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Browsing by Author "Learman, Lee A."

Now showing 1 - 4 of 4
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    Building Health Systems Science Education from the Core Domain of Interprofessional Education at Virginia Tech Carilion School of Medicine
    Musick, David W.; Vari, Richard; Kraemer, M. Suzanne; Trinkle, David B.; Vari, Patty M.; Smith, Judy C.; Learman, Lee A. (2020-11-23)
    The Virginia Tech Carilion School of Medicine (VTCSOM) is a 4-year allopathic medical school in Roanoke, VA. The curriculum is organized into four learning domains: basic science, clinical science, research, and interprofessionalism (IPE). A recent curriculum renewal effort allowed the school to embark upon a redesign of the IPE learning domain to incorporate new core content from health systems science (HSS).We describe how our unique approach to IPE is being preserved as we innovate to produce graduates who are future thought leaders and “systems citizens,” prepared to deliver patient care with an expanded knowledge of the health systems in which they will eventually practice.
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    The DoCTRINE Guidelines: Defined Criteria To Report INnovations in Education
    Blanco, Maria; Prunuske, Jacob; DiCorcia, Mark; Learman, Lee A.; Mutcheson, Brock; Huang, Grace C. (Lippincott Williams & Wilkins, 2022-05-01)
    Purpose: Reporting guidelines assist authors in conducting and describing their research in alignment with evidence-based and expert-determined standards. However, published research-oriented guidelines do not capture all of the components that must be present in descriptions of educational innovations in health professions education. The authors aimed to create guidelines for educational innovations in curriculum development that would be easy for early-career educators to use, support reporting necessary details, and promote educational scholarship. Method: Beginning in 2017, the authors systematically developed a reporting checklist for educational innovations in curriculum development, called Defined Criteria To Report INnovations in Education (DoCTRINE), and collected validity evidence for its use according to the 4 inferences of Kane's framework. They derived the items using a modified Delphi method, followed by pilot testing, cognitive interviewing, and interrater reliability testing. In May-November 2019, they implemented DoCTRINE for authors submitting to MedEdPORTAL, half of whom were randomized to receive the checklist (intervention group). The authors scored manuscripts using DoCTRINE while blinded to group assignment, and they collected data on final editorial decisions. Results: The final DoCTRINE checklist consists of 19 items, categorized into 5 components: introduction, curriculum development, curriculum implementation, results, and discussion. The overall interrater agreement was 0.91. Among the 108 manuscripts submitted to MedEdPORTAL during the study period, the mean (SD) total score was higher for accepted than rejected submissions (16.9 [1.73] vs 15.7 [2.24], P =.006). There were no significant differences in DoCTRINE scores between the intervention group, who received the checklist, and the control group, who did not. Conclusions: The authors developed DoCTRINE, using systematic approaches, for the scholarly reporting of educational innovations in curriculum development. This checklist may be a useful tool for supporting the publishing efforts of early-career faculty.
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    The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders
    Meissner, Mark H.; Khilnani, Neil M.; Labropoulos, Nicos; Gasparis, Antonios P.; Gibson, Kathleen; Greiner, Milka; Learman, Lee A.; Atashroo, Diana; Lurie, Fedor; Passman, Marc A.; Basile, Antonio; Lazarshvilli, Zaza; Lohr, Joann; Kim, Man-Deuk; Nicolini, Philippe H.; Pabon-Ramos, Waleska M.; Rosenblatt, Melvin (2021-06)
    As the importance of pelvic venous disorders (PeVD) has been increasingly recognized, progress in the field has been limited by the lack of a valid and reliable classification instrument. Misleading historical nomenclature, such as the May-Thurner, pelvic congestion, and nutcracker syndromes, often fails to recognize the interrelationship of many pelvic symptoms and their underlying pathophysiology. Based on a perceived need, the American Vein and Lymphatic Society convened an international, multidisciplinary panel charged with the development of a discriminative classification instrument for PeVD. This instrument, the Symptoms-Varices-Pathophysiology ("SVP") classification for PeVD, includes three domains-Symptoms (S), Varices (V), and Pathophysiology (P), with the pathophysiology domain encompassing the Anatomic (A), Hemodynamic (H), and Etiologic (E) features of the patient's disease. An individual patient's classification is designated as SVPA,H,E. For patients with pelvic origin lower extremity signs or symptoms, the SVP instrument is complementary to and should be used in conjunction with the Clinical-Etiologic-Anatomic-Physiologic (CEAP) classification. The SVP instrument accurately defines the diverse patient populations with PeVD, an important step in improving clinical decision making, developing disease-specific outcome measures and identifying homogenous patient populations for clinical trials.
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    Targeting NMDA Receptors to Tune Corticothalamic Circuit Function
    Chen, Yang (Virginia Tech, 2023-02-09)
    The somatosensory corticothalamic (CT) circuit processes ascending sensory signals, and disruption to the balance of excitation and inhibition (E/I) within CT circuitry leads to absence seizures, sleep disorders, and attention deficits. E/I balance may be restored by independently modulating excitatory CT input to the ventral posteromedial (VPM) thalamus and inhibitory input to the VPM through the CT-thalamic reticular nucleus (nRT)-VPM pathway. This work revealed novel N-methyl-D-aspartate receptor (NMDAR) nucleus-specific and frequency-dependent functional diversity in the somatosensory CT circuit. Specifically, these findings illustrate the different effects of NMDAR negative modulation in the nRT and the VPM, which offers a method to preferentially decrease high frequency excitatory CT input to the VPM while having no significant effect on nRT activity. These results demonstrate the potential of utilizing NMDAR selective modulators to decrease overall excitation within the somatosensory CT circuit. Further investigation is required to elucidate the precise mechanisms underlying this phenomenon, including where NMDARs are localized at CT synapses and the effect of positive NMDAR modulators on nRT and VPM activity.