Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students

Introduction Common variable immunodeficiency (CVID) is the most common symptomatic antibody deficiency, with a prevalence of 0.6-6.9 depending on the population studied. In contrast to other primary immunodeficiency diseases (PIDDs), symptoms may not appear until the third decade of life. Lack of r...

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Autores principales:	Maria-Louise Barilla-LaBarca, Monica Rodriguez, Kelly Connors, Theresa Wanamaker, Marie Cavuoto Petrizzo
Formato:	article
Lenguaje:	EN
Publicado:	Association of American Medical Colleges 2019
Materias:	Primary Immunodeficiency Common Variable Immunodeficiency OSCE Immunology Allergy and Immunology Rheumatology Medicine (General) R5-920 Education L
Acceso en línea:	https://doaj.org/article/054367952a814221bd23056d537246d9
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spelling	oai:doaj.org-article:054367952a814221bd23056d537246d92021-11-22T13:56:24ZCommon Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students10.15766/mep_2374-8265.108372374-8265https://doaj.org/article/054367952a814221bd23056d537246d92019-10-01T00:00:00Zhttp://www.mededportal.org/doi/10.15766/mep_2374-8265.10837https://doaj.org/toc/2374-8265Introduction Common variable immunodeficiency (CVID) is the most common symptomatic antibody deficiency, with a prevalence of 0.6-6.9 depending on the population studied. In contrast to other primary immunodeficiency diseases (PIDDs), symptoms may not appear until the third decade of life. Lack of recognition of CVID is a persistent problem. Myriad confounding clinical phenotypes and frequent infections, including autoimmunity, malignancy, chronic lung disease, granulomatous disease, and gastrointestinal disease, complicate the diagnosis. Often it is years before a diagnosis is made, leading to irreversible morbidities and mortality. Methods Second-year medical students are introduced to CVID during their session on PIDDs that occurs during the immunology/rheumatology course. To assess students’ recognition of CVID, a 15-minute OSCE encounter was created that included a simulation of lung sounds (rhonchi), physical exam cards (clubbing, otitis media with effusion), and moulage of skin (petechiae). A standardized patient (SP) portrayed a patient requesting antibiotics for a sinus infection. Students were tasked to both interview the patient and perform a hypothesis-driven physical exam. A postencounter exercise queried the students on their differential diagnosis and their rationale. Results Item analysis of the case showed high levels of difficulty and strong discrimination between high- and low-performing students in both communication skills and clinical reasoning in CVID. Discussion This SP encounter can be used in both formative and summative assessments to measure the recognition of CVID.Maria-Louise Barilla-LaBarcaMonica RodriguezKelly ConnorsTheresa WanamakerMarie Cavuoto PetrizzoAssociation of American Medical CollegesarticlePrimary ImmunodeficiencyCommon Variable ImmunodeficiencyOSCEImmunologyAllergy and ImmunologyRheumatologyMedicine (General)R5-920EducationLENMedEdPORTAL, Vol 15 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Primary Immunodeficiency Common Variable Immunodeficiency OSCE Immunology Allergy and Immunology Rheumatology Medicine (General) R5-920 Education L
spellingShingle	Primary Immunodeficiency Common Variable Immunodeficiency OSCE Immunology Allergy and Immunology Rheumatology Medicine (General) R5-920 Education L Maria-Louise Barilla-LaBarca Monica Rodriguez Kelly Connors Theresa Wanamaker Marie Cavuoto Petrizzo Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students
description	Introduction Common variable immunodeficiency (CVID) is the most common symptomatic antibody deficiency, with a prevalence of 0.6-6.9 depending on the population studied. In contrast to other primary immunodeficiency diseases (PIDDs), symptoms may not appear until the third decade of life. Lack of recognition of CVID is a persistent problem. Myriad confounding clinical phenotypes and frequent infections, including autoimmunity, malignancy, chronic lung disease, granulomatous disease, and gastrointestinal disease, complicate the diagnosis. Often it is years before a diagnosis is made, leading to irreversible morbidities and mortality. Methods Second-year medical students are introduced to CVID during their session on PIDDs that occurs during the immunology/rheumatology course. To assess students’ recognition of CVID, a 15-minute OSCE encounter was created that included a simulation of lung sounds (rhonchi), physical exam cards (clubbing, otitis media with effusion), and moulage of skin (petechiae). A standardized patient (SP) portrayed a patient requesting antibiotics for a sinus infection. Students were tasked to both interview the patient and perform a hypothesis-driven physical exam. A postencounter exercise queried the students on their differential diagnosis and their rationale. Results Item analysis of the case showed high levels of difficulty and strong discrimination between high- and low-performing students in both communication skills and clinical reasoning in CVID. Discussion This SP encounter can be used in both formative and summative assessments to measure the recognition of CVID.
format	article
author	Maria-Louise Barilla-LaBarca Monica Rodriguez Kelly Connors Theresa Wanamaker Marie Cavuoto Petrizzo
author_facet	Maria-Louise Barilla-LaBarca Monica Rodriguez Kelly Connors Theresa Wanamaker Marie Cavuoto Petrizzo
author_sort	Maria-Louise Barilla-LaBarca
title	Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students
title_short	Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students
title_full	Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students
title_fullStr	Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students
title_full_unstemmed	Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students
title_sort	common variable immunodeficiency: a standardized patient case for second-year medical students
publisher	Association of American Medical Colleges
publishDate	2019
url	https://doaj.org/article/054367952a814221bd23056d537246d9
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Common Variable Immunodeficiency: A Standardized Patient Case for Second-Year Medical Students

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