Stronger but Not Faster : Flipped Classroom Teaching Significantly Improves Resident\u27s Skills but Not Speed

Objective: Flipped classroom teaching is a nontraditional education model where instructional content is delivered outside the classroom. This constructivist approach emphasizes self-direction, active inquiry; the instructor’s role is to foster critical reflection and facilitate the application and understanding of concepts. Our objective was to study the difference in time taken and quality of patch graft angioplasty performed by residents with and without flipped teaching. Methods: The study was set in a skills simulation teaching session overseen by attending surgeons. The intervention consisted of introducing a video outlining the technical aspects of patch graft angioplasty, watched before the session. The first group (2018 postgraduate year [PGY] 1 and 2 residents) was given instructions at the time of the class without a prior educational video or resources (Figs 1 and 2). The second group (2019, 2020 PGY 1 and 2 residents) was asked to watch a 20-minute video on the technical aspects of the procedure before the class. Participants then performed a standardized patch graft closure of a 1 cm arteriotomy using a polytetrafluoroethylene patch. The groups were timed. The quality of the closure was tested by assessing the number of leaks and the quantity of leak of the patch (Fig 3). Bivariate analysis sample t-tests were used for statistical analysis. P value \u3c.05 was considered significant. Pre- and post-session surveys were conducted to assess residents’ experience. Results: Forty-two residents (PGY 1 and 2) were enrolled in the study, 15 in nonintervention group 1 and 27 in intervention group 2, compared with 7 staff vascular surgeons. The mean completion time was 26 minutes (group 1) vs 27 minutes (group 2), P ¼ .6. The staff completion time was 12 minutes, P ¼ .001. The number of major leaks (not needle holes) was 2.0 (group 1) vs 1.6 (group 2), P ¼ .007, none for staff. The total quantity of leak was 42 mL (group 1) vs 15 mL (group 2), P ¼ .0001 (Table I). There was perceived improvement in skill on analyzing pre- and post-session surveys (Table II). Conclusions: A structured educational intervention, watching a video of a procedure before the skills session, did not change the time needed to complete the skill. There was improvement in the technical outcome of the procedure defined by a decrease in the total quantity of leak. Reversed classroom teaching significantly improves resident’s skill, not speed. There was also a perceived improvement in skill by participants. This is a pilot study and further instructional outcomes are being studied

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies

Cold atoms in space: community workshop summary and proposed road-map

We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies

Infectious disease providers’ knowledge of and engagement in quality improvement

BACKGROUND: Although engagement of infectious disease physicians has been demonstrated to improve clinical outcomes in a variety of disease states, the extent of infectious disease (ID) physician engagement in quality improvement (QI) or their knowledge of QI has not been assessed. METHODS: A 12-question, web-based survey was distributed to members of the Infectious Diseases Society of America (IDSA) between August and October 2019 to assess knowledge of and engagement in QI. The survey link was sent to IDSA members who self-identified patient care as their primary professional activity. RESULTS: Responses were received from 200 individuals (5.4% response rate, which is just below the standard IDSA survey response rate of 6%), consisting of 175 adult infectious disease physicians (IDPs). Most respondents were employed in a hospital or clinic (41%), private or group practice (25%), or university/medical center (24%). Fifty-eight percent of respondents currently participate in QI projects, while 38% serve on QI oversight committees. Among respondents, 27% reported not being engaged in QI. Infection prevention/hospital epidemiology (77%), stewardship (72%), and antimicrobial resistance (56%) were the most commonly reported measure types. Respondents reported barriers that limited participation in QI, including cost (61%), lack of time (56%), lack of data collection resources (48%), and lack of an ID-specific registry (46%). IDPs report significant interest in additional training in QI and new quality measures. CONCLUSIONS: Although IDPs participate in QI, there are gaps in QI knowledge and measurement systems. The low response rate of our survey also suggests a lack of engagement in QI among IDPs. Closing these gaps will benefit ID in a value-driven health care economy

Abstract 1122‐000154: Effect of Intravenous Thrombolysis on Early Clot Lysis in Large Vessel Occlusion Strokes Undergoing Thrombectomy

Introduction: Intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) are both standard of care treatments for acute ischemic stroke patients with large vessel occlusion (LVO) who are eligible for one or both treatments. IVT may result in early recanalization in some patients with LVO. The objective of this study is to analyze whether IVT influences pre‐thrombectomy clot lysis in LVO acute ischemic strokes. Methods: We reviewed prospectively collected data for all patients with LVO ischemic strokes who were transferred to the angiography suite with intention to perform EVT at a single comprehensive stroke center between January 2016 to December 2018. We identified subjects who showed partial or complete clot lysis vs no lysis based on the first angiographic picture of the occluded territory at the time of the initial vessel selection. Descriptive statistics were used to summarize demographic and clinical characteristics. We compared key predictor variables between lysis and no lysis groups including baseline variables, effect of IVT, time from IVT to groin puncture, LVO location, final modified treatment in cerebral ischemia (mTICI) score and discharge Modified Rankin Scale (mRS). t‐test or Kruskal‐Wallis test for continuous variables and chi square test or Fisher’s Exact test for categorical variables. Results: Two hundred and fifty‐nine patients were included. Among these patients, 10.8% (28/259) showed partial or complete lysis of the clot vs 89.2% (231/259) with no lysis. Among these patients who showed clot lysis, 16/28 (57.1%) received IVT. The use of IVT did not show differences between both groups (p = 0.18). There were no differences in the baseline characteristics except for gender, which was the only variable significantly associated with clot lysis. Men had 2‐fold higher odds of spontaneous lysis compared to females (OR [95%CI]: 2.39 [1.01, 5.65], p = 0.04). There was significant difference in the final mTICI between both groups (p <0.001). Conclusions: Our study showed that IVT in a modern practice was not associated with pre‐thrombectomy lysis. Some patients had pre‐thrombectomy lysis despite not receiving IVT