What should be clariﬁed when learning the International Standards to Document Remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) among medical students

Spinal Cord Series and Cases, 2021 · DOI: https://doi.org/10.1038/s41394-021-00431-4 · Published: July 19, 2021

Simple Explanation

The International Standards to Document Remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) is a classification system to assess autonomic dysfunction after spinal cord injury (SCI). Based on feedbacks from a group of medical students who have received ISAFSCI training, our study attempted to identify the problems during ISAFSCI implementation, and to provide revision suggestion for a better instruction. We found three types of problems and provided suggestion to make further clariﬁcations, which may facilitate a better understanding of the ISAFSCI content and more accurate ISAFSCI implementation.

Study Duration

Not specified

Participants

36 medical students

Evidence Level

Not specified

Key Findings

1
Definitions of resting hypotension, orthostatic hypotension (OH), and autonomic dysreflexia (AD) were difficult for medical students to remember, particularly regarding the inclusion or exclusion of threshold values in diagnostic criteria.
2
Inconsistent descriptions for the same ISAFSCI item between the instruction text and assessment form created confusion, particularly with terms like supine hypotension versus resting hypotension.
3
Nine ISAFSCI items presented confusion in choosing the appropriate answer options, including determining 'normal' autonomic control and differentiating levels of urinary and fecal incontinence.

Research Summary

This study aimed to identify challenges faced by medical students learning the International Standards to Document Remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) and to suggest revisions for better instruction. The research involved collecting comments from 36 medical students after an ISAFSCI training course, categorizing their difficulties, and proposing solutions for improved understanding and implementation. The study concluded that clarifying definitions, reducing inconsistencies between text and assessment forms, and providing clearer guidance on answer options are essential for improving ISAFSCI training and implementation.

Practical Implications

Improved Training Materials

Supplementary material with detailed explanations for the grading system should be developed.

Consistent Terminology

Standardize terminology between ISAFSCI text and assessment forms to reduce confusion.

Clarified Definitions

Provide clear and unambiguous definitions for key terms, especially those with threshold values.