Giant cell myocarditis is a rare but often devastating diagnosis. Advances in cardiac imaging and mechanical circulatory support have led to earlier and more frequent diagnoses and successful management. This disease state has wide variation in acuity of presentation, and consequently, optimal treatment ranging from intensity and type of immunosuppression to mechanical circulatory support is not well defined. The following case describes the management of a patient with an unusual presentation of giant cell myocarditis over a 10 year course of advanced heart failure therapies and immunomodulatory support. This case highlights emerging concepts in the management of giant cell myocarditis including sub‐acute presentations, challenges in diagnosis, and treatment modalities in the modern era.
Simulation, an educational, assessment, and research technique used to mimic real‐world situations, is increasingly used in pharmacy education. The most‐used simulation methods include high‐fidelity simulation (HFS), low‐fidelity simulation (LFS), standardized patients, and game‐based simulation. A common element of simulation is its ability to offer learners the chance to practice a skill or acquire knowledge in a safe and accessible space. Simulation methods differ in key aspects, including cost and other resource investment as well as ideal venue for use in education. HFS provides a more realistic simulation environment than LFS but is typically more expensive. Standardized patients offer learners the opportunity to engage with a live person but may elicit greater variability in responses to learners' input than HFS. Computer‐based simulation uses technology to supply a wide variety of learning opportunities; however, it may require the use of proprietary software and devices. Despite widespread use, literature describing learning outcomes of simulation in pharmacy education is limited. Some existing reports with positive findings have focused on learner satisfaction with or perceived benefit of simulation activities. The few existing publications summarizing changes in skills or knowledge demonstrate a positive impact. Simulation is a promising modality for educating pharmacy students and residents; however, more data summarizing the benefit of learning outcomes are needed.
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