Ethical Considerations on Representing Slavery in Curriculum

Critical discourse on the role of slavery in U.S. history curriculum has tended to rely on calls for justice through truth and complexity. Yet the “truth” of slavery is almost incomprehensibly violent, constituting a form of “historical trauma”; the resultant instructional methods thus resemble what Berry and Stovall term a “curriculum of tragedy.” Ethical questions emerge regarding this method. Chiefly, if slavery constitutes a “historical trauma,” what are the possibilities of a Trauma-Informed curriculum? What are the responsibilities owed to students and historical subjects? Building from critical interventions in Black Feminist Theory and the work of the Frantz Fanon, I propose curricular interventions that attempt to mediate concurrent dynamics of trauma, pain, mourning, action, and revenge.

The role and effectiveness of School-based Extra-Curricular Interventions on children’s health and HIV related behaviour: the case study of Soul Buddyz Clubs Programme in South Africa

Background HIV education targeting children and adolescents is a key component of HIV prevention. This is especially important in the context of increasing HIV prevalence rates among adolescents and young people. The authors sought to examine the role and effectiveness of an extra-curricular school based programme, Soul Buddyz Clubs (SBC) on HIV knowledge, attitudes, behaviours and biomedical outcomes. Methods This paper employs a mixed methods approach drawing on data from independent qualitative and quantitative sources. Secondary data analysis was performed using survey data from a nationally representative sample that was restricted to 10-14 year-old males and females living in South Africa. Ten focus group discussions and ten in-depth interviews conducted with SBC members and facilitators from 5 provinces, as part of a process evaluation are used to triangulate the effectiveness of SBC intervention. Results The analysis of survey data from 2 198 children indicated that 12% of respondents were exposed to SBC with 4% reporting that they had ever belonged to a club. Children exposed to SBC were more likely to be medically circumcised (AOR 2.38; 95%CI 1.29 -4.40, p=0.006), had correct HIV knowledge (AOR 2.21; 95%CI 1.36 – 3.57, p<0.001) and had less HIV stigmatising attitudes (AOR 0.54; 95%CI 0.31-0.93, p=0.025), adjusting for age, sex, province and exposure to other media – in comparison to those not exposed. Propensity Score Matching findings were consistent with the regression findings. Qualitative findings also supported some of the quantitative results. SBC members reported having learnt about HIV prevention life skills, including condom use, positive attitudes towards people living with HIV, and alcohol abuse. Conclusions Participation in SBC is associated with accessing biomedical HIV prevention services, specifically MMC, correct HIV prevention knowledge and less HIV stigmatizing attitudes. This paper demonstrates the effectiveness of a school-based extracurricular intervention using a club approach targeting boys and girls ages 10-14 years on some of the key HIV prevention biomarkers as well as knowledge and attitudes. The article suggests that extra-curricular interventions can form an effective component of school-based comprehensive sexuality education in preventing HIV and promoting medical male circumcision.

COVID-19 Impact on Intern Exposure to Common Inpatient Diagnoses

OBJECTIVE We sought to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on the clinical exposure of pediatric interns to common pediatric inpatient diagnoses. METHODS We analyzed electronic medical record data to compare intern clinical exposure during the COVID-19 pandemic from June 2020 through February 2021 with the same academic blocks from 2017 to 2020. We attributed patients to each pediatric intern on the basis of notes written during their pediatric hospital medicine rotation to compare intern exposures with common inpatient diagnoses before and during the pandemic. We compared the median number of notes written per intern per block overall, as well as for each common inpatient diagnosis. RESULTS Median counts of notes written per intern per block were significantly reduced in the COVID-19 group compared with the pre–COVID-19 group (96 [interquartile range (IQR): 81–119)] vs 129 [IQR: 110–160]; P &lt; .001). Median intern notes per block was lower in the COVID-19 group for all months except February 2021. Although the median number of notes for many common inpatient diagnoses was significantly reduced, they were higher for mental health (4 [IQR: 2–9] vs 2 [IQR: 1–6]; P &lt; .001) and suicidality (4.5 [IQR: 2–8] vs 0 [IQR: 0–2]; P &lt; .001). Median shifts worked per intern per block was also reduced in the COVID-19 group (22 [IQR: 21–23] vs 23 [IQR: 22–24]; P &lt; .001). CONCLUSIONS Our findings reveal a significant reduction in resident exposure to many common inpatient pediatric diagnoses during the COVID-19 pandemic. Residency programs and pediatric hospitalist educators should consider curricular interventions to ensure adequate clinical exposure for residents affected by the pandemic.

The Role and Effectiveness of School-Based Extra-Curricular Interventions on Children’s Health and HIV Related Behaviour: The Case Study of Soul Buddyz Clubs Programme in South Africa

This paper sought to examine the role and effectiveness of an extra-curricular school based programme, Soul Buddyz Clubs (SBC) on HIV knowledge, attitudes, behaviours and biomedical outcomes. Secondary data analysis was performed on survey data of a nationally representative sample that was restricted to 10 -14-year-old males and females, using bivariate and multivariate methods in Stata14. Fifteen focus group discussions and 24 in-depth interviews conducted with SBC members, programme implementers and stakeholders in five provinces were analysed using thematic analysis in ATLAS.ti. The results indicated that 12% of respondents were exposed to SBC. Children exposed to SBC were more likely to be medically circumcised (AOR 2.38; 95%CI 1.29 -4.40, p=0.006), had correct HIV knowledge (AOR 2.21; 95%CI 1.36 – 3.57, p<0.001) and had less stigmatising attitudes (AOR 0.54; 95%CI 0.31-0.93, p=0.025) – in comparison to those not exposed. Qualitative findings also supported some of the quantitative results. SBC members reported having learnt about HIV prevention life skills, including condom use, positive attitudes towards people living with HIV, and alcohol abuse. Participation in SBC is associated with accessing biomedical HIV prevention services, specifically MMC, correct HIV prevention knowledge and less stigmatizing attitudes. This paper demonstrates the effectiveness of a school-based extracurricular intervention using a club approach targeting boys and girls ages 10-14 years on some of the key HIV prevention biomarkers as well as knowledge and attitudes. The article suggests that extra-curricular interventions can form an effective component of school-based comprehensive sexuality education in preventing HIV and promoting medical male circumcision.

A Survey of Residents/Fellows, Program Directors, and Faculty About Telepsychiatry: Clinical Experience, Interest, and Views/Concerns

The effectiveness of telepsychiatry video for clinical care is well established, and clinician and psychiatry resident interest in it is growing—particularly in light of the COVID-19 impact. Still, few residency programs in the United States have core curricula, rotations/electives available, and competencies, and many faculty have no experience. A survey was sent via national organization listserves for residents, fellows, faculty, and program directors to complete. The survey queried demographics, clinical experience and interest, and views/concerns, using Likert-like and yes/no questions. Descriptive statistics and other analyses compared the groups to assess impact of clinical experience on interest and views/concerns. Respondents (N = 270) have limited clinical experience with telepsychiatry (46% none), with trainees having less than others, and yet, most were very interested or interested in it (68%). Trainees (N = 123) have concerns about being prepared for future practice. Clinical experience with video in the range of 6–20 h appears to dramatically increase interest and reduce concerns, though less time has a positive effect. Respondents have concerns about connectivity, medico-legal issues, and clinical effectiveness (e.g., diverse populations, psychosis, and emergencies) with telepsychiatry. More research is needed to assess current clinical and curricular experience, interest, and concerns. Additional curricular interventions during residency and fellowship training could build skills and confidence, if this is feasible, and the benefits outweigh the costs.

Broadening student musicians’ career horizons: The importance of being and becoming a learner in higher education

Research in higher music education acknowledges a persistent divide between performance studies and the realities of musicians’ work. Alongside this is global pressure for curriculum that is more supportive of students’ metacognitive engagement, experiential learning and career preparation. However, scholars assert that the provision of these curricular elements is insufficient unless students recognise their value and engage in them at a deep level; this is because career-long employability in precarious industries such as music is underpinned by strategic, lifelong and self-regulated learning. The study reported here featured a scaffolded employability intervention located within the existing curriculum and trialled with seven student musicians at a European institution. The study had three aims: to understand the students’ career-related thinking and confidence; to determine whether such an intervention might be scalable; and to gauge the intervention’s potential efficacy in helping students to become conscious of their learner identity. Results indicate that many student musicians are aware of the need to extend their essential professional capabilities but unaware of how to address these deficits. Participants realised that ‘learning how to learn’ would help them achieve personal and professional goals. The findings suggest that similar in-curricular interventions are achievable at scale. Furthermore, they have the potential to foster a more holistic vision of performance education and practice such that aspiring musicians might graduate as both skilled professionals and agentic learners.

A Curriculum to Increase Resident Scholarly Activity

Background and Objectives: Scholarly activity (SA) is an Accreditation Council of Graduate Medical Education (ACGME) requirement for family medicine residents. Engaging residents in scholarly activity can be challenging. Naval Hospital Jacksonville Family Medicine Residency (NHJ) pioneered a curriculum that led to a dramatic, sustained increase in resident SA. We sought to implement the curriculum in other family medicine residency programs. Methods: The curriculum was implemented at two additional family medicine residencies. Three curricular interventions were identified: a 3-hour case report workshop, a written practical guide to scholarly activity, and a resident peer research leader. One program implemented all three elements. The other implemented the workshop and written guide, but did not identify a resident peer leader. SA was measured using the annual ACGME program director report and compared the intervention year to the previous 3 years of SA using a 2-sample test for equality of proportions with continuity correction. We used pre- and postintervention surveys to evaluate resident attitudes about SA. Results: The program implementing all three interventions increased residents’ conference presentation 302% (n=34, P&lt;.001). The program that did not identify a resident peer leader had no significant change in SA as reported to the ACGME. Conclusions: The curriculum was implemented in two additional residencies with promising results. We recommend further implementation across multiple sites to determine the extent to which the results are generalizable.