Making the Grade through the Front Door: Evaluation and Innovation in a Registered Practical Nurse to Bachelor of Science in Nursing Program

Background: Education of nurses from a diploma to a degree is a global phenomenon. However, bridging is often seen as a ‘backdoor’ route to becoming a Registered Nurse and very little evaluation data exists to challenge this notion. Objectives: This research project was undertaken to explore student characteristics, academic performance, outcomes, and experiences in an RPN-to-BScN Bridging Program. Design: A mixed method design was employed. Student admission and registrarial data were examined in relation to student characteristics and academic performance. Secondary data analysis was conducted on focus group interviews with 110 students that explored their perceptions of the impact of the program on their lives. Setting: Data was collected through University databases and face to face focus groups. Participants: Admission and registrarial data for all students admitted to a nursing bridging program in Ontario, Canada, from 2005-2011 were analyzed. Participants in the qualitative focus group interviews included 110 students across all years of the program. Methods: Descriptive and analytical statistics provide insight into student performance and characteristics. Qualitative data analysis was conducted using NVivo 9 with multi-member teams. Results: Data analysis reveals important insights into student academic performance, including exploration of relevant variables such as ongoing and cumulative GPA, entrance GPA, and program completion. Qualitative analysis provides insight into how studying in the program affects students’ lives. Conclusions: RPN-to-BScN education is not a “back door” to a nursing degree. Rather, it is a front door, as rigorous and as personally and professionally transformative as we expect a 4-year BScN Degree to be

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Early 20th C Russian painting? Raman identification of modern pigments on a pastel supposedly Painted by the renowned artist Natalia Goncharova

A pastel painting considered to have been painted by renowned Russian artist Natalia Goncharova in c. 1913 has been shown by Raman microscopy of the pigments to have been painted after 1952, with the identification of dioxazine violet. The implications of this discovery are discussed. This result highlights the need for reliable and perceptive dating procedures for valuation purposes

Overarching challenges to the implementation of competency-based medical education

Medical education is under increasing pressure to more effectively prepare physicians to meet the needs of patients and populations. With its emphasis on individual, programmatic, and institutional outcomes, competency-based medical education (CBME) has the potential to realign medical education with this societal expectation. Implementing CBME, however, comes with significant challenges. This manuscript describes four overarching challenges that must be confronted by medical educators worldwide in the implementation of CBME: (1) the need to align all regulatory stakeholders in order to facilitate the optimization of training programs and learning environments so that they support competency-based progression; (2) the purposeful integration of efforts to redesign both medical education and the delivery of clinical care; (3) the need to establish expected outcomes for individuals, programs, training institutions, and health care systems so that performance can be measured; and (4) the need to establish a culture of mutual accountability for the achievement of these defined outcomes. In overcoming these challenges, medical educators, leaders, and policy-makers will need to seek collaborative approaches to common problems and to learn from innovators who have already successfully made the transition to CBME