Medical school curricula often lack specific disability educational content. This project, driven by medical students, identified specific disability-centered educational learning points that could be integrated into existing preclinical neurology content as part of an integrated disability curriculum.
View Article and Find Full Text PDFAs a form of discrimination, ableism impacts access to and the experience of clinical care for patients with disabilities as well as the daily experiences of learners and clinicians with disabilities. Ableist beliefs and practices conflict with physicians' professional responsibilities and legal obligations to provide care that is nondiscriminatory and accessible. An actionable pedagogical approach within medical education is needed to prepare a physician workforce that is able to meaningfully identify and mitigate ableism at all levels of the health care system.
View Article and Find Full Text PDFThe medical specialty of physical medicine and rehabilitation (PM&R) focuses on quality of life, function, ability, and interdisciplinary care. PM&R clerkships are uniquely qualified to teach medical students about rehabilitation and the spectrum of postacute care, medical knowledge, and medical decision making related to health care affecting people with disabilities, health care disparities affecting people with disabilities, and the communication and teamwork strategies to provide a patient-centered approach to optimize function and outcomes. PM&R clerkships can be used to fulfill stakeholder and governing body requirements, such as medical knowledge, rehabilitation, critical judgment, health disparities, ethics, communication, teamwork, and patient-centered medical care, in order to maintain accreditation and provide a high-quality education This review provides both a rationale for a medical student clerkship in PM&R and an effective example of such an experience that has been implemented during medical school training.
View Article and Find Full Text PDFResident teaching of medical students is integral to medical education; however, there are few studies surveying residents, especially U.S. Physical Medicine and Rehabilitation (PM&R) residents, about their perspectives on teaching medical students.
View Article and Find Full Text PDFPhysical medicine and rehabilitation (PM&R) is a specialty of medicine that focuses on function and the care of people with disabilities. Many medical schools offer PM&R content by means of PM&R clerkships for career development purposes with varying curricula and assessments; however, there is limited information regarding the optimal way to teach clinical skills relating to the field of PM&R. This narrative review study was performed to evaluate PM&R specific clinical curricular interventions.
View Article and Find Full Text PDFBackground: Diversity in medical school students is essential to ensure that future physicians can care for a range of patients from different backgrounds. However, disability is often overlooked and there are potential examples of discrimination in US medical schools.
Objective: To determine if students with disabilities are included in online recruitment, diversity equity and inclusion (DEI), or nondiscrimination materials for US allopathic medical schools.
Top Stroke Rehabil
August 2024
This case report discusses the functional outcomes and multidisciplinary coordination of care for a patient with hemiplegia due to stroke complicated by a migrated inferior vena cava (IVC) filter embedded in the right side of the heart. The patient suffered an acute right-sided stroke with hemorrhagic transformation requiring hemicraniectomy with left hemiplegia. The patient developed a subsequent pulmonary embolism requiring IVC filter placement as anticoagulation was contraindicated due to risk of further intracranial hemorrhage.
View Article and Find Full Text PDFNerve conduction studies are a commonly performed procedure and a core competency for physical medicine and rehabilitation residents. Nerve conduction studies are complex to learn and no standardized training protocols exist across physical medicine and rehabilitation programs. The aims of this study are to standardize training and assessment of resident proficiency in nerve conduction studies skills and to evaluate the impact of an educational intervention on skills development.
View Article and Find Full Text PDFBackground: Survivors of hospitalization for severe acute COVID-19 infection faced significant functional impairments necessitating discharge to inpatient rehabilitation facilities (IRFs) for intensive rehabilitation prior to discharge home. There remains a lack of large cohort studies of the functional outcomes of patients admitted to IRFs with COVID-19-related impairments and the relationship to patient-specific factors.
Objective: To characterize functional outcomes of patients admitted to IRFs for COVID-19-related debility and to investigate associations between functional outcomes and patient-specific factors.
Disability is a large and growing minority population worldwide. People with disabilities continue to experience health and healthcare disparities. Despite multiple calls to action to provide disability education within undergraduate medical education as a strategy to mitigate ongoing inequities, robust disability education is not routinely provided across medical schools.
View Article and Find Full Text PDFHeart transplantation is considered definitive treatment for patients with end-stage heart failure. Unfortunately, medical and functional complications are common after heart transplantation for a variety of reasons, and these may impact the patients' functional recovery. Rehabilitation is often needed post-operatively to improve functional outcomes.
View Article and Find Full Text PDFCommunication challenges in persons with aphasia may negatively affect their health care. Building effective communication skills is critical for health professional student education, yet communication skills for interacting with persons with aphasia are often not taught or practiced within health care education. A review of the literature found that research is limited but does demonstrate evidence-based training can improve skills for health professional students.
View Article and Find Full Text PDFBackground: Coronavirus disease (COVID-19) has introduced a new subset of patients with acute end-stage lung damage for which lung transplantation has been successfully performed.
Objective: To describe the inpatient rehabilitation course of patients who underwent bilateral lung transplant due to severe COVID-19 pulmonary disease.
Design: Retrospective chart review.
Context: The transition of graduate medical education to competency-based education systems has resulted in exploration of the efficacy of Entrustable Professional Activities (EPAs) and related Observable Practice Activities (OPAs) as evaluation tools. EPAs were introduced to PM&R in 2017, but no OPAs have been reported for a non-procedurally based EPA. The primary aims of this study were to create and form consensus on OPAs for the Spinal Cord Injury EPA.
View Article and Find Full Text PDFHeart transplantation is a definitive treatment option for patients with end-stage heart failure. Medical and functional complications are common after this procedure, and rehabilitation is often needed postoperatively. Physiatrists caring for persons who have received a donor heart must appreciate the surgical background, the physiologic changes expected, as well as the potential medical complications for which they are at risk after heart transplantation.
View Article and Find Full Text PDFOpportunities for early medical student exposure to the field of physical medicine and rehabilitation (PM&R) are desirable for promoting the field as a career choice and are useful for introducing students to the care of people with disabilities. The COVID-19 pandemic disrupted medical education and caused the cancellation of many in-person clinical programs, including the Medical Student Summer Clinical Externship in PM&R supported by the Association of Academic Physiatrists. This article describes the process by which an in-person summer clinical externship program was effectively converted into a Virtual PM&R Experience using a combination of independent assignments and small-group sessions.
View Article and Find Full Text PDFWe diagnosed 66 peripheral nerve injuries in 34 patients who survived severe coronavirus disease 2019 (COVID-19). We combine this new data with published case series re-analyzed here (117 nerve injuries; 58 patients) to provide a comprehensive accounting of lesion sites. The most common are ulnar (25.
View Article and Find Full Text PDFCoronavirus disease of 2019 presented significant challenges to residency and fellowship programs. Didactic lectures were particularly affected as redeployment of faculty and trainees, limitations on in-person gathering, and other barriers limited opportunities for educational engagement. We sought to develop an online didactic series to address this gap in graduate medical education.
View Article and Find Full Text PDFBackground: The acceptance of ABO-incompatible (ABOi) liver grafts will expand the donor pool for a patient in urgent need for a liver transplantation (LT). Here we report our results with emergency ABOi DD (deceased donor) LT using rituximab and antigen specific immunoadsorption.
Patients And Methods: 2009 to 2019 we performed 20 ABOi DD LTs (adults = 17, children = 3) for patients in urgent need for a LT.
Ann Clin Transl Neurol
August 2021
Many survivors from severe coronavirus disease 2019 (COVID-19) suffer from persistent dyspnea and fatigue long after resolution of the active infection. In a cohort of 21 consecutive severe post-COVID-19 survivors admitted to an inpatient rehabilitation hospital, 16 (76%) of them had at least one sonographic abnormality of diaphragm muscle structure or function. This corresponded to a significant reduction in diaphragm muscle contractility as represented by thickening ratio (muscle thickness at maximal inspiration/end-expiration) for the post-COVID-19 compared to non-COVID-19 cohorts.
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