The Use of “Effect Size” in Augmenting the Results of Significance Testing: A Comparison of Pre/Post Data from a Geriatric Interclerkship

Most research in medical education, when examining the impact of an intervention, report findings based primarily on significance testing despite the controversy of its appropriate use. Moreover, the p-value used to determine rejection or acceptance of the null hypothesis tells nothing about the magnitude of the significance. Using a pre/post assessment of a Geriatric Interclerkship as a case study, this study examines the utility of effect size measures in augmenting significance testing results. Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2004

Nursing Students Teaching Medical Students: An Interdisciplinary Teaching Experience

For a number of years, Advanced Practice Nursing ( APN) students have taught interested 1st year medical students to perform intramuscular injections prior to their participation in community flu clinics. When several 4th year medical students needed documentation of competency in intravenous (IV) cannulation prior to participating in an elective rotation at another institution, the Director of Interdisciplinary Partnerships in the Graduate School of Nursing requested assistance from the medical school\u27s Dean of Students. In fact, all medical students need IV therapy training prior to graduation, not just those who seek out elective rotations at other medical schools. Integration of IV therapy training into the Undergraduate Medical Education Surgery Clerkship curriculum supports the clinical objectives of the Surgery Clerkship along with the developing use of simulation within the medical school. This need led to the development of this interprofessional simulation education initiative. Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2008

Setting the Standard for a High-Stakes End of Third Year Assessment

Purpose: - Conduct modified Angoff standard setting procedure due to planned move to “high-stakes” End of Third Year Assessment (EOTYA) - Assess the result of applying cutoffs to EOTYA student performance data - Analyze judges’ perceptions and confidence in setting cutoffs for three skill areas across seven Objective Structured Clinical Examinations (OSCEs) Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2007

Comparison and potential determinants of health-related quality of life among rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis: A cross-sectional study

Objectives: This study aimed to compare the health-related quality of life scores among rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis and to evaluate socio-demographic and clinical determinantes of quality of life across diseases. Methods: The sample comprised 490 patients with rheumatoid arthritis, 198 with psoriatic arthritis, and 119 with spondyloarthritis who completed a series of health examinations and self-reported questionnaires. Quality of life was evaluated using the Short-Form 36 Health Survey, disease activity by DAS28-CRP, DAPSA, and ASDAS-CRP (for rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis, respectively), depression and anxiety using the Hospital Anxiety and Depression Scale. ANOVA was used to compare the quality of life dimensions and their physical and mental summary measures among rheumatic diseases, and multivariate analysis was used to explore their potential determinants. Results: Rheumatoid arthritis had significantly worse scores than spondyloarthritis in the following dimensions: physical functioning, role limitation due to physical health, physical component score, and mental health. Psoriatic arthritis was not significantly different from the other two diseases. Multivariate analysis revealed that physical quality of life was mainly associated with disease activity across rheumatic diseases, rheumatological treatment and depression in rheumatoid arthritis and psoriatic arthritis. Mental quality of life is primarily associated with depression and anxiety across rheumatic diseases. Conclusion: There were differences in quality of life among patients with inflammatory rheumatic diseases, but overall, approximately uniform factors explained the variance in quality of life across diseases. Clinicians should develop general approaches and strategies for inflammatory rheumatic diseases to improve patients' quality of life

Rolling Out a State-of-the-Art Simulation Center: Early Experiences

The Simulation Center, opened in the Fall 2006, contains state-of-the-art simulation technology (e.g., high-fidelity adult and pediatric mannequins, task trainers, and real-time/recorded observation and scenario review via audio-visual equipment) that provides an interactive learning environment designed to replicate the clinical setting. It is available to the School of Medicine, Graduate Medical Education, the School of Nursing, and the Graduate School of Biomedical Sciences. Event facilitators (i.e., faculty or residents) were asked to assess their initial perception and utilization of the center. Presented at the 2008 Society on Simulation in Healthcare Conference

Using a Targeted OSCE Station to Measure Unprofessional Behavior

Standardized patients are widely used in medical education but their use to assess professionalism is limited. With grant support from the Edward J. Stemmler, MD Medical Education Research Fund (“Stemmler Fund”) of the National Board of Medical Examiners (NBME), the usefulness of standardized patients (SPs) in the assessment of professional behavior was investigated. A targeted professionalism OSCE station featuring a values conflict was written. A professionalism instrument was developed and subsequently revised during the course of the study, with the final version containing various components of American Board of Internal Medicine (ABIM) core set of eight professionalism attributes and several other scales in recent medical research. Presented at the Ottawa Conference, 2006

Measuring Unprofessional Behavior During an 8-Station OSCE

Standardized patients (SPs) are widely used in medical education but their use to assess professionalism is limited. This study investigated the utility of SPs assessing unprofessional behavior during an annual end of third year Objective Structured Clinical Examination (OSCE). Presented at the AAMC (Association of American Colleges) Annual Meeting, RIME (Research in Medical Education) Program, November 2006

Sustainability of using vineyard pruning residues as an energy source: Combustion performances and environmental impact

Open burning of agricultural waste is still a common practice as it is a rapid method for waste disposal, although natural biomass, including agriculture residues, can be exploited as a renewable energy source. We assessed the viability and sustainability of using vineyard pruning residues, as wood chips, for energy conversion. Wood chips, obtained from vineyards in the Prosecco DOCG region (Italy), were characterized in terms of chemical composition, calorific value, ash content and humidity. Combustion tests were performed in a medium-size biomass boiler (maximum power 500 kW) to assess the viability of the approach in terms of sustainable steady-state combustion. Primary emissions of both macro- and micro-pollutants were measured to assess the environmental impact. An analytical method was purposely developed for the determination of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) and in three matrices: fly ashes, condensate and gas. The results showed that vineyard pruning residues can be used for energy conversion in medium- and large-scale biomass boilers. Primary emissions of measured pollutants were all below limit values set by current European legislation except for particulate matter, for which current available abatement technologies are required to contain emissions, abatement technologies are required to contain emissions, thus making the use of vineyard pruning residues unsuitable for combustion in domestic appliances where such technologies are not installed. Bottom ashes produced during combustion were also characterized to assess whether they can be recycled in the vineyard as soil amendments/fertilizer. Copper content in combustion ashes exceeded limit values for ashes to be used as fertilizers in agricultural fields for some European countries but not for others, indicating that ashes may need to be disposed as waste

Parametrization of the calcaneus and medial cuneiform to aid potential advancements in flatfoot surgery

Introduction: Flatfoot is a condition commonly seen in children; however, there is general disagreement over its incidence, characterization and correction. Painful flatfoot accompanied with musculoskeletal and soft tissue problems requires surgery to avoid arthritis in adulthood, the most common surgical approach being two osteotomies to the calcaneus and medial cuneiform bones of the foot. Objectives: This study focuses on the parametrization of these two bones to understand their bone morphology differences in a population sample among 23 normal subjects. Population differences could help in understanding whether bone shape may be an important factor in aiding surgical planning and outcomes. Methods: A total of 45 sets of CT scans of these subjects were used to generate surface meshes of the two bones and converted to be iso-topological meshes, simplifying the application of Generalized Procrustes Analysis and Principal Component Analysis, allowing the main sources of variation between the subjects to be quantified. Results: For the calcaneus, 16 Principal Components (PCs) and, for the medial cuneiform, 12 PCs were sufficient to describe 90% of the dataset variability. The quantitative and qualitative analyses confirm that for the calcaneus PC1 describes the Achilles attachment location and PC2 largely describes the anterior part of the bone. For the medial cuneiform, PC1 describes the medial part of the bone, while PC2 mainly describes the superior part. Conclusion: Most importantly, the PCs did not seem to describe the osteotomy sites for both bones, suggesting low population variability at the bone cutting points. Further studies are needed to evaluate how shape variability impacts surgical outcomes. Future implications could include better surgical planning and may pave the way for complex robotic surgeries to become a reality.This work was supported by grant EP/R513027/1 from the EPSRC DTP 2018–201