Readiness of Medical Students to Care for Diverse Patients: A Validated Assessment of Cross-Cultural Preparedness, Skills, and Curriculum.

Introduction: Effective cross-cultural care is foundational for mitigating health inequities and providing high-quality care to diverse populations. However, medical school teaching practices vary widely, and learners have limited opportunities to develop these critical skills. To understand the current state of cross-cultural education and to identify potential opportunities for improvement, we disseminated a validated survey instrument among medical students at a single institution.

Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning.

Virtual reality exposure therapy (VRET) is a novel intervention technique that allows individuals to experience anxiety-evoking stimuli in a safe environment, recognise specific triggers and gradually increase their exposure to perceived threats. Public-speaking anxiety (PSA) is a prevalent form of social anxiety, characterised by stressful arousal and anxiety generated when presenting to an audience. In self-guided VRET, participants can gradually increase their tolerance to exposure and reduce anxiety-induced arousal and PSA over time.

Creating opportunities to engage with prospective historically marginalized trainees with clinical simulation.

Background: Recruiting a diverse group of medical students, house officers, and faculty in medicine is challenging-particularly for predominantly white, midwest institutions that may not be racially or ethnically diverse.

Purpose: To evaluate a novel clinical simulation program, SiMfest, for recruiting house officers from historically marginalized populations to our institution to demonstrate our leadership's commitment to high-quality education and recruitment of these students to enhance diversity in academic medicine.

Methods: The Office for Health Equity and Inclusion, institutional leadership, and clinical department chairs developed a novel and engaging series of clinical simulations, SiMfest, to engage the pipeline of historically marginalized trainees and demonstrate our leadership's commitment to high-quality education.

Disparities in access to translational research.

Translational research describes the process of applying observations and scientific discoveries made in the laboratory to clinical applications that can improve the health of individual patients, most often through clinical trials. To apply the findings of translational research studies to the broader population, the study population must accurately reflect the group of patients afflicted by a particular disease. Yet, it is well known that significant disparities exist for underrepresented groups and lower socioeconomic populations in clinical trials.

Strategies to Increase Racial and Ethnic Diversity in the Surgical Workforce: A State of the Art Review.

Objective: To evaluate strategies to increase racial and ethnic diversity in the surgical workforce among trainees and faculty across surgical specialties.

Data Sources: Embase, OVID/Medline, and Web of Science Core Collection.

Review Methods: A review of US-based, peer-reviewed articles examining the effect of targeted strategies on racial and ethnic diversity in the surgical workforce was conducted from 2000 to 2020 with the PRISMA checklist and STROBE tool.

The Value of Diversity, Equity, and Inclusion in Otolaryngology.

Diversity impacts performance of our teams, fosters innovation, and improves outcomes of our patients in otolaryngology head and neck surgery. In addition to the moral imperative, increasing the otolaryngology diversity workforce will decrease health care disparities while equity and justice can increase the culture humility to take care of an increasingly diverse patient population. To move toward justice, otolaryngology departments need to end biases in faculty hiring, development, research evaluations, and publication practices.

The Effectiveness of Self-Guided Virtual-Reality Exposure Therapy for Public-Speaking Anxiety.

Self-guided virtual-reality exposure therapy (VRET) is a psychological intervention that enables a person to increase their own exposure to perceived threat. Public-speaking anxiety (PSA) is an anxiety-provoking social situation that is characterized by fear of negative evaluation from an audience. This pilot study aimed to determine whether self-guided VRET (1) increases exposure to PSA-specific virtual social threats, and (2) reduces anxiety, arousal, heartrate and PSA over repeated exposure.

Critical Components of Diversity Initiatives.

The importance of diversity is well established and holds important implications for workplace and physician-patient relationships. Evaluation of diversity statistics within otolaryngology-head and neck surgery reveals areas of deficiency that may be improved with targeted proactive approaches. This article provides a general overview of diversity within otolaryngology, highlights key components of diversity initiatives, and provides strategies for implementation.

The Clarion Call of the COVID-19 Pandemic: How Medical Education Can Mitigate Racial and Ethnic Disparities.

Public health crises palpably demonstrate how social determinants of health have led to disparate health outcomes. The staggering mortality rates among African Americans, Native Americans, and Latinx Americans during the COVID-19 pandemic have revealed how recalcitrant structural inequities can exacerbate disparities and render not just individuals but whole communities acutely vulnerable. While medical curricula that educate students about disparities are vital in rousing awareness, it is experience that is most likely to instill passion for change.

Validation of an Objective Assessment Tool for Tonsillectomy in Otolaryngology Resident Training.

Objective: Create and validate an objective structured assessment of technical skills (OSATS) for otolaryngology residents learning how to perform a tonsillectomy.

Study Design: Multicenter prospective longitudinal validation study.

Methods: A multi-institutional study at six tertiary academic otolaryngology residency programs from July 2009 to May 2012.

Visual-to-auditory sensory substitution alters language asymmetry in both sighted novices and experienced visually impaired users.

Visual-to-auditory sensory substitution devices (SSDs) provide improved access to the visual environment for the visually impaired by converting images into auditory information. Research is lacking on the mechanisms involved in processing data that is perceived through one sensory modality, but directly associated with a source in a different sensory modality. This is important because SSDs that use auditory displays could involve binaural presentation requiring both ear canals, or monaural presentation requiring only one - but which ear would be ideal? SSDs may be similar to reading, as an image (printed word) is converted into sound (when read aloud).

Adultification of Black Children in Pediatric Anesthesia.

Background: Unconscious racial bias in anesthesia care has been shown to exist. We hypothesized that black children may undergo inhalation induction less often, receive less support from child life, have fewer opportunities to have a family member present for induction, and receive premedication with oral midazolam less often.

Methods: We retrospectively collected data on those <18 years of age from January 1, 2012 to January 1, 2018 including age, sex, race, height, weight, American Society of Anesthesiologists (ASA) physical status, surgical service, and deidentified anesthesiology attending physician.

Safety of radiofrequency ablation for adenotonsillectomy after cochlear implantation.

Objective: While a cadaveric animal study has suggested that radiofrequency ablation can be safely used in patients with cochlear implants, no in vivo studies have been published to confirm that radiofrequency ablation does not alter the integrity of the cochlear implant device.

Methods: Cochlear implant impedance and functional performance were studied through a prospective case series in five children with seven functioning multichannel implants before and after radiofrequency ablation adenotonsillectomy.

Results: There were 4 females and 1 male patient, aged 6-10 years (mean 8.

Synesthetic hallucinations induced by psychedelic drugs in a congenitally blind man.

This case report offers rare insights into crossmodal responses to psychedelic drug use in a congenitally blind (CB) individual as a form of synthetic synesthesia. BP's personal experience provides us with a unique report on the psychological and sensory alterations induced by hallucinogenic drugs, including an account of the absence of visual hallucinations, and a compelling look at the relationship between LSD induced synesthesia and crossmodal correspondences. The hallucinatory experiences reported by BP are of particular interest in light of the observation that rates of psychosis within the CB population are extremely low.

Other ways of seeing: From behavior to neural mechanisms in the online "visual" control of action with sensory substitution.

Vision is the dominant sense for perception-for-action in humans and other higher primates. Advances in sight restoration now utilize the other intact senses to provide information that is normally sensed visually through sensory substitution to replace missing visual information. Sensory substitution devices translate visual information from a sensor, such as a camera or ultrasound device, into a format that the auditory or tactile systems can detect and process, so the visually impaired can see through hearing or touch.

Auditory scene analysis and sonified visual images. Does consonance negatively impact on object formation when using complex sonified stimuli?

A critical task for the brain is the sensory representation and identification of perceptual objects in the world. When the visual sense is impaired, hearing and touch must take primary roles and in recent times compensatory techniques have been developed that employ the tactile or auditory system as a substitute for the visual system. Visual-to-auditory sonifications provide a complex, feature-based auditory representation that must be decoded and integrated into an object-based representation by the listener.

Assessment of Insulin Administration Methods: Perceptions by Patients and Significant Others Instrument Development.

Background And Purpose: To develop, test, and establish the validity and reliability of 4 instruments to evaluate perceptions of paired patients and patient-identified significant others to assess the impact of continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDII) on diabetes management and lifestyle.

Methods: Sociotechnical systems theory and the life patterns model framed the study. Four parallel survey instruments (patient CSII and MDII and significant other CSII and MDII) were developed to elicit demographic information and perceptions concerning CSII and MDII.

Case Report: Neonate With Stridor and Subcutaneous Emphysema as the Only Signs of Physical Abuse.

A stridulous, dysphonic cry with no external signs of trauma is a unique and unusual presenting sign for physical abuse. We report a previously healthy neonate with unremarkable birth history and medical history who presented with stridor and hypopharyngeal perforation due to physical abuse. This case highlights the need for further evaluation for traumatic injuries in the setting of unexplained new-onset stridor and consideration of physical abuse in the differential diagnosis.

Visual objects in the auditory system in sensory substitution: how much information do we need?

Sensory substitution devices such as The vOICe convert visual imagery into auditory soundscapes and can provide a basic 'visual' percept to those with visual impairment. However, it is not known whether technical or perceptual limits dominate the practical efficacy of such systems. By manipulating the resolution of sonified images and asking naïve sighted participants to identify visual objects through a six-alternative forced-choice procedure (6AFC) we demonstrate a 'ceiling effect' at 8 x 8 pixels, in both visual and tactile conditions, that is well below the theoretical limits of the technology.