Hoffmann, Chelsey

Background Peripheral nerve stimulation (PNS) is an emerging neuromodulation therapy for chronic pain, yet its use in clinical practice varies significantly. Although temporary PNS is widely incorporated, either as a screening trial or a treatment itself, the evidence supporting the use of temporary PNS prior to permanent implantation is limited. We aimed to compare pain relief, opioid consumption, and adverse events between an approach implementing temporary PNS before permanent implantation (temporary-to-permanent (TTP)) vs proceeding directly to permanent PNS implantation (direct-to-permanent (DTP)). Methods A multicenter retrospective study was undertaken at seven major academic institutions from January 1, 2014, to January 1, 2024. Adult patients who underwent permanent PNS implantation for the treatment of chronic pain conditions were included and were divided into TTP or DTP cohorts based on their clinical approach. The dual primary outcomes were pain relief and opioid consumption (in oral morphine equivalents) at 6 months compared with baseline before any PNS therapy. Multivariable Tobit regression analysis was performed to identify predictors of pain relief at 6 months using a stepwise approach. Results A total of 130 patients were analyzed (54 in TTP approach, 76 in DTP approach). Patient-reported percentage pain relief was 56.7%±27.9% at 6 months compared with baseline (before PNS implantation) in the TTP cohort, and 45.1%±33.6% in the DTP cohort. The estimated mean percentage pain relief at 6 months was similar in the TTP and DTP cohorts (between-group difference 15.24%; 95% CI −0.32 to 30.80, p=0.052), with consistent findings after sensitivity analysis with multiple imputation. Opioid consumption declined similarly in the TTP (−3.1±9.9 mg) and DTP (−2.1±8.1 mg) cohorts at 6 months with no statistical difference between cohorts (mean between-group difference: −1.00, 95% CI −4.57 to 2.57, p=0.580), and with consistent findings after sensitivity analysis. Device explantation rates and adverse event profiles were comparable between cohorts. Conclusion Although temporary PNS is widely performed prior to permanent PNS implantation, there was no evidence that the TTP approach is associated with superior analgesic outcomes compared with the DTP approach. Further, patients in both approaches achieved clinically meaningful pain relief at 6 months compared with baseline status prior to PNS therapy.

Introduction Research on note-taking strategies in the higher education setting has been in existence since the 1920s. While both pros and cons exist for handwritten and digital note-taking techniques, recent research has focused on novel ways to optimize digital note-taking. With more students using laptops or tablets with a stylus, educators need to be equipped to coach students on evidenced-based ways to improve their digital note-taking. Methods PubMed, ERIC, and CINAHL databases were searched on January 6, 2025, using combinations of the following key words: digital, technology, analogue, note-taking, cognition, memory, laptop, stylus, and tablet. Studies were included if they were performed with adult learners in the higher education setting with a primary focus on note-taking. Results Three hundred thirty records were screened with 25 included in final review. Thematic analysis identified three emerging themes: (1) collaborative/group note-taking, (2) outlines, and (3) mind mapping, concept maps, or matrixes. Discussion Physician assistant/associate faculty can educate students on ways to conduct collaborative or group note-taking, create outlines, and generate mind maps, concept maps, or matrixes. These evidence-based digital note-taking strategies can be conducted independently or as a group. By supplementing these strategies with basic retrieval practices outside of the classroom, students will increase their likelihood of academic success.

Introduction Physician Assistant/Associate (PA) clinicians face a major learning curve when transitioning from patient provider to PA educator. Furthermore, PA educators juggle multiple responsibilities including teaching, grading, advising, mentoring, interviewing, researching, writing, and more. Recently published research has indicated that 52.4% of PA educators thought about leaving their faculty roles within the past year. To assist in the effort to prioritize faculty retention, a personal story of faculty burnout and lessons learned is shared. Methods Burnout and its three associated subscales are defined, while symptoms of burnout are outlined in a manner specific to the role of a PA faculty member. Results Drawing from the existing evidence base, suggestions are made to improve the well-being of PA educators and prevent faculty burnout or turnover. Discussion While being a PA faculty member is extremely rewarding, it can also be challenging, particularly for early-career PAs or those transitioning from clinical practice with no prior work experience as an educator. Strategic implementation of good habits may aid faculty members in preventing burnout and improving work-life balance.

Introduction Physician associate/assistant (PA) faculty benefit from learning the definitions and applications of pedagogy and andragogy within PA education. However, we are now in an era where PA learners may fall along the continuum between pedagogy and andragogy, particularly in PA programs with a preprofessional phase such as the 3 + 2 model. Given PA programs with a preprofessional phase now make up 12.7% of all PA programs, faculty need to be equipped with effective strategies and techniques for engaging this population of learners. Methods PubMed, MEDLINE, and Google Scholar databases were queried to find existing research on the topics of andragogy and pedagogy in 3 + 2-modeled PA programs. The Journal of Physician Assistant Education was also reviewed for articles relevant to these topics. Results There is minimal evidence to guide PA faculty on education models, theory, or learning philosophy for students enrolled in 3 + 2 PA programs. As such, this manuscript presents 5 lessons learned from a former faculty member of a 3 + 2-modeled PA program who has experience teaching both traditional PA students in addition to 3 + 2 learners. Discussion The 5 lessons learned include the importance of scaffolding, explaining the “why,” emphasizing knowledge acquisition, integrating novel learning experiences, and creating channels for communication. While each of these lessons will apply to all PA students, they may be particularly impactful to those in 3 + 2-modeled PA programs. Moving forward, PA education would benefit from research dedicated to PA programs with a preprofessional phase.