Auburn Research Day 2022

Cl i n i ca l Case Repor t | Med i ca l St udent Case Report in Pediatrics: Failure To Thrive – Cystinosis 75

(1)Jacob Greenspan; (1) Kiveum Kim; (2) Claire Yother, MD (1)VCOM – Auburn Campus; (2) Gadsden Pediatrics, Gadsden Regional Medical Center

This patient was born at 25.4 weeks gestation via urgent cesarian section due to uncontrolled maternal hypertension with Apgar scores of five and eight at one and five minutes respectively due to low tone and respiratory effort. The patient then endured a 92-day Neonatal Intensive Care Unit stay complicated by acute respiratory distress syndrome, bacterial sepsis, idiopathic hypotension, bacterial pneumonia, empiric treatment for possible meningitis, among various other conditions. Following this hospital course, the patient failed to gain weight even after being put on a 27-calorie formula,

eventually being diagnosed with failure to thrive. After referral to gastroenterology revealed nothing pointing to an etiology for his failure to thrive and admission to the hospital for vomiting and hydrocephalus and work-up by nephrology, the patient was diagnosed with cystinosis at 11 months old. Since this diagnosis, the patient was treated with growth hormone to get caught up on the growth chart and extensive drug regiment including cysteamine to increase lysosomal cysteine transport.

Cl i n i ca l Case Repor t | Med i ca l St udent Small Bowel Diverticulitis: Case Report

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(1) Nikki Lauderback; (2) Dr. Andrew May, MD (1) VCOM- Auburn; (2) Gadsden Regional Medical Center

Small bowel diverticulitis is a rare disease typically found incidentally in asymptomatic patients in their 60s and 70s. 1 It is managed similarly to colonic diverticulitis due to the numerous comparable characteristics allowing for conservative treatment with antibiotics and surgical treatment, when necessary, requiring a small bowel

resection and anastomoses. Awareness of small bowel diverticulitis as a possible differential diagnosis is needed due to the unique presentations that this disease can have including pancreaticobiliary diseases, hemorrhage, obstruction, and perforation. 2

S imu l a t i on Resea rch | Med i ca l St udent Telemedicine Encounters Take Longer Than In-Person Encounters in Standardized Patient Testing 77

Ana Paraiso; Adam Fralich; Jacob Adams; Dr. David Kashmer VCOM-Auburn- Center of Simulation and Technology

Objective: The COVID-19 pandemic has dramatically changed the lives and relationships globally. One of the most significant effects of the pandemic is the use of virtual learning to abide by social distancing guidelines. Throughout the pandemic, telemedicine has become an essential method not just in providing medical services but also in medical training. This raises the question as to how online medical training will affect the quality of care provided by future physicians. Research has shown that integration of telemedicine- based education provides substantial knowledge, and that medical students express the value of such training in their didactic and clinical curriculum (Waseh & Dicker 2019). With the new influence of telemedicine in medicine, this quality assessment study compares medical students, who started medical school in a virtual setting, to students who learned through the traditional in-person setting.Total standardized encounter times from taking quality medical history to performing physical exam were collected to assess whether a difference exists between telemedicine and in-person encounters. Methods: Data were collected prospectively from 80 subjects. The Class of 2024 are assigned as the telemedicine group and the Class

of 2025 are assigned as the in-person training group. Total encounter times and accuracy of diagnosis were each collected over two weeks. Data were collected with no patient identifiers. Data for total encounter times were obtained through recorded patient encounters from Block 2 for both Class of 2024 and Class of 2025. Results: The students participating in the Telemedicine training demonstrated longer encounter times compared to students assigned to the in-person training group. The mean time for the Telemedicine group and in-person group were 19.99 minutes and 17.09 minutes respectively. Data were normally distributed per Andersen-Darling Test (AD = 0.149). A 2 Sample T- test was performed. The mean encounter time for each group differed at the 0.01 level of significance (p<0.01) per the 2 Sample T-test. Conclusion: In this study, encounter times were significantly different among groups with longer mean time noted in the Telemedicine group. Further investigation into the specifics of telemedicine and its role in simulated patient encounters may reveal factors contributing to the increased encounter length seen with Telemedicine visits.

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