Teaching Human Anatomy: A Comparison of In-Person and Online Learning Programs

Background: The COVID-19 pandemic created challenges in providing anatomy instruction to allied health professions. Human anatomy laboratory classes often rely on human cadavers as instructional material. At some institutions, the anatomical instructional method shifted to online resources. It was essential to compare online methods to those used in the traditional cadaver-based curriculum to determine efficacy. A technique was devised to compare these two approaches. The working hypothesis was that virtual human anatomy models are equally effective to traditional methods in providing anatomy instruction to allied health students. Methods: Students enrolled in this study participated in a human anatomy course delivered either in-person or virtually via Aclan’s Anatomy, NetAnatomy, and Anatomy TV. The instructional design was the same except that the in-person learning group participated in a real-time cadaver anatomy lab, while the virtual learning group utilized online models and simulations. Students were assessed using the same three written tests and three laboratory examinations. Results: Student demographics and evaluation outcomes were presented, and no significant differences concerning sex or educational program between the two student cohorts were identified. Post hoc testing revealed no statistically significant differences between student cohort and test-type. The three-way interaction between test type, test number, and cohort was not significant. Conclusions: The findings confirmed the hypothesis. There were no statistically significant differences between the test performance of human anatomy students who received online training versus those who participated in in-person classroom instruction. These results suggest that human anatomy can be taught effectively using an online format.

Patterns of SARS-CoV-2 Testing Preferences in a National Cohort in the United States: Latent Class Analysis of a Discrete Choice Experiment (Preprint)

BACKGROUND Inadequate screening and diagnostic testing in the United States throughout the first several months of the COVID-19 pandemic led to undetected cases transmitting disease in the community and an underestimation of cases. Though testing supply has increased, maintaining testing uptake remains a public health priority in the efforts to control community transmission considering the availability of vaccinations and threats from variants. OBJECTIVE This study aimed to identify patterns of preferences for SARS-CoV-2 screening and diagnostic testing prior to widespread vaccine availability and uptake. METHODS We conducted a discrete choice experiment (DCE) among participants in the national, prospective CHASING COVID (Communities, Households, and SARS-CoV-2 Epidemiology) Cohort Study from July 30 to September 8, 2020. The DCE elicited preferences for SARS-CoV-2 test type, specimen type, testing venue, and result turnaround time. We used latent class multinomial logit to identify distinct patterns of preferences related to testing as measured by attribute-level part-worth utilities and conducted a simulation based on the utility estimates to predict testing uptake if additional testing scenarios were offered. RESULTS Of the 5098 invited cohort participants, 4793 (94.0%) completed the DCE. Five distinct patterns of SARS-CoV-2 testing emerged. Noninvasive home testers (n=920, 19.2% of participants) were most influenced by specimen type and favored less invasive specimen collection methods, with saliva being most preferred; this group was the least likely to opt out of testing. Fast-track testers (n=1235, 25.8%) were most influenced by result turnaround time and favored immediate and same-day turnaround time. Among dual testers (n=889, 18.5%), test type was the most important attribute, and preference was given to both antibody and viral tests. Noninvasive dual testers (n=1578, 32.9%) were most strongly influenced by specimen type and test type, preferring saliva and cheek swab specimens and both antibody and viral tests. Among hesitant home testers (n=171, 3.6%), the venue was the most important attribute; notably, this group was the most likely to opt out of testing. In addition to variability in preferences for testing features, heterogeneity was observed in the distribution of certain demographic characteristics (age, race/ethnicity, education, and employment), history of SARS-CoV-2 testing, COVID-19 diagnosis, and concern about the pandemic. Simulation models predicted that testing uptake would increase from 81.6% (with a status quo scenario of polymerase chain reaction by nasal swab in a provider’s office and a turnaround time of several days) to 98.1% by offering additional scenarios using less invasive specimens, both viral and antibody tests from a single specimen, faster turnaround time, and at-home testing. CONCLUSIONS We identified substantial differences in preferences for SARS-CoV-2 testing and found that offering additional testing options would likely increase testing uptake in line with public health goals. Additional studies may be warranted to understand if preferences for testing have changed since the availability and widespread uptake of vaccines.

Change of Direction Speed Tests in Basketball Players: A Brief Review of Test Varieties and Recent Trends

Change of direction speed (CODS) is essential for basketball performance, extensively assessed by various tests. This review aimed to summarize the CODS test varieties for basketball players on publications until 2019 and identify recent trends regarding what types of tests have gained attention in the 2010s. Electronic literature searches were conducted using three databases with relevant keywords. 104 studies were found eligible, conducting CODS tests 159 times in total with 48 test varieties. To facilitate distinctions between the tests, each test was categorized into one of three types based on the distinctive movement characteristics and changing angles as follows: Defensive (involving lateral shuffling), 180°-turn (exerting only 180°-turns), and Cutting (performing diagonal- or side-cut). We then counted the number of publications and adopted times reported per year for each test, and calculated the adoption rate for each categorized test type. The first CODS test performed in basketball players was the T-Test, reported in 1991, and this was the most commonly adopted test (44/159 times). The 2010s saw abrupt increases in the number of publications (1990s-2000s-2010s: 5-9-90) and test varieties (4-7-44). The adoption rates in the 2010s were similar among the three types (i.e., Defensive/180°-turn/Cutting: 37%/30%/33%), with the Cutting type gradually increasing over the last three decades (1990s-2000s-2010s: 0%-9%-33%). These results suggest that while CODS performances in basketball players are increasingly studied with various tests, recent studies give equal weight to all of the three categorized test types, with increasing adoption of the Cutting type, to assess specific CODS performances.

An Overview of Fatigue Testing Systems for Metals under Uniaxial and Multiaxial Random Loadings

This paper presents an overview of fatigue testing systems in high-cycle regime for metals subjected to uniaxial and multiaxial random loadings. The different testing systems are critically discussed, highlighting advantages and possible limitations. By identifying relevant features, the testing systems are classified in terms of type of machine (servo-hydraulic or shaker tables), specimen geometry and applied constraints, number of load or acceleration inputs needed to perform the test, type of loading acting on the specimen and resulting state of stress. Specimens with plate, cylindrical and more elaborated geometry are also considered as a further classification criterion. This review also discusses the relationship between the applied input and the resulting local state of stress in the specimen. Since a general criterion to classify fatigue testing systems for random loadings seems not to exist, the present review—by emphasizing analogies and differences among various layouts—may provide the reader with a guideline to classify future equipment.

SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment

Background Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. Objective This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. Methods We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in >5 days. Results Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. Conclusions Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment (Preprint)

BACKGROUND Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. OBJECTIVE This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. METHODS We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in >5 days. RESULTS Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. CONCLUSIONS Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

Analysis of National Healthcare Safety Network Clostridioides difficile Infection Standardized Infection Ratio by Test Type

Background: The NHSN has used positive laboratory tests for surveillance of Clostridioides difficile infection (CDI) LabID events since 2009. Typically, CDIs are detected using enzyme immunoassays (EIAs), nucleic acid amplification tests (NAATs), or various test combinations. The NHSN uses a risk-adjusted, standardized infection ratio (SIR) to assess healthcare facility-onset (HO) CDI. Despite including test type in the risk adjustment, some hospital personnel and other stakeholders are concerned that NAAT use is associated with higher SIRs than are EIAs. To investigate this issue, we analyzed NHSN data from acute-care hospitals for July 1, 2017 through June 30, 2018. Methods: Calendar quarters for which CDI test type was reported as NAAT (includes NAAT, glutamate dehydrogenase (GDH)+NAAT and GDH+EIA followed by NAAT if discrepant) or EIA (includes EIA and GDH+EIA) were selected. HO CDI SIRs were calculated for facility-wide inpatient locations. We conducted the following analyses: (1) Among hospitals that did not switch their test type, we compared the distribution of HO incident rates and SIRs by those reporting NAAT vs EIA. (2) Among hospitals that switched their test type, we selected quarters with a stable switch pattern of 2 consecutive quarters of each of EIA and NAAT (categorized as pattern EIA-to-NAAT or NAAT-to-EIA). Pooled semiannual SIRs for EIA and NAAT were calculated, and a paired t test was used to evaluate the difference of SIRs by switch pattern. Results: Most hospitals did not switch test types (3,242, 89%), and 2,872 (89%) reported sufficient data to calculate SIRs, with 2,444 (85%) using NAAT. The crude pooled HO CDI incidence rates for hospitals using EIA clustered at the lower end of the histogram versus rates for NAAT (Fig. 1). The SIR distributions of both NAAT and EIA overlapped substantially and covered a similar range of SIR values (Fig. 1). Among hospitals with a switch pattern, hospitals were equally likely to have an increase or decrease in their SIR (Fig. 2). The mean SIR difference for the 42 hospitals switching from EIA to NAAT was 0.048 (95% CI, −0.189 to 0.284; P = .688). The mean SIR difference for the 26 hospitals switching from NAAT to EIA was 0.162 (95% CI, −0.048 to 0.371; P = .124). Conclusions: The pattern of SIR distributions of both NAAT and EIA substantiate the soundness of NHSN risk adjustment for CDI test types. Switching test type did not produce a consistent directional pattern in SIR that was statistically significant.Disclosures: NoneFunding: None