The practicum script concordance test: an online continuing professional development format to foster reflection on clinical practice.

Introduction: Judgment in the face of uncertainty is an important dimension of expertise and clinical competence. However, it is challenging to conceive continuing professional development (CPD) initiatives aimed at helping physicians enhance their clinical judgment skills in ill-defined situations. We present an online script concordancebased CPD program (the Practicum Script Concordance Test, copyright c2006 by Practicum Foundation), a tool that can be used to support health professionals in the development of their reflective clinical reasoning ability. We describe the rationale and principles and report on the implementation of 2 online programs based on this new CPD initiative. Method: The Practicum Script Concordance Test program consists of daily testing and feedback over the course of a year using SCT items. Feedback is both global (eg, health professionals are told their cumulative mean score) and specific (eg, they can view the expert panel’s responses together with their justifications for their answers). Participants have the option of contacting a personal tutor, to whom they can send questions. Data regarding feasibility, participation, and acceptability were collected. Results: Initial implementation took place inMexico where 1901 physicians (1349 paediatricians, 552 cardiologists) were enrolled in Practicum programs. Around 70% of those enrolled pursued the program and were very satisfied with its format and content. The online format was an important factor in the development and maintenance of the programs. Dropouts had issues with the SCT concept and the time required to participate. Discussion: The on-line Practicum Script Concordance Test program was designed to foster expertise development based on practice, reflection and feedback. Although further research is needed to examine its impact physicians’ practice and ultimately on patient outcomes, it is an original and promising development in CPD

Size and shape analysis of gunflints from the British shipwreck Deltebre I (1813), Catalonia, Spain: a geometric morphometric comparison of unused and used artefacts

Gunflints represent a worldwide feature of lithic technology in modern times. This type of artefact was used to ignite the powder of firearms through a flintlock mechanismfrom the middle-seventeenth to the early-twentieth century in different contexts aroundthe world. Taking what is a novel and exploratory approach in historical archaeology, this paper offers a quantitative analysis of a random sample of 200 unused gunflints recovered from the British shipwreck Deltebre I. This cargo ship belonged to an alliedconvoy that unsuccessfully tried to liberate Tarragona city from the Napoleonic forces, and sunk in the Ebro river delta, Catalonia, Spain, in 1813. The results from size and shape characterisation of the unused gunflints using geometric morphometric methodsare presented. In order to assess morphometric variation between used and unused artefacts, this sample was compared with published images of 22 used British gunflints from different archaeological contexts. Finally, the usefulness of applied methodology to quantitatively characterise the design and morphometric variations of this kind of artefacts is highlighted.Fil: Ciarlo, Nicolás Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras. Instituto de Arqueología; ArgentinaFil: Charlin, Judith Emilce. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; Argentina. Universidad de Buenos Aires. Facultad de Filosofía y Letras; ArgentinaFil: Alberti, Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; ArgentinaFil: Buscaglia, Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Multidisciplinario de Historia y Ciencias Humanas; ArgentinaFil: Vivar Lombarte, Gustau. Centro de Arqueología Subacuática de Catalunia; EspañaFil: Geli Mauri, Rut. Centro de Arqueología Subacuática de Catalunia; Españ