Curricular Factors that Unintentionally Affect Learning in a Community-Based Interprofessional Education Program: The Student Perspective

Background: The Dalhousie Health Mentors Program (DHMP) is a community-based, pre-licensure interprofessional education initiative that aims to prepare health professional students for collaborative practice in the care of patients with chronic conditions. This program evaluation explores the students’ 1) learning and plans to incorporate skills into future practice; 2) ratings of program content, delivery, and assignments; 3) perspectives of curricular factors that inadvertently acted as barriers to learning; and 4) program improvement suggestions.Methods: All students (N = 745) from the 16 participating health programs were invited to complete an online mixed methods program evaluation survey at the conclusion of the 2012–2013 DHMP. A total of 295 students (40% response rate) responded to the Likert-type questions analyzed using descriptive and non-parametric statistics. Of these students, 204 (69%) provided responses to 10 open-ended questions, which were analyzed thematically.Findings: While the majority of respondents agreed that they achieved the DHMP learning objectives, the mixed-methods approach identified curriculum integration, team composition, and effectiveness of learning assignments as factors that unintentionally acted as barriers to learning, with three key student recommendations for program improvement.Conclusions: Educators and program planners need to be aware that even well-intended learning activities may result in unintended experiences that hamper interprofessional learning

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice