Background: The COVID-19 pandemic halted elective orthopaedic surgeries, necessitating alternative consultation methods. Virtual consultations emerged as a solution to manage elective waiting lists for conditions such as carpal tunnel syndrome, stenosing tenosynovitis and Dupuytren's contractures. This study aimed to evaluate the effectiveness and patient satisfaction of virtual consultations in an upper-limb orthopaedic clinic.
Local Problem: Elective waiting lists for conditions such as carpal tunnel syndrome, stenosing tenosynovitis and Dupuytren's contractures increased significantly, requiring alternative consultation methods.
Methods: The Virtual Upper-Limb Clinic was composed of a virtual consultation, which included a focused history and examination. If there is uncertainty of diagnosis or a lack of appropriate examination findings at that time, the patient would then be booked into an in-person clinic for further assessment.If the virtual examination demonstrated marked pathology, surgical treatment would be proposed. Patients accepting surgical management were assessed and diagnosed formally on the day of surgery, followed by another virtual consultation postoperatively. The aim of this study is to demonstrate overall advantages and patient experiences of the virtual clinic. Data were collected in a retrospective manner using an improvised questionnaire based on the Telehealth Satisfaction Scale.
Interventions: Patients received focused history and examination assessments via video consultation. Surgical treatment was carried out electively if required, followed by a postoperative virtual review.
Results: Fifty patients were included, predominantly female, with an average age of 57.48 years. Diagnoses included 25 carpal tunnel cases, 15 trigger fingers, two ganglion cysts and eight Dupuytren's contractures. Ninety-six per cent of patients were satisfied with the virtual service, citing reduced travel costs and convenience. However, only 54% preferred virtual consultations preoperatively.
Conclusions: Virtual upper-limb orthopaedic clinics provide a safe, cost-effective and satisfactory alternative to in-person care. However, preferences varied, underscoring the need for a hybrid model integrating virtual and in-person consultations based on clinical and patient needs.
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http://dx.doi.org/10.1136/bmjoq-2024-002938 | DOI Listing |
JMIR Med Educ
March 2025
Division of Pulmonary, Critical Care, & Sleep Medicine, Department of Medicine, NYU Grossman School of Medicine, 550 First Avenue, 15th Floor, Medical ICU, New York, NY, 10016, United States, 1 2122635800.
Background: Although technology is rapidly advancing in immersive virtual reality (VR) simulation, there is a paucity of literature to guide its implementation into health professions education, and there are no described best practices for the development of this evolving technology.
Objective: We conducted a qualitative study using semistructured interviews with early adopters of immersive VR simulation technology to investigate use and motivations behind using this technology in educational practice, and to identify the educational needs that this technology can address.
Methods: We conducted 16 interviews with VR early adopters.
Am J Public Health
April 2025
Kristen M. Brown, Brigette Courtot, Zara Porter, and Sofia Hinojosa are with the Health Policy Center, Urban Institute, Washington, DC.
The Centers for Disease Control and Prevention's Partnering for Vaccine Equity program was developed during the COVID-19 public health emergency to fund more than 500 community-based organizations working to improve vaccine equity. Organizations were supported by a virtual learning community where members received tailored learning content, peer-to-peer learning opportunities, and resources that facilitated deployment of vaccine-related programming during a dynamic pandemic. Process evaluation metrics indicate successful implementation of the learning community.
View Article and Find Full Text PDFSci Adv
March 2025
Department of Developmental Immunology, Max Planck Institute of Immunobiology and Epigenetics, Freiburg, Germany.
To provide protection, anticipatory T cell-dependent immunity is reliant on the generation and maintenance of a naïve T cell repertoire, which is sufficiently diverse to ensure recognition of newly encountered antigens. Therefore, under steady-state conditions, a given individual needs to maintain a large pool of naïve T cells, ready to respond to potential threats. Here, we demonstrate that N-myc downstream-regulated gene 3 (Ndrg3) is essential for naïve T cell stability.
View Article and Find Full Text PDFJ Immunol
February 2025
Department of Biochemistry and Molecular Biology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States.
In naïve mice, a fraction of CD8 T cells displaying high affinity for self-MHC peptide complexes develop into virtual memory T (TVM) cells. Due to self-reactivity, TVM cells are exposed to persistent antigenic stimulation, a condition known to induce T cell exhaustion. However, TVM cells do not exhibit characteristics similar to exhausted CD8 T (TEX) cells.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
March 2025
From the Albany Medical College, Albany, NY (Debopadhaya), the Tulane University School of Medicine, New Orleans, LA (Saker), the Stanford University School of Medicine, Palo Alto, CA (van Niekerk), the George Washington University School of Medicine and Health Sciences, Washington, DC (Agarwal), the George Washington University School of Medicine and Health Sciences, Washington, DC (Zhao), the University of Missouri Kansas City, Kansas City, MO (Amin), the Department of Orthopaedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, PA (Bonaddio), the George Washington University School of Medicine and Health Sciences, Washington, DC (Bracey), the Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL (Cho), the New York Presbyterian/Columbia University, New York, NY (Czerwonka), the Medical College of Wisconsin, Milwaukee, WI (Dawes), the Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC (Gu) Cooper Medical School of Rowan UniversityCamden, NJ (Hughes), the Atrium Health Musculoskeletal Institute, Department of Orthopaedic Surgery, Charlotte, NC (Kammire), the Department of Orthopaedic Surgery, University of Florida College of Medicine, Gainesville, FL (Phillips), the George Washington University Hospital, Washington, DC (Ranson), the Geisel School of Medicine at Dartmouth, Hanover, NH (Stach), the University of North Carolina, Department of Orthopaedics, Novant Health Orthopaedic Fracture Clinic, Chapel Hill, NC (Cannada), the Stanford University School of Medicine, Palo Alto, CA (Shea), and the Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL (Mulcahey).
Introduction: Limited access to resources and stereotypes about orthopaedic surgeons may contribute to the low percentage of women and people of underrepresented in medicine (URiM) backgrounds in orthopaedic surgery. Several organizations have created resources to address these barriers, but medical students are unlikely to be exposed to the initiatives through traditional curricula. The purpose of this study was to (1) evaluate the ability of a 1-day virtual Diversity, Equity, Inclusion, and Accessibility (DEIA) summit to effectively reach URiM medical students, (2) increase medical students' knowledge of DEIA resources, and (3) augment the perception of diverse backgrounds in orthopaedic surgery.
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