Search

Thomas Picht,1,2 Anna L Roethe,1 Katharina Kersting,1 Milena Burzlaff,1,3 Maxime Le Calvé,2 Robert Schenk,1,3 Denny Chakkalakal,1 Peter Vajkoczy,1 Kirsten Ostherr4 1Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; 2Cluster of Excellence: “Matters of Activity. Image Space Material”, Humboldt-Universität zu Berlin, Berlin, Germany; 3Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany; 4Medical Humanities Research Institute, Rice University, Houston, TX, USACorrespondence: Thomas Picht, Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin, 10117, Germany, Email thomas.picht@charite.deAbstract: The field of medicine is quickly evolving and becoming increasingly more multidisciplinary and technologically demanding. Medical education, however, does not yet adequately reflect these developments and new challenges, which calls for a reform in the way aspiring medical professionals are taught and prepared for the workplace. The present article presents an attempt to address this shortcoming in the form of a newly conceptualized course for medical students with a focus on the current demands and trends in modern neurosurgery. Competency-based education is introduced as a conceptual framework comprising academic and operational competence as well as life-world becoming. This framework provides a sound educational foundation for future medical professionals, equipping them with the knowledge as well as skills needed to successfully navigate the medical field in the current day and age. Three competencies are identified that are central to day-to-day medical practice, namely digitalization, multidisciplinarity, and the impact of recent developments on the changing patient-practitioner relationship. These competencies are relevant for all medical disciplines, but are demonstrated here in a neurosurgical context and visualized using a real patient’s case study. Students follow this sample patient’s way through each step of the neurosurgical workflow, from planning to performing the procedure, and can see for themselves the importance and application of the aforementioned competencies based on this real-world example. Courses such as the one presented here may prepare medical students more adequately for their future work by combining theoretical and practical skills and critical reflection, thereby providing holistic and practical insights as well as a conceptual framework for their future careers.Keywords: competency-based learning, medical education, multidisciplinarity

Background: There is little consensus on the conservative management of lateral patellar dislocations (LPD). Mechanical diagnosis and therapy (MDT) is an established classification system in the spinal and extremity population. This case report describes the use of MDT in the management and classification of a patient with LPD. Case Description: The patient was a 20-year-old female with a 3-month history of left knee pain precipitated by a lateral patellar dislocation. The patient described pain and a feeling of instability with standing and walking and limitations in work and recreational activities which involve lifting, squatting, and running. Based on the patient’s response to repeated end range knee movements, the patient was found to have a directional preference (DP) for knee extension and instruction in performance of knee extension DP exercises was provided. Outcomes: The patient’s knee examination and subsequent intervention included her responses to repeated end range knee movements. Her knee pain was abolished, and strength, function, and motion were fully restored in five visits. A minimal clinically important difference (MCID) was achieved on the Lower Extremity Functional Scale (LEFS). At discharge, the patient was able to independently manage symptoms and perform all work and recreational activities at a pre-injury level and these improvements were maintained at a 9-month follow-up. Discussion: There are various management strategies for lateral patellar dislocation. This case demonstrated the use of classifying, subgrouping, and treating a patient with lateral patellar dislocation using the principle of DP. Conclusion: The patient’s outcomes suggest that MDT may be used in the nonoperative management of people with LPD who present with a DP. [ABSTRACT FROM AUTHOR]

The efficacy of Bio-Oss as a graft material for sinus floor elevation was studied in 15 patients. A total of 20 sinus augmentation procedures was performed, and 6 months later 57 implants were placed into the augmented sinuses. New bone formation was confirmed in biopsies of 3 patients (new bone: 21.08% +/- 7.25% after 6 mo, 27.55% +/- 4.88% after 12 mo; Bio-Oss: 39.17% +/- 4.36% after 6 mo, 27.01% +/- 11.64% after 12 mo). After a mean loading period of 4.0 +/- 0.5 years (range 3.2 to 4.8 y), 56 implants remained in place. This study confirms Bio-Oss's good osteoconductive properties. [ABSTRACT FROM AUTHOR]