[1] SW Texas State Univ, Ctr Med, Dept Biomed Commun, Dallas, TX 75390 USA
[2] SW Texas State Univ, Ctr Med, Off Med Educ, Dallas, TX 75390 USA
[3] SW Texas State Univ, Ctr Med, Dept Family Practice & Community Med, Dallas, TX 75390 USA
[4] Hamot Med Ctr, Erie, PA USA