Welcome to the highlights and the review of the AWESOME material published over the last quarter in Current Sports Medicine Reports (CSMR). I’m going to do something a little different this quarter and highlight a couple invited commentaries, along with interesting case reports and section articles.

Invited Commentaries

The Cannabis Shift: How We Educate and Message is Key submitted by Jeff Konin, PhD, ATC, PT, FACSM. The times are changing, and our athletes deserve better from us is the message from Dr. Konin in this commentary. This invited commentary lays out an effective framework for how those caring for athletes need to frame and deliver the message. I was unable to attend but Dr. Konin spoke to our athletes here at the University of North Carolina-Chapel Hill and I can report that across the board from athletes to coaches to administrators his message was well received. 

You can also read a blog post from Dr. Konin on his article here.

Transgender Athlete Participation in Sport: Misplaced Fear and the Harms of Exclusion submitted by Robert S. Phillips, PT, DPT, PhD; Lee R. Ryder, PT, DPT and Ebony Jackson Clark, PT, DPT.  The last thing we need to do in this country and across the world is put up more barriers to physical activity, sport participation and inclusion. It is common knowledge that physical activity is good, no it’s great for a person’s health and well-being and it has a positive impact on multiple aspects of patients’ lives.  The same is true for sports participation on a team or as an individual. There is no reason to demonize, add to the exclusion and isolation of any subset of our population. The authors’ message comes from the viewpoint of physical therapists and translates across all medical specialties. 

Case Reports

Case reports are a great way to learn whether the write-up is about some rare, uncommon condition or just a different presentation of a common problem. I would like to highlight two not-to-be-missed cases from the past quarter:

Hip Pain…Is It All in Your Head? submitted by Lammlein and Creech-Organ. This is very interesting case that highlights the need for a broad differential to help determine the true etiology of the problem and not just focus on the chief complaint. This is an interesting case of a 40-year-old women with a couple of chronic medical issues who was found to have bilateral  avascular necrosis of the femoral head. After the second joint replacement, the patient developed premature ovarian failure and endocrinology work up revealed a pituitary microadenoma. Upon resection a couple of her chronic medical issues resolved. It makes me wonder, if the hip replacements, at least the second one, could have been avoided.

Exertional Compartment Syndrome in a Volleyball Player with Structural Abnormalities: A Case Report submitted by Wilson, Oca, Meller, Allen, and Strauss. Exertional compartment syndrome is a great example of one of those conditions that you should have in your differential diagnosis for exertional lower extremity pain. While it can be easy to diagnose based on pressure testing, the treatment can be challenging, and surgery is not a guarantee. This case highlights the importance of follow up, developing a plan, revising the plan based on what happens and, when the time is right, definitively treating. 

Articles

We also have some awesome articles that cover a variety of areas, and I would like to highlight three from the past quarter:

Vigorous Exercise in Patients with Hypertrophic Cardiomyopathy submitted by Fox, Fox, Jacobsen, Blumenthal, and Barouch. I found this article so interesting as it changes the narrative around hypertrophic cardiomyopathy (HCM), a condition that impacts 1 in 200 to 500 patients. Speaking for myself, HCM has always been thought of as the cause of sudden cardiac death, a murmur that we all got asked about over and over but rarely heard about, not a condition that was managed in patients. The timing of this article was fortuitous as I now have HCM patients on my panel. The authors do a great job laying out an active management plan for HCM patients.

Managing Pediatric Hip Pain Patients with Precision submitted by Knobloch, Kim, Babo, McCall and Covey. Pediatric hip pain can be incredibly challenging, and the differential includes infectious, metabolic and traumatic etiologies. This article is excellent, well-written and thorough and can help with the proper diagnosis and work up of a pediatric patient with hip pain. If you are involved in medical education, I would recommend using this article when teaching about the pediatric hip. 

Contemporary Issue: Health and Safety of Female Wrestlers submitted by Jagim, Moschelli,  Woodroffe, Horswill, and Bloomfield. The sport of female wrestling is growing exponentially. This paper goes into the many challenges of keeping female wrestlers healthy. Determining the minimal wrestling weight and having a safe and effective plan to get there is essential for the health and safety of the wrestlers. 

CSMR is ACSM’s official monthly clinical-review e-journal. Written specifically for physician and clinician members, CSMR articles provide thorough overviews of the most current sports medicine literature. ACSM physician members receive an online subscription to this journal as a member benefit.

Shawn F. Kane, MD, FACSM is a family physician, professor in the Department of Family Medicine, and adjunct assistant professor in the Department of Exercise and Sports Science at the University of North Carolina (UNC) Chapel Hill. He received his medical degree from the Uniformed Services University of the Health Sciences and served in the U.S. Army for 27 years. While in the Army he spent more than 18 years serving as a physician-leader in numerous units within the US Army Special Operations Command. He is interested in sports medicine, concussion care, veterans’ health, and primary care of patients with post-traumatic stress disorder. Dr. Kane joined ACSM in 2003 and became a fellow in 2011. He currently serves as the editor-in-chief for Current Sports Medicine Reports, on ACSM’s Clinical Sports Medicine Leadership Committee, ACSM’s Health & Fitness Summit Program Committee, and ACSM’s Program Committee. Outside of the office, Dr. Kane enjoys hanging out with his Leonbergers (big, furry, cute German Mountain dogs), as well as working out and traveling.

In recent years, every college professor at universities big and small has been faced with the fundamental question of how to adapt course materials into a digital platform. Each one of us must find the platform that fits, adapts, and is amicable to our needs as well as the needs of our department’s curriculum and students. My exercise testing, prescription, and assessment class uses ACSM’s Exercise Testing and Prescription, 2e on the Lippincott Connect digital courseware platform. The course is taught three days a week on Monday, Wednesday, and Friday (MWF) for 50 minutes per class session. I integrate both formative and summative assessment techniques with the goal of maximizing student learning.  The table below helps describe how I integrate my weekly materials. The following five tips are what I have learned when teaching ACSM’s material and how Lippincott Connect assists both myself and my students.

Table 1: Weekly Course Instructional Plan

Tip #1: Be Able to Walk into your Classroom and Talk to your Students

On Mondays I lecture using resources and videos provided within Lippincott Connect. I build my lecture by developing notes using the PowerPoint slides, the eBook chapter, and the Chapter Proficiency Quizzes. Together, the videos, assessment, and resources provide the foundation for my lectures and our class discussions, allowing me to introduce the weekly topic and highlight the major points of the material.

My students want more than just the professor reading the slides to them during the lecture² and Lippincott Connect helps me deliver. I need to make my lectures practical for those students who learn by visual means as well as conceptual ideas which can lead to richer, fuller discussions about the materials. Using an ACSM video at the beginning or middle of the lecture can emphasize a point or demonstrate a technique. The ACSM videos and worksheets in Lippincott Connect offer several potential discussion opportunities which I craft into our discussions. This allows me to employ a formative form of assessment for the students¹.

Tip #2 Lab Day- Practical Application. This is Where the Rubber Meets the Road!

On Wednesday, Lab provides a practical application of the materials and enables students to learn the necessary skills they will need in real life clinical settings. This is not just a formative form of assessment, but also a summative evaluation when I can grade the students in their performance of techniques.

The application of laboratory experiments provides the student and the professor a practical method of integrating cognitive information (ACSM protocols) with the practical skills the students will be using in clinical settings. This is where Lippincott Connect excels in providing detailed charts defining ACSM standards for testing. These charts can be used in the lab to help students understand, when they perform their lab tests in real time, if their performance numbers are within a predetermined standardized range. Best of all, it allows me to provide immediate feedback to the students².

Tip #3 Provide Closure on the Week - “Repetition, Repetition, Under Constant Supervision”

On Friday I wrap up the material and answer any student questions applying to my lectures and the lab. Additionally, I use Lippincott Connect case studies to start an in-class discussion. This discussion ends with the class taking the Case Study Quiz directly in Lippincott Connect during class. Around every two to three weeks, I give a traditional in-class test on the material. The test bank questions available in Lippincott Connect are valuable for designing an in-class test; I integrate my own questions from the material with some from the test bank. My goal is to write objective exam questions (usually multiple choice mixed with true/false and fill-in-the-blank questions). I found this mix gives the highest level of reliability when designing a relevant test.

During our class discussions I encourage my students to use the rationales and remediations available in Lippincott’s Connect to assist them with their answers. This format allows students to communicate using reliable ACSM material; not referencing AI options, which could be less trustworthy. When using this type of formative assessment, I find this is critical to providing closure on the topic and addressing any questions the students had during the week¹.

Tip #4 – Materials Promote Student Driven Learning - Weekly Topic and Focus on the Weekly Work Due

When experimenting to promote student driven learning, utilizing an LMS system paired with Lippincott Connect allows both the instructor and student flexibility and the ability to reinforce the material taught throughout the week. All weekly assignments are due by Sunday night at 11:59 pm. Lippincott Connect allows you to choose multiple time and due date options for exams, quizzes and other work assigned. Having flexibility in weekly deadlines helps students with busy schedules. My students have extremely busy schedules due to either their work or intercollegiate sports competitions over the weekend. 

Some tools unique to Lippincott Connect assist in student driven learning by ensuring students receive immediate feedback. The Hidden Reserve Prep U tests offer the instructor the option to customize in class assessment and assignments for home, and I know that all questions include rationales for right and wrong answers. This means no matter where my students are when they take PrepU quizzes, Chapter Proficiency Quizzes, video assessment, or Case Study Quizzes, they’re receiving feedback. Lippincott Connect also provides opportunities for remediation by pointing back to the text, and by using videos and Case Studies and the Stedman dictionary to provide additional support. This promotes student driven learning by encouraging students critical thinking skills.

Tip #5 – Immediate Grading Feedback Offers Professor Self-Assessment & Further Student Interaction

The most important step in my teaching strategy occurs in the first 5 minutes of each Monday’s class, when I request feedback from the students on the previous week’s work. This is very informal and immediate, but I can glean from it how the students learned the material and if I need to adjust the material to their needs.

The gradebook in Lippincott Connect under the “Results” tab allows Prep U options feedback on how my students are progressing. Not only do I have access to analytics that let me know who has performed chapter reading, but I also can see how each student has performed on quizzes. Assessment even accompanies videos, so I can view the data to ensure that students grasped the concepts within the videos. If I had Lippincott Connect set up to integrate with our LMS, I could have this data populate my grade book.

Conclusion

During the last year I started using Lippincott Connect in my university’s exercise prescription and assessment course. Initially motivated by the use of ACSM materials, I have experimented with the Lippincott Connect courseware platform and have discovered new and innovative teaching techniques to bring to my students. Further advances in the Lippincott technology will only further drive the students’ interactive educational experience, accelerating the learning potential for each individual student.

References

1. Nallaya, S., Gentili, S., Weeks, S., & Baldock, K. (2024). The validity, reliability, academic integrity and integration of oral assessments in higher education: A systematic review. Issues in Educational Research, 34(2), 629–646.

2. Peacock, J. L., FitzPatrick, K., & Finn, K. E. (2023). Student Performance and Perceptions of Adopting the Flipped Learning Approach into an Integrated Anatomy and Physiology Course. Journal of Higher Education Theory & Practice, 23(18), 145–161. https://doi.org/10.33423/jhetp.v23i18.6628

Dr. Dan Dieringer is an associate professor of Health and Human Performance at Bethel University (TN) for the past four years. He is also the coordinator of the Exercise Science major at Bethel University and is a professional member of the ACSM.

Resources

ACSM/Bayles: ACSM's Exercise Testing and Prescription, 2nd Edition | ISBN: 9781975214142 

For more information, or to request a demonstration of the new Lippincott^® Connect, please contact your sales representative.