Creativity in a COVID-19 Virtual Learning Space

The COVID-19 pandemic has changed the world, and education too has been affected in many ways. In particular, much learning in higher education has moved to synchronous virtual spaces. Regardless of context, the principles of learning and teaching remain at the foreground, and the importance of developing active and creative learning spaces has never been greater. We are a group of one faculty member, six graduate students, and one teaching assistant who came together to write this paper so that we could share our online experiences in a clinical education course during the summer of 2020. We used a variety of active-learning and creative-teaching approaches. In this paper, we share our virtual use of video-based learning, gaming/crosswords, speed dating, blowing bubbles as a way to learn how to teach a psychomotor skill, image-based art, forum theatre, and found poetry. We share a crossword designed specifically for readers with which to grapple and our summary is presented as a found poem. Student author quotes are interspersed throughout the paper. Résumé La pandémie de COVID-19 a changé le monde et du même coup, a fait basculer le domaine de l’éducation. Principalement en enseignement supérieur une grande partie de l’apprentissage a maintenant lieu dans des espaces virtuels synchrones. Mais peu importe le contexte, les principes d’apprentissage et d’enseignement restent à l’avant-plan et le besoin de développer des espaces d’apprentissage actifs et créatifs est plus important que jamais. Notre groupe, composé d’un membre du corps professoral, de six étudiantes des cycles supérieurs et d’une auxiliaire d’enseignement, fut créé pour rédiger cet article et ainsi partager nos expériences d’un cours en ligne de formation clinique à l’été 2020, dans lequel une variété d’approches d’apprentissage actif et d’enseignement créatif ont été utilisées. Dans cet article, nous partageons notre utilisation virtuelle d’outils d’apprentissage tels les vidéos, jeux/mots croisés, rencontres express (speed dating), faire des bulles pour apprendre à enseigner une habileté psychomotrice, l’art visuel par l’image, le théâtre-forum et la poésie retrouvée. Nous partageons également un mot croisé conçu spécifiquement à l’intention de nos lecteurs et lectrices et notre résumé est présenté comme un poème retrouvé. Quelques citations d’étudiantes ayant participé à la rédaction, ont été insérées çà et là à travers l’articl

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London