Evaluation of a multifaceted "Resident-as-Teacher" educational intervention to improve morning report

BACKGROUND: Resident-led morning report is an integral part of most residency programs and is ranked among the most valuable of educational experiences. The objectives of this study were to evaluate the effect of a resident-as-teacher educational intervention on the educational and teaching experience of morning report. METHODS: All senior internal medicine residents were invited to participate in this study as teaching participants. All internal medicine residents and clerks were invited to participate as audience participants. The educational intervention included reading material, a small group session and feedback after teaching sessions. The educational and teaching experiences were rated prior to and three months after the intervention using questionnaires. RESULTS: Forty-six audience participants and 18 teaching participants completed the questionnaires. The degree to which morning report met the educational needs of the audience was higher after the educational intervention (effect size, d = 0.26, p = 0.01). The perceptions of the audience were that delivery had improved and that the sessions were less intimidating and more interactive. The perception of the teaching participants was that delivery was less stressful, but this group now reported greater difficulty in engaging the audience and less confidence in their medical knowledge. CONCLUSION: Following the educational intervention the audience's perception was that the educational experience had improved although there were mixed results for the teaching experience. When evaluating such interventions it is important to evaluate the impact on both the educational and teaching experiences as results may differ

Why work-life balance now?

In the vast literature on work-life balance one question remains seriously under-elaborated: Why now? The paper opens by recognising that flexible working practices can be employee friendly or employer friendly, and that current employer friendly practices tend to constrain, rather than enable, possibilities for work-life balance. Part two introduces neoliberalism, interpreting it as a new class strategy: the iron fist of a renewed ruling class offensive is wrapped in the velvet glove of freedom, individualism, and (re-habilitated) discourses of flexible working practices. Part three introduces socio-linguistics to overcome an elision between work-life balance as a set of practices and as a set of discourses. We then see that discourses of flexibility have been un-coupled from discourses associated with employee unfriendly flexible working practices, and re-coupled with discourses associated with employee friendly working practices and, hence, with work-life balance. Data show that current flexible working practices are characterised as much by employee unfriendly working practices that tend to constrain work-life balance, as they are by employee friendly practices that tend to enable work-life balance. Shorn of its employee unfriendly connotations, the term 'flexibility' has been discursively 'rehabilitated' such that it no longer connotes any negativity. In conclusion one of New Labour's work-life balance policies (the right to request and the duty to consider flexible working practices) is analysed in an attempt to answer the initial question: 'Why work-life balance now?

Parental investment and egg yolk lipid composition in gulls.

1. Within-clutch variation in parental investment of yolk lipid (including essential fatty acid composition and fat-soluble vitamin content) was investigated in whole clutches of three eggs of Lesser Black-backed Gulls, Larus fuscus. 2. Although there were no significant differences between years in egg size or yolk mass among eggs of the same laying order, eggs collected in 1996 had significantly lower lipid content than those collected in 1997. 3. In both years third-laid c-eggs were smaller, had a smaller mass of yolk and had significantly lower yolk lipid mass compared with earlier laid (a- and b-) eggs. 4. Despite this lower lipid mass of c-eggs, of the different lipid fractions only cholesterol content of c-eggs was significantly lower than that of a- or b-eggs. 5. Earlier laid eggs had greater amounts of arachidonic acid in the phospholipid and cholesterol ester fractions of yolk lipid, and considerably greater quantities of vitamin E and carotenoids. 6. Conversely, levels of linoleic acid and vitamin A were equalized among eggs of different laying sequence as both these essential nutrients have primarily systemic roles. 7. The probable effect of increased antioxidant (vitamin E and carotenoid) content of earlier-laid eggs is to enhance embryonic and neonatal growth and development, reduce susceptibility to pathogens and increase the ability of the embryo to withstand the oxidative stress associated with hatching. 8. The results suggest that there is maternal bias of essential nutrients to offspring with the highest reproductive value in order to maximize reproductive success