Beyond the medical model:Thinking differently about medical education and medical education research

Issue: In medical education, teaching is currently viewed as an intervention that causes learning. The task of medical education research is seen as establishing which educational interventions produce the desired learning outcomes. This ‘medical model’ of education does not do justice to the dynamics of education as an open, semiotic, recursive system rather than a closed, causal system. Evidence: Empirical ‘evidence’ of ‘what works’–that is, what is supposed to affect ‘learning’–has become the norm for medical educational improvements, where generalized summary outcomes of research are often presented as must-follow guidelines for myriad future educational situations. Such investigations of educational processes tend to lack an explicit engagement with the purposes of medical education, which we suggest to understand in terms of qualification (the acquisition of knowledge, skills, and understanding), socialization (becoming a member of the professional group) and subjectification (becoming a thoughtful, independent, responsible professional). In addition, investigations of educational processes tend to rely on causal assumptions that are inadequate for capturing the dynamics of educational communication and interaction. Although we see an increasing acknowledgement of the context-dependency of teaching practices toward educational aims, the currently prevailing view in medical education and educational research limits understanding of what is actually going on when educators teach and students participate in medical education–a situation which seriously hinders advancements in the field. Implications: In this paper, we hope to inform discussion about the practice of medical education by proposing to view medical education in terms of three domains of purpose (professional qualification, professional socialization, and professional subjectification) and with full acknowledgement of the dynamics of educational interaction and communication. Such a view implies that curriculum design, pedagogy, assessment, and evaluation should be reoriented to include and integrate all three purposes in educational practice. It also means that medical education research findings cannot be applied in just any teaching context without carefully considering the value of the suggested courses of actions toward the particular educational aims and teaching setting. In addition, medical educational research would need to investigate all three purposes and recognize the openness, semiotic nature, and recursivity of education in offering implic

The Effect of Spring Grass Availability on Dry Matter Intake of Early Lactation Dairy Cows

Spring grass availability has a major impact on dry matter intake (DMI) of dairy cows during early lactation. The objective of this study was to investigate the effects of opening farm cover (OFC) on DMI during early lactation. A twelve week experiment, which was split into two 6 week periods (Period 1 (Week 1 – 6) and period 2 (Week 7 – 12), was conducted over a two year period. A high and low OFC were established for two treatment groups; 1253 kg DM/ha (High grass = HG) and 887 kg DM/ha (Low grass = LG). Animals were randomly assigned to either the HG or LG treatment as they calved. Cows on the LG treatment were offered a lower daily herbage allowance (DHA) (10.99 kg DM/cow/day) and were offered silage supplementation at a rate of 3 kg DM/cow/day, while the cows on the HG treatment, were offered a higher DHA (13.98 kg DM/cow/day) with no silage supplementation. Dry matter intake was measured bi-weekly using the n-alkane technique. Silage supplementation on the LG treatment did not significantly affect (P \u3e 0.05) total DMI (TDMI), however, the LG cows TDMI was lower than HG cows throughout the experimental period. The inclusion of silage in the diet of early lactation dairy cows, resulted in a significantly (P \u3c 0.05) lower grass DMI, milk yield and milk protein concentration. Increasing OFC results in higher DHA which increases grass DMI and milk production

Working paper 18: Prescribed and wildland use fires in the southwest: Do frequency and timing matter?

Support for the use of prescribed fire and wildland fire use has increased in the Southwest in recent decades. However, the frequency and seasonality of these contemporary fires is typically different than historical fires, which burned during late spring and early summer in the driest and windiest time of the year. Contemporary changes in the landscape, including unprecedented fuel loads and human development in and around forests, now limit the ability to use fire during those times of the year. Most managed fire now occurs outside the windy fire season because it is safer and allows managers to provide greater protection to susceptible cultural or natural resources, such as historic structures or dry snags

A study of the interacting binary V 393 Scorpii

We present high resolution J-band spectroscopy of V 393 Sco obtained with the CRIRES at the ESO Paranal Observatory along with a discussion of archival IUE spectra and published broad band magnitudes. The best fit to the spectral energy distribution outside eclipse gives $T_{1}$= 19000 $\pm$ 500 $K$ for the gainer, $T_{2}$= 7250 $\pm$ 300 $K$ for the donor, $E(B-V)$= 0.13 $\pm$ 0.02 mag. and a distance of $d$= 523 $\pm$ 60 pc, although circumstellar material was not considered in the fit. We argue that V 393 Sco is not a member of the open cluster M7. The shape of the He I 1083 nm line shows orbital modulations that can be interpreted in terms of an optically thick pseudo-photosphere mimicking a hot B-type star and relatively large equatorial mass loss through the Lagrangian L3 point during long cycle minimum. IUE spectra show several (usually asymmetric) absorption lines from highly ionized metals and a narrow L$\alpha$ emission core on a broad absorption profile. The overall behavior of these lines suggests the existence of a wind at intermediate latitudes. From the analysis of the radial velocities we find $M_{2}/M_{1}$= 0.24 $\pm$ 0.02 and a mass function of $f$= 4.76 $\pm$ 0.24 M$\odot$. Our observations favor equatorial mass loss rather than high latitude outflows as the cause for the long variability.Comment: 13 pages, 14 figures, 7 tables. Accepted for publication in MNRAS, main journa

Aluminum removal from washed sludge

Purpose of this project is to reduce the volume of storage tank sludge to be treated by removing the Al and other nonradioactive components. In initial sludge surrogate studies, Al, Cr, and Zn showed the highest solubility in NaOH solutions; Ce and Zr were the least soluble of the elements tested. Removal of Fe and Bi approached 2%, the rest of the elements studied showed <1% removal. Amount of Al removed increased as the NaOH conc. increased from 0.1 to 6 M. Sequential washing of the sludge surrogate with 3 M NaOH removed 84% of the Al, 39% of the Cr, and 65% of the Zn. Surrogate sludges containing U and Th were also studied

Phase field modeling of electrochemistry I: Equilibrium

A diffuse interface (phase field) model for an electrochemical system is developed. We describe the minimal set of components needed to model an electrochemical interface and present a variational derivation of the governing equations. With a simple set of assumptions: mass and volume constraints, Poisson's equation, ideal solution thermodynamics in the bulk, and a simple description of the competing energies in the interface, the model captures the charge separation associated with the equilibrium double layer at the electrochemical interface. The decay of the electrostatic potential in the electrolyte agrees with the classical Gouy-Chapman and Debye-H\"uckel theories. We calculate the surface energy, surface charge, and differential capacitance as functions of potential and find qualitative agreement between the model and existing theories and experiments. In particular, the differential capacitance curves exhibit complex shapes with multiple extrema, as exhibited in many electrochemical systems.Comment: v3: To be published in Phys. Rev. E v2: Added link to cond-mat/0308179 in References 13 pages, 6 figures in 15 files, REVTeX 4, SIUnits.sty. Precedes cond-mat/030817

Development and testing of inorganic sorbents made by the internal gelation process for radionuclide and heavy metal separations

The objectives of this task are to develop, prepare, and test microspheres and granular forms of inorganic ion exchangers to remove radionuclides and heavy metals from waste streams occurring at various sites. Several inorganic materials, such as hexacyanoferrates, titanates, phosphates, and oxides have high selectivities and efficiencies for separating and removing radionuclides such as uranium, technetium, cesium, and strontium, and metals such as cobalt, silver, zinc, and zirconium from aqueous waste streams. However, these sorbents frequently exist only as powders and consequently are not readily adaptable to continuous processing such as column chromatography. Making these inorganic ion exchangers as microspheres or granular forms improves the flow dynamics for column operations and expands their practical applications. Microspheres of several materials have been prepared at ORNL, and the effectiveness of zirconium monohydrogen phosphate and hydrous titanium oxide microspheres for removing radionuclides from hot cell waste solutions has been demonstrated

MoveBox: Democratizing MoCap for the Microsoft Rocketbox Avatar Library

This paper presents MoveBox an open sourced toolbox for animating motion captured (MoCap) movements onto the Microsoft Rocketbox library of avatars. Motion capture is performed using a single depth sensor, such as Azure Kinect or Windows Kinect V2. Motion capture is performed in real-time using a single depth sensor, such as Azure Kinect or Windows Kinect V2, or extracted from existing RGB videos offline leveraging deep-learning computer vision techniques. Our toolbox enables real-time animation of the user’s avatar by converting the transformations between systems that have different joints and hierarchies. Additional features of the toolbox include recording, playback and looping animations, as well as basic audio lip sync, blinking and resizing of avatars as well as finger and hand animations. Our main contribution is both in the creation of this open source tool as well as the validation on different devices and discussion of MoveBox’s capabilities by end users