3-year Program Research Articles

Genetic and T2 biomarkers linked to the efficacy of HDM sublingual immunotherapy in asthma

BackgroundHypersensitivity to house dust mite (HDM) allergens is a common cause of allergic asthma symptoms and can be effectively treated with allergy immunotherapy (AIT).ObjectiveTo investigate whether genetic and type 2...

Can an Orthopedic Hip Fracture Simulator Advance Orthopedic Residents’ Hip Fracture Fixation Skills to an Expert Level?

This study was undertaken to evaluate hip fracture simulator training and orthopedic resident skill attainment. We hypothesized that after 6 training sessions, improvement in post-training scores in junior residents would exceed that of senior residents and that senior residents would attain expert level proficiency sooner. Thirty orthopedic residents from a single institution completed 6 training sessions. Sessions included a pretest, 9 training modules, and post-test. An expert score was obtained from the average scores of 8 trauma fellows and attending orthopedic traumatologists. The primary outcome measure was overall score. A single academic institution. Orthopedic residents (postgraduate years [PGYs] 1-5). Twenty-six residents completed the study. The mean overall post-training score was 87% of the expert level. Factors associated with post-training score changes were additional training sessions (4.2% improvement [p < 0.01]), time between training sessions (0.3% decrease [p = 0.05]) and PGY5 class (12.1% improvement [p = 0.03]). Fifty-four percent of residents attained the expert overall score. Expert score attainment was not associated with an additional year of training or case log volume. Post-training scores plateaued for the PGY1s and showed linear improvement for the PGY5s. Differences in trends between training levels suggest this simulator is a useful adjunct to a 5-year orthopedic residency training program.

The role of the Dual X-Ray Absorptiometry investigation in the design of personalized training programs for women with postmenopausal osteopenia / osteoporosis

Osteoporosis affects many postmenopausal women and represents an economic burden. The purpose of the study was to observe the effects of a 1-year strength program on the bone mass at the level of the femur. Twenty-nine women were included in the randomized study, being divided into an exercise group (56±2.9 years old, n = 20) and a control group (56.4±2.1, n = 19). After 12 months of participation in the strength program (twice a week, using intensities of 70% of 1RM and 50% of 1RM) the exercise group showed statistically significant increases in all areas of interest of the femur as follows: femoral neck (+2.05%, p = .001, η_p^2 = .45), trochanteric area (+3.80%, p &lt; .001, η_p^2 = .75), intertrochanteric area (+0.97%, p = .013, η_p^2 = .37), Ward's triangle (+1.77%, p = .023, η_p^2 = .24) and femur's total bone mineral density (+1.97%, p &lt; .001, η_p^2 = .51). After 12 months, at the femoral neck region, the increase in bone density was 7.3 times higher compared to the control group (p = .01, F(1, 36) = 6.62, η_p^2 = .15, 95% CI [0.002, 0.020], at the trochanteric area the increase was 8 times higer compared to the control group (p &lt; .001, F (1, 36) = 16.48, η_p^2 = .31, 95% CI [0.009, 0.027] and at the total level of the femur, the increase in bone density was 8.6 times higher compared to the control group (p = .01, F (1, 36) = 7.09, η_p^2 = .17, 95% CI [0.003, 0.024]. In conclusion, alternating the intensities of 70% of a maximum repetition with those of 50% of a maximum repetition within the same set of 12 repetitions, bone mineral density at the level of the femur can undergo improvements.

The quest for the ideal business translator profile in the Romanian context

Abstract An ideal translator profile is a crucial issue for both translation providers, who want to deliver impeccable performance, and translation beneficiaries, whose purpose is to obtain flawless services. In the context of Romanian higher education, two distinct educational profiles of providers are distinguished in the business translation market: graduates of Philology, who have been trained in translation (3-year BA and 2-year MA programmes in Translation Studies), and graduates of Faculties of Economics or Business who have undertaken 3-year and/or 2-year MA study programmes in a foreign language. Showing the results of a study conducted with groups of third year Bachelor students of the University of Craiova, Romania (students in Translation Studies and students in the Finance and Banking English-taught programme), across a 3-year period (2015–2017), our research aims at providing answers to the following questions: To what extent does each of these two profiles match the ideal one of a business translator? What are the strengths and weaknesses of each of the two training profiles? What specific actions can and should be taken for each of the two target groups in terms of university training?

Peculiarities of training neurosurgeons in modern conditions using the example of a number of foreign countries

The possibility of unifying the training of neurosurgeons using the experience of different countries seems to be the most promising. At the same time, the uniqueness of the countries, the historical facts of the development of the neurosurgical specialty, scientific and technical achievements in them determined the diversity and specificity of individual neurosurgical schools. As a result, there is no unified model for a neurosurgical training program. In order to study the peculiarities of training neurosurgeons in foreign countries for the subsequent development of optimal models for training and advanced training of neurosurgery specialists in the Russian Federation, a search for foreign information was conducted in the databases Scopus, Web of Science, MedLine, Cochrane Library, EMBASE, Global Health, CyberLeninka, eLibrary.ru, RSCI for 2015–2022 to study the peculiarities of training neurosurgeons in the USA, England, Germany, Italy, Turkey. The analysis undertaken showed that the scope and training programs for neurosurgeons have their own characteristics in a number of countries. Thus, the duration of residency training in neurosurgery varies from 2 years in Russia to 6 years in Italy, Germany and 8 years in the UK. In the USA, postgraduate education for training a neurosurgeon includes 7 years of residency. Training programs also differ: in Italy they focus on primarily mastering practical skills; in Germany, during a 6-year training program, the student must master a wide range of theoretical and practical surgical skills. In the UK, training takes place in several stages: at the initial stage, mastering basic surgical skills common to all surgical specialties, skills and competencies in the field of basic neurosurgical care and emergency medicine. Competencies are further developed in relation to traumatic brain injury, degenerative spinal diseases, neuro-oncology and many other conditions. The final stage of training in the UK is in-depth neurosurgical training with the student spending a large amount of time in the operating room. In the USA, the “red thread” is the interdisciplinary integration of competencies and technologies. International cooperation within the framework of global neurosurgery is considered as the main vector for the development of the neurosurgical industry. The possibility of unifying the training of neurosurgeons using the experience of different countries and creating a global platform for the exchange of knowledge in the field of neurosurgery seem to be the most promising and useful in revising the training programs for neurosurgeons in our country.

Optimizing rural healthcare through improved team function: a case study of the Rural Surgical Obstetrical Networks programme

ABSTRACT We explored enablers and mechanisms of optimal team function within rural hospital teams, and the impact of these factors on health service sustainability in British Columbia. The data were drawn from interviews and focus groups with healthcare providers and administrators (n = 169) who participated in the Rural Surgical Obstetrical Networks (RSON) initiative to support low-volume rural surgical and obstetrical services in British Columbia, Canada. The 5-year programme (2018–2022) provided evidence-based system interventions across eight rural sites with the objective of providing sustainable, quality health services to meet population needs. To explore the impact of RSON interventions on local team function, we performed a scoping review, to assess the current literature surrounding enablers of effective rural hospital teamwork. Through inductive thematic analysis of interview data, we identified five enablers of good team function at RSON sites, including emphasis on local leadership, shared direction, commitment to sustainability, respect and solidarity among colleagues, and meaningful communication. The RSON project led to a shift in team culture in participating sites, improved team function, and contributed to improved clinical processes and patient outcomes. The findings have implications for rural health policy and practice in British Columbia and other jurisdictions with similar health service delivery models and geographic contexts.

FC5: The Maintain Your Brain online multidomain intervention for dementia risk reduction: qualitative exploration of lifestyle changes made, continued, or declined, and why

Objective:Explore end-user evaluations and feedback focused on lifestyle change in a large-scale multidomain online intervention targeting modifiable risk factors for dementia.Methods:Online survey and semi-structured interviews at conclusion of the Maintain Your Brain (MYB) randomized controlled trial. Participants were 55-77 years of age at baseline, and had engaged in assessments, brain training, nutrition and physical activity, and mental health modules over three years. Of 5,260 participants invited, 2,386 completed online surveys and 1,589 of these respondents provided free text comments. Nearly 250 survey respondents agreed to be contacted for additional interviews; 70 of these were invited, 40 interviewed. Survey respondents and interview completers endorsed whether they had made lifestyle changes because of MYB participation and whether they would continue healthy lifestyle changes going forward. Interview participants endorsed whether they thought similar programs can be useful in delaying or preventing dementia, whether their views regarding this type of program had changed over time, answered open-ended follow-up questions and provided additional feedback. Data were summarized using descriptive statistics and explored using multiple qualitative methods.Results:Of survey respondents, 90.5% endorsed intention to continue a healthier lifestyle; 63.2% endorsed that lifestyle changes had occurred. Interview participants thought similar programs could be useful in delaying or preventing dementia, but some were unsure. Trial participation had not changed many individuals’ views about online lifestyle programs. Survey free-text and interview comments indicated diversity in pre-intervention knowledge, lifestyle and health-related behavior. Many respondents reported improved knowledge and awareness, some detailed relevant and continued lifestyle change. Those who were already well informed and/or leading healthy lifestyles explained that trial participation had confirmed their existing practices. Trial characteristics, personal characteristics, social relationships and significant events impacted whether respondents had made and/or continued changes. More flexible, adaptive individually tailored goals and timely feedback were requested to better support change.Conclusion:Surveyed participants who engaged in the 3-year MYB online multidomain dementia risk reduction program reported lifestyle changes and intention to continue having a healthier lifestyle. Older adults in this study suggested that similar online programs need to provide flexible, individualized guidance and feedback to support lifestyle change.

Effect of an educational intervention on diet and physical activity among school-aged adolescents in Delhi -The i-PROMISe (PROMoting health literacy in Schools) Plus Study.

Emerging lifestyle changes due to rapid urbanization have led to an epidemiological transition and the rising prevalence of obesity is responsible for major non-communicable diseases (NCDs) which have further aggravated due to the COVID-19 pandemic. This study aims to assess the effectiveness of a comprehensive school-based intervention on diet and physical activity-related behavior of adolescents. In 2019, a cluster-randomized controlled trial was conducted in randomly selected (n=8) private schools. A 2-year intervention program was implemented over consecutive academic years (2019-2020 and 2020-2021) with students who were in the 6th and 7th grades when the study began. Four schools were randomly assigned to the intervention (n=794) and four schools to the control group (n=774). The difference in changes in diet and physical-activity-related behaviors of the students between the intervention and control schools were not significant in the intention to treat analysis probably due to the large drop-out due to COVID-19 measures: 304 students were available for follow-up in the intervention group and 122 in the control group (391 cases were excluded to make data comparable with baseline survey). The intake of vegetables (once a day) [β=0.35, OR=1.42, 95% CI (1.03, 1.95)] in the per-protocol analysis has increased among adolescents in the intervention group as compared to the control group. The findings of this study indicated a positive effect of the intervention on diet and physical-activity-related changes in the expected direction and highlights the importance of addressing such behavior to prevent obesity among adolescents and thus NCDs in the later stage of life.

Fixing the leaky physician-scientist pipeline: Integrated-dedicated research period programs in emergency medicine.

Emergency physicians (EPs) are well positioned to perform medical research. EPs are exposed to a wide range of disease types, medical specialties, and treatment modalities. Furthermore, emergency medicine (EM) serves as the safety net for the U.S. health care system. The diverse exposure provides a vast opportunity for EP to perform many worthwhile research projects. Yet, EM has historically had the lowest amount of funding and a lower number of National Institutes of Health-funded research projects. Many suggest the etiology is a "leaky" educational pipeline with loss of many potential physician-scientists over the training and development course. Current research training options for the EM physician-scientist includes MD-PhD, 4-year EM residency program and postresidency fellowships. While each has its advantages and disadvantages, we describe an additional educational alternative of EM physician-scientists, which we have named the integrated-dedicated research period within an EM residency. We describe the features of these programs and preliminary results from the graduates and current trainees.

Designing sustainability changes in a tourist accommodation context from a systems perspective

Pro-sustainability changes are slow and incremental at best in the tourism sector. Research on the topic can take the form of secondary data (e.g., content analysis of strategic documents, social media posts), survey-based intent studies (e.g., willingness to pay), survey-based studies of self-reported behaviors, observation of actual behaviors (e.g., benchmarking studies), lab-based experimental manipulations of measurable behaviors, and, finally, in situ, or field-based, experimental manipulations of measurable behaviors. The latter are some of the rarest studies and are held up as the gold standard for changing behaviors by providing evidence-based, measurable, and actionable sustainability interventions for tourism businesses. This study draws inspiration from a 4-year program of action research into pro-sustainability changes in tourist accommodations. It questions whether any of these approaches are sufficient for changing sustainability-oriented behaviors. This questioning extends to whether the theoretical approaches that underpin even “gold standard experiments” capture the operational contexts of accommodation businesses. It proposes instead that a scaffolded approach, built from a systems map of the theories, tools, experimental findings, interviews with stakeholders and operational context is necessary to create sustainability transformations in tourism businesses. This is a radical departure from the dependent/independent variable approach adopted in traditional scientific methods and that requires a different ontological approach to the science of sustainability. The study has implications for contextualizing intervention-based experimental studies within a wider system of influential factors within tourist accommodations.

Putting Youth in Charge: Exploring a Multi-Year Interagency Community Engagement Experiential Programme for Youth with Disabilities and Their Families

ABSTRACT This paper outlines a qualitative exploration of the experiences of Youth in Charge (YiC), a 3-year pilot programme. YiC was designed to promote early, immersive community participation for students with physical disabilities, and was co-developed/co-hosted by three agencies (hospital, community rehabilitation, school board). To better understand the experiences of the youth, parents, and staff involved in this broad intervention, observation of 10 programme sessions and annual semi-structured interviews with youth (n = 5), parents (n = 4) and staff (n = 6) were undertaken. Qualitative results comprise six themes based in the two major thematic areas of participation-related experiences and programme considerations. Results indicate the need for community-based experiences, measured risk-taking, long-term engagement, parental involvement, and greater interagency collaboration and integration.

Three years versus four years Saudi Board Family Medicine program: Graduates' academic performance, perceptions, burnout, and satisfaction with professional life.

The specialty of family medicine, established in Saudi Arabia in the 1980s, has rapidly progressed in healthcare settings and is increasingly utilized by the population as well as recent MBBS graduates. Universally, there is ambiguity in the duration, curriculum, and assessment methods used in family medicine specialization programs. A cross-sectional study was conducted among 183 fresh graduates from a 3-year and 4-year residency program. Data were collected using electronic forms, which were subsequently transferred to Microsoft Excel. Following appropriate coding, the data were transferred to SPSS for analysis. The dataset was then cleaned, and statistical tests, such as Chi-square and independent t-tests, were used to draw inferences. Males (50.3%) and females (49.7%) had almost equal distribution in the study. Overall, 67.6% of respondents had passed the final exam; the pass percentage was 69.3% for the 3-year residency program and 66.4% for the 4-year program. The overall mean score for perceived achievement of SaudiMED-FM 2020 competencies was 23.06 ± 5.52 out of a total score of 30. On comparing the 3-year versus 4-year residency program, there was no statistically significant difference between perceived competency scores and professional satisfaction scores. Among the study participants, 19 (10.4%) had 'serious burnout', and 22 (12%) had 'extremely serious burnout'. Professional satisfaction was significantly associated with burnout (P = 0.006). Based on the study results, there was no significant difference regarding academic performance, perceived competencies, and professional satisfaction among the graduates of the 3-year versus 4-year residency program. Approximately more than half of the graduates had suffered from burnout which was reported more by the females and those with financial issues. The majority of the respondents suggested improvements in clinical rotation and assessment methods.

The impact of hospice on end-of-life expenditures and total cost of care in episodic value-based care models at a community oncology network.

228 Background: The Institute of Medicine highlighted that multiple care transitions and fragmented care delivery at the end-of-life (EOL) is a burden to patients and caregivers. Hospice care has been shown to deliver high-quality, coordinated, and comprehensive EOL care while reducing unneeded healthcare interventions and improving EOL patient experience (preference of place of death, type of EOL care). The impact of timely hospice care on Total Cost of Care (TCOC) in episodic value-based care (VBC) models and patient experience at the EOL is largely unknown. The Oncology Care Model (OCM) was a 6-year long Medicare VBC program that encouraged care transformation at Oncology practices to drive better quality of care and patient experience, while decreasing TCOC. We studied the impact of timely hospice enrollment on TCOC, EOL expenditures, and patient experience. Methods: We obtained episode level data for patients who died in an episode (decedents) during the 6-years of the OCM (July 2016 to June 2022), for 15 practices in The US Oncology Network (The Network) participating in the OCM, along with several expenditure, clinical and episodic characteristics. We evaluated utilization and experience outcomes for episodes with and without hospice. Results: Of the 26,074 decedents during the 6-year period of the OCM, 55% were enrolled in hospice for 3 or more days (Hsp), and 45% were not enrolled or enrolled in hospice for less than 3 days (NoHsp). Mean TCOC for Hsp episodes ($41,297, n = 14,240) was significantly lower (Mann Whitney U test, p-value &lt; 0.0001, significance level = 0.01) than NoHsp ($47,601, n = 11,834) episodes. TCOC comparison by expense cohort results are provided in Table 1. Median duration of hospice for Hsp episodes was 9 days. Mean ICU and inpatient spend in last 30 days of life in NoHsp group was more than 2 times the spend in Hsp group. 44% of patients in NoHsp group died in a hospital or an ICU setting, whereas 97% of patients in Hsp group died at home or in a hospice setting. Conclusions: Patients enrolled in hospice for 3 or more days had lower EOL care expenditures, fewer acute care interventions, and died at home or in hospice. Timely and proactive enrollment in hospice and coordinated EOL care can improve patient experience, but also reduce EOL costs for the healthcare system and patients. CMMI Disclaimer: The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.[Table: see text]

Improving early infant diagnosis for HIV-exposed infants using unmanned aerial vehicles for blood sample transportation in Conakry, Guinea: a comparative cost-effectiveness analysis

BackgroundEarly infant diagnosis (EID) for HIV-exposed infants is essential due to high mortality during the first months of their lives. In Conakry (Guinea), timely EID is difficult as traffic congestion...

Deep-time Arctic climate archives: high-resolution coring of Svalbard's sedimentary record – SVALCLIME, a workshop report

Abstract. ​​​​​​​We held the MagellanPlus workshop SVALCLIME “Deep-time Arctic climate archives: high-resolution coring of Svalbard's sedimentary record”, from 18 to 21 October​​​​​​​ 2022 in Longyearbyen, to discuss scientific drilling of the unique high-resolution climate archives of Neoproterozoic to Paleogene age present in the sedimentary record of Svalbard. Svalbard is globally unique in that it facilitates scientific coring across multiple stratigraphic intervals within a relatively small area. The polar location of Svalbard for some of the Mesozoic and the entire Cenozoic makes sites in Svalbard highly complementary to the more easily accessible mid-latitude sites, allowing for investigation of the polar amplification effect over geological time. The workshop focused on how understanding the geological history of Svalbard can improve our ability to predict future environmental changes, especially at higher latitudes. This topic is highly relevant for the ICDP 2020–2030 Science Plan Theme 4 “Environmental Change” and Theme 1 “Geodynamic Processes”. We concluded that systematic coring of selected Paleozoic, Mesozoic, and Paleogene age sediments in the Arctic should provide important new constraints on deep-time climate change events and the evolution of Earth's hydrosphere–atmosphere–biosphere system. We developed a scientific plan to address three main objectives through scientific onshore drilling on Svalbard: a. Investigate the coevolution of life and repeated icehouse–greenhouse climate transitions, likely forced by orbital variations, by coring Neoproterozoic and Paleozoic glacial and interglacial intervals in the Cryogenian (“Snowball/Slushball Earth”) and late Carboniferous to early Permian time periods.b. Assess the impact of Mesozoic Large Igneous Province emplacement on rapid climate change and mass extinctions, including the end-Permian mass extinction, the end-Triassic mass extinction, the Jenkyns Event (Toarcian Oceanic Anoxic Event), the Jurassic Volgian Carbon Isotopic Excursion and the Cretaceous Weissert Event and Oceanic Anoxic Event 1a.c. Examine the early Eocene hothouse and subsequent transition to a coolhouse world in the Oligocene by coring Paleogene sediments, including records of the Paleocene–Eocene Thermal Maximum, the Eocene Thermal Maximum 2, and the Eocene–Oligocene transition. The SVALCLIME science team created plans for a 3-year drilling programme using two platforms: (1) a lightweight coring system for holes of ∼ 100 m length (4–6 sites) and (2) a larger platform that can drill deep holes of up to ∼ 2 km (1–2 sites). In situ wireline log data and fluid samples will be collected in the holes, and core description and sampling will take place at The University Centre in Svalbard (UNIS) in Longyearbyen. The results from the proposed scientific drilling will be integrated with existing industry and scientific boreholes to establish an almost continuous succession of geological environmental data spanning the Phanerozoic. The results will significantly advance our understanding of how the interplay of internal and external Earth processes are linked with global climate change dynamics, the evolution of life, and mass extinctions.

Selecting an Endourology Society Fellowship Program: The Candidates' Perspectives.

Introduction: Understanding the factors that influence the decision of urology residents to pursue an Endourology Society (ES) fellowship and the criteria used by applicants to rank programs may help residents and program directors (PDs) optimize the match process. In the present study, we surveyed current ES fellows to gain better insight surrounding their decision-making process. Materials and Methods: A survey was emailed to all ES fellows, comprising Endourology and Stone Disease (ESD), Laparoscopic and Robotic Surgery (MIS), and combination of ESD/MIS (COM) programs. A Likert scale ranging from 1 to 5 was used. The survey captured demographics such as geographic region, program type, duration, applicants' reasons for pursuing fellowship, criteria for ranking programs, and perceived improvements in surgical comfort levels at the end of their training. Results: Out of the 60 fellows who were surveyed, 40 (66.7%) responded. Among the respondents, 9 (22.5%) pursued ESD, 10 (25%) pursued MIS, and 21 (52.5%) pursued COM programs. The primary reason for seeking a fellowship was to improve surgical skills while increasing earning potential and enhancing research opportunities were deemed the least important. Fellows enrolled in 1-year programs were less likely to pursue fellowships for academic reasons. The two most significant factors in selecting a program were both related to gaining operative experience. Lastly, there was an increase in the level of comfort performing all endourological surgeries independently after fellowship. Conclusions: ES fellowship is seen as an opportunity to hone surgical skills and increase job competitiveness. When selecting a program, operative experience is the most important factor, and fellowship improves operative confidence. The information obtained from this study may mutually help guide future applicants and PDs in the decision process of the Endourology Match.

Transfer-bound community college students' biology identity and perception of teaching.

Community colleges are frequently an affordable, accessible entrance to a Science, Technology, Engineering, and Mathematics (STEM) education and career, but the transition from a 2-year program to a 4-year institution can be tumultuous. In this mixed-methods study, we explore the experiences of transfer and prospective transfer students. Through surveys and interviews, we identify the challenges faced by and the supports desired by biology transfer students. We describe how community college students perceive their introductory biology courses, and we compare the biology identity and self-efficacy of these students to peers at a 4-year institution. Students expressed uncertainty about what to expect from the transfer experience, and they benefitted from interventions that made the university experience more concrete or clarified their expectations. We found that community college students are just as interested in biology as peers at a 4-year university, but they are significantly less likely to believe that others recognize them as "biology people" and report less self-efficacy regarding biology courses. Students felt particularly well-prepared for transfer after community college biology courses they described as "rigorous" and "demanding," especially because students expressed that the community college environment helped support them through the challenges of higher education.

Challenges and successes in implementing an integrated electronic patient record (HIVE) at the Manchester University National Health Service Foundation Trust, England: 1000+ legacy systems, 10 hospitals, one electronic patient record.

The Manchester University National Health Service (NHS) Foundation Trust (MFT) is one of the largest NHS Trusts in England. Historically, the Trust has had very mixed clinical record keeping, including over 1000 individual information systems. None of these health information technology systems had the full functionality of an integrated electronic patient record (EPR). MFT evolved to its current size and complexity with a vision to improve patient care in Greater Manchester by adopting a Trust-wide EPR. The EPR "Go Live" occurred in September 2022. To describe the process of EPR integration as it reflected and impacted upon MFT's health information management (HIM) teams. MFT worked through a 2-year readiness program of work. This included technical readiness, software development and migration planning. Migration of data from the approximately 1000 systems was a major undertaking, during which access to the clinical history and ongoing operational reporting needed to be maintained. Pre-implementation requirements were outlined, a change management program was implemented, and the overall implementation was managed to tight timelines. "Go Live" was achieved for the EPIC EPR product (HIVE) within MFT. Legacy systems are still in the process of being decommissioned and staff are transacting within HIVE. Significant changes in processes and reporting continue to be made, despite some challenges. The Trust delivered the single largest EPIC European "Go live." Lessons learnt continue to be identified. The impact of what the EPR means for the HIM function is described.

On the Spot Presentation-Based Assessment (OTSPA): Student Perception and Predictive Value of a Novel Summative Assessment with a Formative Assessment Flavour

University of Surrey’s School of Veterinary Medicine introduced an assessment called On The Spot Presentation-based Assessment (OTSPA) into the 3rd and 4th year of a 5-year veterinary degree programme. The OTSPA is designed as a low-weightage summative assessment, conducted in a supportive learning environment to create a better learning experience. The OTSPA is a timed oral assessment with an ‘on the spot’ selection of taught topics, i.e., students prepare to be assessed on all topics but a subset is chosen on the day. The OTSPA was designed to test the students’ depth of knowledge while promoting skills like communication and public speaking. The aim of this study is to describe the design and operation of the OTSPA, to evaluate student perception of the approach, and to assess the OTSPA’s predictive value in relation to the final written summative assessment (FWSA), which is an indicator of academic performance. This study assessed the student perceptions (N = 98) and predictive value of the OTSPA on the FWSA in three modules: Zoological Medicine (ZM), Fundamentals of Veterinary Practice (FVP), and Veterinary Research and Evidence-based Veterinary Medicine (VREBVM). In the perception study, 79.6% of students felt that their preparation for OTSPAs drove an understanding and learning of topics that formed part of the module learning outcomes. Only a small group (21.4%) reported the assessment to be enjoyable; however, 54.1% saw value in it being an authentic assessment, reflecting real-life situations. The majority of students felt that the OTSPA helped with improving communication skills (80.4%). There was a small but significant positive correlation between the performance in OTSPAs and the FWSA in all modules. This suggests that OTSPAs can be useful in predicting the outcomes of the FWSA and, furthermore, could have utility in identifying where support may be helpful for students to improve academic performance. Outcomes from this study indicate that the OTSPA is an effective low stake summative assessment within the Surrey veterinary undergraduate programme.

UK-wide survey of gastroenterology and hepatology trainees in 2022: endoscopy, workforce planning and the Shape of things to come

ObjectiveShape of Training has shortened the gastroenterology curriculum in the UK from a 5 to 4-year programme. There are ongoing concerns that this will negatively impact training and the attainment...