Irene Alexandraki, Anne L. Kern, Russell T. Baker, Gary L Beck Dallaghan, Jeffrey Seegmiller
{"title":"Exploring Community Preceptors’ Professional Identity Formation as Medical Educators: A Qualitative Study","authors":"Irene Alexandraki, Anne L. Kern, Russell T. Baker, Gary L Beck Dallaghan, Jeffrey Seegmiller","doi":"10.24926/jrmc.v8i3.6694","DOIUrl":"https://doi.org/10.24926/jrmc.v8i3.6694","url":null,"abstract":"Purpose A sense of professional identity as a medical educator nurtures self-efficacy, commitment, job satisfaction, and motivation to engage deliberately in teaching which are essential in becoming an effective teacher. Engagement in communities of medical educators may foster the formation of a teacher identity. For community preceptors who practice in settings away from the medical school the formation of professional identity as educators is less understood. This study aimed to explore the formation of community preceptors’ sense of self-identity as medical educators. Method Semi-structured interviews were conducted with community preceptors from two medical schools from May to July 2022. Transcripts were analyzed using open coding. Cruess et al. Professional Identity Formation framework was used to organize codes into categories and themes. Results Eleven community preceptors practicing in rural settings were interviewed. Participants reported feeling isolated, and lacking contemporary role models. They identified teaching faculty during their medical school and residency training as role models. Opportunities to socialize with other medical educators and engage in faculty development were limited. Clinical demands, time constraints, and practice location hindered their engagement and sense of belonging in the community of medical educators. Their self-confidence as educators was founded on their self-assessed competency as clinicians. They perceived clinical competency as most important in their ability to teach. They acknowledged the value of teaching in their professional growth and patient care. Conclusions Community preceptors had limited opportunities for socialization with other medical educators, faculty development, and engagement with the medical school. They attributed their self-confidence as medical educators to their self-assessed clinical competency. Teaching was valuable to their professional growth and patient care. More research is needed to better understand the factors influencing the formation of an educator identity in community preceptors to develop strategies for their successful integration into the community of medical educators.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://pubs.lib.umn.edu/index.php/jrmc/article/download/6694/4090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147886345","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 Curious Reflection","authors":"W. Crump","doi":"10.24926/jrmc.v6i3.5100","DOIUrl":"https://doi.org/10.24926/jrmc.v6i3.5100","url":null,"abstract":"A regional campus dean provides a reflection for colleagues on the importance of maintaining curiosity to find meaning in work.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"2012 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86375643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Behind the Mask II","authors":"Ryan D. Murphy, Miki Calderon, M. Stephens","doi":"10.24926/jrmc.v6i3.5063","DOIUrl":"https://doi.org/10.24926/jrmc.v6i3.5063","url":null,"abstract":"The COVID-19 pandemic presented the medical education community with unprecedented challenges. Little is known about the impact of the pandemic on professional identity formation (PIF) in matriculating students. The objective of this study is to explore the impact of COVID-19 on PIF in a cohort of first-year medical students using mask-making and narrative reflection. This study took place in the spring of 2021. Following IRB approval, Penn State College of Medicine’s University Park Entering Class of 2020 (n=12 students) was invited to create a mask to express the impact of COVID-19 on their sense of professional identity. In addition, students completed a written narrative and a brief survey to further explore how COVID-19 has affected their learning and professional development. Basic descriptive statistics were used to analyze survey responses. Visual thematic analysis was used to analyze the masks and principles of grounded theory with iterative constant comparison was used to extract emergent themes from student narratives. Ten students completed the survey. Five students further completed the reflection and created a mask. Students generally felt that the pandemic strengthened their resolve to become a physician and were optimistic that training will eventually return to normal. When analyzing masks and narratives, COVID was mentioned only in the context of qualities of an ideal physician, but not when relating elements of self-identity. The most salient domains coded within the mask and narrative included “habits” and “personal characteristics”, respectively. While COVID has had a significant impact on medical training, this cohort of first year students exhibited remarkable resilience, reported minimal emotional impact from the pandemic, and shared themes of developing strong habits and laudable professional characteristics as more central to their developing sense of PIF than any specific element of COVID.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88497447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Characterization of COVID-19 Mitigation Measures Among Workers from May 2020-June 2021","authors":"Carly D. Robinson, Shannon Gidley, Kara Garcia","doi":"10.24926/jrmc.v6i3.5284","DOIUrl":"https://doi.org/10.24926/jrmc.v6i3.5284","url":null,"abstract":"Objectives: To determine the relationship between early adherence to COVID-19 mitigation measures (before vaccine availability) and later vaccination status (after vaccines were widely available) in the Southwest Indiana workforce population. \u0000Design: Retrospective analysis of existing longitudinal cohort from two surveys: a COVID-19 prevalence survey in May 2020 and a follow up survey in June 2021. \u0000Setting: This study focused on secondary analysis of existing data from two surveys of the same Southwest Indiana workforce population, spanning manufacturing, finance, healthcare, and service industries. \u0000Participants: The analysis included participants who completed the 2020 survey (845), 2021 survey (492), or both (343). \u0000Main Outcome Measures: Relationship of adherence to early mitigation measures on vaccine adoption. We also examined differences in demographic characteristics including age, rurality (rural, rural/mixed, or urban county based on zip code of residence), education level, gender, and workplace environment. \u0000Results: Significant differences in age (p=0.02) and education (p=0.01), but not rurality, were observed between the vaccinated and unvaccinated groups. Furthermore, comparison of vaccinated and unvaccinated groups found significantly different responses to the degree of self-reported mitigation practices in early 2020. \u0000Conclusions: Consistent with previous studies, we found that demographic characteristics such as age and education may influence vaccination status. Furthermore, our data suggest an association between willingness to practice mitigation measures at the beginning of the pandemic and willingness to receive the COVID-19 vaccine. ","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75137774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohamed Aldallal, Deeb Omari, Baraka Muvuka, Elizabeth Ryan
{"title":"The Impacts of the COVID-19 Pandemic on Youth Violence: Insights from Professional Key Informants","authors":"Mohamed Aldallal, Deeb Omari, Baraka Muvuka, Elizabeth Ryan","doi":"10.24926/jrmc.v6i3.5070","DOIUrl":"https://doi.org/10.24926/jrmc.v6i3.5070","url":null,"abstract":"Introduction\u0000The COVID-19 pandemic has had drastic effects on youth violence protective and risk factors by isolating many at risk youth. While youth violence is a growing global health problem, there are limited studies exploring youth violence during the COVID-19 pandemic. Lake County in Northwest Indiana presents an opportunity for youth violence research and prevention given its socio-demographic context and its limited youth violence data. This study explored the COVID-19 pandemic’s impacts on youth violence and its risk and protective factors from the perspectives of professional key informants in Lake County, Indiana.\u0000 Methods\u0000This study utilized a descriptive qualitative design inspired by the constructivist grounded theory. We recruited professional key informants through purposive and snowball sampling. Data collection consisted of virtual semi-structured key informant interviews that were audio-recorded and transcribed verbatim. Data analysis consisted of inductive thematic analysis with open line-by-line coding, focused coding in Dedoose, and theme identification.\u0000 Results\u0000A total of six key informants were interviewed, representing diverse youth-serving occupations. These interviews revealed five general themes portraying the impacts of the COVID-19 pandemic on youth violence: mental health impacts on youth; socialization of youth; youth as victims, perpetrators, or witnesses; shifting of learning environments; and parent-child relationships. Key informants observed an increase in less visible types of youth violence, underlying pandemic-induced or-exacerbated youth mental and behavioral health issues, strained parent-child relationships, and the educational marginalization of youth in underserved communities during online learning transitions.\u0000Conclusions\u0000This study highlighted underserved youth’s vulnerability to the COVID-19 pandemic’s adverse impacts on youth violence experiences, risk, and protective factors. Our findings support the need to prioritize youth during and after crises, to utilize innovative strategies to better reach underserved youth, and to develop ethical and integrated youth violence data systems. Future research should explore youth’s lived experiences with violence throughout the pandemic. ","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"65 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88843500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Seeking Education, Equity, and Diversity (SEED)","authors":"Crystal Ackles Ackles, None Michael Anders, Ph.D","doi":"10.24926/jrmc.v6i3.5099","DOIUrl":"https://doi.org/10.24926/jrmc.v6i3.5099","url":null,"abstract":"Introduction Health care work cultures that embrace diversity, equity, and inclusion (DEI) foster innovations, synergy, and appreciation for differences. To promote DEI, health care systems have encouraged professional development on cultural humility, which is awareness of one’s values, beliefs, and social position, given the current cultural context while mindful of history. The national SEED Project (Seeking Educational Equity and Diversity) is a professional development program that prompts reflection and perspective shifting about workplace culture and systemic change. However, reports that examine the SEED learning experience and the participants’ intention for behavior change are lacking. The purpose of our study was to examine: (a) The SEED learning experience, (b) How personal views can foster cultural humility, and (c) The impact of SEED on intentions to effect change. Methods A purposive sample of eight (N = 8) faculty and staff from a SEED cohort at an academic health science center, with regional programs, participated in in-depth interviews to explore their personal views of how to foster cultural humility in health care and the impact of SEED to prompt intentions for behavior change. The investigators conducted a thematic analysis using an inductive, iterative method. Independently, they read each transcript and created codes for each comment. Subsequently, they compared findings, developed a coding frame, and grouped codes into potential themes. They then individually applied the coding frame to the data and considered themes. Finally, they built consensus on codes and synthesized codes into themes. Results Thematic analysis indicated the participants had a profound learning experience, which prompted them to develop cultural humility by re-framing cultural experiences and resolving to become more proactive about DEI in the workplace. They found small group discussions were insightful and provocative. These discussions led to new perspectives and behavior change or intentions for behavior change. Our analysis generated three themes: (1) Connecting with diverse perspectives, (2) Developing new perspectives, and (3) Being proactive with advocacy and new strategies. Conclusion Health care professionals and organizations can use our findings to encourage professional development that potentially stimulates behavior change, the ultimate goal of professional development, related to DEI. Future studies should examine the impact of this professional development within their organization and in the delivery of health care.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"456 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135960372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cody C. Stewart, Baraka Muvuka, Will Hutwagner, Hunter McCollum, William K. Dyer, Elizabeth R. Ryan
{"title":"“Vets Restoring Vets”","authors":"Cody C. Stewart, Baraka Muvuka, Will Hutwagner, Hunter McCollum, William K. Dyer, Elizabeth R. Ryan","doi":"10.24926/jrmc.v6i3.5157","DOIUrl":"https://doi.org/10.24926/jrmc.v6i3.5157","url":null,"abstract":"Introduction \u0000Military Veterans disproportionately experience mental health issues due to unique service-related experiences. Peer and social support interventions have shown promise in improving Veterans’ mental health alongside clinical mental health interventions yet there are limited studies on Veteran-designed and Veteran–led peer or social support interventions. This study explored the perceptions and experiences of Veterans participating in an innovative Veteran-designed and Veteran-led peer and social support program. It was a preliminary study in a long-term Community Based Participatory Research partnership between Indiana University School of Medicine-Northwest regional campus and Operation Combat Bikesaver (OCB). \u0000Methods \u0000This mixed methods study utilized a limited dataset from pre-and-post-session surveys collected by OCB between September 2019 and August 2021. We examined pre-post differences in participants’ self-rated “feelings” (i.e., emotional state) with the following independent variables through Linear Mixed Models in SPSS: OCB location, OCB event attended, day of the week, time of day, duration of attendance, frequency of attendance, and social assistance. We analyzed participants’ qualitative OCB experiences using inductive thematic analysis in Dedoose. This study was reviewed and exempted by The Indiana University Human Research Protection Program (Protocol # 12499) on August 16, 2021. \u0000Results \u0000A total of 128 participants completed pre-post surveys for 746 OCB sessions. There was a statistically significant pre-post session increase in participants’ feelings (mean=34.6; SD=21.7; p<0.001), with increasing effects by duration (p=0.002) in an OCB session. There was no linear trend in individual pre-and-post session changes in feelings over time. The following themes describe participants’ OCB experiences: sense of purpose and meaning, regaining comradery and brotherhood, “Vets restoring Vets,” satisfaction with OCB structure and processes, and experiencing OCB impacts. \u0000Conclusions \u0000Convening Veterans with shared experiences around innovative and supportive social activities may develop their perceived sense of purpose, belonging, and mutual support and produce improvements in perceived mental health. Future research within this community-regional medical campus research partnership will explore jointly determined research questions to follow-up on the main findings and limitations of the current study.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78955695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William J. Crump, James A Dodds, Caitlan S. Jones, James B. Watson
{"title":"An 8 Week Rural Surgical Clerkship: Does It Help to Produce more Rural Physicians?","authors":"William J. Crump, James A Dodds, Caitlan S. Jones, James B. Watson","doi":"10.24926/jrmc.v6i3.5090","DOIUrl":"https://doi.org/10.24926/jrmc.v6i3.5090","url":null,"abstract":"Purpose: The purpose of our study was to determine what effect an 8-week rural surgical clerkship rotation during the 3rdyear of medical school has on future practice site location. Methods: We report the subsequent practice site for ninety-five 3rd year medical students who completed an 8-week rural surgical clerkship from 2013-2016 compared to a cohort from the same time who completed this clerkship on the urban campus, matched by year and specialty chosen. Findings: On first analysis, there is a significant correlation (p=.0026) between rural clerkship and subsequent rural practice. With secondary analysis, all but one of the students in the rural clerkship group who chose rural practice were rural track students completing most of both clinical years in the rural setting. Conclusions: As found previously, longer duration rural exposures are associated with more frequent subsequent rural practice, but we found no such association for the 8-week rural surgical clerkship. The previous report of positive attitude changes among urban-based medical students completing this rural clerkship may help them understand rural patients seeking their care in an urban setting, but such attitude changes are not adequate to affect the complex decision of practice choice. Future studies of rural exposures during medical school should focus on intermediate duration exposures as well as different specialty clerkships beyond surgery and seek an association with subsequent practice site location.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"296 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135960373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Dbeibo, D. Cooper, Bradley L Allen, K. Hiller, P. Ko, Christopher Weaver, Deborah R. Birnbaum, Jennifer Weddle, P. Wallach
{"title":"Medical students rise to the COVID-19 vaccine challenge","authors":"L. Dbeibo, D. Cooper, Bradley L Allen, K. Hiller, P. Ko, Christopher Weaver, Deborah R. Birnbaum, Jennifer Weddle, P. Wallach","doi":"10.24926/jrmc.v6i2.4923","DOIUrl":"https://doi.org/10.24926/jrmc.v6i2.4923","url":null,"abstract":"Abstract \u0000Background \u0000The COVID-19 pandemic disrupted medical student education at a time when they were most eager to step up and help with the pandemic response. Indiana University School of Medicine (IUSM) leveraged an existing relationship with the Indiana Department of Health (IDOH) and the major healthcare systems in the state to assist with the state’s mass vaccination campaign. In this paper, we describe the development and implementation of a medical student volunteer program and highlight the main components of integrating community service programs into medical education. \u0000Methods \u0000IUSM appointed a taskforce to create a state-wide IUSM Medical Student Volunteer Vaccinator program to quickly train and deploy a medical student volunteer workforce. This taskforce was charged with (1) creating and delivering asynchronous and in-person training curriculum for all nine regional campuses and (2) coordinating medical student volunteerism for vaccine delivery across the state of Indiana. \u0000Results \u0000A total of 517 of 739 targeted medical students were fully trained in vaccine administration and contributed to over 2,000 hours of volunteer community service and delivered over 15,000 vaccine doses across the state of Indiana. Students also participated in other essential vaccination delivery roles, such as screening and registration of patients, exit monitoring, and pre-calling patients to remind them of their appointments. \u0000Conclusions \u0000Community service should be a critical component of medical student education. The IUSM Medical Student Volunteer Vaccinator program is an example of what the collaboration between medical schools, state health departments, and healthcare systems can achieve. This model can not only be disseminated to other medical school / healthcare system dyads for mass vaccination efforts but can also be expanded to other public health initiatives such as health screening programs, health education programs, contact tracing programs, community outreach programs, and global health initiatives. \u0000 \u0000Conflicts of interest: None","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86011880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Komal Kochhar, Krista Longtin, Shawn Wilson, Monling Ho, J. Brokaw, P. Wallach
{"title":"Implementation of Faculty Learning Communities to Support Medical Education Scholarship in a Regional Campus System","authors":"Komal Kochhar, Krista Longtin, Shawn Wilson, Monling Ho, J. Brokaw, P. Wallach","doi":"10.24926/jrmc.v6i2.4886","DOIUrl":"https://doi.org/10.24926/jrmc.v6i2.4886","url":null,"abstract":"Introduction: Medical educators need targeted faculty development programs to give them the skills necessary to produce educational scholarship for promotion and tenure. At the Indiana University School of Medicine, which encompasses a large regional campus system, we implemented Faculty Learning Communities (FLCs) to provide a platform for medical educators to engage in a collaborative, year-long educational research project facilitated by a faculty member well-versed in educational research. Methods: 18 faculty participants were assigned to one of 4 FLC groups, which met monthly from 2019 to 2020. The participants also attended a series of one-hour monthly educational seminars designed to build foundational skills in educational research. To assess program effectiveness, participants were surveyed at 6 months and 18 months after the start of the program. Results: 94% of participants completed the 6-month survey and 56% completed the 18-month survey. A majority of respondents at both time-points (88% and 60%, respectively) agreed or strongly agreed that the FLC process met their professional development needs to help move their educational scholarship forward. At the time of the 18-month survey, 50% of respondents had submitted their work for presentation at a regional or national conference or for publication in a peer-reviewed journal, with the remainder intending to do so. Discussion: The inaugural offering of this FLC program has established a successful and sustainable model for developing medical educators. By employing the Plan-Do-Study-Act cycle for process improvement, several changes to the program have already been instituted that should further bolster the scholarly productivity of our medical educators.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83812845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}