Acidifiers as Alternatives for Antibiotics Reduction and Gut Health Improvement for Poultry and Swine

Using antibiotics of low doses as feed additives could support to improve poultry and swine performances. However, these applications have caused resistance of bacteria and antibiotic residues in foods of animal origins. Therefore, efforts were focused on solutions to replace antibiotics as growth promoters (AGPs). There are many alternatives for AGPs, in which organic acids are one of the important alternatives. The aim of this chapter is to review publications on these acids and their other forms namely as acidifiers using as feed additives including their names and forms, mode of actions, spectrum against bacteria, combinations among them, and latest updates on their effects on swine and poultry production. The scientific findings show that acidifiers can inhibit pathogenic bacteria growth, improve nutrient digestibility, enhance immunity and overall gut health, consequently increase performances of poultry and swine. Several acids and their salts in both liquid and solid forms have been studied and applied as poultry and swine feed additives; however, the efficacy levels and the mode of actions are dependent on the single acidifiers, their salts, and combinations among them. The uses of acidifiers in their salts and derivative forms and mixtures of different acidifiers seem to be more favorable

Promoting inclusivity in health professions education publishing

A taskforce established by Medical Education asks readers to engage in discussion about how the journal and field can do better to ensure that health professional education publishing is inclusive of diverse knowledge and perspectives.https://onlinelibrary.wiley.com/journal/13652923hj2023School of Health Systems and Public Health (SHSPH

Describing, Teaching and Predicting Medical Problem-Solving: A Review

This article reviews: (a) the descriptive models and research findings of the processes and skills characterizing medical problem-solving, and (b) the recent investigations of teaching and predicting medical problem-solving ability. Results are discussed and suggestions for direction and design of future studies are provided in an effort to increase the usefulness of results for applications to medical education. </jats:p

How medical students learn

With recent concerns over and attempts to address issues regarding medical students' processes of learning and development of lifelong learning habits, a question often asked is: How do medical students learn in the present medical curriculum? In this study, the authors directly attempt to answer that question--they assess the learning behaviors of 254 students in two medical schools, one with an objectives-based mastery and one with a traditional curricula, and discuss whether the students' adopted behaviors are conducive to the development of effective, analytic, and independent learning. Most students of both medical schools reported very similar effective and ineffective learning behaviors. The students' behaviors were found to dispose them more to analytic learning than to independent learning. Suggestions to restructure the curriculum for better development of students' independent learning habits are proposed

Developing and evaluating the student assessment system in the preclinical problem-based curriculum at Sherbrooke

BACKGROUND: Students' learning was used as an outcome measure in the first phases of the major curriculum reform started in 1987 by the Université de Sherbrooke Faculty of Medicine, which shifted from a traditional to a student-centered, problem-based learning (PBL) and community-oriented program. The system for evaluating preclinical students' learning is intended to reinforce the integration of basic and clinical sciences. METHOD: To discover whether the evaluation system was fulfilling its intended goals, the authors used data from the classes of 1991-1993 to assess the reliability and validity of three evaluation instruments. The three instruments were (1) written examinations composed of multiple-choice questions (MCQs), short-answer questions (SAQs), and problem-analysis questions (PAQs); (2) PBL tutor rating forms that evaluate students' reasoning skills, communication and group-interaction skills, and autonomy and humanism; and (3) clinical skills evaluations, including objective structured clinical examinations (OSCEs). The weights allocated to the instruments reflected how the faculty valued each evaluation dimension in each of the three phases of the preclinical curriculum. RESULTS: Reliability indexes improved throughout the system implementation. The written examinations proved to have content validity according to the PBL learning objectives. As evaluated by students, the PAQs were found to be at a taxonomic level that assessed ability to analyze information a third of the time in the first year of implementation of the PBL curriculum and 17% in the second year. Variations and correlations of students' mean performances across instructional units and between the evaluation instruments led to the development of a student longitudinal performance profile to be used before yearly promotion decisions are proposed. The profile was introduced in the fifth year of PBL implementation. CONCLUSION: The system allows students to learn higher-taxonomic-level content and fulfills the institution's social responsibility of judging program outcomes and promoting qualified students, although evaluation by PBL tutors is still psychometrically questionable and the measurement of students' reasoning and ability to analyze problems is still an unfinished evaluation tas

Patients simulés/standardisés

Les compétences cliniques occupent une place de premier ordre dans l'exercice des professions de la santé. En médecine, par exemple, elles concernent la prise en charge du patient, notamment la récolte de l'information auprès d'un patient, l'examen physique, le raisonnement médical, la structuration de l'entretien et la construction de la relation médecin-patient [1, 2]. Ces compétences ne sont pas innées, elles s'acquièrent, se travaillent et se développent. Or, si l'enseignement des connaissances a fait ses preuves pour l'acquisition des bases théoriques, il reste d'une efficacité toute relative pour transmettre le savoir-faire et le savoir-être: une compétence clinique ne s'acquiert que par la pratique et elle se développe par une pratique répétée [3, 4] et systématisée (deliberate practice) [5]. Les compétences techniques, le raisonnement médical et les relations interprofessionnelles peuvent se travailler à l'aide de mannequins et d'outils informatiques. Mais la relation interpersonnelle médecin-patient, dimension incontournable et déterminante de la pratique médicale, exige une démarche différente. Les jeux de rôles entre apprenants sont certainement une première approche utile, mais ils sont encore trop éloignés de la réalité professionnelle pour satisfaire à tous les besoins. Par ailleurs, l'appel à de vrais patients soulève de nombreuses difficultés organisationnelles: les patients ne sont pas disponibles pour l'enseignement (hospitalisations courtes, examen rapprochés), la programmation des rencontres apprenant-patient est malaisée. Du point de vue éthique, ce mode d'apprentissage n'est pas sans risques, car le patient peut avoir à pâtir de l'inexpérience des apprenants