Pediatric faculty and residents’ perspectives on In-Training Evaluation Reports (ITERs)

Background: In-training evaluation reports (ITERs) are used by over 90% of postgraduate medical training programs in Canada for resident assessment.  Our study examined the perspectives of faculty and residents in one pediatric program as a means to improve the ITER as an evaluation tool.Method: Two separate focus groups were conducted, one with eight pediatric residents and one with nine clinical faculty within the pediatrics program of Memorial University’s Faculty of Medicine to discuss their perceptions of, and suggestions for improving, the use of ITERs.Results:  Residents and faculty shared many similar suggestions for improving the ITER as an evaluation tool.  Both the faculty and residents emphasized the importance of written feedback, contextualizing the evaluation and timely follow-up.  The biggest challenge appears to be the discrepancy in the quality of feedback sought by the residents and the faculty members’ ability to do so in a time effective manner.  Others concerns related to the need for better engagement in setting rotation objectives and more direct observation by the faculty member completing the ITER.Conclusions: The ITER is a useful tool in resident evaluations, but a number of issues relating to its actual use could improve the quality of feedback which residents receive

The accuracy of MRI in the detection of Lumbar Disc Containment

<p>Abstract</p> <p>Background</p> <p>MRI has proven to be an extremely valuable tool in the assessment of normal and pathological spinal anatomy. Accordingly, it is commonly used to assess containment of discal material by the outer fibers of the anulus fibrosus and posterior longitudinal ligaments. Determination of such containment is important to determine candidacy for intradiscal techniques and has prognostic significance. The accuracy of MRI in detecting containment has been insufficiently documented.</p> <p>Methods</p> <p>The MRI's of fifty consecutive patients undergoing open lumbar microdiscectomy were prospectively evaluated for disc containment by a neuroradiologist and senior spinal surgeon using criteria available in the literature and the classification of Macnab/McCulloch. An independent surgeon then performed the surgery and documented the actual containment status using the same methods. Statistical evaluation of accuracy was undertaken.</p> <p>Results</p> <p>MRI was found to be 72% sensitive, 68% specific, and 70% accurate in detecting containment status of lumbar herniated discs.</p> <p>Conclusion</p> <p>MRI may be inaccurate in assessing containment status of lumbar disc herniations in 30% of cases. Given the importance of containment for patient selection for indirect discectomy techniques and intradiscal therapies, coupled with prognostic significance; other methods to assess containment should be employed to assess containment when such alternative interventions are being considered.</p

A two-chambered experimental apparatus for the Mongolian gerbil cochlea

Thesis (M.S.)--Boston UniversityPLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at [email protected]. Thank you.There are two types of extracellular fluid in the cochlea: the endolymph of the scala media and the perilymph of the scala vestibuli and scala tympani. Cochlear endolymph and perilymph have different compositions, and the concentration gradient of solutes across the cochlear partition is actively maintained in vivo. In experiments involving fresh cochleas that have been dissected to allow access to the cochlear partition, the cochlea is generally placed in a single medium that aims to nourish the cochlear cells. However, the dissection usually disrupts the separation of endolymph and perilymph across the organ of Corti, the organ in the cochlear partition that contains the auditory sensory cells. Separating the fluids across the cochlear partition during experiments involving dissected cochleas would allow for more physiologically relevant observations to be made. This work was aimed at creating a two-chambered device for holding excised Mongolian gerbil (Meriones unguiculatus) cochlear preparations during in vitro electrical stimulation experiments. Primarily, this device creates experimental conditions that more closely mimic the in vivo physiologic conditions found within the gerbil cochlea by isolating the endolymph medium and perilymph medium bathing the opposing surfaces of the organ of Corti. The device also provides a means to electrically stimulate the organ of Corti and allows for imaging of the response to stimulation. The ability of the device to seal endolymph medium from perilymph medium is shown via electrical resistance measurements between the chambers. The imaging of hair cell motion during electrical stimulation is also demonstrated.2031-01-0

Telemedicine For Retinal Care In Developing Nations: The Orbis Cyber-Sight Programme, 2003-2011

ORBIS International has provided a web-based ophthalmic disease consultation service, Cyber-Sight, for developing nations since 2003. The system connects partner physicians with mentor physicians. We have reviewed consultations concerning retinal cases submitted from June 2003 to December 2011. Of 943 retinal consultations reviewed, 117 were excluded, mainly for reasons of technical limitations at the partner sites. Of the 826 included cases, 504 patients were male and 322 were female. The average age of the patients was 43 years (range 2 months to 86 years). Cases were submitted from partner physicians in 30 countries, with five countries accounting for 82% of the cases (India, Vietnam, Indonesia, China, Jordan). There was a rise in the case submission rate to a peak of 251 cases in 2010. The mean consultant response time was 5 days (SD 9). The mean time to case closure was 19 days (SD 92). The most common diagnoses were diabetic retinopathy (n = 101), retinal vascular occlusion (n = 75) and retinal detachment (n = 61). The working diagnosis submitted by the partner did not match the mentor\u27s diagnosis in 153 cases (19%). The number of incorrect initial partner diagnoses demonstrates that the teleretinal programme serves a useful diagnostic role for partner physicians. The Cyber-Sight programme is a viable method of delivering advanced retinal expertise to partner institutions and increasing capacity for partner doctors in the developing world. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav