Grappling For Answers: Exploring the Process of Life Skills Development in Youth Mixed Martial Arts Athletes

Mixed martial arts (MMA) is a form of combat sport that was legalized in Ontario in 2013. Immediately, media began to profile life skill outcomes associated with youth participation in MMA. Evidence in support of these claims is often anecdotal. To date no studies have utilized Positive Youth Development (PYD), a strengths-based approach to youth development (Lerner et al., 2005) to explore youth in MMA. Therefore, the overall objective of this research project was to explore the potential benefits, factors and processes of youths (ages 9-18) life skill development in MMA using a PYD approach. Data was collected in three phases. In phase one data was collected from Toronto MMA gym websites (N=18). One manuscript was written that identified the life skills MMA gyms suggest they can develop in youth. Findings revealed that MMA gym websites included general information, developmental outcomes (4Cs) and processes, resources and not relevant messages. In phase two semi-structured interviews were conducted with youth (n=13) and coaches (n=10) from MMA gyms. Two manuscripts were written, the first manuscript identified the life skills youth developed in MMA and the factors that contributed to their development. The second manuscript explored the role of the MMA coach in the process of facilitating life skills development and transfer of life skills from MMA to non-sport contexts. MMA coaches primarily used explicit techniques to facilitate life skill development and transfer. In phase three, two manuscripts were written. First, a pilot study was conducted to determine the effectiveness of using an online journal and two types of questions (i.e., direct and indirect) as a method of recalling transfer experiences. Second, youth in MMA (N=9) completed an online journal over a one-month period. Findings revealed that MMA coaches facilitated the development of a value for life skills transfer. Participants in the direct and indirect groups demonstrated differences in their description of transfer experiences

Perceptions des résidents sur la formation médicale fondée sur les compétences

Background: Residency training programs in Canada are undergoing a mandated transition to competency-based medical education (CBME).  There is limited literature regarding resident perspectives on CBME.  As upper year residents act as mentors and assessors for incoming cohorts, and are themselves key stakeholders in this educational transition, it is important to understand how they view CBME.  We examined how residents who are not currently enrolled in a competency-based program view that method of training, and what they perceive as potential advantages, disadvantages, and considerations regarding its implementation. Methods: Sixteen residents volunteered to participate in individual semi-structured interviews, with questions focussing on participants’ knowledge of CBME and its implementation.  We used a grounded theory approach to develop explanations of how residents perceive CBME. Results: Residents anticipated improved assessment and feedback, earlier identification of residents experiencing difficulties in training, and greater flexibility to pursue self-identified educational needs.  Disadvantages included logistical issues surrounding CBME implementation, ability of attending physicians to deliver CBME-appropriate feedback, and the possibility of assessment fatigue.  Clear, detailed communication and channels for resident feedback were key considerations regarding implementation. Conclusions: Resident views align with educational experts regarding the practical challenges of implementation.  Expectations of improved assessment and feedback highlight the need for both residents and attending physicians to be equipped in these domains.  Consequently, faculty development and clear communication will be crucial aspects of successful transitioning to CBME

More Than Self-Management: Positive Youth Development at an Inclusive Type 1 Diabetic Camp

Diabetes-focused camps emerged as a way to provide ongoing diabetes self-management education to youth and their families in a physically active context. Past research suggests participation at camp can enhance youths’ glycemic control and glucose monitoring abilities; however, recent studies claim camps can also offer psychological and social benefits. Drawing upon a positive youth development (PYD) approach, the current study examined an inclusive diabetic-focused youth sport camp to (a) identify life skills developed, and (b) explain processes and factors involved in youths’ development of life skills. Focus groups were conducted with 54 youth living with type 1 diabetes mellitus (T1DM) attending an inclusive T1DM sport camp. The model of PYD through sport (Holt et al., 2017) guided the analysis. PYD outcomes (i.e., life skills developed through the camp) were (a) enhanced self-efficacy for self-monitoring of blood glucose, (b) enhanced self-efficacy for sport while living with T1DM, and (c) development of positive relationships. These outcomes were facilitated through the camp’s inclusive approach (i.e., including youth living with and without T1DM), and a PYD climate (implicitly), which included supportive relationships with counsellors and peers, and interestingly, the lack of parental involvement at the camp. The camp’s explicit life skills program focus (i.e., on diabetes self-care skills) also facilitated these outcomes. This study gives camp professionals insight into how an inclusive T1DM sport camp can facilitate life skills, and optimize PYD

Simulation-based evaluation of anaesthesia residents:optimising resource use in a competency-based assessment framework

INTRODUCTION: Simulation training in anaesthesiology bridges the gap between theory and practice by allowing trainees to engage in high-stakes clinical training without jeopardising patient safety. However, implementing simulation-based assessments within an academic programme is highly resource intensive, and the optimal number of scenarios and faculty required for accurate competency-based assessment remains to be determined. Using a generalisability study methodology, we examine the structure of simulation-based assessment in regard to the minimal number of scenarios and faculty assessors required for optimal competency-based assessments. METHODS: Seventeen anaesthesiology residents each performed four simulations which were assessed by two expert raters. Generalisability analysis (G-analysis) was used to estimate the extent of variance attributable to (1) the scenarios, (2) the assessors and (3) the participants. The D-coefficient and the G-coefficient were used to determine accuracy targets and to predict the impact of adjusting the number of scenarios or faculty assessors. RESULTS: We showed that multivariate G-analysis can be used to estimate the number of simulations and raters required to optimise assessment. In this study, the optimal balance was obtained when four scenarios were assessed by two simulation experts. CONCLUSION: Simulation-based assessment is becoming an increasingly important tool for assessing the competency of medical residents in conjunction with other assessment methods. G-analysis can be used to assist in planning for optimal resource use and cost-efficacy

Knowledge retention after focused cardiac ultrasound training: a prospective cohort pilot study

Background and objectives: Focused Cardiac Ultrasound (FoCUS) has proven instrumental in guiding anesthesiologists’ clinical decision-making process. Training residents to perform and interpret FoCUS is both feasible and effective. However, the degree of knowledge retention after FoCUS training remains a subject of debate. We sought to provide a description of our 4-week FoCUS curriculum, and to assess the knowledge retention among anesthesia residents at 6 months after FoCUS rotation. Methods: A prospective analysis involving eleven senior anesthesia residents was carried out. At end of FoCUS Rotation (EOR) participants completed a questionnaire (evaluating the number of scans completed and residents’ self-rated knowledge and comfort level with FoCUS), and a multiple-choice FoCUS exam comprised of written- and video-based questions. Six months later, participants completed a follow-up questionnaire and a similar exam. Self-rated knowledge and exam scores were compared at EOR and after 6 months. Spearman correlations were conducted to test the relationship between number of scans completed and exam scores, perceived knowledge and exam scores, and number of scans and perceived knowledge. Results: Mean exam scores (out of 50) were 44.1 at EOR and 43 at the 6-month follow-up. Residents had significantly higher perceived knowledge (out of 10) at EOR (8.0) than at the 6-month follow-up (5.5), p = 0.003. At the EOR, all trainees felt comfortable using FoCUS, and at 6 months 10/11 still felt comfortable. All the trainees had used FoCUS in their clinical practice after EOR, and the most cited reason for not using FoCUS more frequently was the lack of perceived clinical need. A strong and statistically significant (rho = 0.804, p = 0.005) correlation between number of scans completed during the FoCUS rotation and 6-month follow-up perceived knowledge was observed. Conclusion: Four weeks of intensive FoCUS training results in adequate knowledge acquisition and 6-month knowledge retention. Resumo: Justificativa e objetivos: A ultrassonografia cardíaca no local de atendimento (USCLA) provou ser importante para orientar o processo de tomada de decisão clínica dos anestesiologistas. Treinar os residentes para fazer e interpretar uma USCLA é viável e eficaz. No entanto, o grau de retenção do conhecimento após o treinamento permanece um assunto de debate. Procuramos fornecer uma descrição do currículo de quatro semanas do treinamento de USCLA e avaliar a retenção do conhecimento entre os residentes de anestesia seis meses após a rotação em USCLA. Métodos: Uma análise prospectiva foi realizada com 11 residentes seniores de anestesia. Ao final da rotação em USCLA, os participantes preencheram um questionário (avaliando o número de exames ultrassonográficos concluídos, o conhecimento adquirido e o nível de conforto dos residentes com a USCLA) e fizeram um exame de múltipla escolha para USCLA, composto por perguntas escritas e baseadas em vídeo. Seis meses depois, os participantes preencheram um questionário de acompanhamento e um exame similar. A autoavaliação do conhecimento e os escores do exame foram comparados no final da rotação e após seis meses. Correlações de Spearman foram usadas para testar a relação entre o número de exames concluídos e os escores dos exames, o conhecimento percebido, os escores dos exames, o número de exames e o conhecimento percebido. Resultados: Os escores médios dos exames (50) foram: 44,1 no final da rotação e 43 após seis meses. Os residentes tiveram conhecimento percebido significativamente maior (10) no final da rotação (8,0) que após seis meses (5,5), p = 0,003. No final da rotação, todos os residentes se sentiram confortáveis usando o aparelho de USCLA e, aos seis meses, 10/11 ainda se sentiam confortáveis. Todos os residentes haviam usado o USCLA em sua prática clínica após o final da rotação e a razão mais citada para não usar o USCLA com mais frequência foi a falta de necessidade clínica percebida. Uma correlação forte e estatisticamente significativa (rho = 0,804, p = 0,005) foi observada entre o número de exames realizados durante a rotação em USCLA e o conhecimento percebido em seis meses de seguimento. Conclusão: Quatro semanas de treinamento intensivo de USCLA resultaram em aquisição e retenção adequadas do conhecimento por seis meses. Keywords: POCUS, FoCUS, Knowledge retention, Education, Anesthesia, Palavras-chave: POCUS, USCLA, Retenção de conhecimento, Educação, Anestesi