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      Multidisciplinary diagnosis and treatment training simulation by paired teachers using case-based teaching of oral histopathology that promotes clinical thinking

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      1 , 2 , , 3 ,
      Scientific Reports
      Nature Publishing Group UK
      Health care, Medical research

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          Abstract

          The multidisciplinary diagnosis and treatment (MDT) model has significant advantages in the diagnosing and treatment of intricate cases. In addition, it can eliminate subspecialty barriers and provide a more accurate and individualized diagnosis and treatment plan. It has been assumed that the future development of diagnosis and treatment will retain this course, and the MDT is an essential type of clinical thinking, especially for medical students. This study attempted to guide stomatology undergraduates’ thinking via an MDT simulation in oral histopathology practicums through typical case-based education and paired-teachers’ explanations. The aim was to cultivate clinical thinking among students based on individual cases and to improve class participation and students’ clinical thinking ability. Forty-six undergraduates in a 5-year stomatology program who enrolled in 2018 participated in a simulation MDT model. Ten typical clinical cases were selected, and they were previously collected and analyzed by clinicians in accordance with the simulation MDT model and handed out to teachers and students before the class. Two to three cases were interpreted by teacher pairs that included a pathologist (oral pathology teacher) and a radiologist (oral imaging teacher). The rest of the cases were used for simulation MDT student groups in class. The oral pathology teacher and oral imaging teacher illustrated the corresponding data from typical cases in advance. The simulation MDT group members acting as a surgeon, pathologist, or radiologist demonstrated their own cases assigned randomly before the class. A curriculum satisfaction survey illustrated that the simulation MDT group agreed that simulation MDT was novel for them, and they had a strong sense of participation. The mimic MDT training with typical cases guided by paired teachers was useful for establishing student clinical thinking.

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          Multidisciplinary treatment of primary Ewing's sarcoma of bone. A 6-year experience of a European Cooperative Trial.

          The German Society of Pediatric Oncology in 1981 initiated the Cooperative Ewing's Sarcoma Study (CESS 81) using a four-drug combination of chemotherapy prior to definitive local control with surgery and/or radiation. From January 1, 1981 until February 28, 1985, 93 patients were registered at the trial office from 54 participating institutions in West Germany, Austria, Switzerland, and the Netherlands. On February 1, 1987, 54 of 93 patients were disease-free. Using the Kaplan-Meier life table analysis, the estimated disease-free survival (DFS) rate was 60% at 36 months and 55% at 69 months. The median period of observation was 29 months, ranging from 22 months to 69 months. Twenty-one of 93 patients (23%) had local failure, 18 of 93 patients (19%) developed systemic metastases. The local failure rate was particularly high in patients treated with radiation and was reduced when radiation planning was centralized within the study based upon the extent of disease at diagnosis. Cox regression analysis of prognostic factors showed that tumor volume was a significant factor influencing prognosis. The estimated 3-year DFS rate was 80% for patients with small tumors (volume less than 100 ml) compared to 31% for patients with large tumors (volume greater than or equal to 100 ml). In patients who had surgery for local control, the histologic response to chemotherapy was analyzed on the surgical specimen and had a strong influence on survival: 79% DFS at 3 years for patients with less than 10% viable tumor (good responders) compared to 31% DFS for patients with more than 10% viable tumor (poor responders). Tumor load and responsiveness to chemotherapy are the two major factors influencing prognosis in patients with primary Ewing's sarcoma of bone.
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            Management of Hepatocellular Carcinoma in Japan: Current Trends

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              An interdisciplinary approach to case-based teaching: does it create patient-centered and culturally sensitive providers?

              This investigation explored whether teaching a case-based seminar influenced dental students' perceptions of the importance of various factors for diagnosis and treatment planning. In addition, the effects of an interdisciplinary approach to case-based teaching were analyzed. During the winter semesters 2004 and 2005, 204 second-year dental students participated in a case-based comprehensive care seminar. The students were randomly assigned either to a section with a behavioral science instructor present or to a section without a behavioral science instructor. At the beginning and end of each semester, the students evaluated the importance of various factors for diagnosis and treatment planning in self-administered questionnaires. This seminar increased students' importance ratings of subjective oral health-related factors (such as dental fear) and diversity-related factors (such as the patient's ethnicity/race) from the beginning to the end of the semester. Students in the section with a behavioral science instructor rated the importance of behavioral and diversity-related factors higher than students in the section without the behavioral science instructor. These findings suggest that interdisciplinary, case-based teaching increased students' appreciation of the complexity of patient care and of a patient-centered, culturally sensitive approach to diagnosis and treatment planning.
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                Author and article information

                Contributors
                birchtree20032003@126.com
                1679314251@qq.com
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                27 January 2023
                27 January 2023
                2023
                : 13
                : 1531
                Affiliations
                [1 ]GRID grid.443397.e, ISNI 0000 0004 0368 7493, Department of Oral Pathology, School of Stomatology, , Hainan Medical College, ; Haikou, 571199 People’s Republic of China
                [2 ]GRID grid.443397.e, ISNI 0000 0004 0368 7493, Department of Stomatology, , The Second Affiliated Hospital of Hainan Medical University, ; Haikou, 570216 People’s Republic of China
                [3 ]GRID grid.412596.d, ISNI 0000 0004 1797 9737, Department of Oral Radiology, Hospital of Stomatology, , The First Affiliated Hospital, Harbin Medical University, ; Harbin, 150001 People’s Republic of China
                Article
                28786
                10.1038/s41598-023-28786-8
                9883218
                36707532
                30875bfb-187d-4a65-9e7e-917e13bd32d4
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 4 August 2022
                : 24 January 2023
                Funding
                Funded by: Cultivation project of university-level teaching achievement award of Hainan Medical College
                Award ID: HYjcpx202220
                Award Recipient :
                Funded by: Educational research Project of Hainan Medical College
                Award ID: HYYB202280
                Award Recipient :
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                © The Author(s) 2023

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                health care,medical research
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                health care, medical research

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