Human Trafficking Education: A Pilot Study of Integration into Medical School Curriculum.

OBJECTIVES: Few medical schools incorporate formal education on human trafficking (HT) and sex trafficking (ST) into their curriculum. Our objective was to develop, implement, and evaluate education on HT and ST in the first-year medical student curriculum. METHODS: The curriculum included a standardized patient (SP) experience and lecture. As part of their mandatory sexual health course, students interviewed an SP who presented with red flags for ST and then participated in a discussion led by a physician-facilitator in an observed small group setting. A multiple-choice survey to assess knowledge about HT and ST was developed and administered to students before and after the SP interview. RESULTS: Of the 50 first-year medical students, 29 (58%) participated in the survey. Compared with the students' baseline scores (according to the percentage of correct responses), scores after the educational intervention showed a significant increase in percentage correct on questions related to trafficking definition and scope (elder care, P = .01; landscaping, P = .03); victim identification (P < .001); referral to services (P < .001); legal issues (P = .01); and security (P < .001). On the basis of the feedback, a 2-hour lecture, which was adapted from the American Medical Women's Association-Physicians Against the Trafficking of Humans "Learn to Identify and Fight Trafficking" training, was presented the next year to all first-year medical students as part of their longitudinal clinical skills course and before the SP case. Curriculum objectives included learning trafficking definitions, victim/survivor identification, intersections with health care, the local impact of HT, and available resources. CONCLUSION: This curriculum fulfills course objectives and could be replicated at other institutions. Further evaluation of this pilot curriculum is necessary to evaluate its effectiveness.

ANCA-associated vasculitis and severe proximal muscle weakness.

ANCA-associated vasculitis is a multiorgan autoimmune inflammatory disease that has a heterogeneous clinical presentation. Our case report provides additional evidence supporting the association between granulomatosis with polyangiitis and myositis. In our patient with proximal muscle weakness and pain, a normal creatine kinase and lack of antibodies to muscular fiber units ruled out primary myositis. Distinct magnetic resonance imaging of the brain within the deep gray matter in addition to positive serologies were consistent with a diagnosis of granulomatosis with polyangiitis. ANCA-associated vasculitis, specifically granulomatosis with polyangiitis, may be overlooked if musculoskeletal manifestations are the presenting symptoms. Prompt and aggressive treatment prevented this patient from experiencing multiorgan failure.

Review of Published Curriculum on Sex Trafficking for Undergraduate Medical Trainees.

Educational councils and medical societies recommend that medical students learn to recognize and care for victims of sex trafficking. Previous research has found that healthcare providers are one of the few professionals to interact with sex trafficking victims during exploitation. This review evaluates currently published curricular and extracurricular U.S. medical education resources. A literature review of MEDLINE, PubMed, Embase, MedEdPORTAL, Google Scholar, and Google was conducted in December 2018 to January 2019 using the search terms: human trafficking OR sex traffic OR sex violence OR sex work OR sex exploitation OR child prostitution AND education, medical, undergraduate OR students, medical OR medical student or medical education OR education, medical. The inclusion criteria included informational educational materials for medical students on sex trafficking. Studies were excluded for: non-English language, empirical research on sex trafficking, nonhealth or nonundergraduate medical students, and resources focused on other sexual health topics. The database literature search uncovered 64 scholarly articles. Inclusion criteria were met by 4 articles; 2 articles were added from a reference review, and an additional 5 articles were found from an Internet search. These 11 resources provided educational materials relevant to medical students on sex trafficking themes, including scope, consequences, identification, treatment, referral, legal, security, and prevention. The curricula demonstrated a wide variability in delivery method, length, and scope. A limited published sex trafficking curriculum exists for medical student learners. Future research evaluating unpublished curricula within U.S. medical schools is necessary to coordinate efforts for standardized and robust sex trafficking education.