INSIDE WVSMA
Editor ’ s Letter
Type 3c Diabetes , Moses , and Practice-Based Learning and Improvement
Linda S . Nield , MD
A crucial characteristic to look for in a future medical student is an innate motivation to continually learn . One of the six competencies described by the Accreditation Council of Gradual Medical Education called practicebased learning and improvement ( PBLI ) 1 encompasses this characteristic . Continuing medical education ( CME ) is part of PBLI , and physicians are expected to participate in CME for their entire careers . In order to maintain a medical license and remain specialty board certified , CME must be completed on a routine basis .
Another means to participate in PBLI is by reading this letter and other features in the West Virginia Medical Journal ( WVMJ ). Type 3c diabetes is included in the title of this letter along with PBLI because it is speculated that many readers know minimally about this topic . Type 1 and type 2 diabetes are familiar to physicians and the lay population to varied degrees , but some , perhaps most , may not have even heard of type 3c diabetes . In this issue , Fletcher and Unger describe a patient with type 3c diabetes , which will heighten awareness about this health condition and further our understanding of it , thereby enhancing our PBLI . 2 Sharon and colleagues share their research findings , which focus on screening for suicidal ideation in an emergency setting . 3 The team of Durr improves our understanding of barriers to adolescent contraception , 4 and Tolbert et al provide a look at the current gender gap in the care of patients with chest pain 5 in comparison to data from 25 years ago . 6
Moses is also included in this letter title along with PBLI because it is speculated that many West Virginians know minimally about Dr . Marion Moses . Moses was born in Wheeling , West Virginia ( WV ) in 1936 and died in August 2020 , and her obituary in the Los Angeles Times describes her as “ the foremost expert on the health of the nation ’ s 2.5 million agricultural workers beginning in the 1980s .” 7 Part of her life was spent in Charleston , WV , and she was the first in her family to attend college . She was an activist for patients ’ rights who gained national recognition . Her personal account about working with migrant farmers opens with these powerful words from 1973 in the American Journal of Nursing : “ We as health practitioners have much to learn from the poor . Perhaps we can begin by trying to understand the despair and distrust of those who have had only crumbs from the tables of the medically affluent for too many years .” 8 Readers are encouraged to participate in selfdirected learning , a crucial component of PBLI , and discover more about the major accomplishments of WV-born Moses in other publications along with appreciating the works of our WV authors presented in this issue of the WVMJ .
REFERENCES
1 . Accreditation Council for Graduate Medical Education . ACGME Common Program Requirements ( Residency ). Effective on July 1 , 2020 . Available at : https :// www . acgme . org / Portals / 0 / PFAssets / ProgramRequirements / CPRResidency2020 . pdf Accessed on April 1 , 2021 .
2 . Fletcher J , Unger K . Appalachian constellation : Type 3C diabetes as the link between diabetes and chronic pancreatitis . West Virginia Medical Journal . 2021 ; 117 ( 2 ); : 20-23 .
3 . Sharon M , Shaver E , Burrell C et al . Feasibility of utilizing a rapid screening tool for suicide and major depressive disorder in Appalachian acute care settings . West Virginia Medical Journal . 2021 ; 117 ( 2 ): 26-29 .
4 . Durr AJ , Devlin KM , Critch EA , Fitzgerald MP , Fuller KA , Renzelli-Cain RI . What providers know vs . what providers do : barriers to contraception in adolescents . West Virginia Medical Journal . 2021 ; 117 ( 2 ): 30-35 .
5 . Tolbert A , Nemade D , Raines JA , Charles P , Wehner P , Shuler FD . Gender bias in chest pain evaluation in the emergency department : a 25-year update . West Virginia Medical Journal . 2021 ; 117 ( 2 ): 36-39 .
6 . Lehmann JB , Wehner PS , Lehmann CU , Savory LM . Gender bias in the evaluation of chest pain in the emergency department . American Journal of Cardiology . 1996 ; 77 ( 8 ): 641-644 .
7 . Traub A . Marion Moses , Cesar Chavez confidant and expert on farmworkers ’ health , dies . Los Angeles Times . September 3 , 2020 . Available at : https :// www . latimes . com / obituaries / story / 2020-09-03 / marion-moses-cesarchavez-farm-workers-dies Accessed on April 1 , 2021 .
8 . Moses M . Viva la causa ! American Journal of Nursing . 1973 ; 73 ( 5 ): 843-848 .
6 • www . wvsma . org