629 research outputs found
LâintĂ©gration des Ă©valuations de lâapprentissage autorĂ©gulĂ© dans les activitĂ©s dâĂ©valuation dans les professions de la santĂ© : un appel Ă lâaction
How well have healthcare professionals and trainees been prepared for the inevitable demands for new learning that will arise in their future? Given the rapidity with which âcore healthcare knowledgeâ changes, medical educators have a responsibility to audit whether trainees have developed the capacity to effectively self-regulate their learning. Trainees who engage in effective self-regulated learning (SRL) skilfully monitor and control their cognition, motivation, behaviour, and environment to adaptively meet demands for new learning. However, medical curricula rarely assess traineesâ capacity to engage in this strategic process. In this position paper, we argue for a paradigm shift toward assessing SRL more deliberately in undergraduate and postgraduate programs, as well as in associated licensing activities. Specifically, we explore evidence supporting an innovative blend of principles from the science on SRL, and on preparation for future learning (PFL) assessments. We propose recommendations for how program designers, curriculum developers, and assessment leads in undergraduate and postgraduate training programs, and in licensing bodies can work together to develop integrated assessments that measure how and how well trainees engage in SRL. Claims about lifelong learning in health professions education have gone unmatched by responsive curricular changes for far too long. Further neglecting these important competencies represents a disservice to medical trainees and a potential risk to the future patients they will care for.Dans quelle mesure les professionnels de la santĂ© et les Ă©tudiants ont-ils Ă©tĂ© prĂ©parĂ©s aux exigences inĂ©vitables de nouveaux apprentissages qui se prĂ©senteront Ă eux Ă lâavenir? Ătant donnĂ© la rapiditĂ© avec laquelle les «âconnaissances de base en matiĂšre de soins de santĂ©â» Ă©voluent, les enseignants en mĂ©decine ont la responsabilitĂ© de vĂ©rifier si les Ă©tudiants ont dĂ©veloppĂ© la capacitĂ© dâautorĂ©guler adĂ©quatement leurs apprentissages. Ceux qui pratiquent efficacement lâapprentissage autorĂ©gulĂ© (AAR) surveillent et contrĂŽlent habilement leur cognition, leur motivation, leur comportement et leur environnement pour sâadapter Ă la nĂ©cessitĂ© de nouveaux apprentissages. Cependant, les programmes dâĂ©tudes mĂ©dicales Ă©valuent rarement la capacitĂ© des Ă©tudiants Ă sâengager dans ce processus stratĂ©gique. Dans cet exposĂ© de position, nous plaidons en faveur dâun changement de paradigme vers une Ă©valuation plus ciblĂ©e de lâAAR dans les formations doctorale et postdoctorale, ainsi que pour les activitĂ©s dâĂ©valuation. Plus prĂ©cisĂ©ment, nous explorons les rĂ©sultats convaincants de lâemploi dâun mĂ©lange innovant de principes issus de la recherche en matiĂšre dâAAR et dâĂ©valuations de la prĂ©paration Ă lâapprentissage futur. Nous proposons des recommandations pour une collaboration entre les responsables de la conception de programmes dâĂ©tudes, ceux de lâĂ©laboration du cursus, ceux chargĂ©s de lâĂ©valuation dans les programmes dâĂ©tudes prĂ©doctorales et postdoctorales et les organismes responsables de lâoctroi dâun titre de compĂ©tence en vue de crĂ©er des Ă©valuations intĂ©grĂ©es qui mesurent la mĂ©thode et la qualitĂ© de lâAAR chez les Ă©tudiants. Les programmes dâĂ©tudes tardent encore Ă traduire dans la pratique la reconnaissance de lâimportance de lâapprentissage tout au long de la vie dans lâĂ©ducation mĂ©dicale. Continuer Ă nĂ©gliger ces compĂ©tences importantes ne ferait que nuire aux Ă©tudiants en mĂ©decine et potentiellement Ă leurs futurs patients
L'analyse des incidents liés à la sécurité des patients dans le domaine de la santéune séance de formation novatrice pour les étudiants en médecine
Implication Statement
Patient safety incident analysis is a tool which allows for the identification of and learning from patient safety incidents, which are common in healthcare settings. The University of Toronto introduced a patient safety incident analysis session for graduating medical students in the form of a lecture and subsequent student presentations of incident analyses. Student respondents to evaluation rated the session highly and felt that feedback on their presentations was helpful to reinforce material. Medical schools can incorporate this innovative session as an interactive addition to quality improvement and patient safety curricula to provide students with hands-on experience in incident analysis.ĂnoncĂ© des implications de la recherche
Lâanalyse des incidents liĂ©s Ă la sĂ©curitĂ© des patients permet de repĂ©rer et dâapprendre de tels incidents qui sont frĂ©quents dans les Ă©tablissements de santĂ©. LâUniversitĂ© de Toronto a introduit une sĂ©ance dâanalyse des incidents liĂ©s Ă la sĂ©curitĂ© des patients pour les Ă©tudiants en mĂ©decine en fin de cursus, sous la forme dâun cours magistral suivi de prĂ©sentations dâanalyses dâincidents par les Ă©tudiants. Les Ă©tudiants qui ont Ă©valuĂ© la formation ont rapportĂ© un haut taux de satisfaction par rapport Ă la sĂ©ance et ont trouvĂ© que les commentaires reçus sur leurs prĂ©sentations Ă©taient utiles pour mieux assimiler le contenu du cours. Les facultĂ©s de mĂ©decine peuvent intĂ©grer cette formation innovante et interactive comme complĂ©ment aux programmes dâamĂ©lioration de la qualitĂ© et Ă ceux axĂ©s sur la sĂ©curitĂ© des patients afin de fournir aux Ă©tudiants une expĂ©rience pratique en ce qui concerne lâanalyse des incidents
Exploring social media and admissions decision-making â friends or foes?
Background: Despite the ever-increasing use of social media (e.g., Facebook, Twitter) little is known about its use in medical school admissions. This qualitative study explores whether and how social media (SM) is used in undergraduate admissions in Canada, and the attitudes of admissions personnel towards such use.Methods: Phone interviews were conducted with admissions deans and nominated admissions personnel. A qualitative descriptive analysis was performed using iterative coding and comparing, and grouping data into themes.Results: Personnel from 15 of 17 Canadian medical schools participated. A sizeable proportion had, at some point, examined social media (SM) profiles to acquire information on applicants. Participants did not report using it explicitly to screen all applicants (primary use); however, several did admit to looking at SM to follow up on preliminary indications of misbehaviour (secondary use). Participants articulated concerns, such as validity and equity, about using SM in admissions. Despite no schools having existing policy, participants expressed openness to future use.  Conclusions: While some of the 15 schools had used SM to acquire information on applicants, criteria for formulating judgments were obscure, and participants expressed significant apprehension, based on concerns for fairness and validity. Findings suggest participant ambivalence and ongoing risks associated with âhiddenâ selection practices
ĂclipsĂ© par l'observation : comment les Ă©tudiants en mĂ©decine canadiens vivent-ils lâobservation?
Background: Preclinical medical students commonly perceive shadowing as beneficial for career exploration. However, research is sparse on the broader impact of shadowing as a learning strategy. We explored studentsâ perceptions and lived experiences of shadowing to understand its role and impact on their personal and professional lives.
Methods: Between 2020-2021, individual semi-structured video interviews were conducted with 15 Canadian medical students in this qualitative descriptive study. Inductive analysis proceeded concurrently with data collection until no new dominant concepts were identified. Data were iteratively coded and grouped into themes.
Results: Participants described internal and external factors that moulded shadowing experiences, arising tensions between intended and perceived experiences, and how these lived experiences impacted their wellness. Internal factors associated with shadowing behaviour included: 1) aspiring to be the best and shadowing to demonstrate excellence, 2) shadowing for career exploration, 3) shadowing as learning opportunities for early clinical exposure and career preparedness, and 4) reaffirming and redefining professional identity through shadowing. External factors were: 1) unclear residency match processes which position shadowing as competitive leverage, 2) faculty messaging that perpetuates student confusion around the intended value of shadowing, and 3) social comparison in peer discourse, fuelling a competitive shadowing culture.
Conclusions: The tension between balancing wellness with career ambitions and the unintended consequences of unclear messaging regarding shadowing in a competitive medical culture highlights issues inherent in shadowing culture.Contexte : De maniĂšre gĂ©nĂ©rale, les Ă©tudiants en mĂ©decine prĂ©clinique considĂšrent que lâobservation prĂ©sente une occasion intĂ©ressante dâexplorer les possibilitĂ©s de carriĂšre. Cependant, peu de recherches ont Ă©tĂ© menĂ©es sur lâimpact plus large de lâobservation comme stratĂ©gie dâapprentissage. Nous avons explorĂ© les perceptions et les expĂ©riences vĂ©cues des Ă©tudiants en matiĂšre dâobservation afin de comprendre son rĂŽle et ses rĂ©percussions sur leur vie personnelle et professionnelle.
MĂ©thodes : Dans le cadre de cette Ă©tude qualitative descriptive, entre 2020 et 2021, des entretiens vidĂ©o individuels semi-structurĂ©s ont Ă©tĂ© menĂ©s avec 15 étudiants en mĂ©decine canadiens. Lâanalyse inductive sâest dĂ©roulĂ©e simultanĂ©ment Ă la collecte des donnĂ©es jusquâĂ ce quâaucun concept dominant nouveau nâapparaisse. Les donnĂ©es ont Ă©tĂ© codĂ©es de maniĂšre itĂ©rative et regroupĂ©es en thĂšmes.
RĂ©sultats : Les participants ont dĂ©crit les facteurs internes et externes qui ont façonnĂ© leur expĂ©rience de lâobservation et les tensions qui en ont dĂ©coulĂ©, ainsi que lâimpact de ces expĂ©riences sur leur bien-ĂȘtre. Les facteurs internes associĂ©s au comportement dâobservation sont les suivants : 1) vouloir ĂȘtre le meilleur et faire de lâobservation pour montrer son excellence, 2) faire de lâobservation dans le but dâexplorer les dĂ©bouchĂ©s de carriĂšre, 3) faire de lâobservation pour apprendre par lâexposition clinique prĂ©coce et pour se prĂ©parer Ă la carriĂšre, et 4) rĂ©affirmer et redĂ©finir lâidentitĂ© professionnelle par lâobservation. Les facteurs externes sont 1) le manque de clartĂ© dans les processus de jumelage des rĂ©sidents pouvant donner lâimpression que lâobservation est un atout, 2) le discours enseignant qui entretient la confusion des Ă©tudiants quant Ă la valeur de lâobservation, et 3) la comparaison sociale dans le discours des pairs, alimentant une culture de lâobservation compĂ©titive.
Conclusions : La difficultĂ© de trouver un Ă©quilibre entre le bien-ĂȘtre et les ambitions professionnelles, et les consĂ©quences involontaires dâun discours peu clair concernant lâobservation dans le contexte dâun climat compĂ©titif mettent en Ă©vidence les problĂšmes inhĂ©rents Ă la culture de lâobservation
Balloon dilatation and stenting for aortic coarctation: a systematic review and meta-analysis
BackgroundâThere is no systematic assessment of available evidence on effectiveness and comparative effectiveness of balloon dilatation and stenting for aortic coarctation. Methods and ResultsâWe systematically searched 4 online databases to identify and select relevant studies of balloon dilatation and stenting for aortic coarctation based on a priori criteria (PROSPERO 2014:CRD42014014418). We quantitatively synthesized results for each intervention from single-arm studies and obtained pooled estimates for relative effectiveness from pairwise and network meta-analysis of comparative studies. Our primary analysis included 15 stenting (423 participants) and 12 balloon dilatation studies (361 participants), including patients â„10 years of age. Post-treatment blood pressure gradient reduction to â€20 and â€10 mmâHg was achieved in 89.5% (95% confidence interval, 83.7â95.3) and 66.5% (44.1â88.9%) of patients undergoing balloon dilatation, and in 99.5% (97.5â100.0%) and 93.8% (88.5â99.1%) of patients undergoing stenting, respectively. Odds of achieving â€20 mmâHg were lower with balloon dilatation as compared with stenting (odds ratio, 0.105 [0.010â0.886]). Thirty-day survival rates were comparable. Numerically more patients undergoing balloon dilatation experienced severe complications during admission (6.4% [2.6â10.2%]) compared with stenting (2.6% [0.5â4.7%]). This was supported by meta-analysis of head-to-head studies (odds ratio, 9.617 [2.654â34.845]) and network meta-analysis (odds ratio, 16.23, 95% credible interval: 4.27â62.77) in a secondary analysis in patients â„1 month of age, including 57 stenting (3397 participants) and 62 balloon dilatation studies (4331 participants). ConclusionsâDespite the limitations of the evidence base consisting predominantly of single-arm studies, our review indicates that stenting achieves superior immediate relief of a relevant pressure gradient compared with balloon dilatation
Numerical approach to the dynamical Casimir effect
The dynamical Casimir effect for a massless scalar field in 1+1-dimensions is
studied numerically by solving a system of coupled first-order differential
equations. The number of scalar particles created from vacuum is given by the
solutions to this system which can be found by means of standard numerics. The
formalism already used in a former work is derived in detail and is applied to
resonant as well as off-resonant cavity oscillations.Comment: 15 pages, 4 figures, accepted for publication in J. Phys. A (special
issue: Proceedings of QFEXT05, Barcelona, Sept. 5-9, 2005
- âŠ