The role of training in student examiner rating performance in a student-led mock OSCE

Abstract Introduction Peer assessments are increasingly prevalent in medical education, including student-led mock Objective Structured Clinical Examinations (OSCE). While there is some evidence to suggest that examiner training may improve OSCE assessments, few students undergo training before becoming examiners. We sought to evaluate an examiner training programme in the setting of a student-led mock OSCE. Methods A year‑2 mock OSCE comprised of history taking (Hx) and physical examination (PE) stations was conducted involving 35 year‑3 (Y3) student examiners and 21 year‑5 (Y5) student examiners who acted as reference examiners. Twelve Y3 student-examiners attended an OSCE examiner training programme conducted by senior faculty. During the OSCE, Y3 and Y5 student examiners were randomly paired to grade the same candidates and scores were compared. Scores for checklist rating (CR) and global rating (GR) domains were assigned for both Hx and PE stations. Results There was moderate to excellent correlation between Y3 and Y5 student examiners for both Hx (ICC 0.71–0.96) and PE stations (ICC 0.71–0.88) across all domains. For both Hx and PE stations, GR domain had poorer correlation than CR domains. Examiner training resulted in better correlations for PE but not Hx stations. Effect sizes were lower than the minimum detectible effect (MDE) sizes for all comparisons made. Discussion Y3 student examiners are effective substitutes for Y5 student examiners in a Y2 mock OSCE. Our findings suggest that examiner training may further improve marking behaviour especially for PE stations. Further studies with larger sample sizes are required to further evaluate the effects of dedicated examiner training.

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Effectiveness of psychological interventions to improve emotion regulation in youth - a meta-analysis

10.31234/osf.io/3yxcp ◽

2019 ◽

Author(s):

Bettina Moltrecht ◽

Jessica Deighton ◽

Praveetha Patalay ◽

Julian Childs

Keyword(s):

Emotion Regulation ◽

Emotion Dysregulation ◽

Psychological Intervention ◽

Meta Analysis ◽

Age Groups ◽

Effect Sizes ◽

What Works ◽

Large Heterogeneity ◽

Larger Sample

Background: Research investigating the role of emotion regulation (ER) in the development and treatment of psychopathology has increased in recent years. Evidence suggests that an increased focus on ER in treatment can improve existing interventions. Most ER research has neglected young people, therefore the present meta-analysis summarizes the evidence for existing psychosocial intervention and their effectiveness to improve ER in youth. Methods: A systematic review and meta-analysis was conducted according to the PRISMA guidelines. Twenty-one randomized-control-trials (RCTs) assessed changes in ER following a psychological intervention in youth exhibiting various psychopathological symptoms.Results: We found moderate effect sizes for current interventions to decrease emotion dysregulation in youth (g=-.46) and small effect sizes to improve emotion regulation (g=0.36). Significant differences between studies including intervention components, ER measures and populations studied resulted in large heterogeneity. Conclusion: This is the first meta-analysis that summarizes the effectiveness for existing interventions to improve ER in youth. The results suggest that interventions can enhance ER in youth, and that these improvements correlate with improvements in psychopathology. More RCTs including larger sample sizes, different age groups and psychopathologies are needed to increase our understanding of what works for who and when.

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Benefits of EPAs at risk? The influence of the workplace environment on the uptake of EPAs in EPA-based curricula

Perspectives on Medical Education ◽

10.1007/s40037-021-00658-9 ◽

2021 ◽

Author(s):

Karsten Arthur van Loon ◽

Linda Helena Anna Bonnie ◽

Nynke van Dijk ◽

Fedde Scheele

Keyword(s):

At Risk ◽

Postgraduate Medical Education ◽

Training Programme ◽

Workplace Environment ◽

Medical Specialists ◽

Professional Activities ◽

National Training ◽

Local Medical Care

Abstract Introduction Entrustable Professional Activities (EPAs) have been applied differently in many postgraduate medical education (PGME) programmes, but the reasons for and the consequences of this variation are not well known. Our objective was to investigate how the uptake of EPAs is influenced by the workplace environment and to what extent the benefits of working with EPAs are at risk when the uptake of EPAs is influenced. This knowledge can be used by curriculum developers who intend to apply EPAs in their curricula. Method For this qualitative study, we selected four PGME programmes: General Practice, Clinical Geriatrics, Obstetrics & Gynaecology, and Radiology & Nuclear Medicine. A document analysis was performed on the national training plans, supported by the AMEE Guide for developing EPA-based curricula and relevant EPA-based literature. Interviews were undertaken with medical specialists who had specific involvement in the development of the curricula. Content analysis was employed and illuminated the possible reasons for variation in the uptake of EPAs. Results An important part of the variation in the uptake of EPAs can be explained by environmental factors, such as patient population, the role of the physician in the health-care system, and the setup of local medical care institutions where the training programme takes place. The variation in uptake of EPAs is specifically reflected in the number and breadth of the EPAs, and in the way the entrustment decision is executed within the PGME programme. Discussion Due to variation in uptake of EPAs, the opportunities for trainees to work independently during the training programme might be challenging. EPAs can be implemented in the curriculum of PGME programmes in a meaningful way, but only if the quality of an EPA is assessed, future users are involved in the development, and the key feature of EPAs (the entrustment decision) is retained.

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The Role of History Taking in the Diagnosis of Asthma

Hospital Practice ◽

10.1080/21548331.1996.11443368 ◽

1996 ◽

Vol 31 (10) ◽

pp. 155-156

Author(s):

Stuart W. Stoloff

Keyword(s):

History Taking

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The role of paediatricians in specialist nurse training: a community child health example

Archives of Disease in Childhood - Education and Practice ◽

10.1136/archdischild-2020-320797 ◽

2021 ◽

pp. edpract-2020-320797

Author(s):

Cliona Ni Bhrolchain

Keyword(s):

Child Health ◽

Training Programme ◽

Formal Training ◽

Nurse Training ◽

Training Curriculum ◽

Clinical Specialty ◽

Specialist Nurse ◽

Training Programmes ◽

Nursing Roles

Specialist and advanced nursing roles have started to emerge in paediatrics and paediatricians may be asked to support nurses through their training. While there are specific training programmes for some areas of practice eg, neonatology, there are currently no programmes for others. Paediatricians may therefore find themselves being asked to train nurse specialists outside a formal training programme, or to provide the clinical specialty component linked to a generic MSc course, where the paediatrician may be required to devise a training curriculum specific to their area of practice. Using, neonatology, there are currently no programmes for others. Paediatricians may therefore find themselves being asked to train nurse specialists outside a formal training programme, or to provide the clinical specialty component linked to a generic MSc course, where the paediatrician may be required to devise a training curriculum specific to their area of practice. Using community child health as an example, this paper outlines how paediatricians might approach this, based on the experience of the author. However, the principles outlined can apply to any area of paediatrics.

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The Effects of Testosterone on Cognition in Elderly Men: A Review

CNS Spectrums ◽

10.1017/s1092852900016990 ◽

2008 ◽

Vol 13 (10) ◽

pp. 887-897 ◽

Cited By ~ 16

Author(s):

Matthew F. Warren ◽

Michael J. Serby ◽

David M. Roane

Keyword(s):

Cognitive Measures ◽

Elderly Men ◽

Cognitive Domains ◽

Testosterone Levels ◽

Visuospatial Function ◽

Androgen Depletion ◽

The Relationship ◽

With Memory ◽

Larger Sample

ABSTRACTIn this article, the literature examining the relationship between testosterone and various cognitive domains in elderly men is reviewed. The review focuses on the role of endogenous testosterone levels and the effects of androgen depletion and replacement. The cognitive domains most commonly linked to testosterone include memory and visuospatial function. Indeed, the literature suggests that in certain conditions (ie, hypogonadism, cognitive impairment) testosterone levels may be significantly associated with memory and visuospatial function, but not other cognitive functions. Studies with larger sample sizes and more sensitive cognitive measures are indicated, as questions remain about the potential role of testosterone as a cognitive enhancer.

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Investigating Association of rs5918 Human Platelets Antigen 1 and rs1800790 Fibrinogen β Chain as Critical Players with Recurrent Pregnancy Loss

Medical Sciences ◽

10.3390/medsci6040098 ◽

2018 ◽

Vol 6 (4) ◽

pp. 98 ◽

Cited By ~ 3

Author(s):

Fatemeh Karami ◽

Maliheh Askari ◽

Mohammad Modarressi

Keyword(s):

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Human Platelets ◽

P Value ◽

Increased Risk ◽

History Of ◽

Polymerase Chain ◽

Β Chain ◽

Larger Sample

Thrombophilia gene variants have been shown to be associated with higher risk of recurrent pregnancy loss (RPL). Due to the role of human platelets antigen 1 (HPA-1) and fibrinogen β chain (FGB) as critical players in the coagulation process, their most important variants including rs5918 T > C and rs1800790 G > A were selected to be studied in women affected by RPL. Three milliliters of peripheral blood were drawn from 110 women with history of at least two consecutive spontaneous abortion and 110 healthy women controls. rs5918 T > C and rs1800790 G > A of HPA-1 and FGB genes, respectively, were selected to be analyzed through polymerase chain reaction-restriction fragment length polymorphism (PCR_RFLP) following DNA isolation using QIAamp DNA Blood Mini Kit. Heterozygote genotype (TC) of HPA-1 gene rs5918 polymorphism was significantly associated with risk of RPL (p-value = 0.02). Although, rs1800790 G > A of FGB gene was not associated with RPL, its combination with rs5918 polymorphism was associated with increased risk of RPL. Owing to the critical roles of FGB and HPA-1 genes in coagulation, and thrombosis and several confinements on the meaningful association between the combination of those polymorphism with risk of RPL, including them in the thrombophilia panel may increase detection rate of hereditary thrombophilia patients. However, further studies with larger sample sizes are required to shed light on the exact role of the studied gene polymorphism, especially rs1800790 G > A of FGB gene variant in pathogenesis of RPL.

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The Role Of The Academic Portfolio In Documenting Faculty Development

Journal of College Teaching & Learning (TLC) ◽

10.19030/tlc.v7i10.150 ◽

2010 ◽

Vol 7 (10) ◽

Cited By ~ 1

Author(s):

Genevieve Pinto Zipp ◽

Susan Simpkins

Keyword(s):

Faculty Development ◽

Personnel Decisions ◽

Larger Sample

The academic portfolio provides a means for faculty to organize, present and reflect on their accomplishments in the areas of teaching, scholarship and service. Since the portfolio represents faculty accomplishments in these key areas it may be used to support an application for promotion, tenure or merit reviews. Given this, it is important to identify faculty’s knowledge and perspectives on the structure and utility of the academic portfolio. Surveys were sent to faculty at Seton Hall University to gather information on what faculty know about academic portfolios and whether portfolios should be used for promotion/tenure or merit reviews. Results indicate that faculty understand the characteristics and organization of a portfolio, but are not certain about whether portfolios should be used for personnel decisions. The lack of objective criteria for evaluating portfolios may be a factor underlying this perspective. Further research using a larger sample is warranted.

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The Role of Maternal Progesterone and Estradiol Levels in Predicting the Success of Induction of Labour: A Preliminary Study

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v7i2.867 ◽

2019 ◽

pp. 126-129

Author(s):

Kanadi Sumapraja ◽

Hilda R Badruddin

Keyword(s):

Cross Sectional Study ◽

Induction Of Labour ◽

Health Clinic ◽

Cross Sectional ◽

Induction Group ◽

Significant Difference ◽

Preliminary Study ◽

Larger Sample ◽

Estradiol Levels

Objective: to evaluate whether maternal progesterone and estradiol levels could be used to predictthe success ofinduction of labour (IOL) Methods:This cross-sectional study was conducted at the Women’s Health Clinic as well as delivery suite of Dr. Cipto Mangunkusumo Hospital during the period of May 2016 to April 2017. Blood samples of term pregnant women who were indicated for IOL wereobtainedbefore birth. Results:A total 44 subject were recruited in this study.Of these, 24 subjects had successful IOL while the other 20 subjects had IOL failure. There was no significant difference of progesterone among both groups (66,7% vs 75%, p=0,55). The estradiol levels in subjects who successfully performed induction had an average of 16,916.28 ± 2,574.75 pg/mL which did not differ significantly from the failed of induction group with estradiol levels of 14,832.24 ± 2374.47 pg/mL (p = 0,65). Conclusion:We found no significant association between both maternal progesterone and estradiol levels and the success rate of IOL. Further studies with larger sample sizes are required to confirm whether progesterone and estradiol play pivotal roles in the success of IOL. Keywords: progesterone, estradiol, induction of labour Tujuan: mengevaluasi kadar progesteron dan estradiol ibu sebagai prediktor kesuksesan induksi persalinan Metode: Penelitian ini menggunakan desain potong lintang yang berlangsung pada bulan Mei 2016 hingga April 2017 di Poliklinik dan IGD Kebidanan Rumah Sakit Umum Pusat Rujukan Nasional Cipto Mangunkusumo. Pasien hamil aterm yang dilakukan induksi persalinan dan memenuhi kriteria penelitian akan diambil sampel darah sebelum persalinan. Hasil: Dari 44 subjek yang mengikuti penelitian, 24 subjek berhasil dilakukan induksi persalinan dan 20 subjek gagal.Tidakterdapatperbedaanbermaknapadakadarprogesterone Antarakeduagrup(66,7% vs 75%, p=0,55). Kadar estradiol padapasien yang berhasildilakukaninduksimemiliki rata-rata 16.916,28 + 2.574,75pg/mL yang tidakberbedajauhdengankadar estradiol pasien yang gagalinduksiyaitu 14.832,24 + 2374,47pg/mL (p = 0,65). Kesimpulan: Tidakterdapat perbedaan bermakna antara kadar progesteron dan estradiol maternal terhadap keberhasilan induksi persalinan. Penelitian lebih lanjut dengan jumlah sampel yang lebih besar dibutuhkan untuk mengkonfirmasi hubungan ini dengan lebih baik. Kata kunci: progesteron, estradiol, induksi persalinan

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Lack of association between genetic variants at ACE2 and TMPRSS2 genes involved in SARS-CoV-2 infection and human quantitative phenotypes

10.1101/2020.04.22.20074963 ◽

2020 ◽

Cited By ~ 3

Author(s):

Esteban Lopera ◽

Adriaan van der Graaf ◽

Pauline Lanting ◽

Marije van der Geest ◽

Jingyuan Fu ◽

...

Keyword(s):

Genetic Variants ◽

Angiotensin Ii Receptor ◽

Angiotensin Converting Enzyme 2 ◽

Virus Clearance ◽

Receptor Blockers ◽

Males And Females ◽

Metabolic Biomarkers ◽

Larger Sample ◽

Human Receptor

AbstractCoronavirus disease 2019 (COVID-19) shows a wide variation in expression and severity of symptoms, from very mild or no symptomes, to flu-like symptoms, and in more severe cases, to pneumonia, acute respiratory distress syndrome and even death. Large differences in outcome have also been observed between males and females. The causes for this variability are likely to be multifactorial, and to include genetics. The SARS-CoV-2 virus responsible for the infection uses the human receptor angiotensin converting enzyme 2 (ACE2) for cell invasion, and the serine protease TMPRSS2 for S protein priming. Genetic variation in these two genes may thus modulate an individual’s genetic predisposition to infection and virus clearance. While genetic data on COVID-19 patients is being gathered, we carried out a phenome-wide association scan (PheWAS) to investigate the role of these genes in other human phenotypes in the general population. We examined 178 quantitative phenotypes including cytokines and cardio-metabolic biomarkers, as well as 58 medications in 36,339 volunteers from the Lifelines population biobank, in relation to 1,273 genetic variants located in or near ACE2 and TMPRSS2. While none reached our threshold for significance, we observed a suggestive association of polymorphisms within the ACE2 gene with (1) the use of angiotensin II receptor blockers (ARBs) combination therapies (p=5.7×10−4), an association that is significantly stronger in females (pdiff=0.01), and (2) with the use of non-steroid anti-inflammatory and antirheumatic products (p=5.5×10−4). While these associations need to be confirmed in larger sample sizes, they suggest that these variants play a role in diseases such as hypertension and chronic inflammation that are often observed in the more severe COVID-19 cases. Further investigation of these genetic variants in the context of COVID-19 is thus promising for better understanding of disease variability. Full results are available at https://covid19research.nl.

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The role of open reduction and internal fixation in the treatment of the intercondylar fractures of humerus

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193824 ◽

2019 ◽

Vol 5 (5) ◽

pp. 855

Author(s):

Venkata Sivaram G. V. ◽

Y. V. S. Prabhakar

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Early Mobilization ◽

Distal Humerus ◽

Inclusion Criteria ◽

Senior Faculty ◽

Chevron Osteotomy ◽

Stiff Elbow ◽

Condylar Fractures

Background: Inter-condylar fractures represent one of the most complicated and challenging fractures in the upper extremity. The results of managing these fractures non-operatively are limited by failure to get anatomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudo-arthrosis. The objective of this study was to evaluate and analyse the role of open reduction and internal fixation in inter-condylar fractures of distal humerus.Methods: The present study was done in Malla Reddy Institute of Medical Sciences between June 2014 and June 2017. Out of 34 cases of intercondylar fractures of humerus admitted during the period, 25 patients were selected for the study that satisfied our inclusion criteria. Three patients out of those selected could not be included in the study as one had cardiac issues pre-operatively, one refused surgery and one was lost to follow up.Results: Our study included 22 patients, 14 male and 8 female patients. Their average age was 41.4 years. The fractures were classified as per the AO classification. There were B1-3, B2-1, C1-6, C2-5, C3-7 fractures. Both compound and closed fractures were included. All the patients were operated by posterior olecranon Chevron osteotomy approach by a senior faculty member. Twenty two patients who satisfied our inclusion criteria were treated, followed up and the results analyzed using Cassabaum’s scale of elbow function we had 86% of excellent to good results. Our results are comparable with other similar studies.Conclusions: Posterior olecranon approach was found to be of most satisfactory approach by us. It allows good exposure of the joint and the ulnar nerve.

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