Recent Publications by CFE Educators

Gastrointestinal diseases impose a significant morbidity, mortality, and health care cost burden, affecting millions annually in the United States alone. Endoscopy plays a crucial role in managing these conditions. Despite technological advancements in endoscopy, ensuring efficient, high-quality care remains challenging. A critical need to standardize high-quality endoscopy is for education reform in the training of endoscopists. Traditional apprenticeship-based training methods are dependent on the trainer as well as the patient case mix. Simulation-based mastery learning (SBML) emerges as a promising strategy to improve endoscopy training. This review discusses the current state of SBML for optimizing upper endoscopy and colonoscopy efficiency.

BACKGROUND

The impact of clinical factors and social determinants of health on treatment patterns and health care costs among patients with HCC is unknown.

METHODS

Using 100% Medicare Fee-For-Service claims and a commercial multipayor claims database, we identified patients diagnosed with HCC from January 1, 2017, to December 31, 2020. Surveillance receipt was defined 12 months prior to HCC diagnosis, whereas treatment and health care costs were assessed post-HCC diagnosis. Multinomial logistic regression was used to assess the association between demographics, social determinants of health, and surveillance or HCC treatment. Multivariable generalized linear regression was used to identify factors associated with total health care costs.

RESULTS

Of the 32,239 patients with HCC (mean age 68 y, 67% male, 73% White), 70% received surveillance and only half (51%) received any treatment. Curative treatment receipt was higher among those with prior surveillance (24% with CT/MRI and 18% with ultrasound vs. 9% with no surveillance). Curative treatment was independently associated with HCC surveillance and inversely associated with Black race, lower education level, and diagnosis in the year 2020 (COVID-19 year). Higher health care costs were independently associated with Black race, low English proficiency, living alone, and diagnosis in 2018-2020, and inversely associated with CT/MRI-based surveillance.

CONCLUSIONS

Race and social determinants of health were independently associated with curative treatment receipt and health care costs. Increasing access to high-quality HCC surveillance may improve treatment receipt and reduce health disparities among patients with HCC.

OBJECTIVE

Radiographic imaging interpretation is a central competency of the dental profession. Previous research has determined that radiographic interpretations vary across dentists. In addition, the efficacy of empirical learning within the realm of medical imaging analysis remains understudied. This project aimed to improve an existing anatomy curriculum as well as students' radiographic interpretation skills via implementation of medical radiographic case studies with scaffolded exercises.

METHODS

Three medical imaging activities were developed by the authors and presented in the anatomy laboratory for 60 first-year dental students. Each module included identical pre-activity and post-activity questionnaires, radiographic images with corresponding lesson plans, and open-response questions on the activity's valuable and challenging components. Pre-activity and post-activity questionnaire scores were compared via a Wilcoxon signed rank test. Kruskal-Wallis tests were conducted to determine the impact of previous anatomy experience and previous medical imaging experience on student performance. Thematic analysis was applied to open response comments.

RESULTS

A statistically significant improvement in questionnaire scores was observed in the first medical imaging activity. No significant change in scores was observed for the other two activities. Students valued the activities' interactive structure, review of course material, and application to the dental profession. Students reported challenges in radiographic image interpretation and lack of previous knowledge on course concepts.

CONCLUSIONS

While medical imaging activities failed to consistently improve student-learning outcomes, they introduced skill development in radiographic analysis and increased student confidence. These findings suggest a need for additional research on experiential methodologies within medical imaging education.