How an Arts-Based Clinical Skills Set Can Be Assessed During OSCEs

Background: Arts-based activities’ roles in medical education is to challenge students to cultivate clinical skills using ART (aesthetics, reflection, time). ART activities offer opportunities for students to cultivate creative dimensions of their clinical skills and to reflect on their responses to uncertainty and ambiguity. Faculty, however, are challenged to structure these learning activities in diverse, sometimes unfamiliar, health care settings. Methods: This study explored preclerkship medical students’ responses to participating in ART activities presented in the common medical educational format of an objective structured clinical exam (OSCE). Activities included interpreting fine art (eg, images and poetry) and drawing a simulated patient. The discussion section transcript and student sketchbooks were analyzed to identify themes related to participating in the study. Results: Use of arts-based activities elicited behaviors similar to those observed in students’ responses to formal summative OSCEs, although students also wrestled with challenges and expressed their subjective impressions. Conclusions: This study offers an arts-based tool set capable of being delivered within the familiar medical education setting and established structure of the OSCE

Hungry for Respect: Discrimination Among Adults Using Emergency Food Services

Objectives: We examined how adults using emergency food services report discrimination and how these reports may be associated with well-being. Methods: Data come from a survey (n=318) and from five focus groups of adults using emergency food services, conducted between 2003-2004. The survey included measures derived from the Everyday Discrimination Scale and the Centers for Epidemiologic Studies Depression Scale (CES-D). Focus groups were analyzed with content analysis. Results: The survey data suggest that everyday discrimination was associated with the CES-D, conditional on covariates. Focus group data are consistent with the survey results and suggest several avenues for future research, including how some individuals may forgo access to food and medications in order to protect their dignity in the face of discrimination. Conclusions: Qualitative and quantitative data converge into a similar theme - discrimination may be an important factor associated with well-being

The effect of visual support strategies on the quality of life of children with cerebral palsy and cerebral visual impairment/perceptual visual dysfunction in Nigeria: study protocol for a randomized controlled trial.

BACKGROUND: Cerebral visual impairment (CVI), including perceptual visual dysfunction (PVD), is common in children with cerebral palsy (CP). Inventories of questions relating to practical aspects of visual perception in everyday life, in particular the closed-ended Insight Questions Inventory (IQI), can be used to assess CVI/PVD. Studies linking responses to the inventory with specific visual support strategies, aimed at modifying the child's environment and/or behaviour to minimize the impact of the CVI/PVD, have been piloted. The IQI and tailored strategies have not been used in an African population, nor have they been tested in a controlled trial. This trial will compare the effectiveness of the IQI and linked visual support strategies versus general supportive treatments on the quality of life of children with CVI/PVD and CP through a randomized controlled trial. METHODS/DESIGN: This is a prospective, double-blind, parallel-arm, randomized controlled trial. The primary outcome is change in quality of life scores between the two arms of the trial at 6 weeks, assessed using the Paediatric Quality of Life Inventory (PedsQL) generic 4.0 and CP 3.0 module. All children will undergo baseline assessment including the Open Questions Inventory, IQI, PedsQL 3.0, PedsQL 4.0 generic, and the Strengths and Difficulties Questionnaire (SDQ). Eligible children with CP aged 4 years to < 16 years will be stratified and blocked by the age groups 4-9 and 10 to < 16 years and by Gross Motor Function Classification System (GMFCS) levels 1-3 and 4-5. Families in the intervention arm will receive tailored insight visual support strategies and telephone calls during the 6-week trial period. The control arm will receive standard treatment and the intervention after the 6-week trial period. Follow-up interviews will be performed in both arms at 6 weeks with a repeat administration of the PedsQL CP 4.0 and 3.0, the IQI and the SDQ. Secondary outcomes include a change in functional vision. DISCUSSION: This randomized controlled trial will provide evidence of the effectiveness of this intervention for children with CP in a resource-poor setting. TRIAL REGISTRATION: Pan African Clinical Trials Registration, PACTR201612001886396 . Registered on 3 December 2016

Regulating Access to Adult Content (with Privacy Preservation)

In the physical world we have well-established mechanisms for keeping children out of adult-only areas. In the virtual world this is generally replaced by self declaration. Some service providers resort to using heavy-weight identification mechanisms, judging adulthood as a side effect thereof. Collection of identification data arguably constitutes an unwarranted privacy invasion in this context, if carried out merely to perform adulthood estimation. This paper presents a mechanism that exploits the adult's more extensive exposure to public media, relying on the likelihood that they will be able to recall details if cued by a carefully chosen picture. We conducted an online study to gauge the viability of this scheme. With our prototype we were able to predict that the user was a child 99% of the time. Unfortunately the scheme also misclassified too many adults. We discuss our results and suggest directions for future research

Edusource: Canada's Learning Object Repository Network

An alliance of Canadian Universities and government agencies pooled their resources to establish a network to share and combine Learning Objects from a variety of sources and further develop this technology. In the process, they resolved many learning, logistical, and legal problems and moved this technology forward by an order of magnitude. Principal goals include: nationwide interoperability, network of repositories, linked servers, repository software programs, national and international standards, digital rights management, business and management models, evaluation and feedback, dissemination of results, and bilingual access to all Canadians, particularly learners with disabilities. The defined tasks were sub-divided into nine work packages, each with a lead institution as package manager

Involvement of right dorsolateral prefrontal cortex in ill-structured design cognition: An fMRI study

In ill-structured tasks, the problem to be solved is poorly specified and there is no unique correct solution. Most evidence on brain mechanisms involved in dealing with such tasks comes from neuropsychology. Here, we developed an ill-structured design task suitable for testing in a functional neuroimaging environment and compared it with a matched well-structured problem-solving task using fMRI. Consistent with prior neuropsychological results, the design task was associated with greater activity in right dorsolateral prefrontal cortex compared with problem solving. This differential activity was specific to the problem studying phase rather than performance. Furthermore, the design and problem-solving tasks differed not only in overall levels of brain activity but also in patterns of functional interactions between brain regions. These results provide new evidence on the role of right dorsolateral prefrontal cortex in ill-structured situations, such as those involved in design cognition. Additionally, these results confirm the suitability of functional neuroimaging for studying such situations

Facial expressions depicting compassionate and critical emotions: the development and validation of a new emotional face stimulus set

Attachment with altruistic others requires the ability to appropriately process affiliative and kind facial cues. Yet there is no stimulus set available to investigate such processes. Here, we developed a stimulus set depicting compassionate and critical facial expressions, and validated its effectiveness using well-established visual-probe methodology. In Study 1, 62 participants rated photographs of actors displaying compassionate/kind and critical faces on strength of emotion type. This produced a new stimulus set based on N = 31 actors, whose facial expressions were reliably distinguished as compassionate, critical and neutral. In Study 2, 70 participants completed a visual-probe task measuring attentional orientation to critical and compassionate/kind faces. This revealed that participants lower in self-criticism demonstrated enhanced attention to compassionate/kind faces whereas those higher in self-criticism showed no bias. To sum, the new stimulus set produced interpretable findings using visual-probe methodology and is the first to include higher order, complex positive affect displays