message stringlengths 7 12.9k | message_type stringclasses 3 values | message_id int64 0 2 | conversation_id int64 77.4k 898k | cluster float64 68 68 | __index_level_0__ int64 232k 2.69M |
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Please summerize the given abstract to a title | instruction | 0 | 77,383 | 68 | 231,739 |
Crisis as a chance. A digital training of social competencies with simulated persons at the Medical Faculty of RWTH Aachen, due to the lack of attendance teaching in the SARS-Cov-2 pandemic | output | 1 | 77,383 | 68 | 231,740 |
Objective: The AIXTRA Competence Center for Training and Patient Safety at RWTH Aachen University has developed a concept to enable learning of communication skills with simulated persons (SP) digitally. Methodology: Existing SP cases in curricular teaching were checked for digital applicability and modified. Digital seminars with the methodology of simulated conversations with SP, for planned 690 students for the courses "history taking", 6th semester, conversations in psychiatry, 8th semester, and in the clinical competence course, 10th semester, were conducted via video conferencing software. The structure is similar to SP-seminars in classroom teaching with a case presentation, a doctor/patient dialogue and a feedback session. In the 6th and 10th semester, the seminars were evaluated anonymously by the students using an online questionnaire. SP were asked by e-mail for their assessment. The lecturers were asked about their experience with the digital seminars by means of qualitative interviews. Results: The survey of students with 92 completed questionnaires indicates a high level of acceptance. Digital teaching with SP was rated "very good" by 63% of the students and "good" by 37% as an overall mark for the course. The digital implementation is well practicable, the retention and accessibility of all learning goals is rated as given. Conclusion: Digital teaching with SP can be well realized with appropriate preparation. Specific aspects of digital implementation (e.g. role and data protection) must be taken into account. The differentiated evaluation of the surveys will bring further results and deductive questions. | input | 2 | 77,383 | 68 | 231,741 |
Please summerize the given abstract to a title | instruction | 0 | 77,502 | 68 | 232,096 |
Overcoming the Impact of COVID-19 on Surgical Mentorship: A Scoping Review of Long-distance Mentorship in Surgery | output | 1 | 77,502 | 68 | 232,097 |
BACKGROUND: Mentorship in the surgical field has been increasingly recognized as a crucial component of career success. Distance mentorship models may be utilized to overcome geographic limitations, increase mentorship access, and strengthen mentoring relationships in surgery. OBJECTIVE: This review aimed to identify the scope of literature on distance mentoring in surgery, the range of its application, its effectiveness, and any gaps in the literature that should be addressed in order to enhance mentorship in the surgical field. DESIGN: A comprehensive PubMed review was performed in January 2021 on distance mentorship of students, trainees, and surgeons in the surgical field. Reviews, replies, and non-English articles were excluded. Data was extracted regarding publication year, author's country, specialty, subjects, aim of mentorship model, and efficacy. RESULTS: 134 total studies met inclusion and exclusion criteria. Most studies were published in 2020, written by authors in the United States, from general surgery, and featured an expert surgeon paired with a more junior fully trained surgeon. In all, 93.3% of studies utilized distance mentorship to enhance surgical skill through telementoring and only 4.5% were focused on mentorship to enhance careers through professional development. The remaining studies utilized distance mentorship models to increase surgical research (0.7%) and clinical knowledge (1.5%). CONCLUSION: The results of this review suggest successful implementation of distance mentoring in surgery through telementoring, but a lack of professionally aimed distance mentorship programs. Amidst COVID-19, distance mentorship is particularly important because of decreased face-to-face opportunity. Future studies in the surgical field should investigate distance mentoring as a means of increasing mentorship for professional development. | input | 2 | 77,502 | 68 | 232,098 |
Please summerize the given abstract to a title | instruction | 0 | 77,516 | 68 | 232,138 |
Transitioning from In Person to Online Human Anatomy: Student Perspectives from the COVID-19 Pandemic. | output | 1 | 77,516 | 68 | 232,139 |
INTRODUCTION & OBJECTIVE In March 2020, medical schools around the country had to quickly transition from in person cadaveric anatomy curricula to an online distance learning format due to the COVID-19 pandemic. This posed a challenge for students who had acclimated to learning anatomy inside the laboratory for the majority of their first year of medical school. The purpose of this study was to assess student perceptions of the abrupt transition from in person anatomy dissections and practical exams to an exclusively online format. MATERIALS AND METHODS An anonymous survey was distributed to medical students from the Class of 2023 at the Medical College of Georgia at Augusta University (n=191) in February 2021. The survey assessed student perceptions of the impact of COVID-19 shutdowns on their medical education. In total, 45 responses were recorded, and survey data was analyzed using SPSS software. Nonparametric methods were used due to the ordinal nature of the Likert scale responses. A Wilcoxon signed rank test was performed. In addition, focus groups were conducted with 11 medical students who had completed the survey. RESULTS A majority of respondents (82.55%) stated that their learning and understanding of anatomy was worse after cancellation of in person anatomy lab dissections. In contrast, understanding of didactic lecture material was split, with 37.5% stating that online lectures had no impact on their learning and understanding of the material, 31.25% stating understanding was worse, and 25% stating it was better following transition to online-only lectures. The results from the Wilcoxon signed rank test of Likert scale responses indicated that students perceived impact of cancelling in person anatomy lab as significantly worse compared to the impact of cancelling in person lectures (p<0.001). Focus group responses echoed this theme, with the loss of 3-dimensional visual and tactile learning in laboratory cited most frequently by participants as a challenge with the transition to online anatomy. CONCLUSION Medical student respondents in the class of 2023 perceived online anatomy as inferior to in person laboratory sessions after the COVID-19 shut-down in March 2020. The transition from in person to online anatomy was more impactful on student understanding of material than the transition from in person to online didactic lectures. Of note, the students surveyed had completed the majority of their anatomy curriculum in person prior to the transition online. SIGNIFICANCE/IMPLICATION The medical school shutdowns that occurred in March 2020 due to the COVID-19 pandemic highlighted the importance of in person interaction with cadaveric specimens in anatomy education, especially in the context of how students were initially exposed to content. When possible, consideration should be given to learning approaches that students are familiar with and how changes to the curriculum will impact them. | input | 2 | 77,516 | 68 | 232,140 |
Please summerize the given abstract to a title | instruction | 0 | 77,666 | 68 | 232,588 |
The Economic Cost of Burnout in Veterinary Medicine | output | 1 | 77,666 | 68 | 232,589 |
The purpose of this study is to estimate the economic cost of burnout in the veterinary profession and highlight the financial reasons why the industry should address the burnout crisis from an organizational perspective. Using data from 5,786 associate veterinarians in private practice, information was obtained using employment information related to compensation, work hours, hour preferences, and job turnover. Burnout was measured using the Professional Quality of Life Scale and used to calculate conditional probabilities on turnover and reduced working hours due to burnout. Lost revenue from each outcome (turnover and reduced working hours) was then used to calculate the economic costs to the veterinary services industry. The attributable cost of burnout of veterinarians to the US industry is between $1 and 2 billion annually in lost revenue, though there is a large amount of uncertainty. The cost is dependent on whether veterinary technicians are included in the analysis. The highest economic cost per veterinarian is among food animal practitioners, while the lowest is among equine. This study demonstrates that there are significant economic costs due to burnout among veterinarians and veterinary technicians. We suggest pursuing organizational interventions as these have shown the most impact in decreasing burnout and increasing satisfaction among human health physicians. | input | 2 | 77,666 | 68 | 232,590 |
Please summerize the given abstract to a title | instruction | 0 | 77,668 | 68 | 232,594 |
Insights From Veterinary Disciplinary Actions in California 2017–2019 | output | 1 | 77,668 | 68 | 232,595 |
There is increasing concern within the veterinary medical community (veterinarians and veterinary students) that disgruntled clients are unfairly leveraging various legal tools against veterinarians. Clinical veterinarians and veterinary students should be aware of the most common types of problems arising within the clinic and how they can lead to formal consumer complaints. The study describes and categorizes with greater detail the types of violations or “causes for discipline” that occur, as well as specific sanctions imposed on veterinarians formally disciplined for standard of care-related violations between 2017 and 2019, for California. In addition, the study calculated the frequency of disciplinary actions and their basic summary statistics regarding the temporal aspect of how lawsuits typically unfold. Using public documents from California, the study describes the analysis and trends for the purpose of providing contextual evidence to inform and guide potential veterinary educational interventions. Although specific to California, this study can serve as a template methodology for comparisons to other states. | input | 2 | 77,668 | 68 | 232,596 |
Please summerize the given abstract to a title | instruction | 0 | 77,810 | 68 | 233,020 |
Twitter and Instagram Use in the Urology Residency Application Process | output | 1 | 77,810 | 68 | 233,021 |
OBJECTIVE: To define urology applicant attitudes and usage trends of social media (SM) during the 2021 urology match cycle. METHODS: We emailed an anonymous, de-identified 22-question, multiple choice survey to all applicants to our institution for the 2021 Urology Residency Match. We asked participants about use of SM and which aspects they found useful in the application process. Univariate descriptive analyses were conducted based on survey responses. Chi-square analyses were performed to define significant differences in use of social media and resultant match outcomes. RESULTS: Of the 528 students who registered for the 2021 AUA Match, 398 received our survey (75%), and 144 responded (27% of applicants nationwide). Of survey participants, 49% made a new account on Twitter while 30% had a preexisting account. Most participants (71%) had a preexisting Instagram account, while only 3% made a new account. Most participants agreed Twitter was used as a source to gather information about programs (84%) and learn about events (89%). Participants found SM most helpful for announcing event dates (71%) and highlighting resident social life (59%). Applicants did not match more highly on their rank lists if they used Twitter (Pâ¯=â¯.427) or Instagram (Pâ¯=â¯.166) and were not more likely to get more interviews if they used Twitter (Pâ¯=â¯.246) or Instagram (Pâ¯=â¯.114) CONCLUSION: Applicants found Twitter to be an important source of information through the virtual interview process. Despite the use of SM by most applicants, published content did not impact rank list decisions nor did SM engagement predict match outcomes. | input | 2 | 77,810 | 68 | 233,022 |
Please summerize the given abstract to a title | instruction | 0 | 77,819 | 68 | 233,047 |
A dry lab for medical engineers? | output | 1 | 77,819 | 68 | 233,048 |
INTRODUCTION We describe a teaching and training method with objective evaluation to improve medical engineering students' knowledge and analysis skills about Minimally Invasive Surgery (MIS) instrumentation and techniques through hands-on experience. Training has been scheduled during a three-month course. METHODS Twenty medical engineering students were trained to perform three times on a pelvic trainer a sequence of standardized drills connected with the selected MIS techniques, in order to improve their dexterity. The time required to perform each dexterity drill was recorded in seconds.Then, the participants were divided into groups and asked to write an essay about an instrument they chose, analyzing and criticizing the instrument itself. RESULTS All the trainees showed steady improvement in skill acquisition on the laparoscopic simulator and discussed their essays, making proposals in order to improve the instrument they tested. CONCLUSION Significant improvement in performance with increasing skillness has been measured; during the course and during their discussion the participants showed deep knowledge of the instrument, ability to analyze and criticize it and ability to make improvement proposals.Dry lab experience for medical engineering students is useful for teaching and improving analysis and management of laparoscopic devices, allowing identification of problems and developing better devices. | input | 2 | 77,819 | 68 | 233,049 |
Please summerize the given abstract to a title | instruction | 0 | 77,837 | 68 | 233,101 |
Dr.supER: Intubation and ventilator troubleshooting VR simulation | output | 1 | 77,837 | 68 | 233,102 |
This paper presents Virtual Reality 3D interaction and simulation techniques in the context of the 2021 3DUI contest of the IEEE VR conference In our implementation, by taking into consideration the current COVID-19 pandemic situation, we developed a VR gamified simulation regarding the intubation and ventilator troubleshooting procedures, taking place in an Emergency Room (E R ) In this paper, we present the design and development of the overall experience, aiming to train the end-user on these actions to enhance their possibilities of achieving optimal performance under stressful situations By gamifying the above education system, we also expect to empathize the layman regarding the daily challenges that the medical staff is experiencing in an Intensive Care Unit © 2021 IEEE | input | 2 | 77,837 | 68 | 233,103 |
Please summerize the given abstract to a title | instruction | 0 | 77,908 | 68 | 233,314 |
Long experience with a web-based, interactive, conversational virtual patient case simulation for medical students' evaluation: comparison with oral examination | output | 1 | 77,908 | 68 | 233,315 |
Virtual patients (VP) have been advocated as reliable tools for teaching and evaluating clinical skills and competence. We have developed an internet-based, OSCE-like, conversational VP system designed both for training and assessment of medical students. The system, that encompasses complete patient management from H&P to diagnostic procedures and treatment, has now been used regularly during the clerkship of internal medicine. The present article describes the system and compares assessments undertaken with the VP-system over the last five years, to traditional bed-side oral exams. All students practiced on their own exercise VP cases, while preparing for the final exam. A total of 586 students were evaluated simultaneously with both assessment modalities. The αCronbach of the VP exam averaged 0.86. No correlation was found between the grades obtained in the two exams, indicating that the VP exam evaluated different parameters than those assessed by the examiners in the oral examinations. We conclude that a VP system can be utilized as a valid and reliable examination tool. It is also most useful for independent training by students during their ward-based learning, as well as when not studying in classes, wards or clinics, when social distancing is required. | input | 2 | 77,908 | 68 | 233,316 |
Please summerize the given abstract to a title | instruction | 0 | 78,174 | 68 | 234,112 |
Dissecting the Contemporary Clerkship: Theory‐based Educational Trial of Videos Versus Lectures in Medical Student Education | output | 1 | 78,174 | 68 | 234,113 |
BACKGROUND: Despite increasing use of the flipped classroom (FC) technique in undergraduate medical education, the benefit in learning outcomes over lectures is inconsistent. Best practices in preclass video design principles are rarely used, and it is unclear if videos can replace lectures in contemporary medical education. METHODS: We conducted a prospective quasi‐experimental controlled educational study comparing theory‐based videos to traditional lectures in a medical student curriculum. Medical students enrolled in an emergency medicine clerkship were randomly assigned to either a lecture group (LG) or a video group (VG). The slide content was identical, and the videos aligned with cognitive load theory‐based multimedia design principles. Students underwent baseline (pretest), week 1 (posttest), and end‐of‐rotation (retention) written knowledge tests and an observed structured clinical examination (OSCE) assessment. We compared scores between both groups and surveyed student attitudes and satisfaction with respect to the two learning methods. RESULTS: There were 104 students who participated in OSCE assessments (49 LG, 55 VG) and 101 students who participated in knowledge tests (48 LG, 53 VG). The difference in OSCE scores was statistically significant 1.29 (95% confidence interval = 0.23 to 2.35, t(102) = 2.43, p = 0.017), but the actual score difference was small from an educational standpoint (12.61 for LG, 11.32 for VG). All three knowledge test scores for both groups were not significantly different. CONCLUSIONS: Videos based on cognitive load theory produced similar results and could replace traditional lectures for medical students. Educators contemplating a FC approach should devote their valuable classroom time to active learning methods. | input | 2 | 78,174 | 68 | 234,114 |
Please summerize the given abstract to a title | instruction | 0 | 78,264 | 68 | 234,382 |
COVID-19 and its effect on Instagram adoption by #OBGYN residency programs | output | 1 | 78,264 | 68 | 234,383 |
OBJECTIVES: Instagram (IG) is becoming one of the larger resource tools within medicine. Since the onset of the COVID-19 pandemic, it is becoming important for programs to improve virtual presence and outreach. We evaluated the adoption of IG by OB/GYN residency programs in the United States and aimed to see if highly ranked programs had higher utilization rates. METHODS: IG presence and engagement metrics were extracted for all ACGME accredited OB/GYN programs. Doximity residency navigator tool was used to obtain nationwide program rankings, and statistical analysis was performed to prove any significant correlation. Mann-Whitney U test, Cochran-Armitage test and Analysis of variance were used for analysis. IRB exemption was obtained. RESULTS: Seventy percent of programs (202/287) have IG presence, with the majority creating presence after the COVID pandemic began (115/202;57%). Seventy-two percent (83/115) of these programs created their IG account once virtual interviews were announced. The top 25% of programs, as ranked on Doximity, have a higher number of posts, followers and likes when compared to the rest of the programs. CONCLUSIONS: The COVID-19 pandemic has led to increased adoption of IG by residency programs. Highly ranked and reputed programs have higher rates of activity, popularity, and engagement on IG. | input | 2 | 78,264 | 68 | 234,384 |
Please summerize the given abstract to a title | instruction | 0 | 78,284 | 68 | 234,442 |
Validity and reliability of a virtual education satisfaction questionnaire from the perspective of cardiology residents during the COVID-19 pandemic | output | 1 | 78,284 | 68 | 234,443 |
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has prompted the further virtualization of medical education. The satisfaction level of specific users such as cardiology residents with virtual education can augment its quality; hence, the significance of a valid and reliable questionnaire to obtain feedback is needed. This study aimed to design and measure validity and reliability of a satisfaction questionnaire for virtual education of cardiology residents during COVID-19 pandemic. MATERIALS AND METHODS: In this cross-sectional study, a self-administered questionnaire was developed by the faculty members of Rajaie Cardiovascular Medical and Research Center. Reliability was tested utilizing Cronbach's alpha and intercorrelation which was tested using Pearson's correlation coefficient test (ICC). Factor analysis was done by the Kaiser–Meyer–Olkin measure of sampling adequacy and Bartlett's sphericity test. The statistical analyses were performed with the SPSS software version 22. RESULTS: The face validity index was determined via an assessment of the relevance, clarity, and simplicity of each item, and values >0.79 were accepted. The total Cronbach's alpha coefficient was calculated 0.93. Concerning test–retest reliability, the correlation between two rounds of evaluation was >80 (P > 0.001) and ICC was 0.99 (P = 0.001). The content validity evaluation yielded an index of 0.95 and a ratio of 0.91. The principal component factor analysis, conducted to investigate construct validity, generated four domains. CONCLUSIONS: The study results confirmed the validity and reliability of the designed questionnaire to evaluate the level of satisfaction of cardiology residents with virtual learning in COVID-19 pandemic. | input | 2 | 78,284 | 68 | 234,444 |
Please summerize the given abstract to a title | instruction | 0 | 78,285 | 68 | 234,445 |
The pursuit of fairness in assessment: Looking beyond the objective. | output | 1 | 78,285 | 68 | 234,446 |
Health professions education has undergone significant changes over the last few decades, including the rise of competency-based medical education, a shift to authentic workplace-based assessments, and increased emphasis on programmes of assessment. Despite these changes, there is still a commonly held assumption that objectivity always leads to and is the only way to achieve fairness in assessment. However, there are well-documented limitations to using objectivity as the 'gold standard' to which assessments are judged. Fairness, on the other hand, is a fundamental quality of assessment and a principle that almost no one contests. Taking a step back and changing perspectives to focus on fairness in assessment may help re-set a traditional objective approach and identify an equal role for subjective human judgement in assessment alongside objective methods. This paper explores fairness as a fundamental quality of assessments. This approach legitimises human judgement and shared subjectivity in assessment decisions alongside objective methods. Widening the answer to the question: 'What is fair assessment' to include not only objectivity but also expert human judgement and shared subjectivity can add significant value in ensuring learners are better equipped to be the health professionals required of the 21st century. | input | 2 | 78,285 | 68 | 234,447 |
Please summerize the given abstract to a title | instruction | 0 | 78,375 | 68 | 234,715 |
Novel and Innovative Approaches to Teaching Human Anatomy Classes in an Online Environment During a Pandemic | output | 1 | 78,375 | 68 | 234,716 |
In view of the current situation with a worldwide pandemic, the use of online teaching has become critical. This is difficult in the context of human anatomy, a subject contingent primarily on the use of human cadaveric tissues for learning through face-to-face practical laboratory sessions. Although anatomy has been taught using online resources including 3D models and anatomy applications, feedback from students and academic staff does not support the replacement of face-to-face teaching. At Charles Sturt University, we were obligated to cancel all classes on-campus in 2020 due to the COVID-19 pandemic. We ran exclusive online anatomy practical classes replacing classes usually run on campus. We designed an alternative program that consisted of twenty pre-recorded videos that were prepared in the anatomy laboratory using cadaveric tissues, and then discussed in live (and interactive) tutorials. Furthermore, innovative approaches to learning were shown and encouraged by the lecturer. Student survey responses indicated a positive response to both the anatomical videos and the innovative learning approaches. The results obtained by students showed a statistically significant increase in high distinctions and marked decrease in the amount of fail grades, compared with the previous three years (not online). The use of these videos and the encouragement of innovative learning approaches was a novel experience that will add valuable experiences for improved practice in online anatomy teaching. We propose that online anatomy videos of cadavers combined with innovative approaches are an efficient and engaging approach to replace face-to-face anatomy teaching under the current contexts. | input | 2 | 78,375 | 68 | 234,717 |
Please summerize the given abstract to a title | instruction | 0 | 78,622 | 68 | 235,456 |
Student Nurses Undertaking Acute Hospital Paid Placements during COVID-19: Rationale for Opting-In? A Qualitative Inquiry | output | 1 | 78,622 | 68 | 235,457 |
The research aim was to evaluate the rationale of undergraduate final-year student nurses to undertake paid clinical placements during COVID-19 (Wave 1). The nursing profession reacted innovatively to meet demands placed on the National Health Service during COVID-19. Temporary changes to professional regulation enabled final-year United Kingdom nursing students to voluntarily undertake paid placements in the National Health Service. Neither full-time employees nor full-time students, volunteers undertook a unique hybrid role bolstering the front-line health workforce. Using reflective qualitative inquiry, 17 volunteers evaluated reasoning for entering practice in acute hospitals. Online surveys based around the UK Nursing and Midwifery Council Competency Framework (NMC 2012) were completed weekly for 6 weeks. Data were thematically analysed. Six themes were identified, including sense of duty, and opting-in or out. These highlighted the importance of collaboration and the tripartite relationship between University, host and student during placement, and the influence of these on the learning experience. Several significant insights emerged for nurse education and curricula during pandemics related to patient safety, safety climate and governance. The insights were used to develop a “Student Nurses Placement Framework” with recommendations for Pre-During-Post placement, offering a guide for future nursing workforce recruitment and retention. | input | 2 | 78,622 | 68 | 235,458 |
Please summerize the given abstract to a title | instruction | 0 | 78,641 | 68 | 235,513 |
A COVID-19 necessity or the future of medical education? An evaluation of online psychiatry tutorials for medical students | output | 1 | 78,641 | 68 | 235,514 |
IntroductionFollowing the national lockdown in the UK in March 2020 in response to the COVID-19 pandemic, we instigated regular online tutorials for fourth year medical students undertaking their psychiatry placement.ObjectivesThe aims of these tutorials were threefold: to ensure that students covered a range of key psychiatry topics, to enable them to have the opportunity for interactive tutorials with experienced psychiatrists and, not least, to create a sense of continuity and connection with their tutors and peers across the mental health block.MethodsEach student was allocated to a tutorial group comprising 10 – 15 medical students and a psychiatrist facilitator. These groups met weekly for 7 consecutive weeks at an agreed time for 60 – 90 minutes via an online platform and all covered the same allocated topic each week. We evaluated these groups via an online survey sent to the students following the programme.ResultsThe students rated the tutorials on average as 4.5/5 on whether they met the defined learning outcomes. On average the students did not consider that the virtual format made a significant difference to their learning, but this disguised a wide range of views that were expressed via a comment box.ConclusionsThe evaluation of this project supports the use of virtual tutorials as a valuable learning tool but educators need to be aware that student views’ on these can be varied and so, long-term, a blend of virtual and face to face learning is most likely to meet the needs of all students. | input | 2 | 78,641 | 68 | 235,515 |
Please summerize the given abstract to a title | instruction | 0 | 78,730 | 68 | 235,780 |
Learning-by-Teaching and Service Learning to Promote Bleeding Control Education: An Academic-Community Partnership | output | 1 | 78,730 | 68 | 235,781 |
BACKGROUND: Stop the Bleed is a free 1-hour class that teaches laypersons to identify and treat life-threatening bleeding. The training requires a 1:10 instructor-to-participant ratio, which creates a resource drain on volunteer instructors. Nursing students are eligible to assist instructors. PROBLEM: Our State Legislature mandated that public schools equip themselves with bleeding control kits resulting in thousands of school staff needing training. APPROACH: Our nursing school used a service learning model to aid schools. Nursing students coordinated the program, and student learning occurred through a learning-by-teaching strategy. OUTCOMES: We trained 656 community members, taught in 5 counties, and students received 320 clinical hours. If not for COVID-19 (coronavirus disease 2019), numbers would have been doubled. We developed a sustainable relationship with school nurses. Students rated the program highly with respect to meeting course objectives and preparation for professional practice. CONCLUSIONS: The program met its goals and will continue. | input | 2 | 78,730 | 68 | 235,782 |
Please summerize the given abstract to a title | instruction | 0 | 79,329 | 68 | 237,577 |
"Small Bites and Well-Balanced Meals | output | 1 | 79,329 | 68 | 237,578 |
One of the salutary consequences of the 2020-2021 pandemic has been a renewed appreciation for the advantages students find in nondegree credentials, either as stand-alone qualifications or as complements to degrees. Such credentials, which include certificates and certifications as well as boot camps, diplomas, and apprenticeships, often may be obtained in less time and at less expense than associate or baccalaureate degrees. Also, most are closely focused on employable skills. And if students pursue such credentials through systems that enable rational and coherent educational trajectories, they may find it possible to combine them in an aggregate qualification or to stack them toward requirements for an associate or baccalaureate degree. The competitive advantages that a balanced education can offer can be achieved (and may be achieved more fully) through a trajectory that includes "small bites." But that is unlikely without considerable planning on the part of both students and institutions. Learning occurs most readily in the context of other learning. | input | 2 | 79,329 | 68 | 237,579 |
Please summerize the given abstract to a title | instruction | 0 | 79,504 | 68 | 238,102 |
Online anatomy laboratory: a new way to educate allied health students. | output | 1 | 79,504 | 68 | 238,103 |
INTRODUCTION AND OBJECTIVE In-person cadaveric anatomy laboratories allow for students to learn the intricacies of the human body but also develop skills related to communication, clinical reasoning, and interprofessional collaboration. However, the Covid-19 pandemic caused a shift from in-person course delivery to an online medium. Therefore, the objective of this study was to develop and evaluate the implementation and use of an online anatomy laboratory as a replacement for an in-person laboratory component. It is hypothesized that presenting cadaveric images of gross specimens and utilizing break out rooms can mimic aspects of in-person instruction and facilitate teaching anatomy using an online modality. MATERIALS AND METHODS An anatomy course for allied heath students (Pharmacy and respiratory therapy (RT)) that included an in-person cadaveric laboratory was modified for online delivery. The laboratory component utilized cadaveric images presented by the instructor and breakout rooms for small group discussion to simulate in-person anatomy laboratory experiences. Academic performance of the online cohort was compared to previous in-person cohorts to evaluate students' learning of human anatomy in an online laboratory. Upon completion of the online course, students (n=35) completed a questionnaire containing Likert scale and open-ended questions regarding online anatomy learning. Questions related to cadaveric images presented, breakout room use and online instruction were used to evaluate the student experience of an online anatomy laboratory. RESULTS Online anatomical studies had no academic advantage or disadvantage compared to in-person instruction. From the survey results, students indicated that the online laboratories were enjoyable and helpful for learning anatomy (3.3±0.15 and 3.8±0.16 respectively). Students rated the guided cadaveric image portion very highly (4.37±0.13) and the use of cadaveric pictures as an appropriate learning tool in the online setting (4.07±0.13). Students also responded positively to the helpfulness of breakout room sessions in learning anatomy (3.14±0.17). Open-ended comments revealed that students appreciated the presentation of cadaveric images and the ability to ask questions in real time to the instructor. Furthermore, students noted the advantage of discussing anatomical concepts and clinical correlations with their peers in a small group breakout room format. CONCLUSION AND SIGNIFICANCE Moving from an in-person to an online anatomy laboratory experience for pharmacy and RT students had no adverse effect on learning human anatomy. Health professional students found the use of cadaveric images and the use of breakout rooms for small group learning an acceptable and appropriate substitute to traditional in-person cadaveric anatomy laboratories. Based on the results of this study, online delivery of an anatomy laboratory, that was developed to simulate important aspects of in-person learning, can act as a viable alternative-learning platform for anatomical laboratory education. | input | 2 | 79,504 | 68 | 238,104 |
Please summerize the given abstract to a title | instruction | 0 | 79,749 | 68 | 238,837 |
Pedagogical foundations of cybercivility in health professions education: a scoping review. | output | 1 | 79,749 | 68 | 238,838 |
BACKGROUND Teaching cybercivility requires thoughtful attention to curriculum development and content delivery. Theories, models, and conceptual and theoretical frameworks (hereafter "tools") provide useful foundations for integrating new knowledge and skills into existing professional practice and education. We conducted this scoping review to identify tools used for teaching cybercivility in health professions education. METHODS Using Arksey and O'Malley's scoping review framework, we searched six biomedical and educational databases and three grey literature databases for articles available in English published between January 1, 2000 and March 31, 2020. Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), we screened and extracted relevant data, and reported the results of the search. RESULTS The search resulted in 2272 articles, with 8 articles included in this review after inclusion criteria were applied. Four articles (50%) were peer-reviewed journal papers while the other 4 (50%) were dissertations. Eleven unique tools were identified by this review: (1) Transpersonal Caring Theory, (2) Theory of Workplace Incivility, (3) Conceptualization of Incivility, (4) Media Ecology Theory, (5) Principlism, (6) Salmon's Five Stage Model of Online Learning, (7) Learner-Centered Educational Theory, (8) Gallant and Drinan's 4-Stage Model of Institutionalization of Academic Integrity, (9) Theory of Planned Behavior, (10) Communication Privacy Management Theory, and (11) Moral Development Theory. Based on the tools analyzed in our scoping review, we determined three features of cybercivility pedagogy to which the tools provided a guide: (1) behavioral manifestations, (2) academic integrity, and (3) digital professionalism. CONCLUSIONS The reviewed tools provide a pedagogical foundation and guidance for teaching various properties of cybercivility. Future studies should be expanded to include a broader literature body and non-English literature to provide the global perspective and global skills needed by a diverse population of learners. | input | 2 | 79,749 | 68 | 238,839 |
Please summerize the given abstract to a title | instruction | 0 | 79,999 | 68 | 239,587 |
Perception of an Introductory Point-of-Care Ultrasound Course for Thai Medical Students on Emergency Medicine Rotation | output | 1 | 79,999 | 68 | 239,588 |
INTRODUCTION: Point-of-care ultrasonography (POCUS) is increasingly utilized in emergency departments (EDs) throughout Thailand. Although emergency medicine (EM) residents are trained in POCUS, Thai medical students receive limited training. An introductory POCUS course was implemented for medical students to prepare them for internships. OBJECTIVE: This study described the perception and use of POCUS by graduates of an introductory POCUS course. MATERIALS AND METHODS: Medical students who completed the POCUS course were surveyed during their intern year from 2012 to 2015. The survey collected demographic characteristics. The Likert Scale was used to assess POCUS practice patterns and perceptions of the course. RESULTS: There were 230 respondents (98% response rate). All thought that POCUS was important. Furthermore, 96% of respondents felt that the POCUS course meaningfully impacted their ability to deliver care. POCUS use was greatest for obstetrics/gynecology and trauma cases. Over half of respondents (55.2%) felt very confident with using extended-Focused Assessment with Sonography in Trauma. Most respondents (81.8%) were positively impacted by the course, and 61.7% were satisfied with the scope of the course. Recommendations for improvement included increasing the course length, the content, and the hands-on time for POCUS practice. CONCLUSION: Graduates positively perceived the course and felt it dramatically impacted their clinical practice as novice physicians. An introductory POCUS course should be incorporated into the medical school curriculum to prepare graduates for practice. Future goals include increasing the scope of POCUS practice to help guide interns and residents in emergency patient care such as lung ultrasound in COVID-19 or pneumonia patients and studying the impact this course has on patient outcomes. | input | 2 | 79,999 | 68 | 239,589 |
Please summerize the given abstract to a title | instruction | 0 | 80,040 | 68 | 239,710 |
A call to action: why medical education curriculum needs to encourage young physicians to innovate | output | 1 | 80,040 | 68 | 239,711 |
Patient-centered and physician-led innovations are key to promoting physicians as visionary leaders in the healthcare system especially during times of crises. COVID-19 has inspired some promising recent advancements within medicine worth noting, including improvements in telemedicine, 3-D printed personal protective equipment (PPE) and ventilators, drug and vaccine development, sterilization of PPE allowing for reuse, and point of care testing; they highlight a broader lesson for how we might innovate better within medicine, even after the crisis has passed. As such, with the complexities of modern-day medicine, to continue to foster this culture of innovation, it is paramount that going forward, medical education adapt and embrace an innovation curriculum that prepares physicians and healthcare workers to work with their communities and researchers to confidently tackle any challenges that may present. Integrating innovation into our careers and medical training is important for advancement of the field and to be able to handle challenges that may present to the healthcare system. | input | 2 | 80,040 | 68 | 239,712 |
Please summerize the given abstract to a title | instruction | 0 | 80,085 | 68 | 239,845 |
Behind the Scenes of an Educational Escape Room. | output | 1 | 80,085 | 68 | 239,846 |
Educational versions of interactive escape room games can be used to teach and reinforce knowledge and clinical skills. In this article, the authors describe their experience creating, piloting, implementing, and evaluating a safe medication educational escape room for first-year nursing students. They highlight the steps needed to develop an effective learning experience and provide insight into lessons they've learned throughout this process. | input | 2 | 80,085 | 68 | 239,847 |
Please summerize the given abstract to a title | instruction | 0 | 80,155 | 68 | 240,055 |
Efficacy of an online course in developing competency for prescribing balanced diet by medical students: A non - inferiority trial. | output | 1 | 80,155 | 68 | 240,056 |
Background In the COVID era, medical education has been hit hard. Paradoxically, the need for health professionals has increased. Online methods are being widely used, but its efficacy is rarely measured. Objectives This study was conducted to find the efficacy of an online course in developing competency among medical students to prescribe balanced diet. Methods An online module was hosted at https://drzinia.moodlecloud.com/. A noninferiority trial was conducted among voluntary participants of the third MBBS students, in 2019. Stratified block randomization was done, so that ten students were allocated to the intervention arm of online sessions and ten students were allocated to the control arm of classroom sessions. Pretest assessments, seven assessments related to sessions conducted, and a postassessment were done. Generalized estimating equations were done to adjust for the effects of other confounders and see whether the intervention was a significant determinant of ability to prescribe balanced diet. Results Baseline variables were comparable in the two groups. The pretest scores were not significantly different in the two groups. The mean total marks scored by the online group (47.33/70) was not significantly different (t=0.68; p=0.50) from that of the class room group (45.70/70). The posttest scores were significantly higher than the pretest scores. Ninety-percent of students in the online course agreed that they could effectively learn through an online course. Conclusion Online teaching is effective to learn the prescription of balanced diet. Similar efforts in other domains can make medical education evidence based in the current scenario. | input | 2 | 80,155 | 68 | 240,057 |
Please summerize the given abstract to a title | instruction | 0 | 80,172 | 68 | 240,106 |
Web-based 3D visualization system for anatomy online instruction | output | 1 | 80,172 | 68 | 240,107 |
Problem-based instruction is an active learning instructional practice that requires students to use rational and critical thinking skills to generate reasonable solutions to problem-based scenarios. For complex medical conditions such as stroke, degenerative diseases, and traumatic brain injury, students must have a strong command of neuroanatomy and physiology. While virtual and synthetic dissection simulation tools alleviate the need for procuring and maintaining costly resources, like cadavers, these tools are costly, inaccessible to students online, and inadequate in the teaching of practical knowledge needed to solve real-life clinical problems. In the wake of the Covid-19 pandemic, many courses have switched to an online format surprising students and faculty. The web-based visualization repository presented is intended to provide medical students with a comprehensive, web-based visual and problem-based learning tool to assist their learning of anatomical and neurophysiological concepts as applied to various medical disorders. The application can be used for online learning, as well as for in-person learning. © 2021 ACM. | input | 2 | 80,172 | 68 | 240,108 |
Please summerize the given abstract to a title | instruction | 0 | 80,191 | 68 | 240,163 |
Physician Disengagement and Spiritual Dissonance in Medical Students | output | 1 | 80,191 | 68 | 240,164 |
BACKGROUND AND OBJECTIVES: Religion and spirituality constitute aspects of diversity that physicians must respect to provide patient-centered care. By seeing patients as individuals and integrating their religious and spiritual needs into their medical care, providers can deliver personalized health care. Their needs become even more critical for the frontline providers during the COVID-19 pandemic. Most patients want their physicians to address their religious and spiritual needs when it comes to their health (eg, during isolation precautions). Despite increases in educational curricula about this integration, most physicians still do not provide this aspect of patient-centered care. METHODS: In this observational study, we examined how medical students responded to a patient experiencing a religious and spiritual issue by having standardized patients (SPs) rate the students' level of engagement with them. We also asked students to reflect on their own spirituality, in terms of their current and ideal levels of spirituality, the difference of which indicates spiritual dissonance. Medical students (n=232) completed the Spiritual Health and Life-Outcome Measure (SHALOM) questionnaire, and their SPs completed the Princess Margaret Hospital Satisfaction With Doctor Questionnaire (PSQ-MD). RESULTS: Results indicated a significant, positive correlation between disengagement (from PSQ-MD) and transcendent spirituality dissonance (from SHALOM). CONCLUSIONS: Higher levels of disconnection from a patient case with a religious and spiritual issue (portrayed by an SP) were associated with higher levels of incongruity in medical students' responses as to their ideal relationship with the transcendent (eg, God, Allah, peace). | input | 2 | 80,191 | 68 | 240,165 |
Please summerize the given abstract to a title | instruction | 0 | 80,213 | 68 | 240,229 |
The Effects of Pass/Fail USMLE Step 1 Scoring on the Otolaryngology Residency Application Process. | output | 1 | 80,213 | 68 | 240,230 |
OBJECTIVES To investigate how the decision to report United States Medical Licensing Examination (USMLE) Step 1 score as pass/fail will influence future otolaryngology residency application and match processes. STUDY DESIGN Survey study. METHODS An anonymous and voluntary survey approved by the Otolaryngology Program Directors Organization was administered to academic faculty members from April 24, 2020 through May 19, 2020. RESULTS Two hundred fifty-seven surveys were received from department chairs (17.5%), program directors (24.1%), associate program directors (12.5%), and department faculty (45.9%). USMLE Step 1 has been the most heavily weighted metric for offering interviews (44.0%), and it has correlated with residents' medical knowledge (77.0%) and in-service performance (79.8%) but not with surgical skills (57.6%) or patient care (47.1%). In total, 68.1% disagreed with the decision to make USMLE Step 1 pass/fail. This change is anticipated to lead to an increase in significance of USMLE Step 2 CK (89.1%), core clerkship grades (80.9%), elective rotation at the respective institutions (65.7%), Alpha Omega Alpha and other awards (64.6%), and letters of recommendation (63.8%). The new scoring is also anticipated to especially benefit students from top-ranked schools (70.8%), increase medical students' anxiety/uncertainty regarding obtaining interview invites (59.1%), and negatively affect international (51.4%), doctor of osteopathic medicine (45.9%), and underrepresented students (36.9%). Indication that USMLE Step 2 CK will significantly increase in weight varied according to department position (P = .049), geographic region (P = .047), years of practice (P < .001), and residency program size (P = .002). CONCLUSION Most academic otolaryngologists disagreed with changing USMLE Step 1 scoring to pass/fail and believe that it will increase other objective/subjective metrics' weight and put certain student populations at a disadvantage. LEVEL OF EVIDENCE N/A. Laryngoscope, 2020. | input | 2 | 80,213 | 68 | 240,231 |
Please summerize the given abstract to a title | instruction | 0 | 80,265 | 68 | 240,385 |
Age-friendly student senior connection: students' experience in an interprofessional pilot program to combat loneliness and isolation among older adults during the COVID-19 pandemic | output | 1 | 80,265 | 68 | 240,386 |
Loneliness and isolation are concerning consequences of social distancing and other stay-at-home orders for older adults globally, amidst the COVID-19 pandemic. To combat loneliness and isolation among older adults residing in California, the Keck School of Medicine collaborated with other health profession schools at the University of Southern California (USC) to create the Age-Friendly Student Senior Connection (AFSSC). A total of 115 interprofessional graduate students were linked with older adults. Students engaged in 30 to 60 minute phone calls with older adults 2 to 5 times per week for 6 weeks. Student preparation included asynchronous video and web-based learning, weekly synchronous de-briefing sessions with a participating faculty member via Zoom, phone, and e-mail support from faculty, and information about resources for older adults. Faculty held weekly meetings throughout the pilot and developed new resources to respond to older adult needs, as reported by students. A total of 102 students completed pre-program and post-program surveys. Preliminary results show statistically significant changes in the reported benefits and outcomes from students participating in the program. | input | 2 | 80,265 | 68 | 240,387 |
Please summerize the given abstract to a title | instruction | 0 | 80,398 | 68 | 240,784 |
Teaching Social Justice in Undergraduate Nursing Education: An Integrative Review. | output | 1 | 80,398 | 68 | 240,785 |
BACKGROUND Clarification of best practices in teaching social justice concepts is necessary to prepare undergraduate nursing students to address health care disparities. METHOD An integrative literature review was used to analyze literature describing coursework, teaching methods, sites for application of learning, and methods to evaluate student learning. RESULTS Junior- and senior-level coursework and optional opportunities were identified. Traditional and nontraditional approaches to teaching also were evident. Nursing students applied knowledge at sites where health care was provided and vulnerable populations were served, as well as in simulated environments. Evaluation of learning occurred related to students' abilities to inform an empathetic understanding, analyze the community, and become change agents. CONCLUSION Social justice can be threaded throughout the curriculum with the use of traditional and nontraditional teaching strategies. The application of learning can occur in a variety of settings with evaluation demonstrating students' ability to take action to advocate for social justice. [J Nurs Educ. 2021;60(10):545-551.]. | input | 2 | 80,398 | 68 | 240,786 |
Please summerize the given abstract to a title | instruction | 0 | 80,413 | 68 | 240,829 |
Implementing Value-Added Medical Education: Lessons Learned From the Student-Initiated "Stanford Frontline" COVID-19 Consult Service | output | 1 | 80,413 | 68 | 240,830 |
PROBLEM: Value-added medical education (VAME) has been difficult to implement due to student and educator constraints. The COVID-19 pandemic caused a mass transition to online learning, removed students from clinical settings, and underscored students' desires for meaningful VAME opportunities. The authors introduced the Stanford Frontline COVID-19 Consult Service (SFCS), through which off-service medical and physician assistant (PA) students provided assistance to clinicians in the form of rapid research regarding COVID-19 clinical questions. APPROACH: The SFCS, a student-derived VAME initiative, was implemented from March to May 2020 by Stanford University medical students, PA students, and faculty. SFCS aligned with not only the interests of clinicians and students, but also national accreditation standards. Students attended weekly editorial meetings, didactic sessions on literature reviews and information management, and they underwent rigorous training on the peer-review process. After two months, the authors expanded the service to local community clinicians. OUTCOMES: The SFCS enrolled 16 students, was supported by 13 faculty members, and produced 87 peer-reviewed evidence syntheses. Of the 16 SFCS students, 13 (81%) completed evaluations; of 128 Stanford Primary Care and Population Health clinicians, 48 (38%) completed evaluations. Overall student satisfaction with the SFCS was 4.9/5 (standard deviation [SD] 0.3). Self-assessed achievement of SFCS learning objectives exceeded 90% for all objectives. Overall faculty satisfaction with the SFCS was 4.4/5 (SD 0.8). Most faculty (40/46 [87%]) planned to use the database to answer future COVID-19 questions. NEXT STEPS: The SFCS is a novel, student-initiated VAME curriculum focused on increasing students' meaningful contributions to patient care. The authors will track SFCS students throughout their clerkships to gauge clerkship performance/preparedness, and they will develop training for integrating VAME into preclerkship curricula at other institutions. Given its adaptive, student-driven design, the VAME framework used to develop the SFCS empowers students to create their own personalized, experiential learning. | input | 2 | 80,413 | 68 | 240,831 |
Please summerize the given abstract to a title | instruction | 0 | 80,468 | 68 | 240,994 |
Academic performance and dental student satisfaction with emergency remote teaching of endodontics during COVID-19 pandemic: A retrospective cohort study | output | 1 | 80,468 | 68 | 240,995 |
Introduction: The study aimed to evaluate the consequences of introducing online modalities for emergency remote teaching during the coronavirus disease 2019 pandemic, on students' learning satisfaction in the endodontic preclinical course and their performance in the summative examination. Materials and Methods: On completion of the preclinical endodontic course, 39 students were E-mailed an online questionnaire investigating their overall satisfaction with online modalities used for emergency remote teaching. They were requested to evaluate their satisfaction with three methods of lecture delivery: conventional face to face, online synchronized and online asynchronized, in terms of comprehension and retention of knowledge, communication with the lecturer, time convenience, Internet or technical support, transportation for face-to-face lectures, and stress-free learning. Students' scores were compared to scores of students who took the course before the pandemic and received only conventional face-to-face teaching. Data were statistically analyzed. Results: A response rate of 100% showed that 87% of the students were satisfied with the online modalities used for emergency remote teaching. Students were significantly less satisfied with online-asynchronized lectures in terms of communication with the lecturer (P < 0.001) and with online-synchronized lectures in terms of time convenience (P < 0.001). The students' examination performance was not affected by shifting to emergency remote teaching (P = 0.076). Conclusion: Dental students were satisfied with online modalities used for emergency remote teaching in the preclinical endodontic course and their academic performance was not adversely affected. © 2021 Wolters Kluwer Medknow Publications. All rights reserved. | input | 2 | 80,468 | 68 | 240,996 |
Please summerize the given abstract to a title | instruction | 0 | 80,588 | 68 | 241,354 |
Head-neck dissection course during COVID-19 pandemic: challenges, adaptations and how we did it | output | 1 | 80,588 | 68 | 241,355 |
INTRODUCTION: Cadaveric dissection courses have come to a standstill since the onset of the COVID-19 pandemic. In addition to limited operative opportunities, cancellation of such courses has severely impacted surgical training, especially in a craft-based specialty such as head-neck surgery. The aim of this educational project was to: (1) study the feasibility of an in-person head-neck cadaveric dissection course during COVID-19 pandemic; and (2) validate the educational benefit of this teaching method to ear, nose and throat (ENT) trainees. METHODS: We developed a 2-day head-neck cadaveric dissection course for ENT trainees. The course programme covered essential head-neck open surgical procedures. Content validity (subjective feedback) was assessed using a 5-point Likert scale. Construct validity (objective usefulness) was evaluated via two pre- and post-course questionnaires, estimating knowledge of head-neck surgical anatomy and self-assessment of levels of confidence with head-neck procedures, respectively. RESULTS: A risk assessment was conducted and a protocol developed (risk was deemed to be low/tolerable). Content validity showed high satisfaction compared with a median Likert score of 3, 'average' (p=0.000002). For construct validity, the mean score per question improved significantly (p=0.001). Overall levels of confidence showed a trend towards improvement (p=0.08). There was significant improvement in laryngectomy (p=0.01) and level I dissection (p=0.01), with an indication of improvement in level II-V dissection (p=0.07). CONCLUSIONS: We demonstrated that a cadaveric dissection course, using thorough risk assessment and protocol, could be safely conducted with high content and construct validation during these unprecedented times. This is an invaluable learning environment that needs to be encouraged despite infection control restrictions. | input | 2 | 80,588 | 68 | 241,356 |
Please summerize the given abstract to a title | instruction | 0 | 80,595 | 68 | 241,375 |
Global health education for medical students in Italy | output | 1 | 80,595 | 68 | 241,376 |
BACKGROUND: Global health education (GHE) in Italy has spread since the first decade of 21st century. The presence of global health (GH) courses in Italy was monitored from 2007 to 2013. In 2019, a new survey was proposed to assess the availability of educational opportunities in Italian medical schools. METHODS: An online survey was carried out using a questionnaire administered to a network of interested individuals with different roles in the academic world: students, professors, and members of the Italian Network for Global Health Education. The features of courses were analysed through a score. RESULTS: A total of 61 responses were received from affiliates of 33 out of the 44 medical schools in Italy. The national mean of GH courses for each faculty was 1.2, reflecting an increase from 2007. The courses increased nationwide, resulting in a dispersed GHE presence in northern, central and southern Italy. One of the most critical points was related to the nature of “elective” courses, which were not mandatory in the curricula. Enrollees tended to be students genuinely interested in GH issues. Some community and service-learning experiences, referred to as GH gyms, were also detected at national and international levels. CONCLUSIONS: GHE has spreading in Italy in line with the vision of the Italian Network for Global Health Education. Although progress has been made to disperse GH courses around the country, more academic commitment is needed to include GH in the mandatory curricula of medical schools and other health faculties. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02792-8. | input | 2 | 80,595 | 68 | 241,377 |
Please summerize the given abstract to a title | instruction | 0 | 80,942 | 68 | 242,416 |
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