The pioneer cohort of curriculum reform: Guinea pigs or trail-blazers?

With curriculum reform, whether we admit it or not, the first cohort of students will be 'test-driving' the new programme. Not only are they the pioneers of a new curriculum, but as they progress through their studies, they experience each year of the innovation for the first time. As curriculum designers, we learn from their experiences and their feedback to improve the programme content and delivery, invariably for subsequent cohorts. A considerable onus therefore rests with this pioneer group, and their contribution to curriculum design, evaluation and programme revision should be valued

Bird Strike Mitigation, Spring 2020

Bird Strike Mitigation Project for Sustainability Exchange, Washington University in St. Louis, Spring 202

Chasing Clarity: Rumination as a Strategy for Making Sense of Emotions

Research is needed on the affective mechanisms that motivate people to ruminate. One possibility is that some people might ruminate in response to deficits in emotional clarity because not knowing how they feel might be intolerable to them. We tested the hypothesis that the relationship between low emotional clarity and rumination would be moderated by intolerance of ambiguity. Participants in a longitudinal online study (N = 195) provided self- reports of intolerance of ambiguity and rumination and reported state emotional clarity following an idiographic mood induction; three weeks later they reported on rumination again. As predicted, participants with low emotional clarity at Time 1 ruminated more three weeks later, but only if they were intolerant of ambiguity. Findings support the notion that rumination sometimes functions as a search for answers about emotions. We discuss implications for understanding the affective disturbances perpetuating vicious cycles of rumination and for rumination-focused clinical interventions

Using Serious Games to Train Adaptive Emotional Regulation Strategies

[EN] Emotional Regulation (ER) strategies allow people to influence the emotions they feel, when they feel them, how they experience them, and how they express them in any situation. Deficiencies or deficits in ER strategies during the adolescence may become mental health problems in the future. The aim of this paper is to describe a virtual multiplatform system based on serious games that allows adolescents to train and evaluate their ER strategies. The system includes an ecological momentary assessment (EMA) tool, which allows the therapist to monitor the emotional status of teenagers every day in real time. Results obtained from a usability and effectiveness study about the EMA tool showed that adolescents preferred using the EMA tool than other classical instruments.This study was funded by Vicerrectorado de Investigación de la Universitat Politècnica de València, Spain, PAID-06-2011, R.N. 1984; by Ministerio de Educación y Ciencia, Spain, Project Game Teen (TIN2010-20187) and partially by projects Consolider-C (SEJ2006-14301/PSIC), “CIBER of Physiopathology of Obesity and Nutrition, an initiative of ISCIII” and Excellence Research Program PROMETEO (Generalitat Valenciana. Consellería de Educación, 2008-157). The work of Alejandro Rodríguez was supported by the Spanish MEC under an FPI Grant BES-2011-043316.Alcañiz Raya, ML.; Rodríguez Ortega, A.; Rey, B.; Parra Vargas, E. (2014). Using Serious Games to Train Adaptive Emotional Regulation Strategies. Lecture Notes in Computer Science. 8531:541-549. https://doi.org/10.1007/978-3-319-07632-4_51S5415498531Mennin, D., Farach, F.: Emotion and evolving treatments for adult psychopathology. Clinical Psychology: Science and Practice 14, 329–352 (2007)Serrano, A., Iborra, I.: Informe violencia entre compañeros en la escuela. Spanish Version (2005), http://www.centroreinasofia.esInforme Cisneros X.: Acoso y Violencia Escolar en España, por Iñaki Piñuel y Araceli Oñate. Editorial IIEDDI, Spanish Version (2007)Werner, K., Gross, J.J.: Emotion Regulation and Psychopathology. In: Emotion Regulation and Psychopathology: A Transdiagnostic Approach to Etiology and Treatment. Guildford Press (2010)Berking, M., Wupperman, P., Reichardt, A., Pejic, T., Dippel, A., Znoj, H.: Emotion-regulation skills as a treatment target in psychotherapy. Behaviour Research and Therapy 46, 1230–1237 (2008)Shields, A., Cicchetti, D.: Emotion regulation among school-age children: The development and validation of a new criterion Q-sort scale. Developmental Psychology 33(6), 906–916 (1997)Gross, J.J., John, O.P.: Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology 85(2), 348–362 (2003)Gross, J.J., Levenson, R.W.: Hiding feelings: The acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology 106, 95–103 (1997)Winn, et al.: The Effect of Student Construction of Virtual Environments on the Performance of High- and Low-Ability Students. Annual Meeting of the American Educational Research Association (2003)Pantelidis, V.: Reasons to use virtual reality in education. VR in the Schools 1(1) (1995)Playmancer, http://www.playmancer.euBen Moussa, M., Magnenat-Thalmann, N.: Applying affect recognition in serious games: The playMancer project. In: Egges, A., Geraerts, R., Overmars, M. (eds.) MIG 2009. LNCS, vol. 5884, pp. 53–62. Springer, Heidelberg (2009)Replay, http://www.replayproject.euFeldman, L.B., Gross, J.J., Conner, T., Benvenuto, M.: Knowing what you’re feeling and knowing what to do about it: mapping the relation between emotion differentiation and emotion regulation. Cognition and Emotion 15, 713–724 (2001

Community-based distributive medical education: Advantaging society

This paper presents a narrative summary of an increasingly important trend in medical education by addressing the merits of community-based distributive medical education (CBDME). This is a relatively new and compelling model for teaching and training physicians in a manner that may better meet societal needs and expectations. Issues and trends regarding the growing shortage and imbalanced distribution of physicians in the USA are addressed, including the role of international medical graduates. A historical overview of costs and funding sources for medical education is presented, as well as initiatives to increase the training and placement of physicians cost-effectively through new and expanded medical schools, two- and four-year regional or branch campuses and CBDME. Our research confirms that although medical schools have responded to Association of American Medical Colleges calls for higher student enrollment and societal concerns about the distribution and placement of physicians, significant opportunities for improvement remain. Finally, the authors recommend further research be conducted to guide policy on incentives for physicians to locate in underserved communities, and determine the cost-effectiveness of the CBDME model in both the near and long terms

Massive Paradoxical Air Embolism in Brain Occurring after Central Venous Catheterization: A Case Report

Cerebral air embolism is a rare but fatal complication of central venous catheterization. Here, we report a case of paradoxical cerebral air embolism associated with central venous catheterization. An 85-yr-old man underwent right internal jugular vein catheterization, and became obtunded. Brain MR imaging and CT revealed acute infarction with multiple air bubbles on the side of catheter insertion. The possibility of cerebral air embolism should be considered in patients developing neurological impairment after central venous catheterization, and efforts should be made to limit cerebral damage

Metodologias interativas para facilitar a integração da Unidade Curricular de Semiologia Humana

Introduction: Curriculum integration is critical to medical education. It represents a constant challenge for teachers since there is no shared concept about what it means, what is to be included, and the dynamics of operationalization. Objectives: To promote and implement the integration of a human semiology curriculum module (medical clinic, pediatrics, diagnostic imaging, psychology and health informatics) through interactive methodologies; to evaluate the students perception of the module. Methods: Action research involved 76 teachers and 125 third-year medical students. Monthly meetings were held between the coordinators. Discussions focused on monitoring and following-up on implementation of interactive methodologies and reviewing integration of theory and practice. Also included were the implementation of a joint discussion of clinical cases, a holistic view of the patient and presenting problems. Collaboration and communication between teachers, joint classes, integrated evaluation of the process of learning and teaching in small groups. In addition, training workshops were held for the use of a Moodle platform by teachers for page construction of Curriculum Module. The evaluation of students' perceptions was performed through a voluntary and anonymous questionnaire with open questions (qualitative). All 125 students answered the questionnaire. A five-point Likert scale was used with a midpoint indicating intermediate or nullity, domain of discordance (values 1 and 2) and domain of cordance (4 and 5). The analysis of the data was made comparing their results with those obtained in the tests of the previous year. The Statistical Package for the Social Sciences (version 17.0, SPSS®, Chicago, IL, USA). Results: Data analysis showed that there was a positive impact after the integration between the subjects and the introduction of interactive methodologies in the course. Give the data for this statement here. There was a significant improvement in performance, both theoretical and practical, as measured by the scores obtained by the students, when compared to the students of the previous year (p <0.001). On the other hand, in open questions, students still mentioned heterogeneity among teachers and in the evaluation. They students also commented on, the need for a continuous effort to improve and maintain the integration and adjust their workload. Conclusion: The evaluation analysis supported the need to continue to implement teacher development, joint planning and the continuity of the articulation process. The integration of interactive methodologies was shown to improve student performance compared to the previous class in a Semiology Curricular Module. Introdução: A integração do currículo é fundamental para a formação médica. Representa, todavia, um constante desafio para os professores envolvidos, visto que não há uniformidade sobre o conceito, sobre a necessidade de inclusão de atividades integradas, e mesmo sobre sua operacionalização. Objetivos: Promover a integração da unidade curricular (UC) de semiologia humana (clínica médica, pediatria, diagnóstico por imagem, psicologia e informática em saúde) através da implantação de metodologias interativas, e avaliar a percepção dos estudantes do módulo de semiologia humana, após a implementação destas metodologias. Métodos: Utilizou-se pesquisa-ação, envolvendo 76 professores e 125 estudantes da 3ª série do curso médico. Para a integração da UC foram realizadas: reuniões mensais entre os coordenadores para implementação e acompanhamento das metodologias interativas, que consistiram de integração da teoria com a prática, implantação de discussão conjunta de casos clínicos, visão holística do paciente e de seus problemas, colaboração e comunicação entre os professores, aulas conjuntas, avaliação integrada com o processo de aprendizagem e ensino em pequenos grupos. Além disso, foram realizadas oficinas de capacitação para uso da plataforma Moodle pelos professores e construção de página com as atividades da UC. A avaliação da percepção dos estudantes sobre a UC foi realizada através de questionário voluntário e anônimo e de questões abertas (qualitativa). Todos os estudantes responderam ao questionário. Foi utilizada a escala de Likert de cinco pontos com um ponto médio manifestando situação intermediária ou de nulidade, domínio de discordância (valores 1 e 2) e domínio de concordância (4 e 5). A análise do desempenho destes alunos da 3ª série do curso de medicina foi feita comparando-se os seus resultados com os obtidos nas provas do ano anterior. Na análise estatística foi utilizado o Statistical Package for the Social Sciences (versão 17.0, SPSS®, Chicago, IL, EUA). Resultados: A análise conjunta das categorias do questionário demonstrou que houve impacto positivo após a integração entre as disciplinas e a introdução de metodologias interativas no curso. Houve melhora significante do desempenho, tanto teórico quanto prático, avaliado pelas notas obtidas pelos alunos, quando comparado aos alunos do ano anterior (p<0,001). Por outro lado, nas questões abertas, os alunos ainda referiram heterogeneidade entre os professores e na avaliação, necessidade de um esforço contínuo para melhorar e manter a integração, bem como adequar a carga horária, considerada insuficiente. Conclusão: A análise da avaliação evidenciou a necessidade de implementar o desenvolvimento docente, o planejamento conjunto e a continuidade do processo de articulação. A utilização das metodologias interativas contribuiu para a integração da Unidade Curricular de semiologia. Introducción: La integración del currículo es fundamental para la formación médica. Sin embargo, representa un constante desafío para los profesores involucrados, ya que no hay uniformidad sobre el concepto, sobre la necesidad de inclusión de actividades integradas, y incluso sobre su operacionalización. Objetivos: Promover la integración de la unidad curricular (UC) de semiología humana (clínica médica, pediatría, diagnóstico por imagen, psicología e informática en salud) a través de la implantación de metodologías interactivas, y evaluar la percepción de los estudiantes del módulo de semiología humana, después de la aplicación de estas metodologías. Métodos: Se utilizó investigación-acción, involucrando a 76 profesores y 125 estudiantes de la 3ª serie del curso médico. Para la integración de la UC se realizaron: reuniones mensuales entre los coordinadores para implementación y seguimiento de las metodologías interactivas, que consistieron en la integración de la teoría con la práctica, implantación de discusión conjunta de casos clínicos, visión holística del paciente y de sus problemas, colaboración y comunicación entre los profesores, clases conjuntas, evaluación integrada con el proceso de aprendizaje y enseñanza en pequeños grupos. Además se realizaron talleres de capacitación para uso de la plataforma Moodle por los profesores y construcción de página con las actividades de la UC. La evaluación de la percepción de los estudiantes sobre la UC se realizó a través de un cuestionario voluntario y anónimo y de cuestiones abiertas (cualitativa). Todos los estudiantes respondieron al cuestionario. Se utilizó la escala de Likert de cinco puntos con un punto medio manifestando situación intermedia o de nulidad, dominio de discordancia (valores 1 y 2) y dominio de concordancia (4 y 5). El análisis del desempeño de estos alumnos de la 3ª serie del curso de medicina se hizo comparando sus resultados con los obtenidos en las pruebas del año anterior. En el análisis estadístico se utilizó el Statistical Package for the Social Sciences (versión 17.0, SPSS®, Chicago, IL, EE.UU.). Resultados: El análisis conjunto de las categorías del cuestionario demostró que hubo impacto positivo tras la integración entre las disciplinas y la introducción de metodologías interactivas en el curso. Se observó una mejora significativa del rendimiento, tanto teórico como práctico, evaluado por las notas obtenidas por los alumnos, en comparación con los alumnos del año anterior (p <0,001). Por otro lado, en las cuestiones abiertas, los alumnos todavía refirieron heterogeneidad entre los profesores y en la evaluación, necesidad de un esfuerzo continuo para mejorar y mantener la integración, así como adecuar la carga horaria, considerada insuficiente. Conclusión: El análisis de la evaluación evidenció la necesidad de implementar el desarrollo docente, la planificación conjunta y la continuidad del proceso de articulación. La utilización de las metodologías interactivas contribuyó a la integración de la Unidad Curricular de semiología

Does rumination mediate the relationship between emotion regulation ability and posttraumatic stress disorder?

Background and objectives: Trauma-related rumination has been suggested to be involved in the maintenance of posttraumatic stress disorder (PTSD). This view has empirically been supported by extensive evidence using cross-sectional, prospective, and experimental designs. However, it is unclear why trauma survivors engage in rumination despite its negative consequences. The current study aimed to explore the hypothesis that low emotion regulation ability underlies trauma-related rumination. Methods: Emotion regulation ability and trauma-related rumination were assessed in 93 road traffic accident survivors 2 weeks post-trauma. In addition, symptom levels of PTSD were assessed at 2 weeks as well as 1, 3, and 6 months follow-up. Results: Emotion regulation ability was significantly related to trauma-related rumination as well as levels of PTSD symptoms. In addition, the association between low emotion regulation ability and PTSD was mediated by rumination. Conclusions: The findings support the view that rumination is used as a dysfunctional emotion regulation strategy by trauma survivors

Communicating curriculum reform to students: Advice in hindsight.....

BACKGOUND: In view of the changing health care needs of communities, curriculum reform of traditional curricula is inevitable. In order to allay the apprehension that may accompany such change, curriculum development and implementation should be an inclusive process, with both staff and students being well informed of the planned reform. In 2001, the Nelson R. Mandela School of Medicine implemented Year 1 of a problem-based learning curriculum. During the design phase, students and staff were invited to take part in the development and were kept abreast of developments through meetings and newsletters. METHOD: A survey of Years 1–5 students of the last intake into the traditional curriculum was undertaken a few months prior to the implementation of the new programme. RESULTS: Students were generally well informed about the impending change, having heard about it from fellow students and staff. The more senior the students, the less the perceived impact of the reform. Although most of what students had heard was correct, some, however, had misconceptions that were generally extreme views (e.g. all self-directed learning; no Anatomy) about the new programme. Others expressed valid concerns (e.g. underpreparedness of students from disadvantaged schools; overcrowding in hospitals). CONCLUSIONS: Advice offered to institutions considering curriculum reform include using various methods to inform internal and external affected parties, ensuring that the student representative body and staff is well informed, reiterating the need for the change, confirming that the new programme meets recognised standards and that the students most affected are reassured about their future studies