Advisor/Mentor Role in Guiding Future Primary Care Physicians

One component of UMMS’s mission is to provide affordable, high-quality medical education to state residents and to increase the number of PCPs practicing in underserved areas of the state. This study responds to our growing need to recruit future PCPs by investigating differences in relationships with advisors/mentors between those students who pursue a primary care residency and those who do not. Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2009

Independent Learning: Emerging Themes

Previous research findings suggest “independent learning” appeared to be the single most useful method for helping students facilitate learning in their preclinical years. This study extends upon our prior work exploring students’ definition of independent learning. Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2009

Listening to the New Student Voice: How They Learn

In 2003 it was forecasted that medical students’preclinical learning would mostly consist of large portions of educational training and instruction provided on the internet and other technology tools, while the traditional lecture format would become more infrequent. Five years later many medical schools have adapted to this new technological-enhanced learning environment. No one can argue that today’s millennial generation of medical students is more familiar with technology than their predecessors. However, does this technology savvy generation report that these new tools are indeed superior when compared to the traditional tools of facilitating learning and understanding in the preclinical years? Additionally, is there a difference in usefulness of learning techniques for students in year one as compared to year two of medical school? This study examines the learning tools in basic science courses to determine how the millennial generation of students report they are learning best. Tools from our blended learning curriculum were investigated within and across preclinical years one and two. Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2008

Weaving The Threads of Multiculturalism Throughout Medical Education

How do medical students learn about the healthcare impact of essential multiculturalism issues in an increasingly diverse population? This study gauges student participation in a variety of multiculturalism curricula and student assessment of curriculum time devoted to multiculturalism at school versus national levels

Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data

Background: General anaesthesia (GA) during endovascular thrombectomy has been associated with worse patient outcomes in observational studies compared with patients treated without GA. We assessed functional outcome in ischaemic stroke patients with large vessel anterior circulation occlusion undergoing endovascular thrombectomy under GA, versus thrombectomy not under GA (with or without sedation) versus standard care (ie, no thrombectomy), stratified by the use of GA versus standard care. Methods: For this meta-analysis, patient-level data were pooled from all patients included in randomised trials in PuMed published between Jan 1, 2010, and May 31, 2017, that compared endovascular thrombectomy predominantly done with stent retrievers with standard care in anterior circulation ischaemic stroke patients (HERMES Collaboration). The primary outcome was functional outcome assessed by ordinal analysis of the modified Rankin scale (mRS) at 90 days in the GA and non-GA subgroups of patients treated with endovascular therapy versus those patients treated with standard care, adjusted for baseline prognostic variables. To account for between-trial variance we used mixed-effects modelling with a random effect for trials incorporated in all models. Bias was assessed using the Cochrane method. The meta-analysis was prospectively designed, but not registered. Findings: Seven trials were identified by our search; of 1764 patients included in these trials, 871 were allocated to endovascular thrombectomy and 893 were assigned standard care. After exclusion of 74 patients (72 did not undergo the procedure and two had missing data on anaesthetic strategy), 236 (30%) of 797 patients who had endovascular procedures were treated under GA. At baseline, patients receiving GA were younger and had a shorter delay between stroke onset and randomisation but they had similar pre-treatment clinical severity compared with patients who did not have GA. Endovascular thrombectomy improved functional outcome at 3 months both in patients who had GA (adjusted common odds ratio (cOR) 1·52, 95% CI 1·09–2·11, p=0·014) and in those who did not have GA (adjusted cOR 2·33, 95% CI 1·75–3·10, p<0·0001) versus standard care. However, outcomes were significantly better for patients who did not receive GA versus those who received GA (covariate-adjusted cOR 1·53, 95% CI 1·14–2·04, p=0·0044). The risk of bias and variability between studies was assessed to be low. Interpretation: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons