AND MEASURES: Differences measured in newtons (N) for strength and resilience of lateral crura between the preP, postP, and postPG groups. RESULTS: A statistically significant increase in lower lateral cartilage resilience was noted between the preP and postPG groups at all distances of tip deflection (1 mm, 0.20 vs 0.70 N; P < .001; 2 mm, 0.26 vs 1.13 N; P < .001; 3 mm, 0.31 vs 1.53 N; P < .001; 4 mm, 0.41 vs 2.05 N; P < .001; 5 mm, 0.68 vs 2.60 N; P < .001; 6 mm, 1.49 vs 3.26 N; P = .03). There was a statistically significant difference between the postP and postPG groups in the amount of force required to deflect the cartilages 1 to 5 mm (1 mm, 0.24 vs 0.70 N; P < .001; 2 mm, 0.34 vs 1.13 N; P < .001; 3 mm, 0.51 vs 1.53 N; P < .001; 4 mm, 0.77 vs 2.05 N; P < .001; 5 mm, 1.32 vs 2.60 N; P = .01), but not 6 mm (2.33 vs 3.26 N; P = .31). CONCLUSIONS AND RELEVANCE: The lateral crural overlay technique affords increased strength and resilience to the lateral crura of the lower lateral cartilages, which should in turn decrease the likelihood of external nasal valve collapse postoperatively. LEVEL OF EVIDENCE: NA.