Elective Experience Research Articles

Age, Experience and the Contextual Determinants of Turnout: A Deeper Look at the Process of Habit Formation in Electoral Participation

I test two potential mechanisms driving habitual voting: direct self-reinforcement of turnout and social ageing. I do so by critically examining a hypothesis proposed by Franklin who argues that the impact of electoral context on turnout declines as citizens experience more and more elections. I thus attempt to test whether the effects of context on turnout are indeed mediated by what is called “electoral experience” or simply by age. As, in most cases, those two are nearly perfectly correlated, I utilize survey data from Switzerland where women were enfranchised late and thus many female respondents did not experience any elections until reaching relatively old age. My test suggests that it is not experience that mediates the impact of context on turnout. I find weak but suggestive ageing effects. Yet, those effects are surprisingly non-monotonic. The impact of context on turnout is relatively strong for the youngest eligible citizens to decline for those who have entered their 30s. It sharply increases, however, when people are, roughly, in their mid-40s to decline again late in life.

Electoral Experience, Institutional Quality and Economic Development in Latin America

In a panel of 18 Latin American countries from 1900 to 2007, we test the degree to which institutions and geography affect country income. Using a new instrument, we find strong evidence that both institutions and geography are important determinants of country income. However, the penalty for economically unfavourable geography is much smaller than the potential benefits from good institutions. The coefficient estimates do not vary significantly when there are changes in the number of countries included in the analysis; the results for institutions are robust to the inclusion of country-fixed effects.

Scan When You Can: Using Open Ultrasound Practice Sessions as a Venue to Encourage Interprofessional Education

Recently many medical schools have introduced ultrasound education, with several institutions adopting formal teaching of ultrasound into their anatomy curricula. Additionally, medical schools nationwide have begun to incorporate various forms of interprofessional education (IPE) into their programs to prepare medical students for the teamwork necessary to serve as physicians. The Anatomy course at Mayo Medical School incorporated several IPE sessions with physical therapy students. Since the course is integrated with radiology, ultrasound imaging was recently added to complement static images and visualize living anatomy. Due to the success of prior IPE endeavors in anatomy, a new elective experience for hands‐on ultrasound practice sessions was offered to both medical and physical therapy students. The aim of this study was to assess student perception of elective ultrasound practice sessions as an opportunity for interprofessional peer‐learning. Practice sessions were scheduled once a week for 4 hours and a trained teaching assistant was available during the sessions. Students were encouraged to discuss different techniques and anatomical knowledge based on their respective experiences. A sign‐in sheet was kept to monitor how many students from both groups attended. Students were asked to fill out a survey at the end of 4 weeks to assess perceptions of the interprofessional experience. Preliminary results indicate that students appreciated the diversity of an interprofessional approach to learning ultrasound skills and enjoyed teaching each other anatomy through ultrasound.

Successful strategies for integrating bedside ultrasound into undergraduate medical education.

Nearly all physician specialties currently utilize bedside ultrasound, and its applications continue to expand. Bedside ultrasound is becoming a core skill for physicians; as such, it should be taught during undergraduate medical education. When ultrasound is integrated in a longitudinal manner beginning in the preclerkship phase of medical school, it not only enhances teaching the basic science topics of anatomy, physiology, and pathology but also ties those skills and knowledge to the clerkship phase and medical decision-making. Bedside ultrasound is a natural bridge from basic science to clinical science. The Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine is currently in its fourth year of implementing an integrated ultrasound curriculum in the school of medicine. In our experience, successful integration of a bedside ultrasound curriculum should: align with unique focuses of a medical schools' mission, simplify complex anatomy through multimodal teaching, correlate to teaching of the physical examination, solidify understanding of physiology and pathology, directly link to other concurrent content, narrow differential diagnoses, enhance medical decision-making, improve procedural skills, match to year-group skillsets, develop teaching and leadership abilities, and have elective experiences for advanced topics.

A 2‐Week Elective Experience Provides Comparable Training as Longitudinal Exposure During Residency for Pelvic Sonography

The purpose of this study was to compare the accuracy of first-trimester pelvic sonography done by physicians after a 2-week emergency ultrasound elective to similarly numbered examinations done by physicians longitudinally over several years of residency training. We conducted a secondary analysis of a previously reported prospective study of pelvic sonography for symptomatic first-trimester pregnancy. The 21st through 40th examinations were compared between those who completed an emergency ultrasound elective and those who did not. The reference standard was pelvic sonography done by the department of radiology. Eighty-six examinations (34%) were done by 12 operators who did not participate in an emergency ultrasound elective, and 171 examinations (67%) were done by 13 operators who completed an emergency ultrasound elective. There was no statistical difference between the groups with regard to identifying an intrauterine pregnancy, molar pregnancy, ectopic pregnancy, or adnexal mass. The accuracy of pelvic sonography for first-trimester pregnancy was comparable between physicians who participated in a 2-week emergency ultrasound elective and those who performed the same number of examinations over a longer period during residency training.

Does Sector-Specific Experience Matter? The Case of European Higher Education Ministers

This paper looks at the relationship between higher education ministers and the performance of the sector that they govern. Using an original panel dataset with the characteristics of European higher education ministers, we find that having a past experience in the sector leads to a higher level of performance, as measured by ranking data. Making a parallel with the literature about the impact of education on the educated, we discuss potential explanations behind the impact of this on-the-job learning experience. As we find that this characteristic has no impact on the spendings of the sector, we argue that this academic experience makes them more prone to introduce adequate reforms. Furthermore, we find that this result is driven by ministers with both this sector-specific and an electoral experience, the latter measured by a successful election at the regional or national level. This tends to show that political credibility should not be overshadowed by the importance of the sector-specific experience of ministers.

Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents.

To document the pathology learning experiences of pathology residents prior to residency and to determine how confident they were in their knowledge and technical skills. An online survey was distributed to all pathology residency program directors in the United States, who were requested to forward the survey link to their residents. Data were obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. In total, 201 pathology residents responded (8% of residents in the United States). Prior to starting residency, most respondents had exposure to anatomic pathology through elective rotations. Few respondents had work-related experience. Most did not feel confident in their pathology-related knowledge or skills, and many did not understand what pathology resident duties entail. Respondents gained exposure to pathology primarily through elective rotations, and most felt the elective experience prepared them for pathology residency. However, elective time may be enhanced by providing opportunities for students to increase hands-on experience and understanding of resident duties.

Neurological Surgery Training Abroad as a Progression to the Final Year of Training and Transition to Independent Practice.

Residents at the University of Virginia spend 1year abroad at a neurological surgery program prior to their chief year. The Accreditation Council for Graduate Medical Education (ACGME) considers international rotations elective experiences and does not count them toward clinical accreditation. We compared clinical training obtained in New Zealand (NZ) to data from US ACGME-accredited programs to see if it was reasonable to reconsider the former as clinical training. We compared US national average chief case volumes to those performed by University of Virginia residents rotating in NZ over the past 3years, using case volume comparisons and a survey of the residents' experience. The mean number of cases performed in NZ was above the 50th percentile for US averages for adult cranial cases, including the 70th to 90th percentile for aneurysms and 50th to 70th percentile for tumors. The average number of cases performed in 1year in NZ satisfied the cranial case quota for 4 of 6 adult and 2 of 3 pediatric areas over the entire residency. The rotation doubled the cranial exposure of graduating residents at the chief level without diluting the experience of residents in the core program. All residents reported being "very satisfied" with the experience, noting it facilitated their transition to chief year and independent practice. Clinical training obtained during an international rotation in NZ is comparable to that attained in the United States. The international experience in NZ facilitated advancement in all 6 competencies, and should be considered adequate for clinical neurological surgery education.

Factors impacting musculoskeletal knowledge and clinical confidence in graduating medical students.

Despite the prevalence of musculoskeletal disorders, the degree to which medical schools are providing students with the knowledge and confidence to treat these problems is unclear. This study evaluated the factors that impact musculoskeletal knowledge and clinical confidence among fourth-year medical students. Over a three-year period, 253 fourth-year medical students participated in the study at a single institution. Musculoskeletal knowledge was evaluated using a National Board of Medical Examiners' musculoskeletal medicine subject examination. Factors analyzed included sex, class year, musculoskeletal elective experience, duration of musculoskeletal elective, career choice, and musculoskeletal curriculum satisfaction. The participation rate was 95%. The mean National Board of Medical Examiners' musculoskeletal assessment score (and standard deviation) was 70.7 ± 9.5 points for all fourth-year medical students. Taking a musculoskeletal elective significantly increased knowledge (p < 0.001) but not clinical confidence. Increased satisfaction with how musculoskeletal medicine was taught was associated with increased clinical confidence (p < 0.001). No significant differences were seen if students were going into musculoskeletal medicine or primary care for either musculoskeletal knowledge or clinical confidence. Multivariate analysis of musculoskeletal knowledge found that taking a musculoskeletal elective for two weeks led to an increase of 6 points (from a possible 100 points) in the National Board of Medical Examiners' subject examination scores. This study reveals that participation in a clinical elective is the only factor that led to a significant increase in musculoskeletal knowledge in fourth-year medical students. A two-week clinical elective can be sufficient time to have an impact on musculoskeletal knowledge, but it alone does not increase clinical confidence. Further studies are needed to determine how to improve musculoskeletal clinical confidence.

Shame on us! Men need osteoporosis care, too! Commentary on an article by Carl M. Harper, MD, et al.: "Distal radial fractures in older men. A missed opportunity?".

Background: Despite the prevalence of musculoskeletal disorders, the degree to which medical schools are providing students with the knowledge and confidence to treat these problems is unclear. This study evaluated the factors that impact musculoskeletal knowledge and clinical confidence among fourth-year medical students. Methods: Over a three-year period, 253 fourth-year medical students participated in the study at a single institution. Musculoskeletal knowledge was evaluated using a National Board of Medical Examiners’ musculoskeletal medicine subject examination. Factors analyzed included sex, class year, musculoskeletal elective experience, duration of musculoskeletal elective, career choice, and musculoskeletal curriculum satisfaction. Results: The participation rate was 95%. The mean National Board of Medical Examiners’ musculoskeletal assessment score (and standard deviation) was 70.7 ± 9.5 points for all fourth-year medical students. Taking a musculoskeletal elective significantly increased knowledge (p < 0.001) but not clinical confidence. Increased satisfaction with how musculoskeletal medicine was taught was associated with increased clinical confidence (p < 0.001). No significant differences were seen if students were going into musculoskeletal medicine or primary care for either musculoskeletal knowledge or clinical confidence. Multivariate analysis of musculoskeletal knowledge found that taking a musculoskeletal elective for two weeks led to an increase of 6 points (from a possible 100 points) in the National Board of Medical Examiners’ subject examination scores. Conclusions: This study reveals that participation in a clinical elective is the only factor that led to a significant increase in musculoskeletal knowledge in fourth-year medical students. A two-week clinical elective can be sufficient time to have an impact on musculoskeletal knowledge, but it alone does not increase clinical confidence. Further studies are needed to determine how to improve musculoskeletal clinical confidence.

The Sustained, Positive Impact of a Native American Cultures and Health Course on Students’ Education and Practice-Related Choices

To encourage pharmacy students to elect education and practice opportunities in Native American communities, including careers with the Indian Health Service (IHS). Students in 2 elective courses were educated on various aspects of contemporary Native American life in urban and reservation environments, including cultural traditions, social and health-related challenges, health access disparities, and cultural approaches to health and wellness. The teachers were Native American leaders and healers primarily from Plains tribes, as well as non-Native American practitioners affiliated with IHS hospitals and tribal health facilities. Students kept reflective journals, and a subset spent 5 days immersed in a rural Navajo community where they lived and worked alongside IHS practitioners and Community Health Representatives. Student engagement with IHS opportunities was tracked for 11 years. Of the 69 pharmacy students who completed the electives, 11 applied for a Junior Commissioned Officer Student Training and Externship Program (Jr. COSTEP) (8 accepted, 6 completed), 43 requested one or more IHS APPEs (43 accepted, 32 completed, 8 in progress), 17 applied for an IHS residency (1 pending, 8 accepted, 5 completed), and 5 became IHS Commissioned Corps officers. Five additional students accepted an IHS or tribal position, with 3 pursuing a USPHS commission. Since the first report on the impact of this elective experience was published, the course continues to meet its primary objective of promoting interest in IHS/tribal education experiences and pharmacy practice careers.

Election Fundamentals and Polls Favor the Republicans

Election Fundamentals and Polls Favor the Republicans

Is Democracy Being Consolidated in Bhutan?

This article examines the early years of democratization in the small Himalayan Kingdom of Bhutan. Once a reclusive country, Bhutan embarked on a gradual path of socioeconomic modernization and opening up to the rest of the world. A most significant step on that path was the decision to democratize. The first national democratic elections were held in 2007–2008. In 2013, the second national elections took place and marked an appropriate moment to assess the progress of democratization in Bhutan. This article not only analyzes the electoral experience but also evaluates what has occurred in other areas of democratization including the rule of law, accountability of government, civil society, and freedom of expression. The article concludes that Bhutan has made good progress in democratization on many fronts but that its trajectory is unique, reflecting the particular context of Bhutan and the overriding concern with stability in political and social life.

Residency Information Preferences of Recent Pharmacy Residency Applicants.

Background: The increasing number of both postgraduate year (PGY)-1 and PGY-2 residency programs and applicants requires all parties to discriminate among the many options available in the marketplace. Studies assessing the information preferences of pharmacy students searching for residencies, including the utility and popularity of information sources (eg, school brochures, program Web sites, etc), are lacking. Objective: The preferences of recent residency applicants for types and sources of residency program information were assessed to improve the recruitment strategies of residency programs. Methods: A survey was distributed to 1515 residency program directors (RPDs). Questions solicited information regarding use of electronic resources and preference of information used to discriminate between residency programs prior to and during the application/interviewing process. Results: One hundred ninety-two RPDs responded and forwarded the survey to 522 PGY-1 residents and 207 PGY-2 residents. Completed surveys were submitted by 75.7% (n = 395) of PGY-1 residents and 57.5% (n = 119) of PGY-2 residents (overall response rate 71.3%). Participants ranked the program's Web site followed by a flash drive containing information about the program as the most preferred sources of information. Participants noted that required (n = 464) and elective learning experiences (n = 463) and current positions of past residents (n = 310) were very important information when deciding to apply to a program. Overall, 68.3% (n = 341) of participants indicated that they agreed or strongly agreed that electronic information sources were preferred over paper information sources. Conclusion: Residency programs should dedicate resources to ensuring that their Web site includes information regarding learning experiences and the current positions of past residents.

Fostering Reciprocity in Global Health Partnerships Through a Structured, Hands-On Experience for Visiting Postgraduate Medical Trainees

Global health programs that allow international experiences for US learners should also enable reciprocal learning experiences for international learners, particularly if that is a need identified by the partner institution. A partnership between Indiana University and Moi University, Kenya, has successfully hosted 41 visiting Kenyan internal medicine and pediatrics registrars at Indiana University since 2006. The program's logistics, curriculum, and evaluation are described. The registrars rotated through nephrology, cardiology, hematology and oncology, infectious diseases, and intensive care, as well as related ambulatory experiences, functioning on a level comparable to fourth-year medical students. They showed significant improvement in pretest and posttest scores on a standardized National Board of Medical Examiners examination (P = .048). International learners experienced culture shock, yet they felt the Indiana University elective was helpful and would recommend it to future participants. Global health programs can reciprocate the benefits derived for US students and residents by offering learning experiences to international learners if that is an expressed need from the international partner. Barriers to those experiences can be overcome, and the hands-on, elective experience has the potential to positively affect the knowledge and attitudes of participants as well as the home nation.

Betting on Elections: History, Law and Policy

Betting on elections has a long history, despite periods in which wagers were unenforceable and even criminalised. In recent years, significant online markets have emerged, driven by the bookmaking industry in those jurisdictions which license betting on politics. These markets treat election wagers as a form of sports betting. This article examines the provenance and regulation of election betting in the common law. It charts this from early case law holding wagers involving electors to be void (as tainting voting decisions) through criminal prohibitions, some of which are still on the statute books (since wagers could disguise electoral bribes) and onto contemporary regimes for licensing electoral bookmaking. Normative arguments about election betting and the law include the liberal harm principle, the precautionary principle and the concept of commodification. The article concludes that friendly wagers should be permitted, to allow partisans to intensify the ritual experience of elections. But bets involving politicians should be outlawed, and the industrialisation of election betting should not be encouraged given the risk of commodifying the values underlying electoral democracy.

Betting on Elections: History, Law and Policy

Betting on elections has a long history, despite periods in which wagers were unenforceable and even criminalised. In recent years, significant online markets have emerged, driven by the bookmaking industry in those jurisdictions which license betting on politics. These markets treat election wagers as a form of sports betting. This article examines the provenance and regulation of election betting in the common law. It charts this from early case law holding wagers involving electors to be void (as tainting voting decisions) through criminal prohibitions, some of which are still on the statute books (since wagers could disguise electoral bribes) and onto contemporary regimes for licensing electoral bookmaking. Normative arguments about election betting and the law include the liberal harm principle, the precautionary principle and the concept of commodification. The article concludes that friendly wagers should be permitted, to allow partisans to intensify the ritual experience of elections. But bets involving politicians should be outlawed, and the industrialisation of election betting should not be encouraged given the risk of commodifying the values underlying electoral democracy.

An Elective Course in Aromatherapy Science

To evaluate the impact of an innovative team-taught elective course on second-year (P2) students' knowledge and skills relating to the relationship between aromatherapy and pharmacy. An Aromatherapy Science elective course was offered to P2 students in an accelerated doctor of pharmacy (PharmD) degree program and was designed to provide an elective course experience while focusing on active-learning skills such as group work, student-led presentations, and in-class activities. Lectures were designed to reinforce core curricular threads from the basic sciences within the pharmaceutical sciences department while highlighting key aromatherapy principles. Course evaluations, grades, and student self-assessments were used to evaluate student fulfillment and knowledge gained. Students agreed this hands-on course integrated pharmaceutical science experiences, enriched their pharmacy education, and provided knowledge to enhance their confidence in describing essential oil uses, drug interactions, and key aromatherapy clinical implications. Students agreed this course prepared them to identify essential oil therapeutic uses and potential essential oil-drug interactions, and interpret literature. The introduction of aromatherapy principles to pharmacy students will prepare a new generation of healthcare professionals on the role of alternative medicines.

What Accounts for Party System Stability? Comparing the Dimensions of Party Competition in Postcommunist Europe

Why do party systems stabilise quickly in some new democracies while others remain in extended flux? As a core variable of comparative politics, party system stability has led scholars to generate various theoretical explanations, but consensus is still lacking. Given its widely divergent party systems, postcommunist Europe presents an important opportunity to revisit stability's determinants. Applying hypotheses derived from theories about competition in multidimensional policy spaces, I find that they better explain variation in a 14-case sample than contending hypotheses about the electoral system, economic performance, constitutional design, political culture, or previous democratic experience.

The Attack of the Creolian Powers: West Indians at the Parliamentary Elections of Mid‐Georgian Britain, 1754–74

This article seeks to build upon recent work on the impact of empire in mid‐18th‐century Britain by study of the electoral experience of parliamentary candidates who had lived in the West Indies and could boast a direct familiarity with the Caribbean. By 1750, a significant number of rich planters had relocated to Britain, and, in common with the Indian nabobs, their efforts to enter parliament aroused much adverse commentary at the elections of 1754–74. While these attacks were damaging to their interest, and occasioned the most thorough review of Caribbean society to date, the West Indians were able to respond by adapting their political campaigns to assuage metropolitan sensibilities, thereby ensuring that they were not bracketed with the nabobs or rebellious North Americans as imperial sources of domestic upheaval. Their success highlights the possibilities for successful imperial integration in mid‐Georgian Britain, although the West Indians could not rely on the same strategies to combat the abolitionist movement after 1787.