- Browse by Author
Browsing by Author "Bontrager, Erin"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item 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, GrahamIntroduction: 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.Item Targeted FGFR/VEGFR/PDGFR inhibition with dovitinib enhances the effects of nab-paclitaxel in preclinical gastric cancer models(Taylor & Francis, 2021) Crawford, Kate; Bontrager, Erin; Schwarz, Margaret A.; Chaturvedi, Apurva; Lee, Daniel D.; Sazzad, Hassan Md; von Holzen, Urs; Zhang, Changhua; Schwarz, Roderich E.; Awasthi, Niranjan; Surgery, School of MedicineStandard chemotherapy regimens for gastric adenocarcinoma (GAC) have limited efficacy and considerable toxicity profiles. Nab-paclitaxel has shown promising antitumor benefits in previous GAC preclinical studies. Dovitinib inhibits members of the receptor tyrosine kinase family including FGFR, VEGFR and PDGFR, and has exhibited antitumor effects in many solid tumors including GAC. Based on the antimitotic, antistromal and EPR effects of nab-paclitaxel, we investigated augmentation of nab-paclitaxel response by dovitinib in multiple GAC preclinical models. In MKN-45 subcutaneous xenografts, inhibition in tumor growth by nab-paclitaxel and dovitinib was 75% and 76%, respectively. Dovitinib plus nab-paclitaxel had an additive effect on tumor growth inhibition and resulted in tumor regression (85% of its original value). Dovitinib monotherapy resulted in minimal improvement in animal survival (25 days) compared to control (23 days), while nab-paclitaxel monotherapy or dovitinib plus nab-paclitaxel combination therapy led to a clinically significant lifespan extension of 83% (42 days) and 187% (66 days), respectively. IHC analysis of subcutaneous tumors exhibited reduced tumor cell proliferation and tumor vasculature by dovitinib. In vitro studies demonstrated that dovitinib and nab-paclitaxel individually reduced tumor cell proliferation, with an additive effect from combination therapy. Immunoblot analyses of MKN-45 and KATO-III cells revealed that dovitinib decreased phospho-FGFR, phospho-AKT, phospho-ERK, phospho-p70S6K, phospho-4EBP1, Bcl-2 and increased cleaved PARP-1, cleaved-caspase-3, p27, Bax, Bim, with an additive effect from combination therapy. These results demonstrate that the FGFR/VEGFR/PDGFR inhibitor, dovitinib, has the potential to augment the antitumor effects of nab-paclitaxel, with implications for use in the advancement of clinical GAC therapy.