The Baptist Church in Warren: Rehabilitation and Preservation Report

The Baptist Church in Warren is located in the Warren Waterfront Historic National Register District. Warren also has a Voluntary Historic District. Both the National Register Nomination and the Voluntary Historic District have regulations which pertain to changes to the exterior view shed of the building. Exterior work on this project will need to abide by the State of Rhode Island and the Providence Plantations Rehabilitation Code for existing buildings and structures and the Town of Warren Department of Building and Zoning. Exterior work done on a voluntary basis, according to the Warren Voluntary Historic District guidelines, will qualify for a 20% tax credit. The Baptist Church in Warren does not meet the requirements for the local and state tax credit

It teaches them to have a conversation in the real world : an analysis of how identity performances shape classroom discussions.

Although discussion has long played a role in classroom learning, recent focus on moving discussion away from the evaluative and toward the dialogic is key to understanding how discussion can be driven by multiple, shared understandings. Adopting a sociocultural perspective, this dissertation explores the ways in which identity performances shape one teacher and his students’ participation in classroom discussions. The theoretical framework guiding this study draws on the relationship between discourse and identities construction, with further attention given to improvisations of identities, figured worlds, and the ways in which power shapes discourse. This dissertation argues that performed identities shape the ways in which discussion participants engaged in critical talk, particularly in how participants develop disagreement, engage in perspective taking, and foster power, agency, and voice in the classroom. Ultimately, this study suggests that it is imperative to consider the ways in which teachers navigate disagreement in the classroom, provide opportunities for students to participate in political discussion, and consider the ways in which participants’ identities may shape discussion

Education of Residents in the Operating Room

Education of Residents in the Operating Room Megan Arnold1 and Lauren Alden1 Hubert K. Huang, Ph.D.1,2 1Division of Education, Lehigh Valley Health Network 2Research Scholar Program Mentor Abstract It is of paramount importance that the technical skills of surgical residents is evaluated. There are obstacles in the operating room setting, however, that interfere with teaching, such as limited time because of efficiency and patient safety. Debriefing after the case has been found to increase the educational value of a case. For this study, residents from the obstetrics and gynecology training program were observed performing four types of sentinel cases. The number of questions the resident asked and the number of teaching points the attending surgeon asked intraoperatively were observed and recorded. During a debriefing session following each case, the video footage collected was available for review and playback. Of the 40 cases that were observed throughout the study, sufficient data to analyze the educational value of the case was only collected from 15 of the cases. The overall average learning experience reported from the attending and resident surgeons for all collected cases was 4.5 on a 1 to 5 Likert scale. In conclusion, higher-level residents were found to ask less questions and were given fewer teaching points. SimCapture technology was found to be a useful tool for resident evaluation, and should be implemented into other specialties beyond obstetrics and gynecology. Keywords SimCapture, video capture, obstetrics and gynecology, OPRS, surgery, technical skill, evaluation, assessment Introduction Since the Accreditation Council for Graduate Medical Education (ACGME) created six general competencies to be used to evaluate medical education, the complicated system of assessing the proficiency of residents in the operating room has been based heavily on these competencies in many specialties. Patient care, medical knowledge, and interpersonal skills are among the competencies identified by the ACGME.3 Technical skill, however, is critical in the operating room and must also be evaluated. It is important for surgical residents to be objectively assessed concerning their technical skills during surgery. There are many ways to do so, ranging from direct observation to animal models to virtual simulation of procedures.1 Technical skill can be measured using standard validated scoring tools such as the Operative Performance Rating System (OPRS) and milestone evaluations. Financial pressure to increase productivity can limit the volume of surgeries residents are exposed to during their training period,1 therefore each teaching opportunity in the operating room is highly valuable. Residents must become proficient quickly. Video recording of residents performing surgical procedures is a method that may be utilized to assess technical skills without requiring extra staff members to be present in the operating room to watch the live procedure. The videos could be sent to various blinded faculty members for evaluation, which would increase the objectivity of the assessment.1 SimCapture is a portable, multi-camera system complete with video software that has been purchased by Lehigh Valley Health Network (LVHN). Implementation of this system is intended to enhance the education and feedback surgical residents receive after operative cases.2 The system is capable of connecting to the existing endoscopic towers in the operating rooms to record laparoscopic cases. Specific events that occur during the cases can be referenced during debriefing sessions to show residents areas of strength or weakness in their technical skills. The present study aims to assess whether video-capture technology, specifically the SimCapture system, is an effective evaluative tool for resident surgeons. Performance of the resident is to be evaluated by a proctoring surgeon as well as the resident themselves, using several evaluative tools. The patient as well as the operating surgeons will not be identifiable, as only the video from the endoscopic tower and the hands of the resident surgeon will be videotaped.2 Crowdsourcing is collecting services from a large number of people, generally through an online database.4 This study intends to eventually utilize crowdsourcing to evaluate resident performance of technical skills, in order increase objectivity and efficiency. In a recent study, Crowd Sourced Assessment of Technical Skill (CSATS) was used to rate skills of surgical trainees. Results of the study showed that CSATS is an accurate and fast way to gather technical skills assessments for residents, as inter-rater reliability between surgeons and the crowd was found to be excellent.4 Verbal interactions among resident and attending surgeons can serve to keep the operation flow moving forward, as well as provide teaching opportunities. The operating room is one of the most critical places for the education of residents to occur, despite the limited time that is available for teaching during surgical procedures.5 Educational value can be further increased by the attending and resident surgeons having a short debriefing following the case. Discussing the procedure and revisiting teaching points that were touched on during the operation helps solidify the information and leads to better performance in the future.5 Methods Participants comprised of different surgical residents from the obstetrics and gynecology training program. Attending surgeons in the respective programs were also involved in the study in that they participated in evaluation of the residents and debriefing sessions. All participants are employed by Lehigh Valley Health Network. Participants were selected based on operative schedules during weekdays; only resident surgeons performing five specified sentinel case types were recorded and evaluated. A SimCapture team made up of two summer research scholars oversaw the setup and recording of the selected procedures in the operating room. The SimCapture system, provided by B-Line Medical, was utilized for this project. OPRS and milestone evaluation forms were used by residents and attending physicians to rate the performance of the residents during the surgical procedures. An additional form was created for use by the SimCapture team to keep a record of the number of questions asked by the resident and teaching points given by the attending surgeon during each case. Four case types were evaluated for this study, including cesarean sections, operative hysteroscopy, laparoscopic bilateral tubal ligation, and robotic hysterectomy. A SimCapture team set up the system and cameras in the operating room immediately before or after the patient was brought into the operating room. Parts of the surgery that were performed by the resident surgeon were annotated using the SimCapture software for easy playback. During the procedure, a member of the SimCapture team counted the number of questions the resident surgeon asked and the number of teaching points that were offered by the attending surgeon throughout the procedure. After each case, both the resident surgeon and attending surgeon completed two evaluation forms, the OPRS (specific to the particular procedure) and milestone evaluations. A member of the SimCapture team then mediated a brief, five- to ten-minute discussion between resident and attending regarding the resident’s performance. This conversation allowed a comparison of the resident and attending surgeons’ perceptions of how the case went. Lastly, a short survey was sent electronically to both the resident and attending surgeon about their perception of the educational value of the procedure. Results After the collection of the needed data, the SimCapture team collected 40 cases that had usable material to be sent out to third party experts. Most of the results were coming from cesarean sections because they are simply the most common procedures that the SimCapture team was recording (almost always 3 a day are performed). We did run into some problems in the first couple weeks because of issues with the actual technology, and trial and error occurrences. Problems also occurred when cases were cancelled, pushed back, or the resident was simply not going to be performing any of the surgery. Some of the cases that were recorded could not be used due to HIPPA violations. Therefore, the SimCapture team has less data than was expected, but still enough for outside party members to create a fair assessment. Almost always, the attending surgeon, resident, and staff were receptive to the project overall. The SimCapture team was able to find that residents who are at a higher level generally ask less questions and are also given less teaching points, with the exception of some outliers due to the variety in attending surgeons and residents. Most residents who are their second year asked a lot of questions during the procedure as opposed to a fourth year resident. The debriefing sessions varied in length and quality; some were quick and precise and others were lengthy with a lot of description. Some debriefing sessions did not occur at all because of time or schedule conflicts The results from the outside party members is still to be collected although they have been sent out. The SimCapture team will then compare the results from a third party to the results of the attending evaluation of the same case. Discussion SimCapture technology provides an overall beneficial educational value of the residents’ crucial learning period. With the ability to watch the video at their leisure, and have a formal debriefing session with an attending, residents can become efficiently more competent. After analyzing data, we were able to find that both residents and attending physicians find the overall educational value to be very high, averaging a 4.2 on a 1 to 5 scale. The level of a resident was found to impact the number of teaching points as well as the amount of questions asked in the operating room. Many upper level residents asked fewer questions and received fewer teaching points whereas lower level resident tended to do the opposite. In these cases, the overall educational value was still ranked high, even if there were fewer questions asked and fewer teaching points. It was also found that there was no difference in the overall OPRS evaluation and the overall educational value, meaning that the OPRS is an evaluation tool of quality in which attending surgeons can formally recognize how well a resident is performing. Also, the OPRS provides a means for the resident and attending to sit down and have an open discussion about his or her performance, therefore increasing the education value. Because of this, SimCapture technology is crucial to a resident in training. They themselves can go back and watch the footage during a debriefing session and can assess their strengths and weakness. It would be beneficial to continue using SimCapture technology throughout not only the OB/GYN department but all other departments so that residents can more effectively and efficiently learn during a crucial time in their careers. Acknowledgements We would like to thank everyone who assisted us in our research and clinical observation. Thank you to Joe Patruno, President Elect of Medical Staff at Lehigh Valley Health Network, for his guidance and supervision. We could not have made the progress we did without his enthusiasm and help getting into the operating room. Thank you also to Martin A. Martino, gynecologic oncologist, and Timothy M. Pellini, obstetrics and gynecology, for their patience and assistance in getting this project off the ground. Thank you to our mentor and the Summer Research Scholars program director, Hubert Huang, for providing this opportunity for all of our personal and professional growth. References Moorthy Krishna, Munz Yaron, Sarker Sudip K,Darzi Ara. Objective assessment of technical skills in surgery BMJ 2003; 327 :1032 Patruno JE, Pellini T, Huang H, Cesanek P, Martino M. The use of video-capture technology to optimize the education, evaluate technical performance in residents. Greenberg JA, Irani JL, Greenberg CC, et al. The ACGME competencies in the operating room. Surgery.2007 Aug;142(2):180–4. Holst Daniel, Kowalewski Timothy M., White Lee W., Brand Timothy C., Harper Jonathan D., Sorenson Mathew D., Kirsch Sarah, and Lendvay Thomas S.. Journal of Endourology. May 2015, 29(5): 604-609. doi:10.1089/end.2014.0616. Roberts Nicole, Brenner Michael, Williams Reed, Kim Michael, Dunnington Gary. Capturing the teachable moment: A grounded theory study of verbal teaching interactions in the operating room. Surgery. 2012 May; 151(5):643-50

Analyzing Audio/Visual Data in the Digital Humanities

The Bloomsbury Handbook to the Digital Humanities reconsiders key debates, methods, possibilities, and failings from across the digital humanities, offering a timely interrogation of the present and future of the arts and humanities in the digital age.Comprising 43 essays from some of the field\u27s leading scholars and practitioners, this comprehensive collection examines, among its many subjects, the emergence and ongoing development of DH, postcolonial digital humanities, feminist digital humanities, race and DH, multilingual digital humanities, media studies as DH, the failings of DH, critical digital humanities, the future of text encoding, cultural analytics, natural language processing, open access and digital publishing, digital cultural heritage, archiving and editing, sustainability, DH pedagogy, labour, artificial intelligence, the cultural economy, and the role of the digital humanities in climate change. From this chapter: We offer an observation, perhaps even provocation: DH is undergoing an A/V turn. The combination of access to data either through digitization or born-digital sources alongside advances in computing from memory to deep learning is resulting in a watershed moment for the analysis of audio and visual data in the field

Renaming Blaxploitation by Looking at Today’s Film: Black Heroes, White Villains, and Trump’s America

This thesis seeks to re-characterize the blaxploitation as a genre of many positive contributions to Black film. In looking at the positive reception of today's Black film (2010-2018) I argue that much of what blaxploitation films are criticized for still exists today and are not inherently negative facets of the movies. Furthermore, I argue that blaxploitation is not exploitative in the ways it was demonized for, paying particular attention to audience reception, autonomy among Black characters, and autonomy among filmmakers. Despite previous treatments of the films, they present Black men in positions of power, Black women in positions of sexual ownership and desire, and a world and narrative that resonated with Black audiences. While today’s treatment of the films has improved, and blaxploitation is being revisited as an important part of film history and the Black aesthetic, I seek to further this argument with new emphasis on audience autonomy and by deconstructing the dichotomy that has always existed of substantive versus simple, entertaining fil

Finding the Open Spaces in Closed Systems: An Exploration of Critical Pedagogy with a Social Justice Directive in an Ontario Secondary School Classroom

This study examines the first experience of students, teachers, and an administrator in implementing a teacher-designed Leadership in Social Justice Program at a large urban Ontario secondary school. The program aimed to infuse a Freirean concept of critical pedagogical praxis (Freire, 1970/1993) in a grade 12 integrated educational experience with a social justice directive. Data were collected through two questionnaires and eight in-depth interviews. The data identified three areas of awareness that described ways in which student participants were impacted most profoundly (a) developing self-awareness, (b) understanding a new educational paradigm, and (c) finding a place in the world. The study found that the program was successful in highlighting the possibility for more meaningful education and engaged many students deeply; however, its success was limited by the lead teacher’s failure to fully grasp and implement tenets of Freirean critical pedagogy that involved the role of the teacher in pedagogical processes

Walk This Way: The Effects of Wearing a Knee Brace on Gait

Gait is defined as the way a person walks; the manner of his or her steps taken. Walking is a simple concept that can be taken for granted until it is lost. When a movement in the gait cycle is limited due to injury, changes in biomechanical and neurological factors occur. The purpose of this study was to measure and evaluate gait patterns of subjects walking with and without a Breg T Scope Premier Post-Op Knee Brace. Twenty-two Texas Lutheran University students were tested using the Dartfish Software program in the Kieffer Laboratory. Seven females and fifteen males, ranging in ages 18 to 28 years, completed two five meter walks. The first recording was of the subjects walking without the Post-Op Knee Brace and the second recording was of the subjects walking with the Post-Op knee brace. The knee brace was set to limit the subject twenty degrees of full knee extension, not allowing full range of motion. Each subject was recorded from the front view and from the side view; the videos were then analyzed through Dartfish Software. Eight reflective markers were applied to the subject prior to walking to distinguish boney landmarks for angle measurement. Using a Paired Two Sample t-Test, a significant difference was found for hip flexion and extension, hip abduction, dorsiflexion, and plantar flexion. Hip Flexion, hip extension, plantar flexion, and dorsiflexion decreased with the addition on the Post-Op Knee Brace and hip abduction increased, resulting in gait abnormalities