Journal of regional medical campuses最新文献

{"title":"Native Americans into Medicine: A Program focused on Developing Representation and Diversity in Healthcare","authors":"Mary Owen, P. Conway, J. Hanson, Catherine McCarty, Mangan Golden","doi":"10.24926/jrmc.v5i1.4485","DOIUrl":"https://doi.org/10.24926/jrmc.v5i1.4485","url":null,"abstract":"The Center of American Indian and Minority Health (CAIMH), housed in the University of Minnesota Duluth Medical School, aims to reduce American Indian and Alaska Native (AIAN) health disparities by increasing the numbers of AIAN physicians, increasing awareness of AIAN healthcare, and conducting AIAN health related research. For the past 50 years CAIMH has held a summer enrichment program, Native Americans Into Medicine (NAM), with the goal of increasing the numbers of AIAN students successfully matriculating to and graduating from health professions programs. Until 2018, the program focused on improving math and science aptitude. In 2018, CAIMH significantly changed the NAM curriculum, focusing instead on research training, specifically Indigenous informed research conducted with and for AIAN communities. The curriculum and overall program changes were in response to persistent AIAN health disparities, minimal research available on AIAN health disparities, and low AIAN representation in nearly all health professions including medical research. By providing research training, CAIMH improves AIAN students' science and math (statistics) aptitude as before, but now also gives them skills that enhance their standing as applicants to health professions programs and that they can use in their future careers. The training also benefits AIAN communities by increasing the numbers of Tribal members aware of standards of research in Indigenous communities.  The NAM curriculum highlights research best practices when working with AIAN communities.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89327586","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":"Outcomes of a rural-focussed family practice residency","authors":"Dr. Sandra Stover, Julia Lasswell, Samantha C. Friedrichsen, Rebecca P Emery","doi":"10.24926/jrmc.v5i1.4338","DOIUrl":"https://doi.org/10.24926/jrmc.v5i1.4338","url":null,"abstract":"Purpose: Family medicine  physicians play a crucial role in maternity care in community-based settings. However, residency graduates are decreasingly likely to provide delivery services. We explored residency training and graduates' inclusion of obstetrical care in practice by surveying graduates of the Duluth Family Medicine Residency, traditionally producing a high number of graduates serving rural communities and providing obstetrical care. \u0000Methods: Graduates (N=48) were surveyed about their provision of maternity care and perceptions of how well the residency prepared them to provide such services. Additional factors that impacted decisions to provide obstetric care (e.g., post-residency training, community size, and if there were obstetricians providing delivery services in their community) were evaluated. \u0000Findings: Nearly half of graduates (46%) were providing maternity services, most of whom provided perinatal clinical care (68% provided delivery care and 4% operative deliveries).  Seventy-one percent worked in a community with an available obstetrician. Graduates providing obstetric services were more likely to live in rural communities (66% vs 35%, p<0.01). Thirty percent of graduates received extra obstetrical training in residency. Graduates providing obstetric services were more likely to cite that their decision to practice obstetrics was influenced by the number of deliveries performed, interactions with attending obstetricians, and interactions with prenatal and laboring patients during residency compared to those not providing obstetric services. \u0000Conclusions: Residency training has an impact on provision of maternity care and potential practice of family physicians in rural communities. Attention to curricular support, particularly exposure to maternity patients, is important for resident comfort in obstetrics. \u0000  \u0000 ","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88232460","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":"Rural and Urban EMS Level of Comfort with Overdose Treatment","authors":"Brycen J. Ratcliffe, Robin Danek, E. Ireland, E. Reyes","doi":"10.24926/jrmc.v5i1.4388","DOIUrl":"https://doi.org/10.24926/jrmc.v5i1.4388","url":null,"abstract":"Purpose: This study aims to determine aptitude levels of rural and urban EMS providers treating drug overdoses in the field.\u0000Methods: This is both a qualitative and quantitative cross-sectional survey including 90 respondents from urban and rural demographics.\u0000Findings: This study found no evidence (p = 0.126) that the likelihood of being extremely comfortable with administering Naloxone differed between urban and rural EMS workers when accounting for certification level, years of experience and amount of training. We also found no evidence (p = 0.859) of a difference between rural and urban EMS workers administering secondary doses of naloxone.\u0000Conclusion: This study demonstrated that although rural EMS providers have an increased transit time to get an overdose patient to the hospital and were less likely to have an advanced provider available to them at the response scene, rural providers feel similarly comfortable with treating an opioid overdose with naloxone as their urban counterparts when certification level, years of experience and number of hours of training are considered.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"90 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83901585","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":"Engaging Native American Students in Research Methodology through Development and Validation of a Tobacco Survey","authors":"Mangan Golden, Patricia G. Conway, C. McCarty, Amy Versnik Nowak, J. Hanson, Desbah Begay, Maliyan Binette, Linn Birdchief, F. Blaisdell, Ginearosa Carbone, Seth Culver, Teague Goodsky, ZhaaZhaa Greensky, Nizhoni Greyeyes, Joshua Henry, Quinton Impson, Cheyne Littlesun, Genevieve McGeshick, Dannah Nephew, Ty Running Fisher, Michael Spear, Leah Thompson, Mary Owen","doi":"10.24926/jrmc.v5i1.4486","DOIUrl":"https://doi.org/10.24926/jrmc.v5i1.4486","url":null,"abstract":"Background:  The purpose of this project was to provide a learning experience for AIAN undergraduate students participating in a summer academic enrichment program, Native Americans into Medicine (NAM). Through NAM, operated by the Center of American Indian and Minority Health, students learned quantitative and qualitative research skills. They applied these skills through the development of a culturally relevant survey to measure commercial tobacco use in AIAN teens and analysis of the survey results.\u0000Methods: In Phase/year 1, students learned qualitative research methods and interviewed participants of a regional Tribal community powwow to inform the cultural adaptation of the National Youth Tobacco Survey. In Phase/year 2, the students learned about quantitative research methods through the conduct of a cross-sectional study in which the survey was distributed to rural Minnesota schools to assess tobacco attitudes, use, intent to use, and factors influencing tobacco use in AIAN youth. NAM student participants then analyzed the survey data.  Benchmarks for student success included: development of a tool to assess tobacco use in AIAN youth, conduct of research study, and dissemination of research results.\u0000Results:  At the pow wow in year 1, twenty-six youth ranging between 12 and 18 years of age who self-identified as AIAN were recruited to participate in cognitive interviews.  As a group, student researchers reviewed each survey question for possible revision and consideration for inclusion in the final survey. In year 2, completed surveys were obtained from 281 (15% of eligible) students from 5 schools; 256 surveys were usable. Thirty-one percent (N=80) students self-identified as AIAN; 56% were male. Students’ mean age was 15.8 years. Thirty-eight percent had ever tried cigarette smoking, even one or two puffs, and had ever vaped.  As a cohort, students presented research results to health directors and providers at 2 tribal clinics.\u0000Discussion: In conclusion, this two-year cohort approach to teaching qualitative and quantitative research skills to AIAN students was successful by internal benchmarks, namely student researchers developed, implemented, and analyzed a survey appropriate for AIAN high school students, and all student researchers presented their research results at least once.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83550073","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":"A Student-Directed Community Cardiovascular Screening Project at a Regional Campus","authors":"W. Crump, Emma C. Doyle, William R. Southall, Blake S. Edmonson","doi":"10.24926/jrmc.v4i4.4299","DOIUrl":"https://doi.org/10.24926/jrmc.v4i4.4299","url":null,"abstract":"Introduction\u0000Cardiovascular disease (CVD) is an important threat to public health, especially in rural communities. Clinical medical students at a rural regional campus can be a valuable resource to plan and implement CVD risk factor case finding project in the host community.\u0000Methods\u0000Directed by a representative county advisory council and supervised by a regional dean, clinical medical students designed and implemented CVD screenings at several public locations, recording health history and measurements of blood glucose, total blood cholesterol, and blood pressure. Those screened with abnormal readings were directed to definitive care including the local student-directed free clinic. Students were surveyed using a Likert scale before and after participation to assess their confidence in executing a community health project. The Baptist Health Madisonville IRB approved the protocol as exempt and the authors have no conflicts of interest.\u0000Results\u0000Over a period of almost two years in 2017-2019, 572 participants were screened. The demographics reflected those of the entire county, except screening was focused on adults. High blood pressure was found in 43%, high glucose in 28%, and high cholesterol in 48%. These values were similar to published countywide prevalence proportions. The student pre- to post- increase in confidence was remarkable (p< 0.000).\u0000Conclusions\u0000Our results show that regional campus medical students directed by a representative county advisory council and supervised by a regional dean can successfully implement a community CVD screening effort. The students also expressed a dramatic increase in their confidence in designing and implementing such a project. Lessons learned are shared for consideration by those at other regional health campuses.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83395379","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":"Ultrasound Curriculum Integration Review and a Survey of its Utility in Regional Medical Campuses","authors":"Ashley Fankhauser, Morgan Kessler, C. Mccarty, Amy Greminger","doi":"10.24926/jrmc.v4i4.3790","DOIUrl":"https://doi.org/10.24926/jrmc.v4i4.3790","url":null,"abstract":"to guide procedures. As the technology becomes more portable and affordable, schools have increasingly utilized this technology in training physicians. Ultrasonography may be especially useful in rural settings to fill the limitations that rural hospitals have in terms of imaging. The mission of many regional medical campuses is to train physicians to work in rural or underserved communities. Given this goal, we wanted to explore how regional medical campuses are utilizing ultrasound preclinically and determine the best approach for developing a standardized ultrasound curriculum, keeping regional medical campus resources in mind. A literature review of medical schools’ preclinical ultrasound curriculum was completed, and information was collected regarding curriculum programming, faculty, assessment, and student feedback. Based on data from this search, a fourteen question Qualtrics survey was sent out to regional medical campuses with questions regarding the use of ultrasound in their own preclinical curriculum. Of the 11 campuses that responded, 10 (90.9%) indicated that they include ultrasound in their curriculum. Respondents from nine of these schools progressed through the survey and information regarding topics covered in ultrasound curriculum, teachers of curriculum, patients used, ultrasound equipment used, and assessment of student knowledge all varied among medical campuses. The data suggested that regional medical campuses are focusing on similar aspects of ultrasound curriculum however, a standardized curriculum does not currently exist to ensure that all students are receiving similar ultrasound training. ","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86986306","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":"Considerations for Selecting Applicants to Rural Medicine Programs","authors":"David Bramm","doi":"10.24926/jrmc.v4i4.4284","DOIUrl":"https://doi.org/10.24926/jrmc.v4i4.4284","url":null,"abstract":"The selection of medical students destined for rural practice is important in order to help provide access to care for the 20% of the US population who live in rural America.  Knowing which medical school applicants will go into rural practice is an inexact science, although the objective predictive characteristics of future rural doctors are well known and evident in the literature.  The role of rural program directors is to identify which applicants will likely choose a FM residency, done primarily by identifying which rural predictive characteristics the applicants possess. Admissions committee members are not expected to determine the likely practice locations of rural applicants, and need only have the responsibility of determining which applicants should become physicians.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75185050","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":"Impact of Virtual Interviewing on Time and Financial Costs for NRMP© Applicants: Did Regional Campus Students Save More?","authors":"Tiffany Schwasinger-Schmidt, Tessa Rohrberg, Anne Walling, Kari Nilsen","doi":"10.24926/jrmc.v4i4.3925","DOIUrl":"https://doi.org/10.24926/jrmc.v4i4.3925","url":null,"abstract":"Background and Objectives: The sudden change from in-person to remote interviews by the National Residency Matching Program© (NRMP©) in 2020 was expected to result in significant financial and time savings for applicants. This project aimed to compare savings before and after the 2020-2021 interviewing season reported by students graduating from our institution’s regional and main campuses.\u0000Methods: Data were collected over a six-year period at a Midwestern medical school. Each year, approximately 120 main campus and 75 regional campus students are surveyed regarding specialty choice, number of applications and interviews, time, and expenses to complete the NRMP. Chi-square and t-tests were used to determine statistical differences by campus and by specialty in savings during the 2020-21 interviewing season compared to the previous five years.\u0000Results: Data were provided by 957 students. The response rates were 81.5% (regional) and 82% (main campus). Compared to the previous five years, in 2021 main campus students saved $3,990 (79.9%) and regional campus students saved $2,789 (77.1%). The previous highly significant differences in expenses between campuses ($1,386 ± $243) dropped to $185 (p = 0.3). On both campuses, applicants to non-primary care specialties saved more than their classmates applying to primary care. The largest average saving was reported by non-primary care applicants on the main campus ($4,207) and the smallest by regional applicants to primary care ($2,328). Main campus applicants reported saving 13.1 and regional campus 15.4 days interviewing in 2021. The smallest average time saving was reported by main campus applicants to non-primary care (12.7 days) and the largest (16.2 days) by regional campus applicants to primary care. No significant changes occurred in number of applications, interviews, or Match outcomes in 2021 compared to previous years.\u0000Conclusion: Prior to 2021, students from our institution’s regional campus reported lower costs and similar interviewing time than their peers on the main campus. Cost and time were significantly decreased in 2021 for both regional and main campus students applying to any specialty and differences between campuses reduced to non-significant levels. The number of applications, completed interviews, and Match outcomes remained similar to previous years. Changes to the NRMP© incorporating remote interviewing may reduce applicant costs by 80% and provide up to two weeks of available curricular time in the senior year of medical school.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91213634","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":"Does empathy really decline during residency training? A longitudinal look at changes in measured empathy in a community program","authors":"W. Crump, C. Ziegler, Stefan Fricker","doi":"10.24926/jrmc.v4i4.4206","DOIUrl":"https://doi.org/10.24926/jrmc.v4i4.4206","url":null,"abstract":"Introduction\u0000Some studies, most cross sectional and urban, have shown a decline in empathy during residency training prompting medical educators to consider changes in curriculum or training environment. Our aim was to determine if there was a decline using a longitudinal, paired annual empathy measure across three years of a family medicine residency in a rural community hospital.  \u0000Methods\u0000We administered a validated measure from 2015 through 2020 and of the 116 opportunities for survey completion, 112 from 48 residents were available for scoring. We also asked our residents to rank 10 factors that affected their empathy scores. The Baptist Health Madisonville IRB approved the protocol as exempt and the authors have no conflicts of interest..\u0000Results\u0000With a response rate of 97%, we found no statistically significant decrease in our resident scores across the three years. Scores after our PG-1 year were significantly lower than two previous comparable studies. The longitudinal, paired study design revealed very wide ranges among individual residents even when group means indicated a statistical difference. Residents also differed widely on their rankings of factors that could affect the score, with only outlook on life showing a narrow range and high ranking.\u0000Conclusions\u0000The very wide range of individual paired scores as well as the broad range of factors the residents thought affected their scores indicate that empathy is a very individual concept. Some of our residents actually increased scores leading to resilience and others declined toward cynicism. Those seeking to make changes to curriculum or training environment to facilitate empathy during residency should consider this diversity of individual resident training experience.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"39 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72491307","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":"Teleneurology Teaching Service at a Rural Regional Campus","authors":"A. Beck, Leeandra B. Cleaver, Joshua D. Fuqua, Katlyn B. Clark, Rohit S. Nair, Elizabeth P. Hart, Rebecca R. Bolinger, W. Crump","doi":"10.24926/jrmc.v4i3.3534","DOIUrl":"https://doi.org/10.24926/jrmc.v4i3.3534","url":null,"abstract":"Regional rural medical school campuses offer many opportunities for medical students to gain more hands-on experience, have more direct interaction with attending physicians, and cultivate a deeper understanding of challenges and opportunities specific to rural medicine. Some specialty services such as neurology are not available at these small regional campuses, and telemedicine technology can be a valuable tool to address this need. We report the implementation of teleneurology stroke consultation services as part of the third-year neurology clerkship at a regional medical school campus. We analyzed daily clinical notes and student satisfaction surveys. Students saw many common and important presentations of cerebrovascular events. Students worked as part of a multi-disciplinary care team while following these patients through their hospital course with effective instruction provided by remote stroke neurologists. All students strongly agreed that telemedicine was a positive component of the clerkship. We  conclude that teleneurology is an effective way to provide inpatient neurology clinical exposure, especially when remote attendings have a strong screen presence and are enthusiastic about teaching. We believe these findings could be useful to other campuses considering similar teaching methods, as innovations in telemedicine continue to address challenges  in  medical education and clinical care. The authors have no conflicts of interest to report and the Baptist Health Madisonville Institutional Review Board found this study to be exempt.","PeriodicalId":92811,"journal":{"name":"Journal of regional medical campuses","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90740737","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}