LEPTOSPIRA, PARVOVIRUS, AND TOXOPLASMA IN THE NORTH AMERICAN RIVER OTTER (LONTRA CANADENSIS) IN NORTH CAROLINA, USA.

The North American river otter (Lontra canadensis) is the largest mustelid in North Carolina, US, and was once extirpated from the central and western portions of the state. Over time and after a successful reintroduction project, otters are now abundant and occur throughout North Carolina. However, there is a concern that diseases may have an impact on the otter population, as well as on other aquatic mammals, either through exposure to emerging diseases, contact with domestic animals such as domestic cats (Felis catus), or less robust condition of individuals through declines in water quality. We tested brain and kidney tissue from harvested otters for the pathogens that cause leptospirosis, parvovirus, and toxoplasmosis. Leptospirosis and toxoplasmosis are priority zoonoses and are maintained by domestic and wild mammals. Although parvovirus is not zoonotic, it does affect pets, causing mild to fatal symptoms. Across the 2014-15 and 2015-16 trapping seasons, we tested 220 otters (76 females, 144 males) using real-time PCR for Leptospira interrogans, parvovirus, and Toxoplasma gondii. Of the otters tested, 1% (3/220) were positive for L. interrogans, 19% (41/220) were positive for parvovirus, and 24% (53/220) were positive for T. gondii. Although the pathogens for parvovirus and toxoplasmosis are relatively common in North Carolina otters, the otter harvest has remained steady and the population appears to be abundant and self-sustaining. Therefore, parvovirus and toxoplasmosis do not currently appear to be negatively impacting the population. However, subsequent research should examine transmission parameters between domestic and wild species and the sublethal effects of infection.

Metal contamination of river otters in North Carolina.

Aquatic apex predators are vulnerable to environmental contaminants due to biomagnification. North American river otter (Lontra canadensis) populations should be closely monitored across their range due to point and nonpoint pollution sources. Nonetheless, no information exists on environmental contaminants in the North Carolina otter population. Metals and metalloids occur naturally across the landscape, are essential for cellular function, and become toxic when concentrated unnaturally. We conducted our study across the three Furbearer Management Units (FMU) and 14 river basins of North Carolina. We determined the concentrations of arsenic, cadmium, calcium, cobalt, copper, iron, lead, magnesium, manganese, mercury, molybdenum, selenium, thallium, and zinc in liver and kidney samples from 317 otters harvested from 2009 to 2016. Arsenic, lead, and thallium samples were tested at levels below the limit of detection. With the exception of cadmium, we detected all other elements at higher levels in the liver compared with the kidney. Specifically, cadmium, cobalt, copper, iron, magnesium, manganese, mercury, molybdenum, and zinc levels differed by tissue type analyzed. Most element concentrations remained stable or increased with otter age. We detected higher levels of mercury and selenium in the Lower Pee Dee and Cape Fear river basins. River basins within the Mountain FMU were higher in cadmium, copper, iron, lead, and zinc, whereas the Coastal Plain FMU was lower in cobalt and manganese. None of the elements occurred at toxic levels. Our research establishes baseline concentration levels for North Carolina, which will benefit future monitoring efforts and provide insight into future changes in the otter population.

Nephrolithiasis in free-ranging North American river otter (Lontra canadensis) in North Carolina, USA.

The North American river otter (Lontra canadensis) serves as an indicator species for environmental monitoring, is prized as a valuable furbearer, and is a popular display animal in zoologic collections. Nephrolithiasis has been reported as a frequent problem in other free-ranging and captive otter species but is rarely reported in North American river otters. In this study, we compared the prevalence of nephrolithiasis diagnosed using routine gross pathologic examination techniques with the use of computed tomography (CT) of excised kidneys. We also evaluated whether otter nephroliths could be accurately classified by their CT densities, and we examined the renal tissue uric acid concentrations in free-ranging otters in North Carolina, USA. Kidneys were collected from carcasses of legally trapped, free-ranging animals. Nephroliths were observed in 16.2% of the individuals (n = 229). Associations were found between age and nephrolith status and between capture location and nephrolith status (P = 0.026 and < 0.001, respectively). Computed tomography Hounsfield unit density measurements were not useful in determining nephrolith chemical composition in this study. Renal tissue uric acid concentrations were similar across genders, age groups, and stone status. The chemical composition of the nephroliths was determined by scanning electron microscopy-energy dispersive X-ray spectroscopy to be calcium phosphate in the carbonate form.

Learning basic surgical skills with mental imagery: using the simulation centre in the mind.

CONTEXT: Although surgeons and athletes frequently use mental imagery in preparing to perform, mental imagery has not been extensively researched as a learning technique in medical education. OBJECTIVE: A mental imagery rehearsal technique was experimentally compared with textbook study to determine the effects of each on the learning of basic surgical skills. METHODS: Sixty-four Year 2 medical students were randomly assigned to 2 treatment groups in which they undertook either mental imagery or textbook study. Both groups received the usual skills course of didactic lectures, demonstrations, physical practice with pigs' feet and a live animal laboratory. One group received additional training in mental imagery and the other group was given textbook study. Performance was assessed at 3 different time-points using a reliable rating scale. RESULTS: Analysis of variance on student performance in live rabbit surgery revealed a significant interaction favouring the imagery group over the textbook study group. CONCLUSIONS: The mental imagery technique appeared to transfer learning from practice to actual surgery better than textbook study.

A reliable and valid instrument to assess competency in basic surgical skills in second-year medical students.

BACKGROUND: Despite calls for competency based education, a dearth of validated instruments for measuring basic skills currently exists. We developed an instrument to assess competency in basic surgical skills in second-year medical students and tested it for psychometric reliability and validity. METHODS: From a review of the literature, an instrument comprised of numerically scaled items was constructed. After initial tests, several items were divided to produce a final instrument more specific and more appropriate for providing feedback to students. The final instrument was empirically tested for reliability and validity. RESULTS: The final 10-item instrument is presented here along with all of the empirical evidence including internal consistency reliability and interrater reliability, and content, criterion-related, and construct validity. Overall alpha reliability was 0.84 and interrater reliability was r = 0.83, P < 0.01 for the total scores. Factor analysis provided evidence of construct validity. CONCLUSIONS: The instrument has psychometric properties adequate for use as one criterion for summative evaluation and is educationally practical enough to provide focused and detailed feedback for student improvement.

Student Course Evaluations: Common Themes across Courses and Years.

Student course evaluations were analyzed for common themes across five different basic science, clinical, and innovative courses from the first and third years of medical school. Each course had both unique and common numerically scaled items including an overall quality rating item. A principal components analysis was conducted for each course to determine the items that loaded most heavily on the same component as the overall quality item. Across courses and years, the items that consistently loaded on the same component as the overall quality item were (1) administrative aspects including course organization, (2) clearly communicated goals and objectives, and (3) instructional staff responsiveness. These results concur with recent medical education literature in this area. Faculty interested in increasing student ratings of the overall quality of their courses might best attend primarily to carefully organizing course goals and objectives and clearly communicating them. The limitations of these conclusions are discussed.

Comparing the effects of physical practice and mental imagery rehearsal on learning basic surgical skills by medical students.

OBJECTIVE: The purpose of this study was to test the effects of varying the amount of physical practice and mental imagery rehearsal on learning basic surgical procedures. STUDY DESIGN: Using a sample of 65 second-year medical students, 3 randomized groups received either: (1) 3 sessions of physical practice on suturing a pig's foot; (2) 2 sessions of physical practice and 1 session of mental imagery rehearsal; or (3) 1 session of physical practice and 2 sessions of imagery rehearsal. All participants then performed a surgery on a live rabbit in the operating theater of a veterinary college under approved conditions. Analysis of variance was applied to pre- and post-treatment ratings of surgical performance. RESULTS: Physical practice followed by mental imagery rehearsal was statistically equal to additional physical practice. CONCLUSION: Initial physical practice followed by mental imagery rehearsal may be a cost-effective method of training medical students in learning basic surgical skills.

A survey of basic technical skills of medical students.

PURPOSE: In 1998, the Medical Schools Objectives Project (MSOP) Report listed the minimum routine technical procedures that graduating medical students should be proficient to perform. The authors conducted a survey to determine to what extent basic technical skills are being taught formally and how student competence in these skills is being evaluated in U.S. medical schools. METHOD: A questionnaire of five items, designed to supplement existing information in CurrMIT, the national curriculum database for medical schools, was transmitted electronically via the AAMC listserv to associate deans for academic affairs. RESULTS: Sixty-two of the 126 medical schools (52%) responded to the survey. Most agreed that graduating medical students should be proficient to perform basic technical skills. Fifty-five percent of the respondents required students to keep logs of procedures performed. A majority responded that their students were proficient to perform venipuncture, IV placement, suturing lacerations, Foley catheter placement, and arterial puncture. The responding schools stated that few students are proficient in thoracentesis and intubation of children and neonates. CONCLUSIONS: It is likely that half of the medical schools are not attaining the MSOP objective of rigorously teaching and evaluating technical procedures. Currently, more measures and more sophisticated measures of physicians' performance are being implemented in medical practice. The authors' findings call attention to this educational need and act as a stimulus to improve this aspect of medical education.

Attitudes of veterinary medical students and medical students toward collaborative learning: an experiment.

This study measured the attitudes of 55 medical students and 30 veterinary medical students as they participated in an experiment of collaborative teaching and learning about basic surgical skills. Two parallel forms of an attitude questionnaire were developed, with three subscales: confidence in one's own surgical skill; collaboration with the other type of student; and inter-professional collaboration in general. These attitude scales were administered before and after an experiment involving the veterinary medical students teaching the medical students incision and exploratory laparoscopy in a laboratory setting using live rabbits. After the experiment, measures of the medical students' attitudes had increased significantly on all three subscales. Measures of the veterinary students' attitudes increased significantly on two subscales but declined on the subscale of inter-professional collaboration.