Impact of a Longitudinal Medical Spanish Curriculum on Student Communication Skills.

Purpose: This study describes and examines the short- and longer-term impact of a required longitudinal medical Spanish curriculum on physician assistant student preparedness and ability to communicate with patients in Spanish during clinical rotations.

Methods: Fifty-eight preclinical students participated in an 80-hour curriculum delivered weekly over 3 semesters. Teaching followed a framework of second-language acquisition and included structured grammar and medical vocabulary practice with didactic, interactive, and group assignments.

Cannabinoid hyperemesis syndrome: An unrecognized cause of nausea and vomiting.

Cannabis has long been used for medical and recreational purposes because of its antiemetic, analgesic, and mood effects. Ironically, chronic use of cannabis can result in paradoxical effects, including a condition known as cannabinoid hyperemesis syndrome. Patients with this syndrome often are seen in the ED with cyclic vomiting, nausea, and epigastric pain.

Evaluating Medical Spanish Proficiency: A Comparison of Physician Assistant Student Self-Assessment to Standardized Patient and Expert Faculty Member Ratings.

Purpose: Whether physician assistant (PA) students' self-assessment or standardized patient (SP) evaluations of students' medical Spanish proficiency accurately reflect their language proficiency is unclear. This study compares PA student and SP ratings with an expert faculty member's rating to determine whether student or SP ratings can be used to evaluate language proficiency.

Methods: Fifty-eight students participated in a single-station Spanish Objective Structured Clinical Examination (OSCE) at the midpoint of a medical Spanish curriculum.

The role of SGLT2 inhibitors in managing type 2 diabetes.

The sodium glucose cotransporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin represent a novel class of medications to manage type 2 diabetes through urinary excretion of glucose. These drugs block glucose reabsorption by the kidneys to increase glucosuria. These drugs provide hemoglobin A1C reduction, promote weight loss, and remain hypoglycemic-neutral when not used in combination with insulin or secretagogues.

Metacognition, Formative Assessment, and Student Perspective: Learning About Metacognition Through In-Class Comparison of Response Systems.

Purpose: Educators influence learning context through, among other things, triadic reciprocal causation-a behavioral model used in social cognitive theory. Eliciting responses from learners during instruction may contribute to learning by engaging their metacognition. In this study, metacognition was examined based on learners' experience with 2 different polling methods: student response systems (SRS), commonly known as "clickers," and a low-technology response system (LTRS), where students raise labeled signs, each with a different response.

Impact of a Required Service-Learning Curriculum on Preclinical Students.

Purpose: The impact of brief service-learning curricula on physician assistant (PA) students is not well reported. This study explores student learning immediately and then one to 2 years after a preclinical service-learning experience through written reflections and a survey.

Methods: The 16-hour curriculum within a behavioral science course involved community immersion and engagement with underserved clients.

Out of air: Is going to high altitude safe for your patient?

As more people travel to high altitudes for recreation or work, more travelers with underlying medical conditions will need advice before traveling or treatment for altitude illness. This article focuses on the two main issues for travelers: whether travel to a high altitude will have a negative effect on their underlying medical condition and whether the medical condition increases the patient's risk of developing altitude illness. Although patients with severe pulmonary or cardiac conditions are most at risk in the hypoxic environment, other conditions such as diabetes and pregnancy warrant attention as well.

When less is more: validating a brief scale to rate interprofessional team competencies.

Background: There is a need for validated and easy-to-apply behavior-based tools for assessing interprofessional team competencies in clinical settings. The seven-item observer-based Modified McMaster-Ottawa scale was developed for the Team Objective Structured Clinical Encounter (TOSCE) to assess individual and team performance in interprofessional patient encounters.

Objective: We aimed to improve scale usability for clinical settings by reducing item numbers while maintaining generalizability; and to explore the minimum number of observed cases required to achieve modest generalizability for giving feedback.

Exercise: A vitally important prescription.

Sedentary lifestyles and low physical activity have led to rising health concerns and increasing mortality risks. With the growing concern of the inactivity of adult Americans, it is important that physical activity be promoted to prevent disease and reduce health risks. This article reviews the benefits of physical activity and the steps that primary care providers should take to evaluate physical activity as the fifth vital sign in every patient encounter.

Osteosarcoma: Accurately diagnosing this bone-chilling disease.

Osteosarcoma is the most common primary bone malignancy in children and adolescents. Because the incidence of osteosarcoma is low and the disease occurs in physically active patients, it may be misdiagnosed as a more benign condition, thus leading to late diagnosis. This article describes the disease's most frequent presenting complaints and initial radiographic findings, as well as its risk factors and common misdiagnoses.

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care.

Background: The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students.

Purpose: To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients.

Methods: The authors recruited students for a focus group study by purposive sampling and snowballing.

Transfusion-free treatment strategies for acute anemia in critical care.

Acute anemia is a frequently encountered diagnosis in critically ill patients, and can be a challenge if blood products are not readily available or if patients refuse these products on the basis of their religious beliefs. This article discusses the goals of anemia management and summarizes several alternatives to blood transfusions that can be used to prevent and treat acute anemia.

Interprofessional education and practice guide No. 5: Interprofessional teaching for prequalification students in clinical settings.

The importance of interprofessional education in health professions training is increasingly recognised through new accreditation guidelines. Clinician teachers from different professions may find themselves being asked to teach or supervise learners from multiple health professions, focusing on interprofessional dynamics, interprofessional communication, role understanding, and the values and ethics of collaboration. Clinician teachers often feel prepared to teach learners from their own profession but may feel ill prepared to teach learners from other professions.

Healing livers, saving lives: Hepatitis C screening in an era of cure.

Chronic hepatitis C affects more than 3 million people in the United States. In the past, drug therapy with interferon and ribavirin resulted in low overall cure rates and early discontinuation due to adverse reactions. The new direct-acting antivirals offer not only a shorter duration of treatment with fewer adverse reactions, but greatly improved overall cure rates as high as 96%.

New oral anticoagulants for patients with nonvalvular atrial fibrillation.

Four new oral anticoagulants have been approved for reducing stroke risk in patients with nonvalvular atrial fibrillation. Compared with warfarin, these agents offer a more predictable dose response with fewer food and drug interactions and no regular blood monitoring, although some of the drugs have an increased risk of major gastrointestinal bleeding. This article reviews the new drugs.

Fighting childhood obesity one game at a time.

Traditional video games contribute to a sedentary lifestyle. Active video games that include physical activity may help reduce childhood obesity and have found an unconventional niche in medical treatment and training. This article offers providers practical information on how to evaluate popular active video games and how to encourage patients to make them part of a more healthful lifestyle.

Meningomyelocele: early detection using 3-dimensional ultrasound imaging in the family medicine center.

A young primigravida presented to the family medicine clinic 7 weeks pregnant. Standard 2-dimensional ultrasound at 9 weeks revealed a grossly abnormal posterior brain and 2 adjacent sonolucent structures: 2 yolk sacs versus a yolk sac and cyst. Imaging by 3-dimensional ultrasound distinguished these structures, revealing a caudal cyst with continuity of fetal tissue consistent with a meningomyelocele.