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1.  YouTube videos as a source of medical information during the Ebola hemorrhagic fever epidemic 
SpringerPlus  2015;4:457.
The content and quality of medical information available on video sharing websites such as YouTube is not known. We analyzed the source and quality of medical information about Ebola hemorrhagic fever (EHF) disseminated on YouTube and the video characteristics that influence viewer behavior. An inquiry for the search term ‘Ebola’ was made on YouTube. The first 100 results were arranged in decreasing order of “relevance” using the default YouTube algorithm. Videos 1–50 and 51–100 were allocated to a high relevance (HR), and a low relevance (LR) video group, respectively. Multivariable logistic regression models were used to assess the predictors of a video being included in the HR vs. LR groups. Fourteen videos were excluded because they were parodies, songs or stand-up comedies (n = 11), not in English (n = 2) or a remaining part of a previous video (n = 1). Two scales, the video information and quality and index and the medical information and content index (MICI) assessed the overall quality, and the medical content of the videos, respectively. There were no videos from hospitals or academic medical centers. Videos in the HR group had a higher median number of views (186,705 vs. 43,796, p < 0.001), more ‘likes’ (1119 vs. 224, p < 0.001), channel subscriptions (208 vs. 32, p < 0.001), and ‘shares’ (519 vs. 98, p < 0.001). Multivariable logistic regression showed that only the ‘clinical symptoms’ component of the MICI scale was associated with a higher likelihood of a video being included in the HR vs. LR group.(OR 1.86, 95 % CI 1.06–3.28, p = 0.03). YouTube videos presenting clinical symptoms of infectious diseases during epidemics are more likely to be included in the HR group and influence viewers behavior.
PMCID: PMC4550615  PMID: 26322263
Patient education; Ebola; Epidemics; Social media; Multimedia; Ebola hemorrhagic fever
2.  Transitioning From a Noon Conference to an Academic Half-Day Curriculum Model: Effect on Medical Knowledge Acquisition and Learning Satisfaction 
The academic half-day (AHD) curriculum is an alternative to the traditional noon conference in graduate medical education, yet little is known regarding its effect on knowledge acquisition and resident satisfaction.
We investigated the association between the 2 approaches for delivering the curriculum and knowledge acquisition, as reflected by the Internal Medicine In-Training Examination (IM-ITE) scores and assessed resident learning satisfaction under both curricula.
The Cleveland Clinic Internal Medicine Residency Program transitioned from the noon conference to the AHD curriculum in 2011. Covariates for residents enrolled from 2004 to 2011 were age; sex; type of medical degree; United States Medical Licensing Examination Step 1, 2 Clinical Knowledge; and IM-ITE-1 scores. We performed univariable and multivariable linear regressions to investigate the association between covariates and IM-ITE-2 and IM-ITE-3 scores. Residents also were surveyed about their learning satisfaction in both curricula.
Of 364 residents, 112 (31%) and 252 (69%) were exposed to the AHD and the noon conference curriculum, respectively. In multivariable analyses, the AHD curriculum was associated with higher IM-ITE-3 (regression coefficient, 4.8; 95% confidence interval 2.9–6.6) scores, and residents in the AHD curriculum had greater learning satisfaction compared with the noon conference cohort (Likert, 3.4 versus 3.0; P  =  .003).
The AHD curriculum was associated with improvement in resident medical knowledge acquisition and increased learner satisfaction.
PMCID: PMC3963802  PMID: 24701317
3.  A nomogram to predict the probability of passing the American Board of Internal Medicine examination 
Medical Education Online  2012;17:10.3402/meo.v17i0.18810.
Although the American Board of Internal Medicine (ABIM) certification is valued as a reflection of physicians’ experience, education, and expertise, limited methods exist to predict performance in the examination.
The objective of this study was to develop and validate a predictive tool based on variables common to all residency programs, regarding the probability of an internal medicine graduate passing the ABIM certification examination.
The development cohort was obtained from the files of the Cleveland Clinic internal medicine residents who began training between 2004 and 2008. A multivariable logistic regression model was built to predict the ABIM passing rate. The model was represented as a nomogram, which was internally validated with bootstrap resamples. The external validation was done retrospectively on a cohort of residents who graduated from two other independent internal medicine residency programs between 2007 and 2011.
Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2%) successfully passed the ABIM certification examination. The final nomogram included four predictors: In-Training Examination (ITE) scores in postgraduate year (PGY) 1, 2, and 3, and the number of months of overnight calls in the last 6 months of residency. The nomogram achieved a concordance index (CI) of 0.98 after correcting for over-fitting bias and allowed for the determination of an estimated probability of passing the ABIM exam. Of the 126 graduates from two other residency programs used for external validation, 116 (92.1%) passed the ABIM examination. The nomogram CI in the external validation cohort was 0.94, suggesting outstanding discrimination.
A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents. This may guide program directors’ decision-making related to program curriculum and advice given to individual residents regarding board preparation.
PMCID: PMC3475012  PMID: 23078794
board examination; in-training examination; internal medicine; residents; program directors

Results 1-3 (3)