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Background: There is increasing recognition in medical education that greater emphasis must be placed on preparing graduating medical students for their new roles as interns. Few publications in the literature have described transition-to-residency curricula specifically for students interested in pediatrics or pediatric-related fields Approach: We developed novel online pediatric cases, embedded within an innovative, hybrid transition-to-residency course, to address high yield, multi-disciplinary topics within the context of several of the AAMC’s identified Entrustable Professional Activities Evaluation: The pilot cases were evaluated over two academic years (2018, 2019) at a single academic medical center as part of routine student course evaluation (N = 18/35) with the 2019 evaluation containing additional retrospective pre-post survey questions (N = 9/18) assessing self-reported changes in knowledge. Almost all students were very satisfied or satisfied with the modules overall (94%), the quality of the resources provided (100%), and the structure and clarity of the presentation of the material (100%). Among the students who completed the retrospective pre-post survey after participation in the online modules, significant self-reported improvements were noted in writing orders to the pediatrics floor (Z = −2.07, p = 0.04), providing anticipatory guidance (Z = −2.0,p = 0.046), formulating a differential diagnosis for common pediatric conditions (Z = −2.24, P = 0.03), and preparedness for managing common pediatric floor emergencies (Z = −2.33, P = 0.02). Reflection: We demonstrated feasibility of implementation of an interactive, online case-based curriculum, medical student satisfaction with content and delivery, and increased self-reported knowledge after completion of the pilot pediatric cases on the online, asynchronous learning platform.

Language development has been consistently linked with socioeconomic status (SES), with children from lower SES backgrounds at higher risk for language delays. The objective of this study is to investigate the relationship between familial social service use and language development during the first year of life. Thirty-one low-income mothers and their infants were recruited from the New York metropolitan area. Mothers provided information about demographics and utilization of social services (Women, Infants, and Children (WIC), food stamps, Medicaid, and public housing). Infant language skills were assessed using the Preschool Language Scale. Multiple linear regressions were used to investigate the relationship between social service use and language skills. We found that the number of social services utilized was not an overall significant linear predictor of language skills. However, social service use interacted with poverty level to predict language skills. Specifically, for families living in deep poverty, higher service use significantly predicted higher infant language scores (&beta, = 3.4, p = 0.005). These results suggest that social services may be an appropriate target to help narrow socioeconomic disparities in language development.

Purpose To identify differences in breast cancer patient-reported quality of life (QOL) between 2 radiation tumor bed boost dose regimens. Methods and Materials Four hundred patients with stage 0, I, or II breast cancer who underwent segmental mastectomy with sentinel node biopsy and/or axillary node dissection were treated with either a daily or weekly boost. Patients were treated prone to 40.5 Gy/15 fractions to the whole breast, 5 days per week. Patients were randomized to a concomitant daily boost to the tumor bed of 0.5 Gy, or a weekly boost of 2 Gy on Friday. Patients completed 6 validated QOL survey instruments at baseline, last week of treatment (3 weeks), 45-60 days from the completion of radiation treatment, and at 2-year follow-up. Results There were no statistically significance differences in responses to the 6 QOL instruments between the daily and weekly radiation boost regimens, even after adjustment for important covariates. However, several changes in responses over time occurred in both arms, including worsening functional status, cosmetic status, and breast-specific pain at the end of treatment as compared with before and 45 to 60 days after the conclusion of treatment. Conclusions Whole-breast, prone intensity modulated radiation has similar outcomes in QOL measures whether given with a daily or weekly boost. This trial has generated the foundation for a current study of weekly versus daily radiation boost in women with early breast cancer in which 3-dimensional conformal radiation is allowed as a prospective stratification factor.