Elective Experience Research Articles

Implementation and Assessment of an Informal Virtual Elective for Medical Student Radiation Oncology Exploration During the COVID19 Pandemic: a Brief Report.

Subspecialty exposure during medical school can be limited. Moreover, the COVID19 pandemic prevented most onsite elective medical student (MS) rotations during 2020. Therefore, we sought to create and assess the efficacy of an informal virtual elective (IVE) for MSs to explore radiation oncology (RO) at our institution. We created IVE activities including invitations to resident didactics, a faculty lecture series, and interactive virtual events with residents and faculty. MSs were offered RO resident and faculty mentors and the opportunity to deliver a lecture. Pre- and post-IVE evaluation surveys were sent to 27 4th year MSs. Surveys utilized importance ordering (1=most important; reported as median (interquartile range), free response, and Likert-type questions (5 = extremely, 1=not at all). Our IVE, held from July to October 2020, had a median of 11 students (range 7-18) attend each activity. Pre- and post-IVE surveys were completed by 22/27 (81%) and 20/27 (74%) MSs, respectively. In pre-IVE, MSs reported participating in the IVE for faculty/resident interaction (1.5 [1, 2]), networking (3 [2, 3]), and learning (4 [3-5]). In post-IVE, MSs reported benefit from faculty mentors (5 [4, 5]), delivering a presentation (5 [3-5]), and faculty lectures (4.5 [4, 5]). In post-IVE, MSs preferred a full onsite away elective (16, 80%) over an official virtual elective (1, 5%) or IVE (3, 15%). Overall, MSs reported that the IVE provided an adequate introduction to RO at our institution (4 [4, 5]). Alternative virtual elective experiences allow MSs to informally evaluate medical subspecialties and could be offered even if formal elective opportunities are available.

Gender and Geographic Trends Amongst Foot & Ankle Surgeons: Where Are We and Where Do We Need to Improve?

Category:OtherIntroduction/Purpose:Clinical and elective experiences as well as the guidance of mentors are all critical factors in the pursuance of orthopedic residencies and fellowships. Women have historically been underrepresented in orthopedics. Some propose that the root cause lies in the lack of availability in the aforementioned factors. Previous studies demonstrated geographic differences in sex representation in orthopedic residency programs. Studies over geographic distributions of orthopedic foot and ankle (OFA) surgeons showed high variation in geographic density of OFA surgeons throughout the U.S. This study seeks to determine both the gender and geographic distributions of OFA surgeons as well as to determine geographic patterns between their training locations and current practices.Methods:AOFAS data regarding fellowship completion from 1988 through 2021 was analyzed with regards to gender and fellowship location. Internet searches were performed for all those identified within the database for their medical school, residency, and current practice location. This biographical data was obtained from their front-facing biographical webpage or hospital affiliation. States were placed into regions and subsequent divisions as defined according to the US Census Bureau definition: Northeast (New England and Middle Atlantic), Midwest (East North Central and West North Central), South (South Atlantic, East South Central, and West South Central) and West (Mountain and Pacific).Results:1,088 OFA surgeons were analyzed. 168 (15.3%) were female and 922 (84.7%) were male. Female-held OFA fellowship positions increased over time, currently sitting at 13 (22% of all fellowship positions), with a maximum of 15 (25%) in 2017. Geographically, the Pacific had most females (n=26, 15.6% of females), while East South Central had least (n=10, 6.0%). The South Atlantic had most males (n=193, 20.9% of males) while East South Central had least (n=59, 5.3%). The region with the most OFA surgeons in total was the South Atlantic (n=218, 20.0% of the total) whereas the regions with the least were East South Central and New England (n=59, 5.4% in each).Conclusion:Although the amount of female OFA surgeons has increased, the numbers are still low. Geographically, the East South Central division of the U.S consistently had the least number of OFA surgeons whereas the South Atlantic division had the highest.

Virtual APPE grand rounds: A learning activity to enhance remote rotations during the COVID-19 pandemic

Context: To assess students’ perception of a virtual learning activity developed for a remote Advanced Pharmacy Practice Experience (APPE) during the peak of the coronavirus disease 19 (COVID-19) outbreak in New York City. Description of course: Due to the pandemic, many clinical APPEs were converted to remote elective experiences during the final 5-week rotation block (from 1 April to 6 May 2020). A small group of faculty developed and piloted a virtual learning activity (APPE grand rounds) to enhance learning in this setting. Students assigned to participating faculty were tasked to develop 60 to 90-minute presentations scheduled two to three times weekly for large synchronous e-learning experiences across various simultaneous rotations. Evaluation: A questionnaire consisting of nine items utilising a 5-point Likert scale was developed and administered to assess student perception of the virtual format, presentation skills, and overall satisfaction with the experience.

Medical Electives in Sub-Saharan Africa: A 15-Year Student/NGO-Driven Initiative.

Medical schools are developing global health programmes, and medical students are requesting global health training and creating opportunities when these are not provided by medical schools. This article described the Wolisso Project (WP), a medical experience on clinical electives in Sub-Saharan Africa, driven by a collaboration between a student organisation and a Nongovernmental Organization (NGO). Preclinical medical students spent 4 weeks as part of a multidisciplinary medical team in Africa. Post-elective questionnaires were administered to all subjects who participated in the project. Of all, 141 students responded to the questionnaire. The participants came from 30 Italian universities. The main difficulties reported are due to the lack of resources for the exercise of the medical activity, and difficulties related to language and communication. The African experience had a positive impact on the progress of the studies upon return, with an increase in determination and motivation. The experience had also positive influences on the future professional choices and carriers. The experience seems to contribute not only to the professional growth, but also to the personal development. A key factor in the positive outcomes of this experience is it being implemented by an NGO with long-term working relationships with the African populations. Another is that the project is carried out in health facilities where NGO staff have been working for a long time. These factors reduce the potential risks connected with this type of experience. They ensure a satisfactory level of supervision, the lack of which has been a serious problem in many similar experiences. A well-structured, mentored experience in international health can have a positive impact on preclinical students’ attitudes, including their compassion, volunteerism, and interest in serving underserved populations. Only a small number of Italian universities facilitate pre-graduate medical elective experiences in LMICs. The WP seems to be attempting to compensate for the lack of international experience in LMICs offered by universities. Italian medical schools should incorporate changes in their curricula to train socially responsible physicians.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10900-021-01045-5.

793 Orthopaedic Surgical Training in The Independent Sector During the COVID 19 Pandemic

IntroductionThe COVID pandemic had led to the cancellation of elective Orthopaedics in the NHS. The aim of this study was to investigate the effect of the independent sector on orthopaedic training and the effect of the COVID pandemic on training locally.MethodA retrospective review of trauma and elective operations was made between April and September of 2019 and 2020 to compare the effects of COVID on training opportunities and the additional capacity provided by the private sector.ResultsThe impact of COVID on Surgical training at GWH has been no decrease in trauma operating experience, but a 53% decrease in elective operating experience and a 74% decrease in joint replacement operative experience during an equivalent six-month period. Use of the independent hospital has enabled 6% of the total elective surgery experience, and 11% of the joint replacement surgery experience.DiscussionThe private sector has provided additional capacity but a productivity of 66 cases from 48 half day lists is low (1.4 cases per list) has proved disappointing. There has been a low impact on elective training. The challenges have been faced on the elective side as trauma cases have remained consistent during the pandemic.ConclusionsUse of the alliance between the private sector and NHS as a resource to provide additional training opportunities needs to be developed further in the future with incentivised guidance. Orthopaedic training will inevitably adapt to the challenges presented for the next generations of surgeons.

The history of elections in Ghana, Kenya and Uganda. What We Can Learn from These ‘National Exercises’

A large literature has described the years after independence from colonial rule as a period of ‘departicipation’. Africa’s new rulers – whether driven by personal venality or a sincere commitment to nation-building – swiftly gave up on elections, or at best held elections that, by denying choice, left violence as the central dynamic of African politics. This article draws on the cases of Kenya, Ghana and Uganda in the late 1960s to argue that the emphasis often placed on the ‘speed and ease’ of this process has been overstated. Instead, Africa’s politicians and civil servants valued elections as a means to educate and discipline the public, even as they feared their possible outcomes. Building on a literature that focuses on the individual experience of elections rather than the presence or absence of parties, we argue that the rhetoric of politicians and civil servants shows that they saw elections as ‘exercises’ – a revealing term – that would train and test their new citizens. Yet this is not the whole story: voters understood their participation in their own terms and played a role in how early experiments with elections played out. The political closures of these years were real, but their course was unplanned and contingent, shaped partly by popular involvement. These points are not only of historical value, but also provide important insights into the extent to which contemporary elections are instruments of elite power or the drivers of democratisation.

Emergency canthotomy and cantholysis - Factors affecting confidence among ophthalmic trainees in the United Kingdom.

Purpose:Retrobulbar hemorrhage from trauma is the most common cause of orbital compartment syndrome. Emergency canthotomy and cantholysis is a vision-saving procedure. We sought to identify confidence among ophthalmic trainees in this procedure as well as any relevant factors that have any impact.Methods:An online, confidential anonymous questionnaire was distributed to ophthalmology training groups in the UK. Questions explored the participant’s stage of training and grade and confidence in this area as well as their ophthalmic experience in terms of training courses attended and elective versions of the procedure performed.Results:We received 45 completed responses from the survey. 20/23 (87%) of junior trainees had not performed an emergency canthotomy/cantholysis to date, whereas 19/22 (86%) of senior trainees had performed between 1 and 5 such procedures. 15/23 (65%) of junior trainees had not performed an elective canthotomy compared to only 3/22 (14%) of the senior trainees. We found that the main factors that were associated with increased confidence level were the higher numbers of emergency and elective cases performed, training courses, and previous oculoplastic surgery rotation (P = 0.0001).Conclusion:From our survey, we found low confidence levels among junior trainees due to limited exposure. Confidence appeared to be linked to both elective and emergency surgical experience of the procedure as well as training course and having worked in an oculoplastic surgery firm. Changes to training portfolio requirements for junior trainees to incorporate early oculoplastic experience may help to achieve this on a national scale.

German-speaking medical students on international electives: an analysis of popular elective destinations and disciplines

BackgroundInternational medical electives are a well-established part of the curriculum of many western medical schools. It is widely accepted that these electives contribute to improved clinical examination and communication skills. Overseas electives also exert a strong influence over future career decisions and often pave the way for later international work. Whilst the positive outcomes are known, little information exists regarding elective preferences and destinations overall, information that could help optimise a safe learning experience and maximise the potential for one of the highlights of medical education. In order to obtain analytical data that could assist medical elective framework development, we systematically reviewed the two largest German online databases cataloguing abroad elective testimonies.ResultsWe identified 856 overseas elective reports uploaded within the last five years. European destinations were the most sought-after choice among German-speaking medical students. Interest in abroad electives in the United States (U.S.), a traditionally popular destination, was much lower than expected. U.S. elective reports accounted for only 3 % of long-term electives. Electives in low- and middle-income countries were generally less popular than electives in high-income countries. General surgery was the most popular elective discipline, followed by Emergency Medicine and Gynaecology and Obstetrics.ConclusionsWe observed a large inhomogeneity in German-speaking medical students’ elective choices, potentially influenced by financial and organizational aspects as well as geopolitical developments. This highlights a crucial challenge for medical schools and other organizations involved in elective planning. In light of regional differences, our data suggest that a “one size fits all” preparation is not pertinent to optimize students’ elective experience. Country- or region-specific pre-departure trainings and more individualized elective frameworks might be necessary to address these differences and to ensure a safe learning experience for students.

Elective Surgical Experience During COVID Pandemic at a Tertiary Cancer Care Centre in India: A Retrospective Analysis.

To analyse and identify possible outcomes of elective cancer surgeries performed at a tertiary cancer centre during COVID19 pandemic. This is a retrospective study including patients that underwent surgery at HCG Manavata cancer centre, Nashik, Maharashtra, India, from 15 March 2020 to 15 June 2020. Among the 458 patients that underwent elective surgeries, 54% were male and 46% were female, with a median age of 50.57 years. The most common sites of cancer distribution were head and neck (24.67%), colorectal (11.57%), gynaecological (11.35%), and breast (10.26%). Of the included patients, 92% were of American Society of Anaesthesiologists (ASA) II with comorbidities such as hypertension, and 64% underwent major surgeries with a mortality rate of 1.52% (n = 7). Average duration of surgery and hospital stay was observed to be 168.43 min and 4.4 days, respectively. Post-operatively, 7 patients were tested COVID positive and their recovery was uneventful. Despite the difficulty that set in because of COVID19 pandemic, it was proven from our study that elective cancer care surgeries can be successfully performed by following all the set guidelines.

Entrustable professional activities for pharmacy students: A primer for solid organ transplant preceptors.

In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. The role of a solid organ transplant pharmacist is multifaceted and translates to diverse experiential and elective learning experiences that can be provided to pharmacy learners. Here we provide a guide to integrating pharmacy students into patient care and other pharmacist activities in solid organ transplantation. Thoughtful incorporation of learners into clinical practice and clinical research creates a positive learning environment for pharmacy students that can foster the development of core skills necessary for students to become "practice-ready" and "team-ready" pharmacy graduates and can equip them with valuable skills to incorporate into the specialty practice areas and careers they pursue. To help develop these educational experiences, attention to the list of core entrustable professional activities (EPAs) established by the American Association of Colleges of Pharmacy can help create a rich environment of learning with carefully cultivated tasks. Furthermore, learners can serve as transplant pharmacist extenders to assist in overall patient care and multidisciplinary involvement on the transplant team. This article serves as a "how-to" guide for applying the EPA framework to integrating pharmacy students in patient care and other pharmacist activities in solid organ transplantation and other specialty practice areas. As pharmacy preceptors design and operationalize their teaching to incorporate EPAs, they can benefit from recommendations tailored to specialty practice areas such as solid organ transplantation. Students may start and finish these experiences at different EPA levels, but continuance of training will allow them to achieve the final EPA level across the 6 EPA domains.

The Impact of Previous Cardiology Electives on Canadian Medical Student Interest and Understanding of Cardiology

Background: Most Canadian medical schools do not have mandatory cardiology rotations. Early exposure to clinical cardiology aids career navigation, but clerkship selectives are chosen during pre-clerkship. This study investigates whether prior elective experiences affect medical student interest as well as understanding of cardiology before clerkship selections.
 Methods: A literature search was conducted using Google Scholar, Embase and PubMed to create an evidence-based cross-sectional survey. The anonymous questionnaire was administered to 53 second-year medical students at a Canadian medical school via Opinio, an online survey platform. Students were assessed on their interest and understanding of cardiology practice using a 5-point Likert Scale. Descriptive statistics and Chi-Square analysis were applied to assess the relationship between previous elective experience, medical student interest, and understanding of career-related factors pertaining to cardiology.
 Results: Overall, 26 (49.1%) students reported cardiology interest, while it was a preferred specialty for 9 (17.0%). Medical students reported low understanding of community practice (n=20, 37.7%), duration of patient relationships (n=14, 26.4%), spectrum of disorders (n=13, 24.5%), and in-patient care (n=11, 20.8%) associated with cardiology practice. Students with prior cardiology electives had increased understanding of in-patient care (χ2 = 4.688, Cramer’s V = 0.297, p = 0.030 and were more likely to select cardiology as a top specialty choice (χ2 = 7.983, Cramer’s V = 0.388, p = 0.005).
 Conclusions: Pre-clerkship medical students have a low understanding of cardiology practice. Increasing pre-clerkship exposure to cardiology may help students determine their interest in the specialty before clerkship selectives are chosen.

Criteria for selection to anesthesia residency programs: a survey of Canadian anesthesia program directors

IntroductionApplicants to specialty programs lack guidance on knowing what exactly is desired by selection committees and program directors. Anesthesia is especially opaque, given its failure to provide transparency reports nationally. This study was developed to survey Canadian anesthesia program directors about the aspects of the application package desired in an anesthesia applicant. The primary objective is to identify the preferred attributes of anesthesia applications by those mandating the selection committees.MethodsSurvey was developed via Google Surveys, and sent online over a period of two months in June and July 2020. All program directors were sent requests for filling in the survey. STATA was used for all statistical analyses. Two analyses, Mann-Whitney and ANOVA tests, were performed for comparison groups. A p < 0.05 was considered significant.ResultsFourteen of seventeen (83%) Canadian anesthesia program directors completed the survey. Having done an anesthesia elective, good performance in it, and excellence of preclinical academic performance were considered among the most important aspects of the application package with the highest ranking important and smallest standard deviation. Any form of red flag was also considered an important criterion, again with little variation among program directors. The reference letters selected by the applicants were also important, with a personal relationship and well written reference being identified as most important (p < 0.05).ConclusionsAn applicant who has good academic performance, having anesthesia elective experience, personal, well-written reference letters, and general activity and interests that are not necessarily anesthesia-focused would be favoured by Canadian anesthesia programs.

A New Dataset on the Demographics of Canadian Federal Election Candidates

AbstractThis research note reports on a new effort to track candidate diversity in Canadian elections. The dataset covers 4,516 candidates who ran in the 2008, 2011, 2015 and 2019 federal elections and includes novel data on their race, Indigenous background and age, alongside information on gender, occupation, prior electoral experience and electoral outcome. We outline the process for collecting and systematizing these data, which relied on genealogical methods and the principle of triangulation. The data can be used to track diversity among electoral candidates over time or merged with other sources to answer district-level questions about representational diversity, electoral dynamics, vote choice and political communications. The method could also be replicated and applied to other levels of government.

The Impact of Candidates’ Profile and Campaign Decisions in Electoral Results: A Data Analytics Approach

In recent years, a wide range of techniques has been developed to predict electoral results and to measure the influence of different factors in these results. In this paper, we analyze the influence of the political profile of candidates (characterized by personal and political features) and their campaign effort (characterized by electoral expenditure and by territorial deployment strategies retrieved from social networks activity) on the electoral results. This analysis is carried out by using three of the most frequent data analyitcs algorithms in the literature. For our analysis, we consider the 2017 Parliamentary elections in Chile, which are the first elections after a major reform of the electoral system, that encompassed a transition from a binomial to a proportional system, a modification of the districts’ structure, an increase in the number of seats, and the requirement of gender parity in the lists of the different coalitions. The obtained results reveal that, regardless of the political coalition, the electoral experience of candidates, in particular in the same seat they are running for (even when the corresponding district is modified), is by large the most influential factor to explain the electoral results. However, the attained results show that the influence of other features, such as campaign expenditures, depends on the political coalition. Additionally, by means of a simulation procedure, we show how different levels of territorial deployment efforts might impact on the results of candidates. This procedure could be used by parties and coalitions when planning their campaign strategies.

Should We Go Abroad? The Strategic Entry of Ecuadorian Political Parties in Overseas Electoral Districts

ABSTRACT The literature on external voting overlooks why some political parties campaign abroad while others remain focused on the national territory. This article investigates the determinants of the strategic entry of political parties in overseas districts through analysing legislative elections in Ecuador (2007–2017). Based on a study of the incentives and constraints of political party presence abroad, we find that parties are more likely to compete for elections in overseas districts displaying a weaker party competition as well as when they account for previous electoral experience in these districts.

Medical Student Comfort With Procedural Skills Performance Based on Elective Experience and Career Interest.

IntroductionDespite increased efforts, studies suggest that exposure to procedural skills in undergraduate medical training is insufficient. As medical students have low self-reported competence in many skills, a significant concern is that medical students are underprepared for a clerkship. Furthermore, pre-clerkship electives selected based on student career interests can provide students with additional skills learning opportunities. The impact of career interest and elective choice on student comfort with procedural skills is unclear. This study examines the relationship between student procedural skills comfort, career interest, and elective choices.Materials and methodsAn evidence-based questionnaire was synthesized following a literature search using PubMed, Embase, and Google Scholar. Surveys were completed by second-year medical students. A Likert scale was used to evaluate students’ exposure, comfort, and motivation to learn common procedural skills. Descriptive, Pearson’s chi-square and Spearman’s rho correlation coefficient analyses were performed to evaluate the relationship between career interests, elective exposure, and procedural skills.ResultsMedical students (>60%) reported poor comfort levels for most skills, despite >80% of students displaying high motivation to learn. Elective choice impacted student comfort levels as students who completed electives in anesthesiology were more comfortable with performing intubation (23% vs 10%, p = 0.026) and IV insertion (38% vs 13%, p = 0.002). Those with surgical career interests were less comfortable performing Foley catheter insertion in males (7% vs 5%, p = 0.033) and in females (7% vs 5%, p = 0.008).ConclusionsThis study supports that medical students feel low levels of comfort with performing procedural skills despite high motivation for learning. Comfort was influenced by both career interest and elective experience. Programs aiming to increase students’ comfort levels in performing procedural skills should adapt curricula toward increasing early exposure to these skills.

TO A QUESTION OF RESEARCH FACTORS AFFECTING THE POLITICAL CONSCIOUSNESS OF MODERN RUSSIAN YOUTH

The purpose of the study. The article considers the problem of taking into account and analyzing factors affecting the political consciousness of modern Russian youth. Theoretical and scientific-instrumental approaches of foreign and domestic political scientists and sociologists to the study of the political consciousness of youth, motives and archetypes of political behavior are analyzed. Socio-psychological, economic and political factors of the political consciousness formation and transformation of young Russian voters are identified and investigated. The purpose of the study is to substantiate the need to develop in Russian political science a methodology for analyzing the factors of modern Russian youth political consciousness, as well as to make copyright proposals for the development of this methodology. Conclusions. The author concludes that methodological approaches to studying the political consciousness of young people exist in Western European and American socio-political science (the concept of a “purposeful voter”, political behaviorism, globalization and virtualization of the political and social space) need some adjustment in relation to the study of the political consciousness of Russian youth. We must take into account the peculiarities of the national mentality such as antinomies of political consciousness, irrational motives for political participation. Another important factors are: specifics of the functioning of the Russian political system (“catching up” with the nature of political modernization, underdeveloped forms and mechanisms of political participation, scarcity of electoral democratic experience) as well as modern challenges and risks of the development of Russian statehood (multiple crises of socio-economic and political nature, characteristic of turbulence). The political consciousness of Russian youth, like the youth of any modern state, is characterized by instability and a tendency to radicalism. The political archetypes inherited by modern Russian youth from the generation of the 1990s do not contribute to the harmonization of their political consciousness. In these conditions, the most important theoretical and applied task of Russian political science is the development of a methodology for identifying and analyzing political factors that affect the political mentality of young voters in modern Russia.

Describing Overarching Curricular Goals for Individualized Education

Phenomenon: The phenomenon of individualized education, an essential component of competency-based medical education, addresses individual learner needs while working toward standardized learning outcomes. One challenge with broadly implementing individualized education is the lack of a pragmatic operational definition. To formalize expectations for individualized education, the Accreditation Council of Graduate Medical Education in 2013 began requiring six months of individualized curriculum (IC) during pediatric residency; however, there is not a national standard of formal curricular goals for the IC as an educational entity. Examining and describing the overarching curricular goals of IC could provide a framework for discourse about and further study of individualized education in medicine across disciplines and the continuum of medical education. Thus, we aimed to describe the phenomenon of individualized education through the lens of the goals of the IC in pediatric residency in the United States. Approach: In 2017, a purposeful sample of Pediatric Residency leaders were recruited to represent a diverse sample of program sizes, regions of the country, and importance of the IC to the program leadership. They completed an online survey with open-ended questions describing formal and implicit goals of their program’s IC. The authors analyzed responses initially using conventional content analysis, then investigated whether the themes for program goals aligned with any existing educational theory. The concepts and language aligned with the principles of self-determination theory (SDT); therefore, the IC goals were subsequently grouped using the SDT domains of relatedness, autonomy, and competence. A focus group with a subset of survey respondents was conducted for member checking and elaboration of concepts. Findings: Program leaders from a diverse sample of 36 programs participated in the survey and a subset of 11 programs participated in the focus group. The common goals across all programs are listed in parentheses and organized by domains of SDT: 1) Relatedness goals (engage in mentorship, select a career) cultivate resident’s professional identity based on their desired future career path; 2) autonomy goals (create a learning plan, practice accountability) help residents plan their path; and fulfillment of their plans lead to 3) competence goals (develop targeted clinical skills and knowledge, ensure comprehensive exposure, address learning gaps), ensuring they have a comprehensive skill set for their chosen identity. Insights: This study provides a framework to describe the phenomenon of individualized education through the lens of IC curricular goals in pediatric residency. The goals for IC that emerged from this study serve as a pragmatic framework for implementation of individualized education. They provide a common language and structure to promote more rigorous and collaborative study of individualized education across programs, disciplines, and settings in medicine. They may function as a roadmap for learners to navigate educational activities and for programs to help shape the experiences of their learners and examine outcomes of individualized education in their programs. The framework can also help individual pediatric residency programs structure improvements to their IC. Disciplines beyond pediatrics may also use this framework to better structure elective experiences to capitalize on the benefits of individual education.

Mauritius’ Competitive Party Politics and Social Democratic Welfare Outcomes after Independence

Mauritius has cast herself as an outlier on the African political landscape, having hosted peaceful, free and fair elections since the advent of independence in 1968 without fail. The island state of Mauritius, which lies over 2000km off the coast of East Africa, boasts a multiplicity of political parties which have added to the vibrancy of political culture in that country. Election season tends to be a hotly contested period in which various political parties, by virtue of their claims as custodians of collective and national centre left interests, jostle one another for dominance under the banner of pro-poor development. This essay considers Mauritius’ status as a social democratic welfare state by drawing the relation between the country’s competitive political culture and development successes against the backdrop of its democratic election experiences from 1968 to 2005. While election outcomes elsewhere on the continent tend to reflect the maturity of democratic spaces in which political spaces exist, in Mauritius they continue to serve as a litmus test to ascertain the level of commitment to the social cause by the ruling incumbents and aspirants alike.

Calculating Risks: Understanding the 2020 Election Experience and Defining the "New Normal"

The 2020 election revealed the interdependence of election systems and the risk management challenges of decentralization. Future risk management will need an update to deal with new threats, both complexity and adversary driven.