Publications by authors named "Charles Sanky"

7 Publications

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Key Insights from the Development and Implementation of a Novel Virtual Interview Process for Medical School Admissions During the COVID-19 Pandemic.

Acad Med 2021 May 4. Epub 2021 May 4.

E. Garden is a fourth-year medical student and member, Admissions Committee, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: https://orcid.org/0000-0002-7138-5951. E. Loebel is a fourth-year medical student and member, Admissions Committee, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: https://orcid.org/0000-0001-9459-3182. C. Sanky is a fourth-year medical student and member, Admissions Committee, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: https://orcid.org/0000-0003-4165-5081. J. Chudow is assistant director, Admissions and Recruitment, Icahn School of Medicine at Mount Sinai, New York, New York. R. Fallar is associate dean, Assessment and Evaluation and assistant director, Institute for Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York; ORCID: https://orcid.org/0000-0002-2968-7630. V. Parkas senior associate dean, Admissions and Recruitment, and associate professor of medicine and infectious diseases, Icahn School of Medicine at Mount Sinai, New York, New York.

Problem: During the COVID-19 pandemic, medical schools have offered a virtual application process. Minimal literature is available to guide best practices.

Approach: The Icahn School of Medicine at Mount Sinai (ISMMS) implemented a completely virtual interview (VI) process in April/May 2020. Large-group sessions for applicants, interviews with applicants, and ISMMS Admission Committee meetings occurred via Zoom (Zoom Video Communications, Inc., San Jose, California). Large-group sessions and committee meetings occurred via communal conference calls, while one-on-one, semi-structured interviews occurred in individual breakout rooms. ISMMS offered live, virtual question-and-answer sessions with students and faculty, plus digital resources describing program features. After the interview day, applicants and interviewers were invited to complete anonymous surveys regarding their experiences with and perspectives of VI.

Outcomes: Of 125 applicants and 20 interviewers, 99 (79%) and 18 (90%), respectively, completed at least part of the survey. Of the applicants, 85/95 (89%) agreed VI met or exceeded expectations, many praising the day's organization and convenience, and 71/95 (75%) agreed they received a sufficient sense of the student body. A minority (n = 39/95, [41%]) felt limited in their ability to learn about the institution (commonly related to their inability to tour campus), and a majority (n =74/91, [81%]) would have preferred an in-person interview. Most interviewers felt comfortable assessing applicants' verbal communication skills (n = 13/16, [81%]), and most (n = 12/17, [71%]) felt VI should be an option for future applicants.

Next Steps: VI, likely to be a temporary-but-universal fixture of upcoming application cycles, may benefit applicants and interviewers alike by saving resources and diversifying those involved. Next steps are developing programming that will permit applicants to virtually explore the institution and connect more with current students. Future research should evaluate potential bias in VI to ensure an equitable application process for all.
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http://dx.doi.org/10.1097/ACM.0000000000004149DOI Listing
May 2021

Educational Research: Why Medical Students Choose Neurology: A Computational Linguistics Analysis of Personal Statements.

Neurology 2021 Mar 3. Epub 2021 Mar 3.

Icahn School of Medicine at Mount Sinai

Objective: We sought to understand medical students' motivations for choosing neurology and how applicants conceptualize the field. This information can be used to enhance interest in neurology and develop educational programs to help identify, support, and recruit future neurologists.Applicants to neurology residencies submit personal statements describing themselves and their motivations. Textual analysis of personal statements has been performed in internal medicine and general surgery, but never before in neurology. We hypothesized that specific words and themes would be mentioned in residency personal statements with high frequencies indicating student's motivations. To test this hypothesis, we used computational linguistics software to assess key words and thereby study motivations, expectations, and themes present amongst neurology applicants.

Methods: 2,405 personal statements submitted over five years to our institution were de-identified and compiled into a database for evaluation through three computational linguistics software programs. We performed calculations of term frequencies (TF), Term Frequency-Inverse Document Frequencies (TF-IDF) and performed K-means clustering to identify unique words and common themes.

Results: Specific disease states were discussed. For example, stroke (TF=2178), epilepsy (TF=970), dementia (TF=944) were referenced more often than ALS (TF=220) and carpal tunnel (TF=10). The most common proper names cited were Oliver Sacks (TF=94) and Sherlock Holmes (TF=41). Common themes included fascination with the brain, interest in research, desire to help patients, early interests in neurology, continued pursuit of learning, appreciation for time with patients, family history with neurologic illness, and intellectual curiosity.

Conclusions: This first computational linguistic analysis of neurology personal statements provides understanding into medical students' motivations and interests. Ongoing subgroup and thematic analyses may inform educational strategies and enhance recruitment to our field.
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http://dx.doi.org/10.1212/WNL.0000000000011753DOI Listing
March 2021

A Near-Peer Educational Model for Online, Interactive Learning in Emergency Medicine.

West J Emerg Med 2020 Dec 21;22(1):130-135. Epub 2020 Dec 21.

Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York.

Introduction: The COVID-19 pandemic led to a large disruption in the clinical education of medical students, particularly in-person clinical activities. To address the resulting challenges faced by students interested in emergency medicine (EM), we proposed and held a peer-led, online learning course for rising fourth-year medical students.

Methods: A total of 61 medical students participated in an eight-lecture EM course. Students were evaluated through pre- and post-course assessments designed to ascertain perceived comfort with learning objectives and overall course feedback. Pre- and post-lecture assignments were also used to increase student learning.

Results: Mean confidence improved in every learning objective after the course. Favored participation methods were three-person call-outs, polling, and using the "chat" function. Resident participation was valued for "real-life" examples and clinical pearls.

Conclusion: This interactive model for online EM education can be an effective format for dissemination when in-person education may not be available.
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http://dx.doi.org/10.5811/westjem.2020.12.49101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806329PMC
December 2020

Real-time Assessment of Neurology Residents' Perceptions of Inappropriate Consults.

Neurologist 2020 Nov;25(6):168-173

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY.

Background: We sought to characterize perceptions of inappropriate neurology consults of neurology residents (NR) and requesting providers (RP) immediately following the consult interaction.

Methods: Student investigators were embedded in the Mount Sinai neurology consult service for 4 weeks in May/June 2018. For each consecutive neurology consult the NR's real-time attitudes toward the consult were evaluated with a survey using Likert scales. A similar survey was immediately administered to the RP who called the consult. Response scores for each attribute were dichotomized and data were analyzed descriptively in SPSS.

Results: Data from 69 consults were collected. NRs perceived 45% of consults as inappropriate and 82% of all consults as low urgency. When NRs perceived a consult as inappropriate, they felt more resistance (r=-0.79). NRs also felt more resistant when they thought that the RP could have cared for the patient without the consult (r=0.79). NRs felt that perceived medicolegal risk highly influenced the RP's decision to call a consult in 36% of cases. Of these "high liability" consults, NRs considered 76% inappropriate and 100% low urgency.

Conclusions: NRs were more likely to rate consults as inappropriate if they were also perceived as low urgency, strongly influenced by liability concerns, or unnecessary due to belief that the RP could have cared for the patient without the consult. Our findings suggest a discrepancy in how NRs and RPs perceive neurology consult appropriateness, and help to elucidate potential drivers of these perceptions that could be barriers to education and to interdisciplinary care.
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http://dx.doi.org/10.1097/NRL.0000000000000299DOI Listing
November 2020

Convalescent plasma treatment of severe COVID-19: a propensity score-matched control study.

Nat Med 2020 11 15;26(11):1708-1713. Epub 2020 Sep 15.

Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new human disease with few effective treatments. Convalescent plasma, donated by persons who have recovered from COVID-19, is the acellular component of blood that contains antibodies, including those that specifically recognize SARS-CoV-2. These antibodies, when transfused into patients infected with SARS-CoV-2, are thought to exert an antiviral effect, suppressing virus replication before patients have mounted their own humoral immune responses. Virus-specific antibodies from recovered persons are often the first available therapy for an emerging infectious disease, a stopgap treatment while new antivirals and vaccines are being developed. This retrospective, propensity score-matched case-control study assessed the effectiveness of convalescent plasma therapy in 39 patients with severe or life-threatening COVID-19 at The Mount Sinai Hospital in New York City. Oxygen requirements on day 14 after transfusion worsened in 17.9% of plasma recipients versus 28.2% of propensity score-matched controls who were hospitalized with COVID-19 (adjusted odds ratio (OR), 0.86; 95% confidence interval (CI), 0.75-0.98; chi-square test P value = 0.025). Survival also improved in plasma recipients (adjusted hazard ratio (HR), 0.34; 95% CI, 0.13-0.89; chi-square test P = 0.027). Convalescent plasma is potentially effective against COVID-19, but adequately powered, randomized controlled trials are needed.
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http://dx.doi.org/10.1038/s41591-020-1088-9DOI Listing
November 2020

Crisis Standards of Care in the USA: A Systematic Review and Implications for Equity Amidst COVID-19.

J Racial Ethn Health Disparities 2020 Aug 13. Epub 2020 Aug 13.

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Crisis Standards of Care (CSC) provide a framework for the fair allocation of scarce resources during emergencies. The novel coronavirus disease (COVID-19) has disproportionately affected Black and Latinx populations in the USA. No literature exists comparing state-level CSC. It is unknown how equitably CSC would allocate resources.

Methods: The authors identified all publicly available state-level CSC through online searches and communication with state governments. Publicly available CSC were systematically reviewed for content including ethical framework and prioritization strategy.

Results: CSC were identified for 29 states. Ethical principles were explicitly stated in 23 (79.3%). Equity was listed as a guiding ethical principle in 15 (51.7%); 19 (65.5%) said decisions should not factor in race, ethnicity, disability, and other identity-based factors. Ten states (34.4%) allowed for consideration of societal value, which could lead to prioritization of health care workers and other essential personnel. Twenty-one (72.4%) CSC provided a specific strategy for prioritizing patients for critical care resources, e.g., ventilators. All incorporated Sequential Organ Failure Assessment scores; 15 (71.4%) of these specific CSC considered comorbid conditions (e.g., cardiac disease, renal failure, malignancy) in resource allocation decisions.

Conclusion: There is wide variability in the existence and specificity of CSC across the USA. CSC may disproportionately impact disadvantaged populations due to inequities in comorbid condition prevalence, expected lifespan, and other effects of systemic racism.
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http://dx.doi.org/10.1007/s40615-020-00840-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425256PMC
August 2020

What's in a Name? The Implications of Naming Medical Schools After Donors.

Acad Med 2020 03;95(3):332

Fourth-year medical student, Icahn School of Medicine at Mount Sinai, New York, New York; Fourth-year medical student, Icahn School of Medicine at Mount Sinai, New York, New York. Fourth-year medical student, Icahn School of Medicine at Mount Sinai, New York, New York. Fourth-year medical student, Icahn School of Medicine at Mount Sinai, New York, New York.

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http://dx.doi.org/10.1097/ACM.0000000000003113DOI Listing
March 2020