Un examen approfondi de la notion de compatibilité en enseignement médical : un succès garanti ou une menace pour l'inclusivité?

Background: Finding applicants that fit in with educational environments is a goal of many educators in hopes that it will lead to successful training. “Fit” is used colloquially to describe a general feeling, however the field of study has grown to include specific terms describing the compatibility between people and their environments, organizations, and jobs. Despite common use, the term is used often but non-specifically in medical education. This review aims to examine the current literature of fit in medical education, how fit is defined, measured and whether it correlates to educational outcomes. Methods: A systematic database search was conducted in 2024 with Medline, Embase, APA PsychINFO, ERIC and Education Source from 1970 to April 23, 2024. Key search terms included fit, student, medicine, clinical, education. Relevant data included definitions of fit, measurement tools, and correlation with educational outcomes. The standard six-step scoping review framework and PRISMA-ScR reporting guidelines were used. Results: The search identified 1960 non-duplicate articles, 11 of which were included in the review after screening. Fit was specifically defined in only threearticles and was measured primarily through personality and value testing with interviews and surveys. Educational outcomes correlated positively with fit, however were studied in just three articles. Conclusions: Person-organization fit may correlate positively with medical education outcomes however there is limited research in this field. Further research should explore methods in evaluating for fit in trainee selection while focusing on the risk of discrimination based on intrinsic biases.Contexte : Trouver des candidats qui s'adaptent aux environnements éducatifs est un objectif pour de nombreux éducateurs dans l'espoir que cela conduise à une formation réussie. On parlera familièrement de « bon candidat », de « bonne recrue » pour décrire un sentiment général, mais le domaine d'étude s'est développé pour inclure des termes spécifiques décrivant la compatibilité entre les personnes et leur environnement, les organisations et les emplois. Malgré son usage courant, le terme est souvent utilisé, mais de manière non spécifique, dans le domaine de l'enseignement médical. Cette étude a pour but d'examiner la littérature actuelle sur la compatibilité dans l'enseignement médical, la façon dont la compatibilité est définie et mesurée et si elle est en corrélation avec les résultats de l'enseignement. Méthodes : Une recherche systématique a été effectuée dans les bases de données Medline, Embase, APA PsychINFO, ERIC et Education Source entre 1970 et le 23 avril 2024. Les termes clés de recherche comprenaient compatibilité (fit), étudiant, médecine, clinique, éducation. Les données pertinentes comprenaient les définitions de l'adéquation, les outils de mesure et la corrélation avec les résultats éducatifs. Le processus standard d’examen de la portée en six étapes ainsi que les recommandations du PRISMA-ScR ont été utilisés. Résultats : L’étude a permis d'identifier 1960 articles non dupliqués, dont 11 ont été inclus dans la revue après sélection. La compatibilité (le fit) n'a été définie spécifiquement que dans trois articles et a été mesurée principalement par des tests de personnalité et de valeur au moyen d'entretiens et de sondages. Les résultats sur le plan éducationnel sont en corrélation positive avec la compatibilité, mais ils n'ont été étudiés que dans trois articles. Conclusions : La compatibilité entre la personne et l'organisation peut être en corrélation positive avec les résultats des études médicales, mais les recherches dans ce domaine sont limitées. D'autres recherches devraient explorer les méthodes d'évaluation de la compatibilité lors de la sélection des apprenants, tout en considérant le risque de discrimination basé sur les biais intrinsèques

Canadian research contributions to low vision rehabilitation: A quantitative systematic review

Purpose: Low vision rehabilitation research is a quickly growing area, due in part to the increase in the demand for services geared at older adults with age-related vision loss. Various professions collaborate to provide such rehabilitation services; however, it is currently unclear which profession takes the leading role in advancing the frontiers of low vision rehabilitation research. A recent review article proposed that in Canada, this role is held by physicians. The present study was conducted to replicate these findings under conditions of a systematic review. Method: A search of seven databases and a hand-search of four vision rehabilitation journals identified articles on low vision rehabilitation whose first author had an affiliation at a Canadian institution. Data on professional credentials, funding source, and study content was tabulated. Results: Of the 1,870 references, data from 215 eligible articles were extracted. The top four author credentials were optometrists (with or without PhD; 56 papers, 26.0%), followed by researchers with PhDs only (48 papers, 22.3%), researchers with master’s degrees (43 papers, 20.0%), and medical doctors (with or without PhD; 39 papers, 18.1%). Vision rehabilitation journals published 38 per cent of all papers, followed by ophthalmology (27%) and optometry journals (22%). Publications in the past 11 years amounted to over 50 per cent of the output over the 64-year publication history in this field in Canada, 70 per cent of which were based in universities. Conclusion: The results reflect the mosaic structure of low vision rehabilitation research in Canada, highlighting collaborations among researchers, clinicians, funding sources and rehabilitation agencies. Given its multidisciplinary nature, low vision rehabilitation research seems to be driven by collaboration among the professions

A scoping review of Fit in medical education: a guaranteed success, or a threat to inclusivity?

Background: Finding applicants that fit in with educational environments is a goal of many educators in hopes that it will lead to successful training. “Fit” is used colloquially to describe a general feeling, however the field of study has grown to include specific terms describing the compatibility between people and their environments, organizations, and jobs. Despite common use, the term is used often but non-specifically in medical education. This review aims to examine the current literature of fit in medical education, how fit is defined, measured and whether it correlates to educational outcomes. Methods: A systematic database search was conducted in 2024 with Medline, Embase, APA PsychINFO, ERIC and Education Source from 1970 to April 23, 2024. Key search terms included fit, student, medicine, clinical, education. Relevant data included definitions of fit, measurement tools, and correlation with educational outcomes. The standard six-step scoping review framework and PRISMA-ScR reporting guidelines were used. Results: The search identified 1960 non-duplicate articles, 11 of which were included in the review after screening. Fit was specifically defined in only threearticles and was measured primarily through personality and value testing with interviews and surveys. Educational outcomes correlated positively with fit, however were studied in just three articles. Conclusions: Person-organization fit may correlate positively with medical education outcomes however there is limited research in this field. Further research should explore methods in evaluating for fit in trainee selection while focusing on the risk of discrimination based on intrinsic biases

A protocol for a scoping review of equity measurement in mental health care for children and youth

Background: Mental health (MH) problems are among the most important causes of morbidity and mortality for children and youth. Problems of lack of equity in child and youth MH services (CYMHS)-including, but not limited to, problems in inaccessibility and quality of services-are widespread. Characterizing the nature of equity in CYMHS is an ongoing challenge because the field lacks a consistent approach to conceptualizing equity. We will conduct a scoping review of how equity in MH services for children and youth has been defined, operationalized, and measured. Our objectives are to discover: (1) What conceptual definitions of equity are used by observational studies of CYMHS?; (2) What service characteristics of CYMHS care do indices of equity cover?; (3) What population dimensions have been used to operationalize equity?; (4) What statistical constructs have been used in indices that measure CYMHS equity?; and (5) What were the numerical values of those indices? Methods: The following databases will be searched: Medline, Embase, PsycINFO, Cochrane Controlled Register of Trials, CINAHL, EconLit, and Sociological Abstracts. Searches will be conducted from the date of inception to the end of the last full calendar year (December 2019). Studies will be included if they include an evaluation of a mental health service for children or youth (defined as those under 19 years of age) and which quantify variation in some aspect of child or youth mental health services (e.g., accessibility, volume, duration, or quality) as a function of socio-demographic and/or geographic variables. Study selection will occur over two stages. Stage one will select articles based on title and abstract using the liberal-accelerated method. Stage two will review the full texts of selected titles. Two reviewers will work independently on full-text reviewing, with each study screened twice using pre-specified eligibility criteria. One reviewer will chart study characteristics and indices to be verified by a second reviewer. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the types and characteristics of the indices used to evaluate MH services equity. Discussion: The planned, systematic scoping review will survey the literature regarding how equity in MH services for children and youth has been operationalized and help inform future studies of equity in CYMHS. Systematic review registration: Open Science Foundation ID SYSR-D-19-00371, https://osf.io/58srv/

A protocol for a scoping review of equity measurement in mental health care for children and youth

Background: Mental health (MH) problems are among the most important causes of morbidity and mortality for children and youth. Problems of lack of equity in child and youth MH services (CYMHS)-including, but not limited to, problems in inaccessibility and quality of services-are widespread. Characterizing the nature of equity in CYMHS is an ongoing challenge because the field lacks a consistent approach to conceptualizing equity. We will conduct a scoping review of how equity in MH services for children and youth has been defined, operationalized, and measured. Our objectives are to discover: (1) What conceptual definitions of equity are used by observational studies of CYMHS?; (2) What service characteristics of CYMHS care do indices of equity cover?; (3) What population dimensions have been used to operationalize equity?; (4) What statistical constructs have been used in indices that measure CYMHS equity?; and (5) What were the numerical values of those indices? Methods: The following databases will be searched: Medline, Embase, PsycINFO, Cochrane Controlled Register of Trials, CINAHL, EconLit, and Sociological Abstracts. Searches will be conducted from the date of inception to the end of the last full calendar year (December 2019). Studies will be included if they include an evaluation of a mental health service for children or youth (defined as those under 19 years of age) and which quantify variation in some aspect of child or youth mental health services (e.g., accessibility, volume, duration, or quality) as a function of socio-demographic and/or geographic variables. Study selection will occur over two stages. Stage one will select articles based on title and abstract using the liberal-accelerated method. Stage two will review the full texts of selected titles. Two reviewers will work independently on full-text reviewing, with each study screened twice using pre-specified eligibility criteria. One reviewer will chart study characteristics and indices to be verified by a second reviewer. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the types and characteristics of the indices used to evaluate MH services equity. Discussion: The planned, systematic scoping review will survey the literature regarding how equity in MH services for children and youth has been operationalized and help inform future studies of equity in CYMHS. Systematic review registration: Open Science Foundation ID SYSR-D-19-00371, https://osf.io/58srv/

Identifying and understanding factors that affect the translation of therapies from the laboratory to patients: a study protocol

Background: The process of translating preclinical findings into a clinical setting takes decades. Previous studies have suggested that only 5-10% of the most promising preclinical studies are successfully translated into viable clinical applications. The underlying determinants of this low success rate (e.g. poor experimental design, suboptimal animal models, poor reporting) have not been examined in an empirical manner. Our study aims to determine the contemporary success rate of preclinical-to-clinical translation, and subsequently determine if an association between preclinical study design and translational success/failure exists. Methods: Established systematic review methodology will be used with regards to the literature search, article screening and study selection process. Preclinical, basic science studies published in high impact basic science journals between 1995 and 2015 will be included. Included studies will focus on publicly available interventions with potential clinical promise. The primary outcome will be successful clinical translation of promising therapies - defined as the conduct of at least one Phase II trial (or greater) with a positive finding. A case-control study will then be performed to evaluate the association between elements of preclinical study design and reporting and the likelihood of successful translation. Discussion: This study will provide a comprehensive analysis of the therapeutic translation from the laboratory bench to the bedside. Importantly, any association between factors of study design and the success of translation will be identified. These findings may inform future research teams attempting preclinical-to-clinical translation. Results will be disseminated to identified knowledge users that fund/support preclinical research

High dose interleukin-2 (Aldesleukin) - expert consensus on best management practices-2014

Interleukin-2 (IL-2) was historically one of the few treatments for adults with stage IV solid tumors that could produce complete responses (CRs) that were often durable for decades without further therapy. The majority of complete responders with metastatic renal cell carcinoma (mRCC) and metastatic melanoma (mM) could probably be classified as "cures". Recent publications have suggested improved efficacy, perhaps due to improved patient Selection based on a better understanding of clinical features predicting outcomes. Guidelines for clinical management were established from experience at the National Cancer Institute (NCI) and an affiliation of institutions known as the Cytokine Working Group (CWG), who were among the first to utilize HD IL-2 treatment outside of the NCI. As new centers have opened, further management variations have emerged based upon center-specific experience, to optimize administration of IL-2 and provide high quality care for patients at each individual site. Twenty years of evolution in differing environments has led to a plethora of clinical experience and effective management approaches. The goal of this review is to summarize the spectrum of HD IL-2 treatment approaches, describing various effective strategies that incorporate newer adjunctive treatments for managing the side effects of IL-2 in patients with mRCC and mM. The goal for IL-2 therapy is typically to administer the maximum number of doses of IL-2 without putting the patient at unacceptable risk for severe, irreversible toxicity. This review is based upon a consensus meeting and includes guidelines on pre-treatment screening, criteria for administration and withholding doses, and defines consensus criteria for safe administration and toxicity management. The somewhat heterogeneous best practices of 2014 will be compared and contrasted with the guidelines provided in 2001 and the package inserts from 1992 and 1998

Scoping review of patient- and family-oriented outcomes and measures for chronic pediatric disease.

Improvements in health care for children with chronic diseases must be informed by research that emphasizes outcomes of importance to patients and families. To support a program of research in the field of rare inborn errors of metabolism (IEM), we conducted a broad scoping review of primary studies that: (i) focused on chronic pediatric diseases similar to IEM in etiology or manifestations and in complexity of management; (ii) reported patient- and/or family-oriented outcomes; and (iii) measured these outcomes using self-administered tools.We developed a comprehensive review protocol and implemented an electronic search strategy to identify relevant citations in Medline, EMBASE, DARE and Cochrane. Two reviewers applied pre-specified criteria to titles/abstracts using a liberal accelerated approach. Articles eligible for full-text review were screened by two independent reviewers with discrepancies resolved by consensus. One researcher abstracted data on study characteristics, patient- and family-oriented outcomes, and self-administered measures. Data were validated by a second researcher.4,118 citations were screened with 304 articles included. Across all included reports, the most-represented diseases were diabetes (35%), cerebral palsy (23%) and epilepsy (18%). We identified 43 unique patient- and family-oriented outcomes from among five emergent domains, with mental health outcomes appearing most frequently. The studies reported the use of 405 independent self-administered measures of these outcomes.Patient- and family-oriented research investigating chronic pediatric diseases emphasizes mental health and appears to be relatively well-developed in the diabetes literature. Future research can build on this foundation while identifying additional outcomes that are priorities for patients and families