Kirkpatrick B. Fergus

Medical students are not blank slates: Positionality and curriculum interact to develop professional identity

As Stubbing et al. [1] have rightly pointed out, medical students do not enter their training as ‘blank slates’. We carry with us diverse life experiences, which influence early notions of what it means to be a doctor. As co-authors of this accompanying commentary, and as medical students from universities in the US, Canada, and Australia, we entered medical school with a range of preconceptions of what makes a doctor. In writing this commentary, we have drawn from our varied and unique perspectives, including our respective experiences as members of communities often underrepresented in medicine, including LGBT (lesbian, gay, bisexual and transgender), racialized, disabled, refugee, undocumented, and low socioeconomic status communities. Of course, we do not represent the communities to which we belong, and our composite identities include communities well-represented in medicine. Further, our lived experiences cannot possibly capture the multifarious backgrounds of physicians in training. However, these experiences have been influential in our trajectory—they guided our aspirations to pursue medicine as a career, and at times hindered our pathway to medicine, and continually shape our notion of what it means to be a physician. As a result, this commentary aims to reflect on how diverse medical student positionalities influence professional identity formation. Moreover, we aim to highlight the role of medical education institutions’ formal and hidden curricula in empowering students to develop a professional identity that embraces their positionality.

Twelve tips to promote successful development of a learner performance dashboard within a medical education program

Abstract Easily accessible and interpretable performance data constitute critical feedback for learners that facilitate informed self-assessment and learning planning. To provide this feedback, there has been a proliferation of educational dashboards in recent years. An educational (learner) dashboard systematically delivers timely and continuous feedback on performance and can provide easily visualized and interpreted performance data. In this paper, we provide practical tips for developing a functional, user-friendly individual learner performance dashboard and literature review of dashboard development, assessment theory, and users’ perspectives. Considering key design principles and maximizing current technological advances in data visualization techniques can increase dashboard utility and enhance the user experience. By bridging current technology with assessment strategies that support learning, educators can continue to improve the field of learning analytics and design of information management tools such as dashboards in support of improved learning outcomes.

Use of angioembolization in urology: a review

This review discusses current and developing indications for angioembolization (AE) techniques in urology cases, including trauma and non-trauma uses for kidney, prostate, and bladder conditions. AE methods, complications and technical and clinical outcomes are outlined for each indication for the purpose of aiding urologists in selecting ideal candidates for this procedure.

Minority recruitment trends in phase III prostate cancer clinical trials (2003-2014): progress and critical areas for improvement

Purpose: American minority groups have been historically underrepresented in phase III prostate cancer clinical trials despite often having higher risk disease. We analyzed enrollment trends of major racial/ethnic groups in the United States in phase III prostate cancer trials between 2003 and 2014 compared to SEER (Surveillance, Epidemiology and End Results) incidence data. Materials and Methods: Phase III prostate cancer trials primarily enrolling patients from the United States were identified in the ClinicalTrials.gov database. Enrollment trends were analyzed for major racial/ethnic groups. Prostate cancer incidence data from the SEER registry were used to identify enrollment targets. The enrollment difference was determined by calculating the absolute difference between the percent of a racial/ethnic subgroup in the SEER registry population and the percent of that subgroup in the phase III prostate cancer trial population. Results: Among 39 studies identified African American enrollment in therapeutic trials increased across the study period (p <0.001). The enrollment difference for African Americans was –9.0% (95% CI –7.6- –10.5, p <0.001) in 2003 to 2005 and 1.4% (95% CI 0.2–2.6, p = 0.020) in 2012 to 2014. However, African American men were under enrolled in metastatic disease trials (enrollment difference –5.8%, 95% CI –4.8- –6.8, p <0.001). Latino and Asian American men were consistently under enrolled in all trial types. Conclusions: Minority groups in the United States were largely under enrolled in phase III prostate cancer trials between 2003 and 2014. While recruitment efforts may have had an impact, as demonstrated by increased enrollment of African American men, there remains a need to expand recruitment efforts to achieve diversity in trials.

Genital burns in the United States: Disproportionate prevalence in the pediatric population

INTRODUCTION AND OBJECTIVESnTo describe the epidemiology of genital burns in the U.S. and investigate the underlying etiology.nnnMETHODSnThe National Electronic Injury Surveillance System database was queried for individuals who sustained genital burns from 2000 to 2016. We collected data on age, gender, injury diagnosis, disposition, and causative agents. Multivariate analysis was performed to determine predictors of hospitalization.nnnRESULTSnWe estimate 17,026 (95% CI 16,649-17,404) cases of genital burns presented to emergency departments nationally. Genital burns occurred more in males than females (12,295 vs 4,731). Scalding (57.9%) was the most common mechanism of injury and hot water (35.7%) the most common causative agent. Significant predictors of hospitalization on multivariate analysis were multi-surface (OR 4.4), scalding (OR 11.5) and thermal burns (OR 27.9). Children ages 0-2 had the highest prevalence of genital burns, and children ages 0-12 comprised 37.1% of the study. For children <5years of age, majority of the burns were caused by hot water in the bathroom. In age group 6-12, the most common causes of genital burns were cooking-related scalds due to hot foods and water.nnnCONCLUSIONSnChildren sustain genital burns at a higher rate than adults and many appear to have a preventable mechanism. Improved product design for safety and educating caregivers about potential hazardous situations are needed.

The association of bicycle-related genital numbness and Sexual Health Inventory for Men (SHIM) score: results from a large, multinational, cross-sectional study.

To assess the association of genital numbness and erectile dysfunction in male cyclists.