Morcomb, Erin F.

Background and Objectives: Social distancing and quarantine requirements imposed during the COVID-19 pandemic necessitated remote training in many learning situations that formerly focused on traditional in-person training. In this context, we developed an adaptive approach to teaching laceration repair remotely while allowing for synchronous instruction and feedback. Methods: In April 2020, 35 family medicine residents from 4 programs in the Midwest United States participated in a real-time, remotely-delivered, 2-hour virtual procedure workshop of instruction in suture techniques for laceration repair. Paired-sample t tests compared scores of learner self-confidence obtained during pre- and posttests. We interpreted short-answer responses with a mixed-methods analysis. Residents submitted photos and videos of suture techniques and received formative feedback based on a predefined rubric. Results: All residents completed the pre- and posttests. The posttest scores for self-confidence across the participants showed significant improvement for all suture techniques. Of the 67 short-answer responses, 38 responses (56.7%) were positive; 9 (13.4%) negative; 8 (11.9%) neutral; and 12 (17.9%) a combination of positive and negative. The workshop was rated by 34 residents (97.1%) as either “about the same as prior training experiences,” “better than prior training experiences,” or “much better than prior training experiences.” Conclusion: Learners reported that a remotely-delivered, real-time, synchronous suture technique workshop was a valuable experience. Further research is needed to establish the efficacy of this platform to promote procedural competence.

Diabetics tend to have inadequate fruit consumption, elevated plasma glucose and insulin, and increased cardiovascular disease risk. Dried fruit may represent one way to increase fruit consumption among diabetics. Polydextrose is a commonly used soluble fiber and bulking agent providing very little available carbohydrate energy. The glycemic and insulinemic response of type 2 diabetics (n=13) to a single serving of white bread (57g; 160 Cal; 1 g fiber), raw cranberries (RC; 55g; 21 Cal; 1 g fiber), sweetened dried cranberries‐original (SCDO; 40g, 138 Cal; 2.1g fiber), and SDC‐less sugar (SDCLS; 40g; 113 Cal; 1.8g fiber + 10g polydextrose) was measured in a single cross‐over design. Plasma glucose (mg/dl) and insulin ( μU/ml) was measured prior to consumption, then 30, 60 and 120 minutes postprandially. Plasma glucose peaked at 30 or 60 min following bread, RC, SDCO, and SDCLS at 175 ± 10, 127 ± 7, 175 ± 10 and 158 ± 9 min, respectively, and remained significantly elevated 120 min following bread consumption. Peak plasma insulin for SDCO (15 ± 2) and RC (10 ± 1) was significantly less than bread (22 ± 2) or SDCO (22 ± 4), and remained slightly elevated at 120 minutes. The area under the curve values reflected similar changes. SDCLS consumption could be useful for improving fruit consumption by type 2 diabetics in a manner that provides glycemic and insulinemic benefits. Sponsor: Ocean Spray Cranberries Inc.