scholarly journals Assessing and Documenting the Cognitive Performance of Family Medicine Residents Practicing Outpatient Medicine

2014 ◽  
Vol 6 (3) ◽  
pp. 526-531 ◽  
Author(s):  
Allen F. Shaughnessy ◽  
Katherine T. Chang ◽  
Jennifer Sparks ◽  
Molly Cohen-Osher ◽  
Joseph Gravel
Keyword(s):  
Family Medicine ◽  
Cognitive Performance ◽  
Cognitive Skills ◽  
Medical Knowledge ◽  
Time Consistency ◽  
Faculty Members ◽  
Knowledge Domain ◽  
Ambulatory Medicine ◽  
The Individual ◽  
Over Time

Abstract Background Development of cognitive skills for competent medical practice is a goal of residency education. Cognitive skills must be developed for many different clinical situations. Innovation We developed the Resident Cognitive Skills Documentation (CogDoc) as a method for capturing faculty members' real-time assessment of residents' cognitive performance while they precepted them in a family medicine office. The tool captures 3 dimensions of cognitive skills: medical knowledge, understanding, and its application. This article describes CogDoc development, our experience with its use, and its reliability and feasibility. Methods After development and pilot-testing, we introduced the CogDoc at a single training site, collecting all completed forms for 14 months to determine completion rate, competence development over time, consistency among preceptors, and resident use of the data. Results Thirty-eight faculty members completed 5021 CogDoc forms, documenting 29% of all patient visits by 33 residents. Competency was documented in all entrustable professional activities. Competence was statistically different among residents of different years of training for all 3 dimensions and progressively increased within all residency classes over time. Reliability scores were high: 0.9204 for the medical knowledge domain, 0.9405 for understanding, and 0.9414 for application. Almost every resident reported accessing the individual forms or summaries documenting their performance. Conclusions The CogDoc approach allows for ongoing assessment and documentation of resident competence, and, when compiled over time, depicts a comprehensive assessment of residents' cognitive development and ability to make decisions in ambulatory medicine. This approach meets criteria for an acceptable tool for assessing cognitive skills.

Longitudinal Case-Based Evaluation of Diagnostic Competency Among Pathology Residents: A Statistical Approach

2006 ◽  
Vol 130 (2) ◽  
pp. 188-193
Author(s):  
Barbara S. Ducatman ◽  
Alan M. Ducatman
Keyword(s):  
Statistical Approach ◽  
Medical Knowledge ◽  
Faculty Members ◽  
Surgical Pathology ◽  
Percent Agreement ◽  
Learning Competencies ◽  
Pathology Reports ◽  
And Training ◽  
Over Time ◽  
Case Based

Abstract Context.—Accreditation Council for Graduate Medical Education guidelines require the evaluation of residents in 6 competencies. Pathology residents demonstrate medical knowledge, patient care, communication, and practice-based learning competencies in their attainment of competency in surgical pathology diagnosis. Objective.—To implement a prospective case-based approach to longitudinally evaluate the acquisition of competency in surgical pathology diagnosis by trainees. Design.—Each resident made his or her surgical pathology diagnosis on cases before faculty review of the cases. Faculty members scored each resident diagnosis as to whether they agree, partially agree, or disagree with the diagnosis. Forty-three months of surgical pathology reports (August 2001 through January 2005) and 22 252 surgical pathology cases were analyzed. Setting.—Pathology residency program. Participants.—Thirteen faculty members and 21 trainees. Main Outcome Measure.—Time and training year trends for the number of cases reviewed and the percent agreement between faculty and trainees on the diagnoses. Results.—A mean of 146 cases (range, 12–327 cases) was reviewed during each month-long rotation. The number of cases reviewed increased through postgraduate year 4. The percent agreement on the diagnoses was 78% (range, 56%– 99%) for all trainees, with improvement by postgraduate year, although the improvement attenuated by postgraduate year 3. Residents were less likely to preview the most complex cases. Faculty rank and sex and resident sex did not significantly affect outcomes. The overall agreement on the diagnoses increased over time. Residents experiencing difficulty could be identified clearly and early. Conclusions.—Individual resident performance was easily tracked over time. The review of hundreds of reports increases systems accountability and allows more objectivity than traditional evaluations. The use of case-based evaluation fosters earlier identification and remediation of deficiencies.

On the Individual

1999 ◽  
Vol 4 (4) ◽  
pp. 205-218 ◽  
Author(s):  
David Magnusson
Keyword(s):  
School Psychologist ◽  
Real Life ◽  
Psychological Research ◽  
Developmental Research ◽  
Future Directions ◽  
The 1950S ◽  
The Individual ◽  
Over Time

A description of two cases from my time as a school psychologist in the middle of the 1950s forms the background to the following question: Has anything important happened since then in psychological research to help us to a better understanding of how and why individuals think, feel, act, and react as they do in real life and how they develop over time? The studies serve as a background for some general propositions about the nature of the phenomena that concerns us in developmental research, for a summary description of the developments in psychological research over the last 40 years as I see them, and for some suggestions about future directions.

Geographical aspects of the diffusion of passive houses

2013 ◽  
Vol 4 (2) ◽  
pp. 151-156 ◽  
Author(s):  
G. Kozma ◽  
E. Molnár ◽  
K. Czimre ◽  
J. Pénzes
Keyword(s):  
Energy Consumption ◽  
Energy Resources ◽  
Substantial Part ◽  
Renewable Energy Resources ◽  
Passive House ◽  
The Earth ◽  
Passive Houses ◽  
The Individual ◽  
Geographical Locations ◽  
Over Time

Abstract In our days, energy issues belong to the most important problems facing the Earth and the solution may be expected partly from decreasing the amount of the energy used and partly from the increased utilisation of renewable energy resources. A substantial part of energy consumption is related to buildings and includes, inter alia, the use for cooling/heating, lighting and cooking purposes. In the view of the above, special attention has been paid to minimising the energy consumption of buildings since the late 1980s. Within the framework of that, the passive house was created, a building in which the thermal comfort can be achieved solely by postheating or postcooling of the fresh air mass without a need for recirculated air. The aim of the paper is to study the changes in the construction of passive houses over time. In addition, the differences between the geographical locations and the observable peculiarities with regard to the individual building types are also presented.

Personality change and environmental concerns

2020 ◽  
Author(s):  
Christopher James Hopwood ◽  
Ted Schwaba ◽  
Wiebke Bleidorn
Keyword(s):  
Personality Traits ◽  
Personality Change ◽  
Environmental Concerns ◽  
Big Five Personality ◽  
German Population ◽  
Individual Level ◽  
Sustainable Behavior ◽  
Nationally Representative ◽  
The Individual ◽  
Over Time

Personal concerns about climate change and the environment are a powerful motivator of sustainable behavior. People’s level of concern varies as a function of a variety of social and individual factors. Using data from 58,748 participants from a nationally representative German sample, we tested preregistered hypotheses about factors that impact concerns about the environment over time. We found that environmental concerns increased modestly from 2009-2017 in the German population. However, individuals in middle adulthood tended to be more concerned and showed more consistent increases in concern over time than younger or older people. Consistent with previous research, Big Five personality traits were correlated with environmental concerns. We present novel evidence that increases in concern were related to increases in the personality traits neuroticism and openness to experience. Indeed, changes in openness explained roughly 50% of the variance in changes in environmental concerns. These findings highlight the importance of understanding the individual level factors associated with changes in environmental concerns over time, towards the promotion of more sustainable behavior at the individual level.

Michel Foucault and Western Medicine

2019 ◽  
Vol 29 (2) ◽  
pp. 64-81
Keyword(s):  
Western Medicine ◽  
18Th Century ◽  
Medical Knowledge ◽  
Social Medicine ◽  
Western Society ◽  
1960S And 1970S ◽  
The Veil ◽  
The 1960S ◽  
The Individual ◽  
The 19Th Century

The article analyzes Michel Foucault’s philosophical ideas on Western medicine and delves into three main insights that the French philosopher developed to expose the presence of power behind the veil of the conventional experience of medicine. These insights probe the power-disciplining function of psychiatry, the administrative function of medical institutions, and the role of social medicine in the administrative and political system of Western society. Foucault arrived at theses insights by way of his intense interest in three elements of the medical system that arose almost simultaneously at the end of the 18th century - psychiatry as “medicine for mental illness”, the hospital as the First and most well-known type of medical institution, and social medicine as a type of medical knowledge focused more on the protection of society and far less on caring for the individual. All the issues Foucault wrote about stemmed from his personal and professional sensitivity to the problems of power and were a part of the “medical turn” in the social and human sciences that occurred in the West in the 1960s and 1970s and led to the emergence of medical humanities. The article argues that Foucault’s stories about the power of medical knowledge were philosophical stories about Western medicine. Foucault always used facts, dates, and names in an attempt to identify some of the general tendencies and patterns in the development of Western medicine and to reveal usually undisclosed mechanisms for managing individuals and populations. Those mechanisms underlie the practice of providing assistance, be it the “moral treatment” practiced by psychiatrists before the advent of effective medication, or treating patients as “clinical cases” in hospitals, or hospitalization campaigns that were considered an effective “technological safe-guard ” in the 18th and most of the 19th century.

scholarly journals Eye contact effect: The role of vagal regulation and reactivity, and self-regulation of attention

2021 ◽  
Author(s):  
Alicja Niedźwiecka
Keyword(s):  
Executive Functions ◽  
Cognitive Performance ◽  
Self Regulation ◽  
Eye Contact ◽  
Autonomic Regulation ◽  
Face To Face ◽  
Effective Strategies ◽  
Contact Effect ◽  
The Individual

AbstractEye contact is a crucial aspect of social interactions that may enhance an individual’s cognitive performance (i.e. the eye contact effect) or hinder it (i.e. face-to-face interference effect). In this paper, I focus on the influence of eye contact on cognitive performance in tasks engaging executive functions. I present a hypothesis as to why some individuals benefit from eye contact while others do not. I propose that the relations between eye contact and executive functioning are modulated by an individual’s autonomic regulation and reactivity and self-regulation of attention. In particular, I propose that individuals with more optimal autonomic regulation and reactivity, and more effective self-regulation of attention benefit from eye contact. Individuals who are less well regulated and over- or under-reactive and who do not employ effective strategies of self-regulation of attention may not benefit from eye contact and may perform better when eye contact is absent. I present some studies that justify the proposed hypothesis and point to a method that could be employed to test them. This approach could help to better understand the complex mechanisms underlying the individual differences in participant’s cognitive performance during tasks engaging executive functions.

ExpanDrogram: Dynamic Visualization of Big Data Segmentation over Time

2021 ◽  
Vol 13 (2) ◽  
pp. 1-27
Author(s):  
A. Khalemsky ◽  
R. Gelbard
Keyword(s):  
Big Data ◽  
Visual Presentation ◽  
Trend Detection ◽  
Dynamic Visualization ◽  
Segmentation Process ◽  
Key Points ◽  
Wide Range ◽  
History Of ◽  
The Individual ◽  
Over Time

In dynamic and big data environments the visualization of a segmentation process over time often does not enable the user to simultaneously track entire pieces. The key points are sometimes incomparable, and the user is limited to a static visual presentation of a certain point. The proposed visualization concept, called ExpanDrogram, is designed to support dynamic classifiers that run in a big data environment subject to changes in data characteristics. It offers a wide range of features that seek to maximize the customization of a segmentation problem. The main goal of the ExpanDrogram visualization is to improve comprehensiveness by combining both the individual and segment levels, illustrating the dynamics of the segmentation process over time, providing “version control” that enables the user to observe the history of changes, and more. The method is illustrated using different datasets, with which we demonstrate multiple segmentation parameters, as well as multiple display layers, to highlight points such as new trend detection, outlier detection, tracking changes in original segments, and zoom in/out for more/less detail. The datasets vary in size from a small one to one of more than 12 million records.

The Entextualization of Ayurveda as Intellectual Property

2012 ◽  
Vol 19 (3) ◽  
pp. 313-343 ◽  
Author(s):  
Matthew Wolfgram
Keyword(s):  
Intellectual Property ◽  
Global Economy ◽  
Medical Knowledge ◽  
Linguistic Anthropology ◽  
Medical Discourse ◽  
Complex Nature ◽  
Multiple Sources ◽  
The Social ◽  
Rights Discourse ◽  
The Individual

AbstractThis article documents the practices of pharmaceutical creativity in Ayurveda, focusing in particular on how practitioners appropriate multiple sources to innovate medical knowledge. Drawing on research in linguistic anthropology on the social circulation of discourse—a process calledentextualization—I describe how the ways in which Ayurveda practitioners innovate medical knowledge confounds the dichotomous logic of intellectual property (IP) rights discourse, which opposes traditional collective knowledge and modern individual innovation. While it is clear that these categories do not comprehend the complex nature of creativity in Ayurveda, I also use the concept of entextualization to describe how recent historical shifts in the circulation of discourse have caused a partial entailment of this opposition between the individual and the collectivity. Ultimately, I argue that the method exemplified in this article of tracking the social circulation of medical discourse highlights both the empirical complexity of so-called traditional creativity, and the politics of imposing the categories of IP rights discourse upon that creativity, situated as it often is, at the margins of the global economy.

Canada’s changing innovation landscape

2021 ◽  
Author(s):  
Md. Razib Alam ◽  
Bonwoo Koo ◽  
Brian Paul Cozzarin
Keyword(s):  
The United States ◽  
Destination Country ◽  
Firm Level ◽  
Individual Level ◽  
Patent Classification ◽  
The Usa ◽  
The Government ◽  
The Individual ◽  
The University ◽  
Over Time

Abstract Our objective is to study Canada’s patenting activity over time in aggregate terms by destination country, by assignee and destination country, and by diversification by country of destination. We collect bibliographic patent data from the Canadian Intellectual Property Office and the United States Patent and Trademark Office. We identify 19,957 matched Canada–US patents, 34,032 Canada-only patents, and 43,656 US-only patents from 1980 to 2014. Telecommunications dominates in terms of International Patent Classification technologies for US-only and Canada–US patents. At the firm level, the greatest number of matched Canada–US patents were granted in the field of telecommunications, at the university level in pharmaceuticals, at the government level in control and instrumentation technology, and at the individual level in civil engineering. We use entropy to quantify technological diversification and find that diversification indices decline over time for Canada and the USA; however, all US indices decline at a faster rate.

Yet Another Expert Opinion on Bilirubin Toxicity!

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 829-831
Author(s):  
LOIS JOHNSON
Keyword(s):  
At Risk ◽  
Expert Opinion ◽  
Term Newborn ◽  
New Guidelines ◽  
The Individual ◽  
Bilirubin Toxicity ◽  
Toxic Potential ◽  
Over Time

Drs Newman and Maisels1 have provided valuable new guidelines for management of jaundice in the term newborn which take into account age at discharge from the hospital and some of the factors altering the general risk of bilirubin toxicity. They note that much of the information needed to identify the individual at risk is still unavailable and remind their readers that their "recommendations should be reevaluated periodically as new data become available." I have serious concerns, however, with the second half of their paper which almost completely downplays the toxic potential of bilirubin, its often erratic expression, and its ability to cause a spectrum of damage ranging from frank kernicterus to insults that are so minor as to be compensated for completely over time.2-4

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