Background During the COVID-19 emergency, medical students were mandated to remain home, creating challenges to providing education remotely for third-year clinical rotations. This study aims to assess student reception and investigate objective outcomes to determine if online learning is a suitable alternative. Methods Medical students enrolled in the third-year surgical clerkship during COVID-19 were asked to participate in a survey. 19 of 27 (70%) students participated. Content, faculty-led lectures, and resident-led problem-based learning (PBL) sessions were assessed using a ten-point Likert scale. National Board of Medical Examiners (NBME) examination, weekly quiz, and oral examination scores were compared to previous years. Student t-tests compared the groups. Results The median age was 25 years. Comparing in-person to electronic sessions, there was no difference in effectiveness of faculty sessions preparing students for NBME (6.2 vs. 6.7, P = .46) or oral examinations (6.4 vs. 6.8, P = .58); there was also no difference in resident-led PBL sessions preparing students for NBME (7.2 vs. 7.2, P = .92) or oral examinations (7.4 vs. 7.6, P = .74). Comparing this group to students from the previous academic year, there was no difference in weekly quiz (85.3 vs. 87.8, P = .13), oral examination (89.8 vs. 93.9, P = .07), or NBME examination (75.3 vs. 77.4, P = .33) scores. Discussion Surgical medical didactic education can effectively be conducted remotely through faculty-led lectures and resident-led PBL sessions. Students did not have a preference between in-person and electronic content in preparation for examinations. As scores did not change, electronic education may be adequate for preparing students for examinations in times of crisis such as COVID-19.
Hip and knee arthroplasty patients are at high risk of perioperative venous thromboembolic events (VTE). VTE has been well studied in this population and it is recommended that total joint arthroplasty recipients receive chemoprophylactic anticoagulation due to risk factors inherent to the surgical intervention. There are few concise resources for the orthopedic surgeon that summarize data regarding post-operative anticoagulation in the context of currently available therapeutic options and perioperative standards of practice. The periodic reexamination of literature is essential as conclusions drawn from studies predating perioperative protocols that include early mobilization and sequential compression devices as standards of practice in total joint arthroplasty are no longer generalizable to modern-day practice. We reviewed a large number of recently published research studies related to post-operative anticoagulation in total joint arthroplasty populations that received a high Level of Evidence grade. Current literature supports the use of oral aspirin regimens in place of more aggressive anticoagulants, particularly among low risk patients. Oral aspirin regimens appear to have the additional benefit of lower rates of bleeding and wound complications. Less consensus exists among high risk patients and more potent anticoagulants may be indicated. However, available evidence does not demonstrate clear superiority among current options, all of which may place patients at a higher risk of bleeding and wound complications. In this situation, chemoprophylactic selection should reflect specific patient needs and characteristics.
An emergency shelter that provides services to single-parent homeless families is described. Findings indicate that when the concrete needs of families are met during the initial stage of treatment, a trusting relationship can be established between the worker and client.
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