Student Teaching in the Family Medicine Clerkship: Opportunities for Interactive Virtual Learning.

OBJECTIVES: It often is challenging to deliver clerkship didactic sessions in a time-effective and engaging manner for learners. The flipped classroom approach, which fosters independent learning before applying knowledge in group settings, is an evidence-based way to enhance engagement and learning. Electronic learning methodologies were used widely during the coronavirus disease 2019 pandemic to ensure student safety while continuing didactics remotely. Student teaching of didactics delivers key content in innovative ways while also providing students with the opportunity to teach their peers. METHODS: During the Family Medicine clerkship at Florida International University Herbert Wertheim College of Medicine, students deliver an interactive, 15-minute presentation on a core Society of Teachers of Family Medicine National Clerkship Curriculum topic. During the first year of the pandemic (2020), this assignment was transitioned to be conducted remotely via Zoom. For the 2020-2021 academic year, students completed an anonymous, optional, computer-based, postactivity survey to assess their satisfaction with and perceptions of the assignment. RESULTS: The majority (80%) of respondents reported that they enjoyed teaching in the online format. In addition, students reported that this assignment made them feel confident in their teaching abilities, that they learned from their peers, and that teaching helped clarify their understanding of the topic. CONCLUSIONS: Student-led teaching is beneficial to learners because it enhances engagement. It can be easily implemented and help reduce faculty burden for curricular development. In a distributed, community-based clinical model such as ours, electronic learning allows for coordinated teaching efforts across geographical boundaries.

Bell's Palsy Secondary to COVID-19 Infection.

SARS-CoV-2 (COVID-19) is known to present with a variety of features, with the most common being upper and lower respiratory tract symptoms. However, there are emerging reports of COVID-19 infections with extrapulmonary manifestations, including neurological conditions. We report a case of a patient who presented to his primary care physician with symptoms of Bell's Palsy after recovering from a COVID-19 infection. He was given timely and appropriate treatment that resolved symptoms without residual neurological deficits.

Post-Polio Syndrome in a Primary Care Setting: A Case Report.

Post-Polio Syndrome (PPS) is a sequela of poliovirus infection that causes weakness in previously infected polio patients years after the initial infection. The diagnosis is one of exclusion and entails the following: 1) a prior episode of poliomyelitis with residual motor neuron function loss, 2) a period of at least 15 years or more after the acute onset of polio with neurologic and functional stability, and 3) a gradual onset of new weakness and abnormal muscle fatigability that has persisted for at least one year. While the exact etiology is unknown, the prevalence of PPS has increased as patients who have previously survived polio are getting older. In this report, we discuss a patient presenting to his primary care provider for evaluation of worsening lower extremity weakness over the course of the past three years. In addition to general characteristics of PPS, we will review the use of electromyography (EMG)/nerve conduction studies and imaging for evaluation. This report will also review prevention methods with vaccinations and identify potential treatment regimens including aerobic exercise and medications ranging from tricyclic antidepressants (TCAs) to dopamine agonists. The goal of this paper is to not only shine a light on PPS in general, but to show how social determinants i.e., economic stability, healthcare access and quality of health may affect the diagnosis of uncommon conditions.

Family Medicine Clerkship Assessment Analysis: Application and Implications.

INTRODUCTION: Clerkship assessment structures should consist of a systematic process that includes information from exam and assignment data to legitimize student grades and achievement. Analyzing student performance across assessments, rather than on a single assignment, provides a more accurate picture to identify academically at-risk students. This paper presents the development and implications of a structured approach to assessment analysis for the Family Medicine Clerkship at Florida International University Herbert Wertheim College of Medicine. METHODS: The assessment analysis included a table presenting the distribution of all assessment performance results for 166 clerkship students from April 2018 to June 2019. A correlation table showed linear relationships between performance on all graded activities. We conducted a Pearson analysis (r), coefficient of determination (r 2), multiple regression analysis, and reliability of performance analysis. RESULTS: Performance on one assessment-the core skills quiz-yielded a statistically significant correlation (r=.409, r 2= .16, P<.001) with the final clerkship grade. The reliability of performance analyses showed low performers (<-1.7 SD), had both a low mean quiz score (59.6) and final grade (83). Top performers (>-1.7 SD) had both a high mean quiz score (88.5) and final grade (99.6). This was confirmed by multiple regression analysis. CONCLUSION: The assessment analysis revealed a strong linear relationship between the core skills quiz and final grade; this relationship did not exist for other assignments. In response to the assessment analysis, the clerkship adjusted the grading weight of its assignments to reflect their utility in differentiating academic performance and implemented faculty development regarding grading for multiple assignments.

Sexual Health Teaching in the Family Medicine Clerkship: Results of a CERA Survey.

INTRODUCTION: With growing efforts to provide comprehensive and inclusive sexual health care, family medicine clerkships are well positioned to educate learners about a spectrum of related topics. This study investigated the current state of sexual health instruction in family medicine clerkships, including specific factors impacting its delivery. METHODS: Questions about sexual health curricula were created and included as part of the 2020 Council of Academic Family Medicine's Educational Research Alliance survey of family medicine clerkship directors. The survey was distributed via email to 163 recipients between June 1, 2020 and June 25, 2020. RESULTS: One hundred five (64.42%) of 163 clerkship directors responded to the survey. Our results revealed that during family medicine clerkships, family planning, contraception, and pregnancy options counseling are covered significantly more often than topics related to sexual dysfunction and satisfaction and LGBTQ+ health. Most clerkship directors (91.5%) reported less than 5 hours of sexual health training in their curriculum. Those with more dedicated sexual health curricular hours were more likely to include simulation. Lack of time (41.7%) was the most frequently reported barrier to incorporating sexual health content into the clerkship. CONCLUSIONS: Coverage of sexual health topics during the family medicine clerkship is limited in scope and delivery. To support curricular development and integration, future studies should more thoroughly examine the factors influencing the inclusion of sexual health content in family medicine clerkships as well as the development of assessment methods to determine competency.