The assessment of point-of-care ultrasound (POCUS) in residency: the benefits of a four-year longitudinally integrated curriculum.

Context: Point-of-care ultrasound (POCUS) has diverse applications across various clinical specialties, serving as an adjunct to clinical findings and as a tool for increasing the quality of patient care. Owing to its multifunctionality, a growing number of medical schools are increasingly incorporating POCUS training into their curriculum, some offering hands-on training during the first 2 years of didactics and others utilizing a longitudinal exposure model integrated into all 4 years of medical school education. Midwestern University Arizona College of Osteopathic Medicine (MWU-AZCOM) adopted a 4-year longitudinal approach to include POCUS education in 2017.

The assessment of point-of-care-ultrasound (POCUS) in acute care settings is benefitted by early medical school integration and fellowship training.

Context: Point-of-care ultrasound (POCUS) has widespread utilization in multiple clinical settings. It has been shown to positively influence clinician confidence in diagnosis and can help appropriately manage patients in acute care settings. There has been a growing trend of increased emphasis on incorporating POCUS training in the first 2 years of the medical school curriculum.

Musculoskeletal ultrasound training encourages self-directed learning and increases confidence for clinical and anatomical appreciation of first-year medical students.

Best-practice guidelines have incorporated ultrasound in diagnostic and procedural medicine. Due to this demand, the Arizona College of Osteopathic Medicine initiated a comprehensive integration of ultrasound into its first-year anatomy course attended by more than 280 students. Ultrasound workshops were developed to enhance student conceptualization of musculoskeletal (MSK) anatomy through visualizing clinically important anatomical relationships, a simulated lumbar puncture during the back unit, carpal tunnel and shoulder evaluations during the upper limb unit, and plantar fascia, calcaneal tendon, and tarsal tunnel evaluations during the lower limb unit.

Examining concurrent validity between COMLEX-USA Level 2-Cognitive Evaluation and COMLEX-USA Level 2-Performance Evaluation.

Context: The Comprehensive Osteopathic Medical Licensing Examination of the United States of America (COMLEX-USA) is a three level examination used as a pathway to licensure for students in osteopathic medical education programs. COMLEX-USA Level 2 includes a written assessment of Fundamental Clinical Sciences for Osteopathic Medical Practice (Level 2-Cognitive Evaluation [L2-CE]) delivered in a computer based format and separate performance evaluation (Level 2-Performance Evaluation [L2-PE]) administered through live encounters with standardized patients. L2-PE was designed to augment L2-CE.

A Validity Study of COMLEX-USA Level 2-CE and COMAT Clinical Subjects: Concurrent and Predictive Evidence.

Background: The Comprehensive Osteopathic Medical Licensure Examination (COMLEX-USA) Level 2-Cognitive Examination (CE) and the Comprehensive Osteopathic Medical Achievement Test (COMAT) are administered to similar populations (third- and fourth-year osteopathic students) at similar points in time. Examining the relationship between scores on the 2 assessments that measure similar constructs ultimately supports the validity of both.

Objective: The purpose of this study is to provide empirical evidence of the concurrent and predictive validity of COMAT and COMLEX-USA Level 2-CE.

Interarterial course of anomalous right coronary artery: Pathophysiology, diagnosis, and treatment.

Anomalous coronary artery from the opposite sinus is a rare congenital anomaly that can present with symptoms similar to coronary artery disease, and sudden cardiac death. Management of anomalous coronary artery from the opposite sinus varies; however, current guidelines suggest surgery in symptomatic patients. Our patient is a middle-aged male with a history of coronary artery disease and status post coronary artery bypass graft.

Accuracy of hands v. household measures as portion size estimation aids.

Accurate estimation of food portion size is critical in dietary studies. Hands are potentially useful as portion size estimation aids; however, their accuracy has not been tested. The aim of the present study was to test the accuracy of a novel portion size estimation method using the width of the fingers as a 'ruler' to measure the dimensions of foods ('finger width method'), as well as fists and thumb or finger tips.

A Multidisciplinary Intervention to Prevent Catheter-Associated Urinary Tract Infections Using Education, Continuum of Care, and Systemwide Buy-In.

Background: In 2012, the Scottsdale Osborn Medical Center intensive care unit (ICU) had a rate of catheter-associated urinary tract infection (CAUTI) among the highest in Arizona hospitals, with 54 infections reported. To address the high rate of CAUTI in the Osborn campus ICU, the project team participating in the Alliance of Independent Academic Medical Centers (AIAMC) National Initiative IV joined the CAUTI systemwide oversight team in the ambitious goal to eliminate CAUTI from Scottsdale Healthcare.

Methods: The quality improvement project to eliminate CAUTI took place throughout calendar year 2014 at the Osborn campus and involved the AIAMC project team, the CAUTI systemwide oversight team, and support from the Scottsdale Healthcare information technology team.

Analysis of drug distribution from a simulated drug-eluting stent strut using an in vitro framework.

The mechanisms of delivery of anti-proliferative drug from a drug-eluting stent are defined by transport forces in the coating, the lumen, and the arterial wall. Dynamic asymmetries in the localized flow about stent struts have previously been shown to contribute to significant heterogeneity in the spatial distribution of drug in in silico three-compartmental models of stent based drug delivery. A novel bench-top experiment has been created to confirm this phenomena.

Development of an in vitro method for modeling drug release and subsequent tissue drug uptake and deposition in a pulsatile flow network.

A novel benchtop model of drug elution and arterial drug deposition following stent implantation has been developed. The model contains a single drug loaded strut and a compartment simulating the vessel wall, housed in a flow chamber under a pulsatile flow regime. Each component has programmable transport properties that can be implemented into a computational model of drug elution.