1,236 research outputs found
Development of an Objective Structured Clinical Examination as a Component of Assessment for Initial Board Certification in Anesthesiology.
With its first administration of an Objective Structured Clinical Examination (OSCE) in 2018, the American Board of Anesthesiology (ABA) became the first US medical specialty certifying board to incorporate this type of assessment into its high-stakes certification examination system. The fundamental rationale for the ABA's introduction of the OSCE is to include an assessment that allows candidates for board certification to demonstrate what they actually "do" in domains relevant to clinical practice. Inherent in this rationale is that the OSCE will capture competencies not well assessed in the current written and oral examinations-competencies that will allow the ABA to judge whether a candidate meets the standards expected for board certification more properly. This special article describes the ABA's journey from initial conceptualization through first administration of the OSCE, including the format of the OSCE, the process for scenario development, the standardized patient program that supports OSCE administration, examiner training, scoring, and future assessment of reliability, validity, and impact of the OSCE. This information will be beneficial to both those involved in the initial certification process, such as residency graduate candidates and program directors, and others contemplating the use of high-stakes summative OSCE assessments
Survey of self-assessed preparedness for clinical practice in one Croatian medical school
<p>Abstract</p> <p>Background</p> <p>The Croatian higher education system is in the process of reforming its medical curricula to comply with European Union standards. We conducted a survey of students enrolled at the University of Zagreb (Croatia) asking them to rate their perception of preparedness for clinical practice prior to initiation of the reform process. The purpose of the survey was to identify self-perceived deficiencies in education and to establish a reference point for the later assessment of ongoing educational reform.</p> <p>Findings</p> <p>One-hundred and forty seven (N = 147) graduates reported the levels of perceived preparedness on 30 items grouped into 8 educational domains. Main domains were: understanding science, practical skills/patient management, holistic care, prevention, interpersonal skills, confidence/coping skills, collaboration, and self-directed learning. For each item, graduates self assessed their preparedness on a scale ranging from 1 to 4, with 1 = "Very inadequate", 2 = "Somewhat inadequate", 3 = "Somewhat adequate", and 4 = "Very adequate". In 7 out of 8 domains the achieved median score was ≥ 3. Students expressed low confidence (defined when ≥ 25% of respondents supplied a rating for the survey question as: "very inadequate" or "somewhat inadequate") with interpersonal skills (discussing terminal disease, counseling distraught patients, balancing professional and personal life), and in performing certain basic semi-invasive or invasive procedures.</p> <p>Conclusion</p> <p>Zagreb medical graduates identified several deficiencies within educational domains required for standard clinical practice. Ongoing educational efforts need to be directed towards the correction of these deficiencies in order to achieve standards required by the European Union.</p
Boundary Conformal Field Theory and Ribbon Graphs: a tool for open/closed string dualities
We construct and fully characterize a scalar boundary conformal field theory
on a triangulated Riemann surface. The results are analyzed from a string
theory perspective as tools to deal with open/closed string dualities.Comment: 40 pages, 7 figures; typos correcte
Teaching for implementation: A framework for building implementation research and practice capacity within the translational science workforce
Implementation science offers a compelling value proposition to translational science. As such, many translational science stakeholders are seeking to recruit, teach, and train an implementation science workforce. The type of workforce that will make implementation happen consists of both implementation researchers and practitioners, yet little guidance exists on how to train such a workforce. We-members of the Advancing Dissemination and Implementation Sciences in CTSAs Working Group-present the Teaching For Implementation Framework to address this gap. We describe the differences between implementation researchers and practitioners and demonstrate what and how to teach them individually and in co-learning opportunities. We briefly comment on educational infrastructures and resources that will be helpful in furthering this type of approach
On the Connection between N=2 Minimal String and (1,n) Bosonic Minimal String
We study the scattering amplitudes in the N=2 minimal string or equivalently
in the N=4 topological string on ALE spaces. We find an interesting connection
between the tree level amplitudes of the N=2 minimal string and those of the
(1,n) minimal bosonic string. In particular we show that the four and
five-point functions of the N=2 string can be directly rewritten in terms of
those of the latter theory. This relation offers a map of physical states
between these two string theories. Finally we propose a possible matrix model
dual for the N=2 minimal string in the light of this connection.Comment: 40 pages, one figure, harvmac, minor corrections, references adde
Polarized QPOs from the INTEGRAL polar IGRJ14536-5522 (=Swift J1453.4-5524)
We report optical spectroscopy and high speed photometry and polarimetry of
the INTEGRAL source IGRJ14536-5522 (=Swift J1453.4-5524). The photometry,
polarimetry and spectroscopy are modulated on an orbital period of 3.1564(1)
hours. Orbital circularly polarized modulations are seen from 0 to -18 per
cent, unambiguously identifying IGRJ14536-5522 as a polar.
Some of the high speed photometric data show modulations that are consistent
with quasi-periodic oscillations (QPOs) on the order of 5-6 minutes.
Furthermore, for the first time, we detect the (5-6) minute QPOs in the
circular polarimetry. We discuss the possible origins of these QPOs. We also
include details of HIPPO, a new high-speed photo-polarimeter used for some of
our observations.Comment: Accepted for publication by MNRAS. The paper contains 7 figures and 1
tabl
Superhumps in Cataclysmic Binaries. XXIII. V442 Ophiuchi and RX J1643.7+3402
We report the results of long observing campaigns on two novalike variables:
V442 Ophiuchi and RX J1643.7+3402. These stars have high-excitation spectra,
complex line profiles signifying mass loss at particular orbital phases, and
similar orbital periods (respectively 0.12433 and 0.12056 d). They are
well-credentialed members of the SW Sex class of cataclysmic variables. Their
light curves are also quite complex. V442 Oph shows periodic signals with
periods of 0.12090(8) and 4.37(15) days, and RX J1643.7+3402 shows similar
signals at 0.11696(8) d and 4.05(12) d. We interpret these short and long
periods respectively as a "negative superhump" and the wobble period of the
accretion disk. The superhump could then possibly arise from the heating of the
secondary (and structures fixed in the orbital frame) by inner-disk radiation,
which reaches the secondary relatively unimpeded since the disk is not
coplanar.
At higher frequencies, both stars show another type of variability:
quasi-periodic oscillations (QPOs) with a period near 1000 seconds. Underlying
these strong signals of low stability may be weak signals of higher stability.
Similar QPOs, and negative superhumps, are quite common features in SW Sex
stars. Both can in principle be explained by ascribing strong magnetism to the
white dwarf member of the binary; and we suggest that SW Sex stars are
borderline AM Herculis binaries, usually drowned by a high accretion rate. This
would provide an ancestor channel for AM Hers, whose origin is still
mysterious.Comment: PDF, 41 pages, 4 tables, 16 figures; accepted, in press, to appear
December 2002, PASP; more info at http://cba.phys.columbia.edu
Influence of tobacco use on postoperative opiate analgesia requirements in patients undergoing coronary artery bypass graft surgery
Introduction. The objective of this study was to test the hypothesis that tobacco use status is independently associated with postoperative opioid requirements in patients undergoing coronary artery bypass grafting (CABG) when important demographic variables such as age and gender are taken into account. Methods. A retrospective chart review of patients who underwent CABG surgery over a one year period at Mayo Clinic in Rochester, MN was performed. Tobacco users (N=69) were compared to nonusers (N=345) with regards to opiate requirements and the occurrence of severe pain during the first 48 hours postoperatively. For comparison, all postoperative opiates were converted to oral morphine equivalents (OME). Adjusted analysis for age and gender was also performed. Results. Tobacco users were younger than nonusers (P < 0.001), and a greater proportion of former users were male compared to never users (P = 0.003). Tobacco users had greater mean opiate requirements 401 ± 284 than nonusers 314 ± 240 mg OME, (P = 0.009). However, the association between tobacco use and greater postoperative opiate requirements lost significance after adjustment for age and gender. Tobacco use was not associated with increased risk of the development of severe pain (P = 0.51). Conclusions. Although current tobacco users undergoing CABG surgery utilize more opioid analgesics in the first 48 hours following extubation than nonusers of tobacco, when adjusted for age and gender, tobacco use was not independently associated with differences in postoperative opioid use
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