Medical Science Educator最新文献

{"title":"A \"Noodle and Thread\": A Low-Fidelity Simulation of Blood Vessel Ligation Using Common Household Items.","authors":"Justin Markel, Jacob D Franke, Kerri Woodberry, Matthew Fahrenkopf","doi":"10.1007/s40670-025-02315-w","DOIUrl":"https://doi.org/10.1007/s40670-025-02315-w","url":null,"abstract":"<p><strong>Purpose: </strong>Simulation is becoming increasingly essential to surgical education, and many skills are learned in simulation-based training laboratories before being used in the operating room (OR). The COVID-19 pandemic exposed the need for alternative methods of learning important surgical techniques, particularly in resource-limited areas. One of the most important early skills for trainees is surgical knot tying without exerting excessive upward traction, such as that used to ligate blood vessels prior to division and cautery.</p><p><strong>Methods: </strong>To help solve this problem, we have developed a model of blood vessel ligation and surgical knot tying using common, inexpensive household items including noodles, adhesive tape, and thread.</p><p><strong>Results: </strong>The proposed model adequately simulated blood vessel ligation and displayed a wide spectrum of difficulty levels based on the materials chosen.</p><p><strong>Conclusions: </strong>Surgical knot tying can be practiced in private settings with the proposed model of blood vessel ligation. The model is low cost, and its difficulty can be adjusted by changing noodle morphology.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 2","pages":"597-602"},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Knowing to Doing: Implementing Health Equity Education in the Undergraduate Medical Education Clinical Setting.","authors":"Nicholas D Phelps, Sherine E Salib, Stephanie B Corliss, Elizabeth A Nelson","doi":"10.1007/s40670-025-02320-z","DOIUrl":"https://doi.org/10.1007/s40670-025-02320-z","url":null,"abstract":"<p><p>Incorporating health equity into medical education is a crucial component of training the next generation of physician leaders. As such, The University of Texas at Austin's Dell Medical School adopted health equity as a core competency domain in its Leading EDGE curriculum. Health equity teaching begins in the classroom and continues into the clerkship curriculum. MS2 students during the 22-23 academic year (<i>n</i> = 44) exhibited significant increases in health equity competence, evidenced by clinical performance assessments, self-assessments, and student clerkship evaluations. Through assessment and revision of our health equity curriculum, Dell Medical School anticipates further growth in student health equity competence.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1179-1183"},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"A Role Model Is Someone Who…\" A Multi-institutional Study of Clinical Role Models According to Ethnic Minority and Majority Medical Students.","authors":"Isabella Spaans, Renske de Kleijn, Piet Groot, Gönül Dilaver","doi":"10.1007/s40670-025-02317-8","DOIUrl":"10.1007/s40670-025-02317-8","url":null,"abstract":"<p><strong>Purpose: </strong>It is a common conception that students who are culturally underrepresented in medicine (URiM) do not have enough representative role models. This study explores the role of ethnicity in medical students' clinical role model definitions. The authors introduce a conceptual framework that outlines a four-stage process of role modeling: idealization, social comparison, composition, and (behavioral and symbolic) outcomes.</p><p><strong>Method: </strong>In total, 363 Dutch medical students completed the statement \"A role model is someone who…\" Answers were coded based on the conceptual framework. Students also indicated if and how many role models they have (composition) and rated the ethnic similarity to their role model. URiM (<i>N</i> = 62) and non-URiM students (<i>N</i> = 301) were compared using <i>χ</i> ²- and <i>t</i>-tests.</p><p><strong>Results: </strong>URiM and non-URiM students reported a similar number of role models and described the same stages of role modeling. However, URiM students rated the ethnic similarity to their role models lower than non-URiM peers. Additionally. students with less ethnically similar role models reported symbolic role model outcomes less frequently.</p><p><strong>Conclusions: </strong>URiM and non-URiM students generally presented a very similar perception of clinical role models. However, URiM students identified less ethnically representative role models compared to non-URiM students, and the symbolic outcomes of role modeling appeared to be sensitive to this ethnic similarity. This discrepancy may limit the full benefits of role modeling for all students who do not have representative role models. To promote equitable learning experiences in medical education, it is recommended that future research on clinical role models continues to address the social context.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1399-1410"},"PeriodicalIF":1.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Clerkship Length and Sequence on NBME Subject Exam Performance.","authors":"Megan Vaughan, Kory A Johnson, Christina R Bergin","doi":"10.1007/s40670-025-02305-y","DOIUrl":"10.1007/s40670-025-02305-y","url":null,"abstract":"<p><strong>Purpose: </strong>Core clerkships are foundational learning experiences, yet variability in duration exists across medical schools. Many institutions adjust core clinical experiences as part of curricular modifications to meet evolving needs in undergraduate medical education. We investigated if shortened Internal Medicine (IM) and Surgery clerkship lengths or if clerkship sequence within the academic year would have any impact on NBME subject exam scores.</p><p><strong>Methods: </strong>We examined four cohorts of third-year medical students from academic years 2017-2018, 2018-2019, 2019-2020, and 2021-2022. Individual student NBME subject exam data were compared, controlling for MCAT score and clerkship block sequence within the academic year.</p><p><strong>Results: </strong>We found no statistically significant differences in IM or Surgery NBME subject exam scores between the traditional clerkship length (2017-2019) and shortened clerkship length (2019-2022) groups. Mixed-effect regression analyses that included MCAT and block sequence as additional covariates confirmed there were no statistically significant differences in IM or Surgery exam scores between groups. Despite no change in length, the Psychiatry (<i>p</i> = 0.012) and Pediatrics (<i>p</i> = 0.036) clerkships had increased scores post-intervention on the mixed-effects model. MCAT scores were predictive of overall NBME scores on both ANCOVA and regression analyses (<i>p</i>-values ranging < 0.001 to 0.01). Finally, taking a clerkship later in the academic year was associated with increased NBME scores across all subjects (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Shortened clerkship length is not associated with lower performance on NBME subject exams. Clerkship sequence later in the academic year is associated with higher scores. Curricular reform resulting in reduced core clerkship duration may be undertaken without adverse impact on medical knowledge.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40670-025-02305-y.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1313-1322"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negatively Marked Elimination-Format Multiple-Choice Questions Are Associated with High Cognitive Load and Poor Student Experience Compared to Single Best Answer.","authors":"Philip M Newton, Katherine H Furby, Jude Campbell, Atharva Salvi, Gabriella Santiago, Michael Chau","doi":"10.1007/s40670-025-02318-7","DOIUrl":"10.1007/s40670-025-02318-7","url":null,"abstract":"<p><p>Multiple-choice questions (MCQs) are a common form of assessment in medical science education. The traditional MCQ format involves students picking a single best answer (SBA) from four or five options. There are concerns about the ability of SBA formats to reward partial knowledge and their susceptibility to guessing. An alternative to SBA is elimination testing (ET), wherein students eliminate all the <i>incorrect</i> answer options, with negative marking to deter guessing. Cognitive load theory (CLT) is an approach to education that prioritises strategies to minimise the amount of unnecessary 'load' placed upon working memory. The cognitive load imposed by assessment design has received little attention. We evaluated the cognitive load of SBA and ET MCQ formats, using an online participant pool and a survey of students at a UK Medical School. We found that partial knowledge was rewarded with the ET format. However, students strongly preferred the SBA format and reported both that it was easier and imposed a lower cognitive load. Removing negative marking reduced the cognitive load of ET style questions and improved the student experience, but the improvement was insufficient to change student preference for SBA questions.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1411-1422"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Analysis of the Relationship Between Simulated And Clinical Learning Environments in Obstetrics and Gynaecology.","authors":"Ronan Daly, Daniel Kane, Anne Browne, Karen Flood","doi":"10.1007/s40670-025-02313-y","DOIUrl":"10.1007/s40670-025-02313-y","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical placement on the labour ward is an essential component of Obstetrics and Gynaecology curricula in medical schools worldwide. This clinical learning environment (CLE) provides students with a formative opportunity for experiential learning around labour and delivery. However, the CLE presents challenges to learning, in particular diversity of experiences and opportunities. The simulated learning environment (SLE) has been adopted by medical schools worldwide in order to address such issues. The SLE provides a safe space for students to practise clinical skills around care in labour and delivery. These learning experiences form the sole exposure for many students to labour and delivery. This study examines the learner experience of these environments and the relationship between them.</p><p><strong>Methods: </strong>A qualitative research study was performed in the Royal College of Surgeons Ireland. Fourth year undergraduate medical students undertaking their obstetrics and gynaecology rotation were invited to participate. Students attend a labour ward simulation and a week-long clinical placement as part of this rotation. Focus groups were conducted following the simulation and students completed audio diaries during their clinical placement which underwent inductive content analysis.</p><p><strong>Results: </strong>Four major concepts emerged from analysis of the data from 29 participating students. Simulation was viewed by students as preparation for the CLE. Learner safety within the simulated learning space was highly valued by students. Learner roles in the SLE were often assigned, while student identity on the labour ward developed from their own engagement, patient interactions, and interprofessional staff. Students identified the emotional aspect of the CLE of the labour ward as a significant impact on their learning experience.</p><p><strong>Conclusion: </strong>The SLE was valued as a stepping-stone to prepare for the CLE. The safety afforded by the simulated labour ward was important to the student learning experience. The CLE was conducive to the formation of learner identities and students valued the emotional engagement with patients. These two areas require further exploration within the simulated learning space.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40670-025-02313-y.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1371-1383"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student and Faculty Differences in Perceived Utility of Learning Objectives in Pre-Clerkship Self-Learning Guides.","authors":"Cameron J Hill, Thomas McNamara, Roey Ringel, Luke S Scheuer, Carrie Elzie, Gwynneth Offner, Caitlin Neri, Molly Cohen-Osher, Priya S Garg, Jonathan J Wisco","doi":"10.1007/s40670-025-02316-9","DOIUrl":"https://doi.org/10.1007/s40670-025-02316-9","url":null,"abstract":"<p><strong>Purpose: </strong>To compare faculty and student perceptions of the clarity, utility, and specificity of faculty-created self-learning guide (SLG) learning objectives (LOs) and assess the alignment between these perceptions.</p><p><strong>Methods: </strong>We used a mixed-methods narrative inquiry. Medical students and faculty involved in the first-year curriculum completed an online Likert scale survey about SLG LOs, and focus groups were held with a subset of participants. Data were analyzed using <i>t</i>-tests, descriptive statistics, and inductive thematic analysis.</p><p><strong>Results: </strong>Out of 158 students, 72 (45.6%) responded, while 18 of 58 (31.0%) faculty members responded to the survey. Students expressed lower ratings of the SLG LOs (mean ± SD: 3.27 ± 0.92) compared to faculty (4.39 ± 0.49) (<i>p</i> < 0.0001). Student focus group data (<i>n</i> = 11) suggested that LOs are not consistently clear. However, faculty focus group data (<i>n</i> = 3) suggested that LOs are generally answerable.</p><p><strong>Conclusions: </strong>Students seek clear LOs that direct them on what material to study and aid in long-term studying and board exam preparation. The study reveals a gap between faculty and student perceptions of answerable LOs. Clear and specific LOs in self-learning guides (SLGs) are essential for maximizing student preparedness for in-class application and assessments.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40670-025-02316-9.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1393-1397"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study Habits in Medical Education: Examining How German Medical Students Study Using a Cross-sectional Mixed-Methods Survey.","authors":"Sophia Viktoria Ragaller, Johanna Flora Rother, Alexandra Aster, Tobias Raupach","doi":"10.1007/s40670-025-02324-9","DOIUrl":"10.1007/s40670-025-02324-9","url":null,"abstract":"<p><p>The shift to digital teaching and learning during the pandemic has had a lasting impact on how students study medicine. Understanding how medical students learn and which resources they use is essential for successfully implementing teaching innovations. In this cross-sectional survey at a German medical school, 340 students completed the LIST-K questionnaire to assess cognitive, metacognitive, and resource management learning strategies. Additionally, students provided information on their preferences regarding educational media and tools used during their study process. Data were analysed with a specific focus on differences between preclinical and clinical years of medical education. Students primarily used resource management strategies, such as effort and external sources of information, while cognitive strategies such as organisation and critical review were employed less frequently. There was a strong emphasis on using local exam questions and a commercial product providing past exam questions and supplemental content. When examining media and tool use in different phases of medical education, the most significant difference related to a less frequent use of textbooks and other literature in clinical compared to preclinical years. Our results highlight students' focus on assessment-oriented learning, particularly the use of past exam questions, suggesting a performance goal orientation rather than a mastery approach. However, due to its cross-sectional design, the study does not allow causal conclusions to be drawn. The heavy reliance on a commercial product not aligning with the local curriculum is concerning, and future studies should explore underlying reasons and potential interventions to address this unbalance.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s40670-025-02324-9.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1441-1449"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Domain Assessment of Artificial Intelligence Chatbots: A Comparative Study Between ChatGPT and Gemini's Understanding of Anatomy Education.","authors":"Arthi Ganapathy, Parul Kaushal","doi":"10.1007/s40670-025-02303-0","DOIUrl":"https://doi.org/10.1007/s40670-025-02303-0","url":null,"abstract":"<p><strong>Purpose: </strong>The integration of AI chatbots into education has gained traction, particularly in medical fields such as anatomy. This study aims to evaluate and compare the responses of ChatGPT 4o mini and Gemini across different cognitive domains of anatomy education.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to assess the responses of these two AI chatbots to a set of anatomy questions selected from the Manual on Competency-Based Undergraduate Curriculum. Questions were categorized into knowledge, comprehension and application levels of cognitive domain. Responses were scored against an answer key prepared by anatomy experts. Relevant comparative statistical analysis was performed.</p><p><strong>Results: </strong>The overall performance of ChatGPT 4o mini (76.15%) was significantly superior to Gemini (72.84%). In application-level questions, ChatGPT 4o mini outperformed Gemini. Conversely, Gemini scored higher in comprehension-level questions (76.88% vs. 73.66%). Both chatbots exhibited factual inaccuracies and limitations in contextually accurate responses, particularly in application-level questions.</p><p><strong>Conclusion: </strong>Both ChatGPT 4o mini and Gemini demonstrate potential as educational tools in anatomy, with strengths and limitations varying by cognitive domain. While AI chatbots can supplement traditional learning methods, they require ongoing refinement and validation. To ensure the responsible integration of AI into medical education, close attention must be devoted to faculty and student training, setting up relevant IT environment and ethical issues. Future research should focus on expanding question pools, incorporating user feedback and comparing with traditional educational approaches to enhance their effectiveness.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1295-1304"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Physician Assistant Prerequisite Coursework and Student Success.","authors":"Sarah Neguse, Darcy Solanyk, Jennifer L Hellier, David Holmerud, Scott Massey, Cathy Ruff","doi":"10.1007/s40670-025-02326-7","DOIUrl":"10.1007/s40670-025-02326-7","url":null,"abstract":"<p><p>This study investigates the impact of prerequisite science courses on student outcomes in a physician assistant (PA) training program. Given the conflicting literature on the necessity of such coursework and the variation in required courses across PA programs, this study aimed to assess whether prerequisite courses are essential for success. One PA program eliminated prerequisite coursework, allowing analysis of impacts on student outcomes. Data from 2018-2021 Centralized Application Service for Physician Assistants (CASPA) records and student performance metrics were analyzed. Stratification analysis and Pearson correlation coefficients were used to assess the relationship between the number of science credit hours and clinical year variables. Results indicate no consistent correlation between completed prerequisite credit hours and student performance on various assessments. Even applicants with minimal (0-1) credit hours performed similarly to those with extensive (> 15) credit hours. There was no statistically significant correlation between prerequisite courses and Physician Assistant National Certifying Exam (PANCE) scores. Additionally, the study found no significant relationship between the nationally benchmarked Physician Assistant Clinical Knowledge Rating and Assessment Tool (patterned off the PANCE) scores and the number of physiology credit hours, but a notable inverse relationship between genetics credit hours and a nationally benchmarked summative examination (End of Curriculum Exam (ECOE)) performance. The analysis revealed that variations in prerequisite coursework did not consistently correlate with student performance across assessments, casting doubt on the necessity of specific science courses for PA program success. However, limitations including fewer candidates with prerequisite coursework requirements, and variability in assessment tools, may influence the generalizability of these results.</p>","PeriodicalId":37113,"journal":{"name":"Medical Science Educator","volume":"35 3","pages":"1451-1459"},"PeriodicalIF":1.9,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}