To evaluate the impact of the longitudinal extension of intramedullary lesions on the neurological status and postoperative outcome. Forty-six patients operated in our Department between February 2004 and June 2007 have been included in this study. The patients were classified in two groups according to the longitudinal extension of the lesion over less than three vertebral segments (group A) and over exactly three or more vertebral segments (group B). The neurological status was assessed preoperatively, postoperatively and after 3 months and involved both the McCormick (McC) and Klekamp-Samii (KS) scales. The preoperative McC- and KS scores of the patients of group B were statistically significant lower (p < 0.038 and p < 0.027, respectively) than those of group A. Patients of both groups showed an initial postoperative clinical deterioration. The level of statistical significance was reached only in group B (group A McC p < 0.170, KS p < 0.105; group B McC p < 0.012, KS p < 0.020). The patients recovered well and no statistical difference was observed between the preoperative and the 3-month follow-up scores (group A McC p < 0.490, KS p < 0.705; group B McC p < 0.506, KS p < 0.709). Thus, patients with extended intramedullary lesions have a worse neurological status preoperatively, postoperatively and in the 3-month follow-up. The preoperative neurostatus is determinant for the outcome. Even in case of longitudinally extensive intramedullary lesions, early surgery is recommended since satisfactory results can be achieved.
Background Disaster medicine is a component of the German medical education since 2003. Nevertheless, studies have shown some inconsistencies within the implementation of the national curriculum, and limits in the number of students trained over the years. Recently, the SARS-CoV-2 pandemic and other disasters have called attention to the importance of training medical students in disaster medicine on a coordinated basis. The aim of this study is to present and evaluate the disaster medicine and humanitarian assistance course, which was developed in the University of Tübingen, Germany. Methods The University Clinic for Anesthesiology and Intensive Care Medicine in Tübingen expanded the existing curriculum of undergraduate disaster medicine training with fundamentals of humanitarian medicine, integrating distance learning, interactive teaching and simulation sessions in a 40 h course for third-, fourth- and fifth- year medical students. This prospective and cross-sectional study evaluates the Disaster Medicine and Humanitarian Assistance course carried out over five semesters during the period between 2018 and 2020. Three survey tools were used to assess participants’ previous experiences and interest in the field of disaster medicine, to compare the subjective and objective level of knowledge before and after training, and to evaluate the course quality. Results The total number of medical students attending the five courses was n = 102 of which n = 60 females (59%) and n = 42 males (41%). One hundred two students entered the mandatory knowledge assessment, with the rate of correct answers passing from 73.27% in the pre-test to 95.23% in the post-test (t [101] = 18.939, p < .001, d = 1.88). To determine the subjective perception of knowledge data were collected from 107 observations. Twenty-five did not complete the both questionnaires. Out of a remaining sample of 82 observations, the subjective perception of knowledge increased after the course (t [81] = 24.426, p < .001, d = 2.69), alongside with the interest in engaging in the field of disaster medicine (t [81] = 7.031, p < .001, d = .78). The 93.46% of the medical students (n = 100) graded the training received with an excellent overall score (1.01 out of 6). Conclusion The study indicates a significant increase in students’ understanding of disaster medicine using both subjective and objective measurements, as well as an increase interest in the field of disaster medicine and humanitarian assistance. Whereas former studies showed insufficient objective knowledge regarding disaster medical practices as well as subjective insecurities about their skills and knowledge to deal with disaster scenarios, the presented course seems to overcome these deficiencies preparing future physicians with the fundamentals of analysis and response to disasters. The development and successful implementation of this course is a first step towards fulfilling disaster medicine education requirements, appearing to address the deficiencies documented in previous studies. A possible adaptation with virtual reality approaches could expand access to a larger audience. Further effort must be made to develop also international training programs, which should be a mandatory component of medical schools’ curricula.
Background: Disaster medicine is a component of the German medical education since 2003. However, studies have shown some inconsistencies within the implementation of the national curriculum, and limits with the number of students trained over the years. Facing the SARS-CoV-2 pandemic and other disasters, it became much more important to train medical students in disaster medicine on a coordinated basis.Methods: The University Clinic for Anaesthesiology and Intensive Care Medicine in Tübingen, Germany, expanded the existing curriculum of undergraduate disaster medicine training with fundamentals of humanitarian medicine, integrating the experience with distance learning, interactive teaching and simulation sessions. Survey tools were used to assess participants’ previous experiences and interest in the field of disaster medicine, to compare the self-reported degree of knowledge before and after training, and the programme’s quality evaluation. A mandatory pre- and post-test of knowledge was also administered to evaluate learner outcomes. The prospective and cross-sectional study evaluates the pilot course Disaster Medicine and Humanitarian Assistance carried out for third-, fourth- and fifth- year medical students over five semesters during the period between 2018 and 2020.Results: Data was collected from 107 students over five training sessions. Out of a sample of 82 students, the subjective perception of knowledge increased after the course (t [81] = 24.426, p < .001), alongside with the interest in engaging in the field of disaster medicine (t[81 ] = 7.031, p < .001). 102 students entered the mandatory knowledge assessment, with the rate of correct answers passing from 73.27% in the pre-test to 95.23% in the post-test (t [101] = 18.939, p < .001). The 93.46% of the medical students (N = 100) graded the training received with an excellent overall score (1.01 out of 6).Discussion: The study indicates a significant increase in students’ understanding of disaster medicine through the use of both subjective and objective measures, as well as an increase interest in the field of disaster and humanitarian medicine. The educational programme appears to address the deficiencies documented in previous studies, and possible adaptation with virtual reality approaches could expand access to a larger audience.Conclusion: The programme offers an effective and comprehensive tool to address the urgent need of quality education for medical students, suggesting integrated strategies to implement disaster medicine training.
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