Teaching Resident Self-Assessment Through Triangulation of Faculty and Patient Feedback

Problem: To accurately determine one\u27s ability in any clinical competency, an individual must be able to self-assess performance and identify personal limitations. Existing research demonstrates that physicians of all levels are unreliable self-assessors. This poses a concern in medical practice, which requires continuous updates to clinical competencies and awareness of personal limitations. Few published studies examine graduate medical education curricula designed to develop self-assessment skills. Intervention: Conceptual models, such as self-determination theory, suggest that self-assessment is most effectively learned through reflective processes. The Family Medicine Residency Program at Lehigh Valley Health Network developed a learner-centered competency assessment process that integrates advising and performance review. The multisource, observable behavior-based process encourages conversation between resident and advisor. Utilizing feedback from clinical preceptors and patient surveys, advisors guide residents in determining individual learning needs in core competency areas, including relationship-centered care. Development of medical learners\u27 capacity to form relationships is one means to improving the patient experience. Context: This retrospective case study evaluates the accuracy of senior residents\u27 self-assessment in relationship-centered care compared with that of junior residents. The study population includes the 34 residents enrolled from AY 2009–2012. Data sets represent specific 6-month periods and have 3 component scores—Self, Faculty, and Patient—which were triangulated to determine concordance rates by postgraduate year level. Outcome: The concordance rate among first-years was 26.7%, whereas third-years saw 60.0% concordance. A discordance analysis found the Patient score most often deviated from the other 2 scores, whereas the Faculty score was never the sole dissenter. When all 3 scores differed, the Self score frequently fell between the other 2 scores. Lessons Learned: The principles of self-determination theory provide a valuable framework for understanding the development of residents\u27 intrinsic motivation to become lifelong learners. The trend in improved concordance rates among senior residents suggests that prompting learners to triangulate feedback from multiple sources can lead to a shift in perspective about competency. Further study is needed to determine whether our results are generalizable to other competencies and educational setting

Ontogenetic Responses of Calanus chilensis to Hypoxia from Northern Chile (23ºS), Humboldt Current Ecosystem

Eastern Boundary Upwelling Systems are being subjected to expansion, intensification and shoaling of Oxygen Minimum Zones (OMZ's), as a result of ongoing climate change. To understand how dominant epipelagic copepods may respond to stressful conditions induced by low oxygen, we experimentally studied the effect of hypoxia over the stage-specific physiology of Calanus chilensis from the Mejillones Bay (23°S — 70°W), northern Chile, during the winters of 2013 and 2014. Females, eggs and nauplii (NI to NIV) of C. chilensis were incubated under hypoxia (~0.7 mg O2 L-1) and normoxia (~8.3 mg O2 L-1) conditions at a constant temperature of 14ºC as to estimate egg production rate (EPR), hatching success (HS) and naupliar growth and development time. Additionally, we estimated survivorship by using Neutral Red technique, and also examined female metabolism by measuring specific activity of the enzymes Aminoacyl-tRNA synthetases (spAARS) (growth index) and the electron transport system (spETS) (potential respiration). Survival of females and EPR were not significantly affected by dissolved oxygen (DO) conditions, coinciding with no significant changes in their metabolism. By contrast, HS was reduced from normoxia (70%) to hypoxia (30%), whereas naupliar growth (NI to NIII) was lower under hypoxia (0.155 ± 0.007 d-1) than normoxia (0.237 ± 0.006 d-1), resulting also in a longer development time, 6.490 ± 0.353 d and 4.238 ± 0.149 d, respectively. Most eggs and nauplii collected at the end of the experiments were alive, although a higher proportion of organisms were recovered in normoxia than hypoxia. Our results revealed stage-specific responses to hypoxia in C. chilensis and the importance of ontogenetic responses to variable levels of oxygenation in the upwelling zone

William (Bill) Peterson's contributions to ocean science, management, and policy

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Schwing, F. B., Sissenwine, M. J., Batchelder, H., Dam, H. G., Gomez-Gutierrez, J., Keister, J. E., Liu, H., & Peterson, J. O. William (Bill) Peterson's contributions to ocean science, management, and policy. Progress in Oceanography, 182, (2020): 102241, doi:10.1016/j.pocean.2019.102241.In addition to being an esteemed marine ecologist and oceanographer, William T. (Bill) Peterson was a dedicated public servant, a leader in the ocean science community, and a mentor to a generation of scientists. Bill recognized the importance of applied science and the need for integrated “big science” programs to advance our understanding of ecosystems and to guide their management. As the first US GLOBEC program manager, he was pivotal in transitioning the concept of understanding how climate change impacts marine ecosystems to an operational national research program. The scientific insight and knowledge generated by US GLOBEC informed and advanced the ecosystem-based management approaches now being implemented for fishery management in the US. Bill held significant leadership roles in numerous international efforts to understand global and regional ecological processes, and organized and chaired a number of influential scientific conferences and their proceedings. He was passionate about working with and training young researchers. Bill’s academic affiliations, notably at Stony Brook and Oregon State Universities, enabled him to advise, train, and mentor a host of students, post-doctoral researchers, and laboratory technicians. Under his collegial guidance they became critical independent thinkers and diligent investigators. His former students and colleagues carry on Bill Peterson’s legacy of research that helps us understand marine ecosystems and informs more effective resource stewardship and conservation

Synthesis of Pacific Ocean Climate and Ecosystem Dynamics

The goal of the Pacific Ocean Boundary Ecosystem and Climate Study (POBEX) was to diagnose the large-scale climate controls on regional transport dynamics and lower trophic marine ecosystem variability in Pacific Ocean boundary systems. An international team of collaborators shared observational and eddy-resolving modeling data sets collected in the Northeast Pacific, including the Gulf of Alaska (GOA) and the California Current System (CCS), the Humboldt or Peru-Chile Current System (PCCS), and the Kuroshio-Oyashio Extension (KOE) region. POBEX investigators found that a dominant fraction of decadal variability in basin- and regional-scale salinity, nutrients, chlorophyll, and zooplankton taxa is explained by a newly discovered pattern of ocean-climate variability dubbed the North Pacific Gyre Oscillation (NPGO) and the Pacific Decadal Oscillation (PDO). NPGO dynamics are driven by atmospheric variability in the North Pacific and capture the decadal expression of Central Pacific El Niños in the extratropics, much as the PDO captures the low-frequency expression of eastern Pacific El Niños. By combining hindcasts of eddy-resolving ocean models over the period 1950–2008 with model passive tracers and long-term observations (e.g., CalCOFI, Line-P, Newport Hydrographic Line, Odate Collection), POBEX showed that the PDO and the NPGO combine to control low-frequency upwelling and alongshore transport dynamics in the North Pacific sector, while the eastern Pacific El Niño dominates in the South Pacific. Although different climate modes have different regional expressions, changes in vertical transport (e.g., upwelling) were found to explain the dominant nutrient and phytoplankton variability in the CCS, GOA, and PCCS, while changes in alongshore transport forced much of the observed long-term change in zooplankton species composition in the KOE as well as in the northern and southern CCS. In contrast, cross-shelf transport dynamics were linked to mesoscale eddy activity, driven by regional-scale dynamics that are largely decoupled from variations associated with the large-scale climate modes. Preliminary findings suggest that mesoscale eddies play a key role in offshore transport of zooplankton and impact the life cycles of higher trophic levels (e.g., fish) in the CCS, PCCS, and GOA. Looking forward, POBEX results may guide the development of new modeling and observational strategies to establish mechanistic links among climate forcing, mesoscale circulation, and marine population dynamics

CTD profiles of temperature, oxygen, salinity, density, fluorescence, PAR, and pH collected in Hood Canal on cruises CB1072, CB1077, and RC008 during 2017 and 2018

Dataset: Hood Canal CTDCTD profiles of temperature, oxygen, salinity, density, fluorescence, PAR, and pH collected in Hood Canal on cruises CB1072, CB1077, and RC008 during 2017 and 2018. For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/826281NSF Division of Ocean Sciences (NSF OCE) OCE-165799

Carbonate chemistry from Niskin bottle samples collected at Twanoh buoy in Hood Canal during R/V Clifford A. Barnes cruises CB1077 and CB1072 in 2017

Dataset: Hood Canal Carbonate ChemistryCarbonate chemistry from Niskin bottle samples collected at Twanoh buoy in Hood Canal during R/V Clifford A. Barnes cruises CB1077 and CB1072 in 2017. For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/826183NSF Division of Ocean Sciences (NSF OCE) OCE-165799

Species Composition and Distribution of Jellyfish in a Seasonally Hypoxic Estuary, Hood Canal, Washington

Seasonal hypoxia (≤2 mg dissolved oxygen L−1) can have detrimental effects on marine food webs. Recent studies indicate that some jellyfish can tolerate low oxygen and may have a competitive advantage over other zooplankton and fishes in those environments. We assessed community structure and distributions of cnidarian and ctenophore jellyfish in seasonally hypoxic Hood Canal, WA, USA, at four stations that differed in oxygen conditions. Jellyfish were collected in June through October 2012 and 2013 using full-water-column and discrete-depth net tows, concurrent with CTD casts to measure dissolved oxygen (DO). Overall, southern, more hypoxic, regions of Hood Canal had higher abundances and higher diversity than the northern regions, particularly during the warmer and more hypoxic year of 2013. Of fifteen species identified, the most abundant—the siphonophore Muggiaea atlantica and hydrozoan Aglantha digitale—reached peak densities > 1800 Ind m−3 and 38 Ind m−3, respectively. M. atlantica were much more abundant at the hypoxic stations, whereas A. digitale were also common in the north. Vertical distributions explored during hypoxia showed that jellyfish were mostly in the upper 10 m regardless of the oxycline depth. Moderate hypoxia seemed to have no detrimental effect on jellyfish in Hood Canal, and may have resulted in high population densities, which could influence essential fisheries and trophic energy flow

Physiological observations of Euphausia pacifica sampled in Puget Sound, WA aboard R/V Clifford A. Barnes during cruises CB1073 and CB1078 in 2017.

Dataset: Krill physiology - In situ conditionsPhysiological observations of Euphausia pacifica sampled in Puget Sound, WA aboard R/V Clifford A. Barnes during cruises CB1073 and CB1078 in 2017. For a complete list of measurements, refer to the full dataset description in the supplemental file 'Dataset_description.pdf'. The most current version of this dataset is available at: https://www.bco-dmo.org/dataset/840626NSF Division of Ocean Sciences (NSF OCE) OCE-115464