Browsing by Author "Barron, Emily"

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    Fetal Injury from Maternal Penetrating Abdominal Trauma in Pregnancy
    (2023-03-24) Barron, Emily; Jeffries, Alison; Pelton, Sarah; Vogel, Katherine; Byrne, Bobbi
    Relevant Background Information: Pregnant women are particularly vulnerable to abuse, and trauma during pregnancy is the leading cause of non-obstetric maternal mortality. Penetrating abdominal trauma, which is less common than blunt trauma, is associated with higher rates of fetal injury and mortality. Case Description: We report a rare case of penetrating abdominal trauma that resulted in fetal injury following child-to-parent violence. A male infant was born at 36+4 weeks gestation via emergent cesarean section following multiple maternal abdominal stab wounds, one of which penetrated the uterus. Upon arrival at the emergency department, fetal heart tracing displayed decelerations. The infant was delivered with Apgar scores of 7 and 8 at 1 and 5 minutes, respectively. Exam revealed a 1.5 cm laceration over his left buttock, 2 cm from the anus, penetrating 1-2 cm into his subcutaneous tissue. He was transferred to a nearby children’s hospital for surgical evaluation where his wound was inspected, irrigated with normal saline, and reapproximated with sutures. Barium enema study demonstrated no evidence of rectal perforation, and brain MRI was normal without evidence of head trauma. He was discharged at 4 days old and has remained well; no significant issues were noted by his pediatrician at 19 months of age. Conclusions: This case demonstrates the importance of immediate cesarean delivery in a penetrating injury to a gravid woman experiencing fetal distress. Following delivery, a thorough evaluation of the infant is imperative to identify and treat any non-obvious traumatic injuries. Clinical Significance: In addition to harming the mother, physical injury can potentially jeopardize the pregnancy and fetus’ health and may lead to separation during a critical period for mother-baby bonding. Healthcare providers should work to identify women during the antenatal period who are at risk of interpersonal violence and facilitate access to resources and interventions.
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    Inspired to Learn: Integrating Pre-Clinical Respiratory Educational Principles into Clinical Clerkship Practice​
    (2023-04-28) Sharpe, Shannen; Friel, Rylee; Barron, Emily; Shockley, Emily; Thamba, Aish; Bontrager, Erin; Ganapaneni, Sruthri; Stoll, Kennedy; Vellutini, Natalie; Roy, Lynn; Cooper, Shannon; Kochhar, Komal; Carlos, Graham
    Introduction: IUSM students have reported on the Graduation Questionnaire (GQ) that there is a lack of pre-clinical content incorporated into clinical rotations. Student performance on respiratory/pulmonology questions on the USMLE Step 1 and 2 exams is similar to other medical disciplines at IUSM, despite feedback from students that the Pulmonary Grand Rounds (PGR) teaching method is very effective. Rather than presenting content via recorded didactic lectures, the PGR team, composed of a multidisciplinary physician panel, presents clinical vignettes in an interactive setting. Furthermore, according to student feedback, the current model lacks a sufficient content review of relevant Phase I material. Students have requested additional support with pre-clerkship study/review materials content. Through this study, we aim to empirically evaluate the impact of designing interactive pre-clerkship modules reviewing relevant Phase 1 PGR material on the medical knowledge and clinical competencies of Phase II students. Background: The American Medical Women’s Association organization called for scholarship pertaining to educational innovation. The PGR curriculum provides us with a unique opportunity to evaluate the impact of undergraduate medical education on student knowledge retention and engagement from a metacognition perspective. A diverse group of students and faculty was pulled together with the IUSM Research in Medical Education unit to creatively address the ability to quantify engagement and knowledge retention above in a scholarly project. PGR is a unique multi-modal teaching design built at a large medical school with nine campuses to increase student engagement via zoom, Top Hat, and a case-based teaching approach with a multidisciplinary panel. Study objective: Evaluate student engagement and knowledge retention through clerkship standardized examination performance, Step 2 performance, and GQ with the implementation of a spaced repetition learning model comprised of interactive pre-clerkship modules which reinforce session objectives introduced in pre-clinical education. Methods: In Phase I, PGR includes over 200 board-style questions throughout nine sessions. Students engage with the medical content by answering these questions on TopHat and discussing the reasoning for correct vs. Incorrect answers with the expert panel. Students are again tested over similar content during their local and NBME exams. We proposed the creation of an optional module for each clerkship for students to use prior to Phase II. The modules would include a question bank supplemented with videos to foster preparation and enhance performance on clinical clerkships and Step 2. This question bank would utilize the same questions students had originally seen in PGR months earlier to improve concept retention and memory. The instructional videos would connect physiology to the clinical scenarios the students expect to encounter during their clerkship. We would anonymously track student engagement through a pilot-tested survey and performance on the modules along with clerkship National Board of Medical Examiners exams, Step 2, and the GQ. Finally, we plan to assess knowledge gaps to supplement future grand rounds curriculum while providing clinically relevant information to improve patient care.