Career-computer simulation increases perceived importance of learning about rare diseases.

BACKGROUND: Rare diseases may be defined as occurring in less than 1 in 2000 patients. Such conditions are, however, so numerous that up to 5.9% of the population is afflicted by a rare disease. The gambling industry attests that few people have native skill evaluating probabilities. We believe that both students and academics, under-estimate the likelihood of encountering rare diseases. This combines with pressure on curriculum time, to reduce both student interest in studying rare diseases, and academic content preparing students for clinical practice. Underestimation of rare diseases, may also contribute to unhelpful blindness to considering such conditions in the clinic. METHODS: We first developed a computer simulation, modelling the number of cases of increasingly rare conditions encountered by a cohort of clinicians. The simulation captured results for each year of practice, and for each clinician throughout the entirety of their careers. Four hundred sixty-two theoretical conditions were considered, with prevalence ranging from 1 per million people through to 64.1% of the population. We then delivered a class with two in-class on-line surveys evaluating student perception of the importance of learning about rare diseases, one before and the other after an in-class real-time computer simulation. Key simulation variables were drawn from the student group, to help students project themselves into the simulation. RESULTS: The in-class computer simulation revealed that all graduating clinicians from that class would frequently encounter rare conditions. Comparison of results of the in-class survey conducted before and after the computer simulation, revealed a significant increase in the perceived importance of learning about rare diseases (p < 0.005). CONCLUSIONS: The computer career simulation appeared to affect student perception. Because the computer simulation demonstrated clinicians frequently encounter patients with rare diseases, we further suggest this should be considered by academics during curriculum review and design.

No gain without pain education: Improving knowledge and biopsychosocial attitudes and beliefs in a predominantly non-health-related undergraduate target audience.

OBJECTIVES: Chronic pain (CP) impacts individuals and society and is the leading cause of disability globally. Pain education interventions are often evaluated in patients and health professional students, but not in non-health student groups. Increasing knowledge of pain may facilitate shifts in attitudes and beliefs towards sufferers. We report on changes in pain knowledge, attitudes and beliefs of predominantly non-health-related tertiary degree students participating in online education. METHODS: Quantitative cohort study design. Students reported demographics and completed the Chronic Pain Myth Scale and 12-item Neurophysiology of Pain Questionnaire (NPQ) before (T1) and after (T2) the 7-week online module at The University of Sydney in 2020. RESULTS: Twenty-two students undertaking predominantly non-health-related bachelor's degrees (16.5% response rate, 90.9% female, mean = 19.5 years) participated. NPQ scores increased from 47.3% to 62.9%. Attitudes and beliefs towards biopsychosocial impact improved (p < 0.027) but not towards individuals suffering from CP or treatment of CP. A negative correlation was found between age and people suffering from CP (ρ = -0.437, p < 0.042) and age and towards treatment of CP; ρ = -0.556, p < 0.007) at T2. CONCLUSION: Completing the elective online module resulted in improved knowledge and biopsychosocial attitudes towards CP in this predominantly non-health cohort, as reported in health and patient cohorts.

Educating and engaging a new target audience about the problem of pain for society.

Background: Pain education initiatives are typically targeted at health professionals, with less attention being placed on the education of other target audiences. Recent curriculum changes across undergraduate liberal studies degree programs at The University of Sydney presented an opportunity to develop an online course entitled Health Challenges: Pain and Society, which was aimed at a non-traditional target audience. To promote student engagement about the problem of pain for society, the course was designed using the Community of Inquiry framework. Research Design: This paper reports on an Educational Design Research study, investigating the effectiveness of the course in engaging students across two cohorts, in 2019 and 2020. Data Collection: Learning analytics were collected from the Learning Management System each year. The level of student engagement in non-assessable tasks was measured using multiple linear regression. Students' degree type and majors were recorded. In 2020, the quality of student workbook responses was recorded. Results: In both cohorts, engagement with the workbooks was a predictor of academic achievement. In 2020, a significant interaction effect between quantity and quality of engagement was observed. Conclusions: Our findings highlight the importance of designing online learning to facilitate successful engagement for non-traditional target audiences about the issue of chronic pain for society.

Methicillin resistant Staphylococcus aureus: carriage rates and characterization of students in a Texas university.

OBJECTIVE: To evaluate the carriage rates of Staphylococcus aureus and methicillin resistant Staphylococcus aureus (MRSA) in a university student population and describe risk factors associated with the carriage of each. DESIGN: Cross-sectional study (N = 203). Institutional Review Board approval was obtained from Texas State University-San Marcos. SETTING: Texas State University-San Marcos, San Marcos, TX. PARTICIPANTS: Two-hundred and three university student samples were collected from December 2007 to July 2008. INTERVENTIONS: None indicated. MAIN OUTCOME MEASURES: The sample set was screened for S. aureus and MRSA identification by standard microbiological techniques and confirmed by use of a Vitek 2 per manufacturer recommendation. Antibiotic susceptibility testing was conducted on each MRSA isolate by Vitek 2. A questionnaire was conducted with each student to acquire demographic and risk factor information. Demographic data is shown by raw numbers, percentages, mean, and median where applicable. The compiled data was screened and analyzed by chi square (p values) and odds ratio (OR) with confidence interval (CI) to determine significance. RESULTS: Of the 203 participants who were screened, 60 (29.6%) carried S. aureus. Univariate analysis found that only hospitalization in the past 12 months was significantly associated with the risk of being a S. aureus carrier (OR=3.0, 95% CI 1.28-7.03). Of the 60 participants that carried S. aureus, 15 were identified as MRSA. This relates to a 7.4% MRSA carriage rate among generally healthy university students. Univariate analysis found that hospitalization in the past 12 months (OR = 4.2, 95% CI 1.29-13.36) and recent skin infection (OR = 4.4, 95% CI 1.07-18.24) were significantly associated with the risk of being a MRSA carrier. No unique antibiotic susceptibility patterns were identified with the MRSA isolates. CONCLUSIONS: The carriage rate of S. aureus is consistent with similar studies. MRSA carriage in this university study appears high as compared to the general population. Although this study did not confirm a variety of risk factors for carriage of MRSA previously identified by others, university healthcare personnel should be aware of the changing epidemiology of MRSA and preventive measures needed to avoid outbreaks.

Multi-Center Evaluation of the Automated Immunohematology Instrument, the ORTHO VISION Analyzer.

BACKGROUND: ORTHO VISION Analyzer (Vision), is an immunohematology instrument using ID-MT gel card technology with digital image processing. It has a continuous, random sample access with STAT priority processing. The efficiency and ease of operation of Vision was evaluated at 5 medical centers. METHODS: De-identified patient samples were tested on the ORTHO ProVue Analyzer (ProVue) and repeated on the Vision mimicking the daily workload pattern. Turnaround times (TAT) were collected and compared. Operators rated key features of the analyzer on a scale of 1 to 5. RESULTS: A total of 507 samples were tested on both instruments at the 5 trial sites. The mean TAT (SD) were 31.6 minutes (5.5) with Vision and 35.7 minutes (8.4) with ProVue, which renders a 12% reduction. Type and screens were performed on 381 samples; the mean TAT (SD) was 32.2 minutes (4.5) with Vision and 37.0 minutes (7.4) with ProVue. Antibody identification with eleven panel cells was performed on 134 samples on Vision; TAT (SD) was 43.2 minutes (8.3). The installation, training, configuration, maintenance and validation processes are all streamlined to provide a short implementation time. The average rating of main functions by the operators was 4.1 to 4.8. Opportunities for improvement, such as flexibility with editing QC results, maintenance schedule, and printing options were identified. The capabilities to perform serial dilutions, to accept pediatric tubes, and review results by e-Connectivity are enhancements over the ProVue. CONCLUSIONS: Vision provides shorter TAT compared to ProVue. Every site described a positive experience using Vision.