NP preceptor

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Mass Effect said:
There's a big difference in an RN serving as a preceptor and an NP serving as one. Neither is ideal, but the RN is just unacceptable.



No one is saying that doctors shouldn't be trained by doctors. But NPs and PAs have something to offer. So someone met a bad NP who got the pathophysiology all wrong. Guess what? I've met more than one MD who got the pathophysiology wrong as well. There were many MDs preaching about the link between autism and vaccinations. There are still MDs out there who believe all medicine is toxic and people should be healed naturally. The point is, there are bad MDs, just as there are bad NPs and determining that no NP is qualified to teach based on that is short-sighted.



That's just your bias talking. Become a physician, work alongside NPs, and then we'll talk. There are several NPs and PAs that I would trust over the MD they're working under.
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Of course there might be physicians that are incompetent, but for every 1 physician that is incompetent, there will be [insert number] NPs. You can trust them with your health or whatever, but as someone who attended nursing school and worked with people who become NPs, I would not trust the vast majority of them to make healthcare decision for me or my family..
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W19 said:
Of course there might be physicians that are incompetent, but for every 1 physician that is incompetent, there will be [insert number] NPs. You can trust them with your health or whatever, but as someone who attended nursing school and worked with people who become NPs, I would not trust the vast majority of them to make healthcare decision for me or my family..
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I attended medical school and worked with people who became doctors, who I would not trust to make healthcare decisions for me or my family. The point is that just like everything else, there are good ones and bad ones. I've worked with many competent ones and a few less-than-competent ones. But I'm not going to make a blanket statement that none can be trusted. I replied to you because your bias was showing in determining that NPs are incompetent, but PAs are legit. They're frankly the same -- good ones and bad ones.
 
Mass Effect said:
I attended medical school and worked with people who became doctors, who I would not trust to make healthcare decisions for me or my family. The point is that just like everything else, there are good ones and bad ones. I've worked with many competent ones and a few less-than-competent ones. But I'm not going to make a blanket statement that none can be trusted. I replied to you because your bias was showing in determining that NPs are incompetent, but PAs are legit. They're frankly the same -- good ones and bad ones.
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Do you have a SO who is an NP? I don't think you really believe the proportion of physicians that is incompetent is close to NPs...
 
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W19 said:
Do you have a SO who is an NP? I don't think you really believe the proportion of physicians that is incompetent is close to NPs...
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Uh no. I'm just mature enough to understand that one doesn't have to have a personal connection to an NP not to stereotype them. Perhaps as you progress in your career and work with some, you'll realize this too. Perhaps.
 
Mass Effect said:
Uh no. I'm just mature enough to understand that one doesn't have to have a personal connection to an NP not to stereotype them. Perhaps as you progress in your career and work with some, you'll realize this too. Perhaps.
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I've had my share of experience with them already. I will be extremely cautious when I work with them as a physician. I am a glad you've had good experience working with them and think they are on par with physicians, but the majority of physicians I worked with think otherwise including physicians who precepted them...
 
Tired said:
Why? You don't think that you can learn something from an RN? Many of them have far more clinical experience than a medical student. Plus they work very closely with physicians, and so have a basis on which to judge your performance.
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Obvious sarcasm aside, if you don't see the difference in an RN and NP, then there's a problem.
 
Tired said:
Why? You don't think that you can learn something from an RN? Many of them have far more clinical experience than a medical student. Plus they work very closely with physicians, and so have a basis on which to judge your performance.
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I can learn things from any human. I cannot learn how to be a physician from a nurse
 
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Tired said:
In reference to this topic, I do not see a difference.
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You don't see a difference in someone doing vitals all day and not knowing when to give Lasix versus metoprolol versus someone who actually does what an FM does? No, an NP doesn't know medicine like a doctor does, but he/she sure as hell knows more than an RN. To say otherwise is just ignorant.
 
Tired said:
Either you're stereotyping nursing jobs, or you really don't know the range of their practice.
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I know the range of their practice. I just know that their job is very different from that of an NP or physician. They have a different purpose and different tasks. To argue that is just ignorant.
 
Psai said:
The difference is approximately 1 year of online classes about bullcrap
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Correction:

It's actually two years. Here are the courses of a typical FNP online program:

Biostatistics for Evidence Based Practice (An 8-hour 'module' in med school)
Advanced Physiology and Pathophysiology
Theoretical Basis for Clinical Reasoning (Fluff)
Health Care Policy (Fluff)
Advanced Health Assessment
Pharmacology for Advanced Nursing Practice
The Care of Well Women and Children
Family Nurse Practitioner: Practicum I
Family Nurse Practitioner: Seminar I (Fluff)
Research and Best Evidence for Clinical Reasoning (Fluff)
Differential Diagnosis for the Advanced Practice Nurse
Family Nurse Practitioner: Practicum II
Clinical Management I (Probably fluff since they did not give the description)
Family Nurse Practitioner: Seminar II and Capstone (Fluff)
Family Nurse Practitioner: Practicum III
Family Nurse Practitioner: Seminar III and Capstone (Fluff)
Clinical Management II (Probably fluff since they did not give the description)

That is probably one of the better programs I have seen out there, and it still has some fluff classes. One really has to be a bad FM physician to be more incompetent than a FNP...
 
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Tired said:
The point here is not that I'm "talking up" RNs. The point is that you are equating NP practice and MD practice, which is silly. If you think the average NP knows drug pharmodynamics and human physiology much better than the average RN, you haven't spent much time around either of them.
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Where did I equate the two? In fact, what I said was "No, an NP doesn't know medicine like a doctor does..." That's an exact quote. But my experience is that an average NP knows a hell of a lot more human physiology than the average RN, rightly so. They're different jobs with different functions.
 
Mass Effect said:
Where did I equate the two? In fact, what I said was "No, an NP doesn't know medicine like a doctor does..." That's an exact quote. But my experience is that an average NP knows a hell of a lot more human physiology than the average RN, rightly so. They're different jobs with different functions.
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Your experience might be unique then. In fact, most NP programs have no grad level physiology course(s), though I understand there is some physio covered in path.
 
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W19 said:
Your experience might be unique then. In fact, most NP programs have no grad level physiology course(s), though I understand there is some physio covered in path.
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Highly doubt my experience is unique.
 
NPs should not be precepting medical students, period. The lack of quality control from NP to NP is ridiculous, thanks to online degree programs. A fourth-year medical student has more clinical rotation hours than your average new-grad NP. We pay good money to have physician preceptors.

Now, if it's a "specialty shift" where you are intentionally supposed to see what midlevels do, that's different (some students at my school had to do a "nursing shift" on OB/Gyn). If you don't have the physician coverage to supervise medical students, you shouldn't be taking those students.
 
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Tired said:
Sigh. You keep saying "ignorant." It's getting tedious. I was a CNA for six years, I'm married to an RN, I've been a licensed physician for 8 years, have held either a full or training license in four states, and have worked in hospitals and clinics in various capacities in six different states (military and civilian). I think I'm past the point where anyone can reasonably call me ignorant.

The point here is not that I'm "talking up" RNs. The point is that you are equating NP practice and MD practice, which is silly. If you think the average NP knows drug pharmodynamics and human physiology much better than the average RN, you haven't spent much time around either of them.
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I have to say I'm sorry. It seems like my initial conversation with you in this thread made it seem like you don't know what you're saying (which I already tried explaining and I'm guessing you understood).
But I agree. Both in that my experiences are short sided compared to yours and that you are literally hitting the nail on what's important here.
NPs are not equal to MDs by any margin. No one or two year degree after RN means you should utter the phrase you are comparable.
I just took advantage of their position to help me get ahead.
 
Mass Effect said:
Where did I equate the two? In fact, what I said was "No, an NP doesn't know medicine like a doctor does..." That's an exact quote. But my experience is that an average NP knows a hell of a lot more human physiology than the average RN, rightly so. They're different jobs with different functions.
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Uh. What? Based on what? Your experience? I can easily refute that by saying I've met numerous nurses who know "a hell of a lot" of human physiology. Difference is they aren't obvious about it. Or don't use it to condescend. Or just feel comfortable not having to bring up their knowledge of physiology because either the physician knows what they're doing or it's not pertinent to the matter at hand.
I mean... how did you assess these NPs in their physiology knowledge? Did you actively pimp RNs vs NPs? Was there a double blind study to prove this?
 
Fox800 said:
NPs should not be precepting medical students, period. The lack of quality control from NP to NP is ridiculous, thanks to online degree programs. A fourth-year medical student has more clinical rotation hours than your average new-grad NP. We pay good money to have physician preceptors.

Now, if it's a "specialty shift" where you are intentionally supposed to see what midlevels do, that's different (some students at my school had to do a "nursing shift" on OB/Gyn). If you don't have the physician coverage to supervise medical students, you shouldn't be taking those students.
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I guess my confusion comes from how you dictate what "preceptor" means. If it means having someone around to cover the floor and round, but ultimately discuss things with the attending... Then it's not that big of a deal. If it's just you and the NP with no MD, then I agree.
My bias is that I absolutely loved having an NP with no residents on surgery rotations or medicine rotations. They generally let me do more and gave me more responsibility. Plus, their knowledge in the clinic was a huge plus.
 
Why would an MD student want to learn from a Real Nurse with experience (who goes for an NP degree- which can be done in 1.5 years online and the rest with a buddy -buddy relationship with a Doctor she used to work for as her internship (in that speciality- psychiatry for example) of 4-6 weeks. Do yourself a favor, only MDs should learn from MDs.
 
mimelim said:
On average, your NPs are going to know a crap ton more than a new clinical medical student. Whether they went to medical school or not is largely irrelevant.
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Hence why medical school is a complete scam since you can learn everything you need to know to be a specialist in any certain area of medicine from being a nurse then doing an online degree then getting on the job training. The 4 year med school plus residency and all the board exams are complete waste of $ and all med school admins should be imprisoned for fraud (since most of these people say "midlevels" are equivalent to physicians anyway).
 
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Winged Scapula said:
Slightly annoyed because:

1) I'm not really the easy to anger type
2) I tend to understate things

Ok, I'm pretty well annoyed. Is that better? :p

She's been with a local practice that refers heavily to me. While talking about a mutual patient one day, she asked if I took NP students. I didn't have a good reason (then) not to, so said I would consider it if she could provide all the things the medical students and residents do (malpractice, HBV status, HIPAA training etc). I then forgot all about it until her school contacted me.

As for what she's doing with me, I actually thought it would be beneficial to *me*. My partners and I get sent all sorts of non-surgical ****: breast pain, benign nipple discharge, genetic counseling patients (those I don't mind), benign skin lesions on the chest/breasts, bleeding with breast feeding and mastitis. So I was thinking if I could get the PCP community to stop sending me those by training them how to manage them on their own and to stop referring to us as "breast specialists" rather than as surgeons, it would make my life easier and I could focus on the malignancies. The former is a small part of the practice but its frustrating when I can't get a new cancer in because the "emergency" breast pain patient cursed at my staff and refused to be rescheduled.

I think when I send her the information about the rotation I'll put a little blurb in there about calling me "Dr" in front of patients. Since she's ballsy enough to call me by my first name already, I don't want to call her specifically out on it lest she take offense. If she was a stranger and her employer didn't refer to me, I wouldn't care, but I have to play it a little closer to the vest.

@Psai please tell me you're kidding when you said you thought NPs wanted to work in rural areas doing primary care. Nothing could be further from the truth.
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Why would you expect an NP to call you "doctor"?

You and her are basically the same.

If you can call her by her first name, why shouldn't she be allowed to call you by the same?

Lets recite the homily for the SDN nation:

HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
 
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Nurses are not trained to think. They just follow protocols. Thats what all MDs/DOs tell me on every rotation. They tell me on when you become an intern, nurse is going to tell you do this and dont do that. Dont blindly follow her, think and do whats best for the patient.

Nurses are very important for the healthcare, as much ad or even more so important than a doctor. But they have different scope of practice.

You can seek nurses help whenever you want, ask them about certain things or learn from them in areas they know, but they cannot substitute a teaching attending.
 
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cbrons said:
Why would you expect an NP to call you "doctor"?

You and her are basically the same.

If you can call her by her first name, why shouldn't she be allowed to call you by the same?

Lets recite the homily for the SDN nation:

HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
HUMMMMMMMMMMM ALL PROVIDERS ARE EQUAL
HUMMMMMMMMMMM ALL PROVIDERS ARE THE SAME
HUMMMMMMMMMMM ALL PROVIDERS PRODUCE THE SAME OUTCOMES
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1. She is not a nurse practitioner yet
2. She is my student not my colleague
3. A certain level of protocol in professional and social situations is still expected in many arenas vis-à-vis I call my patients by their last name until invited otherwise. Why should I be treated any different?
 
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Winged Scapula said:
1. She is not a nurse practitioner yet
2. She is my student not my colleague
3. A certain level of protocol in professional and social situations is still expected in many arenas vis-à-vis I call my patients by their last name until invited otherwise. Why should I be treated any different?
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Was being sarcastic...
 
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Winged Scapula said:
Gotcha… Hard to tell on my phone when reading the threads.

As an update, she has not used my first name in person during the rotation. Maybe she saw this thread?!
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She shouldn't even know your first name. I don't know the first names of most of my preceptors. They're all "Dr. whoever" to me. Although I have had one or two introduce themselves by their first name to everyone and they were still called Dr. whoever
 
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Medicine is going to ****. It used to be simple. We had doctors and nurses. It was clear what each skillset was and who was the expert in what. Now we have dozens or more types of "providers" and more popping up every day. Thanks to political correctness, we're all equal! Even a medical professional has no way of knowing what all of their skillsets are, forget ordinary people. Pretty soon you might as well load up an app and get your diagnosis that way since you have no idea if the person you're seeing has any actual knowledge or not.
 
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chipwhitley said:
Pretty soon you might as well load up an app and get your diagnosis that way since you have no idea if the person you're seeing has any actual knowledge or not.
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I'm going to start WebNP... give people an alternative to the uncaring WebMD
 
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Nasrudin said:
I might agree yet they seem pretty keen on being called Dr in clinical settings whenever they get their doctor or nursing degree or whatever it is.

But it's unfortunate that WS is bridled by political concern here because if public humiliation has a place in this world, it's here. And also maybe that allo thread with the kid who can't stop crying in public.

There's just too much coddling going on the world these days.
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Link?
 
I'm a PA student almost done w/ rotations. All my preceptors have been primarily MD's which I prefer & enjoy (worked w/ PA's during rotation on the side - rounded with one on the stroke ICU, inpatient surgery, etc great experiences.)
Had 1 NP preceptor (family medicine - 30 yrs exp) - awesome rotation.
Only complaint is from 1 MD preceptor I had (given it was an IMG)

I wouldn't mind who it was as long as I enjoy the environment and learning opportunity. But, obviously see it from y'alls perspective.
 
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torshi said:
I'm a PA student almost done w/ rotations. All my preceptors have been primarily MD's which I prefer & enjoy (worked w/ PA's during rotation on the side - rounded with one on the stroke ICU, inpatient surgery, etc great experiences.)
Had 1 NP preceptor (family medicine - 30 yrs exp) - awesome rotation.
Only complaint is from 1 MD preceptor I had (given it was an IMG)

I wouldn't mind who it was as long as I enjoy the environment and learning opportunity. But, obviously see it from y'alls perspective.
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This has zero relevance for us.
We are training to be doctors, not PAs.
 
Psai said:
No studies have shown webnp to be inferior to webmd. In fact webnp is equal to or even better than webmd
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WebNP has a friendlier user interface. WebNP spends more time searching for answers, making people feel like it has really considered their input.
WebNP costs less bandwidth to the internet and is easier to load for patients with bad internets.

Source = systematic review of retrospective cohort studies from the journal of internet nurse practitionerology
Sent from my SM-N910P using SDN mobile
 
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QualityProcess said:
thank you for the quick lesson on how to construct a strawman argument
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Wait I'm talking about my colleague and not yours because you're a medical student. Medical students also work with me and yet are not my colleagues. See how that works? Probably not.
 
Psai said:
Wait I'm talking about my colleague and not yours because you're a medical student. Medical students also work with me and yet are not my colleagues. See how that works? Probably not.
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wow a lightning quick follow up to the straw man argument with an ad hominem. don't need a medical degree to know what colleague means.

in all sincerity, if we ever discuss something medical, i will certainly defer to you
 
Man go take a class in logic fallacies, it's not an ad hominem just cause someone disagrees with you. It was not an attack on your character, it's directly related to the argument presented. Previous argument was also not a strawman as it was not a misrepresentation of your position, it was illustrating the point with examples. Everyone and their mothers thinks they're socrates on the internet these days, throwing around tired terms that they don't understand in an attempt to sound smart when they have nothing useful to say.
 
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Psai said:
Man go take a class in logic fallacies, it's not an ad hominem just cause someone disagrees with you. It was not an attack on your character, it's directly related to the argument presented. Previous argument was also not a strawman as it was not a misrepresentation of your position, it was illustrating the point with examples. Everyone and their mothers thinks they're socrates on the internet these days, throwing around tired terms that they don't understand in an attempt to sound smart when they have nothing useful to say.
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ad hominem is not necessarily an attack on character, its an argument based on who the opponent is rather than the argument itself. you claimed I could not understand "colleague" based on the fact that Im a medical student. ad hominem. Your definition of colleague is incorrect, regardless of my credentials.

trying to draw me into a discussion about whether or not a janitor was your colleague was a straw man argument. You presented a statement about janitors as if I had argued it. That is a straw man. I never said anything about janitors. Now, if you want to ask me if the janitor is your colleague, maybe we can continue with a logically consistent discussion. But that would be tough because you clearly did your law school rotations with paralegals ;)

(I have no idea what law school students do, it was a joke so don't get all crazy on me, JDs)
 
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