4 research outputs found

    Inter-rater Agreement of End-of-shift Evaluations Based on a Single Encounter

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    Introduction End-of-shift evaluation (ESE) forms, also known as daily encounter cards, represent a subset of encounter-based assessment forms.  Encounter cards have become prevalent for formative evaluation, with some suggesting a potential for summative evaluation.  Our objective was to evaluate the inter-rater agreement of ESE forms using a single scripted encounter at a conference of emergency medicine (EM) educators. Methods Following institutional review board exemption a scripted video simulating an encounter between an intern and a patient with an ankle injury was created.  That video was shown during a lecture at the Council of EM Residency Director’s Academic Assembly with attendees asked to evaluate the “resident” using 1 of 8 possible ESE forms randomly distributed.  Descriptive statistics were used to analyze the results with Fleiss’ Kappa to evaluate inter-rater agreement. Results Most of the 324 respondents were leadership in residency programs (66%).  Despite that, few individuals (5%) felt they were experts in assessing residents based on EM milestones.  Fleiss’ Kappa ranged from 0.157 - 0.308 and did not perform much better in two post-hoc subgroup analyses.  Conclusion The kappa ranges found show only slight to fair inter-rater agreement and raise concerns about the use of ESE forms in assessment of EM residents.  Despite limitations present in this study, these results and a lack of other studies on inter-rater agreement of encounter cards should prompt further studies of such methods of assessment.  Additionally, EM educators should focus research on methods to improve inter-rater agreement of ESE forms or other evaluating other methods of assessment of EM residents

    Global COVID-19 lockdown highlights humans as both threats and custodians of the environment

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    The global lockdown to mitigate COVID-19 pandemic health risks has altered human interactions with nature. Here, we report immediate impacts of changes in human activities on wildlife and environmental threats during the early lockdown months of 2020, based on 877 qualitative reports and 332 quantitative assessments from 89 different studies. Hundreds of reports of unusual species observations from around the world suggest that animals quickly responded to the reductions in human presence. However, negative effects of lockdown on conservation also emerged, as confinement resulted in some park officials being unable to perform conservation, restoration and enforcement tasks, resulting in local increases in illegal activities such as hunting. Overall, there is a complex mixture of positive and negative effects of the pandemic lockdown on nature, all of which have the potential to lead to cascading responses which in turn impact wildlife and nature conservation. While the net effect of the lockdown will need to be assessed over years as data becomes available and persistent effects emerge, immediate responses were detected across the world. Thus initial qualitative and quantitative data arising from this serendipitous global quasi-experimental perturbation highlights the dual role that humans play in threatening and protecting species and ecosystems. Pathways to favorably tilt this delicate balance include reducing impacts and increasing conservation effectiveness
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