scholarly journals Relationship between ratings of performance in the simulated and workplace environments among emergency medicine residents

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 811-818 ◽  
Author(s):  
Nicholas Prudhomme ◽  
Michael O'Brien ◽  
Meghan M. McConnell ◽  
Nancy Dudek ◽  
Warren J. Cheung
Keyword(s):  
Emergency Medicine ◽  
Evidence Base ◽  
First Year ◽  
Training Environment ◽  
Professional Activities ◽  
Simulated Environments ◽  
Workplace Environments ◽  
Within Subjects ◽  
Over Time ◽  
Simulation Environments

ABSTRACTObjectivesThe Emergency Medicine (EM) Specialty Committee of the Royal College of Physicians and Surgeons of Canada (RCPSC) specifies that resuscitation entrustable professional activities (EPAs) can be assessed in the workplace and simulated environments. However, limited validity evidence for these assessments in either setting exists. We sought to determine if EPA ratings improve over time and whether an association exists between ratings in the workplace v. simulation environment.MethodsAll Foundations EPA1 (F1) assessments were collected for first-year residents (n = 9) in our program during the 2018–2019 academic year. This EPA focuses on initiating and assisting in the resuscitation of critically ill patients. EPA ratings obtained in the workplace and simulation environments were compared using Lin's concordance correlation coefficient (CCC). To determine whether ratings in the two environments differed as residents progressed through training, a within-subjects analysis of variance was conducted with training environment and month as independent variables.ResultsWe collected 104 workplace and 36 simulation assessments. No correlation was observed between mean EPA ratings in the two environments (CCC(8) = -0.01; p = 0.93). Ratings in both settings improved significantly over time (F(2,16) = 18.8; p < 0.001; η2 = 0.70), from 2.9 ± 1.2 in months 1–4 to 3.5 ± 0.2 in months 9–12. Workplace ratings (3.4 ± 0.1) were consistently higher than simulation ratings (2.9 ± 0.2) (F(2,16) = 7.2; p = 0.028; η2 = 0.47).ConclusionsNo correlation was observed between EPA F1 ratings in the workplace v. simulation environments. Further studies are needed to clarify the conflicting results of our study with others and build an evidence base for the validity of EPA assessments in simulated and workplace environments.

scholarly journals MP51: The relationship between entrustment scores in the simulated and workplace environments among emergency medicine residents

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S61-S61 ◽  
Author(s):  
N. Prudhomme ◽  
M. O'Brien ◽  
M. McConnell ◽  
N. Dudek ◽  
W. Cheung
Keyword(s):  
Emergency Medicine ◽  
Clinical Performance ◽  
Interobserver Reliability ◽  
Workplace Performance ◽  
Clinical Supervisors ◽  
Professional Activities ◽  
Simulation Performance ◽  
Within Subjects ◽  
The Relationship ◽  
Simulation Environments

Introduction: The Emergency Medicine Specialty Committee of the Royal College of Physicians and Surgeons of Canada (RCPSC) has specified that resuscitation Entrustable Professional Activities (EPAs) can be assessed in either the workplace or simulation environments; however, there is minimal evidence that such clinical performance correlates. We sought to determine the relationship between assessments in the workplace versus simulation environments among junior emergency medicine residents. Methods: We conducted a prospective observational study to compare workplace and simulation resuscitation performance among all first-year residents (n = 9) enrolled in the RCPSC-Emergency Medicine program at the University of Ottawa. All scores from Foundations EPA #1 (F1) were collected during the 2018-2019 academic year; this EPA focuses on initiating and assisting in the resuscitation of critically ill patients. Workplace performance was assessed by clinical supervisors by direct observation during clinical shifts. Simulation performance was assessed by trained simulation educators during regularly-scheduled sessions. We present descriptive statistics and within-subjects analyses of variance. Results: We collected a total of 104 workplace and 36 simulation assessments. Interobserver reliability of simulation assessments was high (ICC = 0.863). We observed no correlation between mean EPA scores assigned in the workplace and simulation environments (Spearman's rho=−0.092, p = 0.813). Scores in both environments improved significantly over time (F(1,8) = 18.79, p < 0.001, ηp2 = 0.70), from 2.9(SD = 1.2) in months 1-4 to 3.5(0.2) in months 9-12 (p = 0.002). Workplace scores (3.4(0.1)) were consistently higher than simulation scores (2.9(0.2)) (F(1,8) = 7.16, p = 0.028, ηp2 = 0.47). Conclusion: We observed no correlation between EPA F1 ratings of resuscitation performance between the workplace and simulation environments. Further studies should seek to clarify this relationship to inform our ongoing use of simulation to assess clinical competence.

Correlating entrance data and first year academic performance of students enrolled in the Integrated Master in Mechanical Engineering at the University of Porto

2021 ◽  
pp. 030641902110156
Author(s):  
TMGP Duarte ◽  
AM Lopes ◽  
LFM da Silva
Keyword(s):  
Academic Performance ◽  
Secondary School ◽  
Undergraduate Students ◽  
Mechanical Engineering ◽  
Institutional Factors ◽  
First Year ◽  
Female Type ◽  
The University ◽  
First Year University ◽  
Over Time

Understanding how the academic performance of first year undergraduate students is influenced by home, personal and institutional factors is fundamental to delineate policies able to mitigate failure. This paper investigates possible correlations between the academic performance of students at the end of high school with their achievements at the end of first year university. Data for students in the Integrated Master in Mechanical Engineering (MIEM) program within the Faculty of Engineering at the University of Porto are analysed for the period 2016/2017 to 2019/2020. The students’ performance is measured by two metrics and the students are structured as a whole and by groups, according to their gender (Male/Female), type of secondary school (Public/Private), living place (Away/Home) and the rank of MIEM in their application list of options (Option 1/Option 2–6). The information is organized statistically and possible correlations between the data are investigated. The analysis reveals limited correlation between the two metrics, meaning that all students may exhibit good or poor results at the end of first year in MIEM, independent of their status at entrance. An unanticipated pattern is exhibited for the group Option 2–6, since it shows that, despite entering into MIEM without top application marks, the students in this group can perform as well as the others. This behavior is consistent over time.

Interaction of Cottonwood Clones with Site and Planting Year

1973 ◽  
Vol 3 (3) ◽  
pp. 329-332 ◽  
Author(s):  
C. A. Mohn ◽  
W. K. Randall
Keyword(s):  
First Year ◽  
Diameter Growth ◽  
Mississippi Valley ◽  
Lower Mississippi Valley ◽  
Large Clone ◽  
Over Time

Height and diameter growth to age three and the number of first year branches were analyzed for 25 cottonwood clones grown in six plantations in central Mississippi. Plantations were on two contrasting sites and planted in three consecutive years. Results showed small clone × planting year interactions and large clone × site interactions for all parameters. In the lower Mississippi Valley, therefore, emphasis should be placed on testing over a range of sites rather than replicating over time.

scholarly journals Three Evidence Based Methods to Compensate for a Lack of Subject Background when Ordering Chemistry Monographs

2008 ◽  
Vol 3 (3) ◽  
pp. 3
Author(s):  
Robert A. Wright
Keyword(s):  
Statistical Analysis ◽  
Statistical Significance ◽  
Evidence Base ◽  
Circulation Rate ◽  
Evidence Based ◽  
Practical Application ◽  
Present Evidence ◽  
Library System ◽  
Over Time ◽  
Selection Of

Objective – The aim of this article is to present evidence based methods for the selection of chemistry monographs, particularly for librarians lacking a background in chemistry. These methods will be described in detail, their practical application illustrated, and their efficacy tested by analyzing circulation data. Methods – Two hundred and ninety-five chemistry monographs were selected between 2005 and 2007 using rigorously-applied evidence based methods involving the Library's integrated library system (ILS), Google, and SciFinder Scholar. The average circulation rate of this group of monographs was compared to the average circulation rate of 254 chemistry monographs selected between 2002 and 2004 when the methods were not used or were in an incomplete state of development. Results – Circulations/month were on average 9% greater in the cohort of monographs selected with the rigorously-applied evidence based methods. Further statistical analysis, however, finds that this result can not be attributed to the different application of these methods. Conclusion – The methods discussed in this article appear to provide an evidence base for the selection of chemistry monographs, but their application does not change circulation rates in a statistically significant way. Further research is needed to determine if this lack of statistical significance is real or a product of the organic development and application of these methods over time, making definitive comparisons difficult.

scholarly journals Situation-Background-Assessment-Recommendation (SBAR) and Emergency Medicine Residents' Learning of Case Presentation Skills

2012 ◽  
Vol 4 (3) ◽  
pp. 370-373 ◽  
Author(s):  
Matthew C. Tews ◽  
J. Marc Liu ◽  
Robert Treat
Keyword(s):  
Emergency Medicine ◽  
Communication Skills ◽  
Comfort Level ◽  
Future Research ◽  
First Year ◽  
Clinical Environment ◽  
General Applicability ◽  
Good Reliability ◽  
First Case ◽  
Patient Handoffs

Abstract Background To date, no standardized presentation format is taught to emergency medicine (EM) residents during patient handoffs to consulting or admitting physicians. The Situation-Background-Assessment-Recommendation (SBAR) is a common format that provides a consistent framework to communicate pertinent information. Objective The objective of this study was to describe and evaluate the feasibility of using SBAR to teach interphysician communication skills to first-year EM residents to use during patient handoffs. Methods An educational study was designed as part of a pilot curriculum to teach first-year EM residents handoff communication skills. A standardized SBAR reporting format was taught during a 1-hour didactic intervention. All residents were evaluated using pretest/posttest simulated cases using a 17-item SBAR checklist initially, and then within 4 months to assess retention of the tool. A survey was distributed to determine resident perceptions of the training and potential clinical utility. Results There was a statistically significant improvement from the resident scores on the pretest/posttest of the first case (P  =  .001), but there was no difference between posttest of the first case and pretest of the second case (P  =  .34), suggesting retention of the material. There was a statistically significant improvement from the pretest and posttest scores on the second case (P  =  .001). The survey yielded good reliability for both sessions (Cronbach alpha  =  0.87 and 0.89, respectively), demonstrating statistically significant increases for the perceived quality of training, presentation comfort level, and the use of SBAR (P  =  .001). Conclusion SBAR was acceptable to first-year EM residents, with improvements in both the ability to apply SBAR to simulated case presentations and retention at a follow-up session. This format was feasible to use as a training method and was well received by our resident physicians. Future research will be useful in examining the general applicability of the SBAR model for interphysician communications in the clinical environment and residency training programs.

scholarly journals Multimorbidity of chronic non-communicable diseases: burden, care provision and outcomes over time among patients attending chronic outpatient medical care in Bahir Dar, Ethiopia—a mixed methods study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051107 ◽  
Author(s):  
Fantu Abebe Eyowas ◽  
Marguerite Schneider ◽  
Shitaye Alemu ◽  
Fentie Ambaw Getahun
Keyword(s):  
Quantitative Study ◽  
Qualitative Data ◽  
Premature Mortality ◽  
Evidence Base ◽  
Communicable Diseases ◽  
Bahir Dar ◽  
Multiple Sources ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Over Time

IntroductionMultimorbidity refers to the presence of two or more chronic non-communicable diseases (NCDs) in a given individual. It is associated with premature mortality, lower quality of life (QoL) and greater use of healthcare resources. The burden of multimorbidity could be huge in the low and middle-income countries (LMICs), including Ethiopia. However, there is limited evidence on the magnitude of multimorbidity, associated risk factors and its effect on QoL and functionality. In addition, the evidence base on the way health systems are organised to manage patients with multimorbidity is sparse. The knowledge gleaned from this study could have a timely and significant impact on the prevention, management and survival of patients with NCD multimorbidity in Ethiopia and in LMICs at large.Methods and analysisThis study has three phases: (1) a cross-sectional quantitative study to determine the magnitude of NCD multimorbidity and its effect on QoL and functionality, (2) a qualitative study to explore organisation of care for patients with multimorbidity, and (3) a longitudinal quantitative study to investigate disease progression and patient outcomes over time. A total of 1440 patients (≥40 years) on chronic care follow-up will be enrolled from different facilities for the quantitative studies. The quantitative data will be collected from multiple sources using the KoBo Toolbox software and analysed by STATA V.16. Multiple case study designs will be employed to collect the qualitative data. The qualitative data will be coded and analysed by Open Code software thematically.Ethics and disseminationEthical clearance has been obtained from the College of Medicine and Health Sciences, Bahir Dar University (protocol number 003/2021). Subjects who provide written consent will be recruited in the study. Confidentiality of data will be strictly maintained. Findings will be disseminated through publications in peer-reviewed journals and conference presentations.

A Longitudinal Investigation of Dropout from College in the United States

2002 ◽  
Vol 4 (2) ◽  
pp. 173-201 ◽  
Author(s):  
Terry T. Ishitani ◽  
Stephen L. DesJardins
Keyword(s):  
United States ◽  
College Students ◽  
Financial Aid ◽  
The United States ◽  
Dropout Rates ◽  
First Year ◽  
Student Financial Aid ◽  
Student Dropout ◽  
Longitudinal Investigation ◽  
Over Time

This study investigates the dropout behavior of college students in the United States. Previous attrition studies have typically focused on dropout at specific points in time, such as the first year of enrollment. In this study we examine the timing of dropout over a five-year period and find that factors that affect student dropout often have effects that change over time. For instance, the results demonstrate that students who receive financial aid generally have lower dropout rates than non-aided students. But of special interest is our findings that dropout rates vary depending on the amount and timing of student financial aid.

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