Lupus erythematosus is an enigmatic disease. Its podiatric manifestations are largely cutaneous, but vasculitic involvements may produce complications. The authors review much of the histopathology of lupus erythematosus that is relevant to the podiatric physician and surgeon. Awareness of the serious systemic implications of lupus erythematosus and the internal medications used in treatment is part of the physician's responsibility in understanding the whole patient.
Podiatric medical abnormalities are highly prevalent, yet few random population studies exist that determine the presence of pathologic abnormalities in the feet, despite their importance. The aim of this study was to determine the prevalence of podiatric medical abnormalities in a random sample population 40 years or older.
An observational study was conducted of a random sample population (n = 1,002) located in A Coruña, Spain. Anthropometric variables, comorbidity (Charlson score), quality of life (36-item Short-Form Health Survey), and podiatric medical examination findings were studied. A descriptive analysis and multivariate logistic regression were performed.
The most common diseases were claw toes (69.7%), hallux valgus (38%), and hallux extensus (15.8%), which increased with age and female sex. The most frequent metatarsal formula was index minus (40.9%), followed by index plus minus (35.0%). The most frequent digital formula was Egyptian foot (57.1%), followed by Greek foot (31.4%). In this study, although the presence of podiatric medical abnormalities reduced the probability of enjoying a better quality of life, it did not do so significantly. After taking into account age, sex, comorbidity, body mass index (BMI), and the presence of podiatric medical abnormalities, the variables with an independent effect that modified the physical component of quality of life were sex (female), comorbidity, and BMI.
There was a high prevalence of podiatric medical abnormalities, which increased with age and female sex. Comorbidity, BMI, and sex modified quality of life independently of podiatric medical abnormalities.
Background: This pilot study explores the influence of preadmission data on podiatric medical school performance, specifically, the role of undergraduate institutional selectivity. This type of study has never been described in the podiatric medical education literature. We conducted a longitudinal analysis of preadmission data on 459 students from the graduating classes of 2000 to 2009 at the College of Podiatric Medicine and Surgery at Des Moines University.
Methods: Multivariate linear regression was used to assess the relationship between performance during the first year of podiatric medical school and a set of independent variables that represent certain preadmission student characteristics. Student demographic characteristics, such as race/ethnicity and sex, were also included in the regression analysis as control variables.
Results: The regression analysis revealed that ethnic origin, undergraduate grade point average, Medical College Admission Test biological science and verbal reasoning scores, and institutional selectivity together had a significant effect on the dependent variable (F = 18.3; P < .001). The variance for the independent variable/constant variables was 32%. Almost twice as many students were dismissed or withdrew in poor academic standing who attended undergraduate institutions in the lowest selectivity category.
Conclusions: This analysis revealed that in the College of Podiatric Medicine and Surgery, some preadmission variables, such as institutional selectivity, undergraduate grade point average, ethnic origin, and Medical College Admission Test verbal reasoning and biological science scores, are statistically significant in predicting first-year podiatric medical school grade point average. The selectivity of a student’s undergraduate institution should be considered when screening potential podiatric medical school applicants. (J Am Podiatr Med Assoc 100(6): 479–486, 2010)
Doctors of Podiatric Medicine—On a Pathway to Becoming Fully Licensed Physicians and Surgeons?
An Evidence-Based Analysis
Since the 1970s, the profession of podiatric medicine has undergone major changes in the dimensions of its practice as well as its education and training. Herein, I describe how podiatric medicine has evolved to become a profession of independent practitioners who now provide patients with comprehensive medical and surgical care affecting the foot and ankle in community practice, academic health centers, and hospital operating rooms. Preparation for the profession virtually mirrors the education and training of the MD and DO, including a 4-year postbaccalaureate curriculum with a preclinical curriculum that matches that of Liaison Committee on Medical Education–accredited medical schools and most of the clinical curriculum of undergraduate medical education. Completion of the degree of doctor of podiatric medicine prepares graduates to enter hospital-based graduate medical education programs, now 3 years in duration. A description is provided of the current podiatric medical practitioner now prepared at a level that is virtually equal to that of medical and surgical specialists who hold an unrestricted medical license.
Background: Diverse theories of orthoses application have evolved with the continual development of podiatric biomechanics and orthotic management. This theoretical disparity can lead to confusion in clinical, educational, and research situations. However, although approaches are varied, the common consensus is that foot orthoses outcomes are generally positive.
Methods: Three main podiatric theories exist: the foot morphology theory, the sagittal plane facilitation theory, and tissue stress theory. By researching the available literature, the perspectives of all three theories are summarized, emphasizing areas of conflict and agreement.
Results: Through a unified theory, we introduce a premise by which the similar orthotic outcomes obtained from the three main podiatric theories may be explained.
Conclusions: It remains up to the individual podiatric physician to decide which method to use to prescribe a foot orthosis. It may be of benefit to encompass all approaches rather than be dogmatic or exclusive. (J Am Podiatr Med Assoc 99(4): 317–325, 2009)
Many regard empathy as a critical component of comprehensive health care. Much interest has been generated in the field of medical empathy, in particular as it relates to education. Many desirable outcomes correlate with perceived empathy during the patient encounter, but paradoxically, empathy levels have been reported to decline during the years of medical education. Several new approaches have been described in the literature that intend to teach or develop empathy skills in health-care students.
PubMed, PsycINFO, and Google Scholar databases were searched for the terms empathy education, medical education, medical student, podiatric medical education, medical empathy, compassion, emotional intelligence, biopsychosocial model, and bedside manner. After implementing inclusion and exclusion criteria, articles were selected for preparation of a literature review. Analysis of the podiatric medical education on empathy was conducted by reviewing descriptions of all courses listed on each of the nine US podiatric medical schools' Web sites. The 2018 Curricular Guide for Podiatric Medical Education was analyzed.
In this review, we examine the current state of empathy from a context of medical education in general, followed by a specific analysis in podiatric medicine. We define key terms, describe the measuring of empathy in medicine, explore outcomes of empathy in the health-care setting, review the reports of a decline in medical education, and highlight some of the current efforts to develop the skill in education. An overview of empathy in the podiatric medical curriculum is presented.
To improve the quality of care that physicians provide, a transformation in podiatric medical education is necessary. A variety of tools are available for education reform with the target of developing empathy skills in podiatric medical students.
Foot and ankle health among the homeless is an important public health concern. There are limited studies done thus far on foot and ankle conditions and the podiatric medical needs of homeless populations. A literature review was undertaken to evaluate any studies published about the lower-extremity health needs among the homeless.
We did a literature search through PubMed, the US National Library of Medicine’s database of biomedical citations and abstracts for relevant publications from 1988 through 2008. We also searched the references cited in the articles found for any studies relevant to podiatric needs for homeless populations.
We found three relevant articles that addressed the needs of podiatric care for the homeless. The articles highlighted the community health importance of foot care for homeless populations, especially in helping prevent potentially limb-threatening pathologies.
The small number of studies published so far all emphasize the major public health need for podiatric care among homeless populations. More studies are needed to help address this important public health concern. (J Am Podiatr Med Assoc 102(1): 54–56, 2012)
There is no information available in the medical literature regarding emergency medical training in the podiatric medicine predoctoral curriculum. This study was undertaken to describe the current state of emergency medical training in US schools of podiatric medicine.
A Web-based descriptive survey was developed to assess course logistics, the curricular topics covered, and the teaching methods used. All of the US schools of podiatric medicine were surveyed.
Completed surveys were returned from all nine schools. All of the institutions incorporate training on the management of medical emergencies into their predoctoral curricula. Four schools (44.4%) reported initiating this training before 2000. All of the schools incorporate a didactic (lecture) component, and eight (88.9%) incorporate a clinical (hands-on) component into their training.
All of the schools of podiatric medicine in the United States incorporate emergency medical training into their predoctoral curriculum. However, despite some similarities across institutions, there seems to be variation regarding curricular topics, didactic teaching, and methods of teaching the material.
This article presents the development, implementation, and evaluation of a national evidence-based medicine faculty-development program for podiatric medical educators. Ten faculty members representing six accredited colleges of podiatric medicine, one podiatric medical residency program, and a Veterans Affairs podiatry service participated in a 2-day workshop, which included facilitated discussions, minilectures, hands-on exercises, implementation planning, and support after the workshop. Participants’ evidence-based medicine skills were measured by retrospective self-reported ratings before and after the workshop. Participants also reported their implementation of “commitments to change” on follow-up surveys at 3 and 12 months. Participants’ evidence-based medicine practice and teaching skills improved after the intervention. They listed a total of 84 commitments to change, most of which related to the program objectives. By 12 months after the workshop, participants as a group had fully implemented 24 commitments (32%), partially implemented 36 (48%), and failed to implement 15 (20%) of a total of 75 commitments with follow-up data. The most common barriers to change at 12 months were insufficient resources, systems problems, and short patient visit times. A train-the-trainer faculty-development program can improve self-reported evidence-based medicine skills and behaviors and affect curriculum reform at podiatric medical educational institutions. (J Am Podiatr Med Assoc 95(5): 497–504, 2005)
The purposes of this study were to develop an instrument to assess the validity of randomized controlled trials and to report on the differences in the validity of randomized controlled trials between two podiatric medical journals and a mainstream medical journal. The study demonstrated that after adequate training, there can be agreement among reviewers evaluating the quality of published randomized controlled trials using an established instrument and guidelines. The results of the study indicate that randomized controlled trials published in podiatric medical journals are less credible than those published in a mainstream medical journal. (J Am Podiatr Med Assoc 93(5): 392-398, 2003)