Self-evaluation Scores Research Articles

Three-Dimensional Accuracy of Bone Contouring Surgery for Zygomaticomaxillary Fibrous Dysplasia Using Virtual Planning and Surgical Navigation

Fibrous dysplasia (FD) is a benign condition in which normal cancellous bone is replaced by immature woven bone and fibrous tissue. The present study aimed to estimate and compare the 3-dimensional (3D) accuracy of bone contouring surgery for zygomaticomaxillary FD performed using virtual planning and surgical navigation versus surgeon's intraoperative assessment. This is a retrospective cross-sectional study. Patients with zygomaticomaxillary FD who underwent bone contouring surgery between 2012 and 2019 were reviewed. They were divided into 2 groups: group A underwent bone contouring surgery using virtual planning and surgical navigation, and group B underwent bone contouring surgery by surgeon's intraoperative assessment. The predictor variable was surgical technique. The other variables were gender, age, and operative region. The primary outcome variable was 3D accuracy, which was indicated by root mean square, calculated as a measure of the deviation of the postoperative computed tomography from the preoperative virtual plan. The other outcome variables were patient satisfaction with the outcome by self-evaluation score and operative times. Correlation analysis between the predictor variables and outcome variables was performed. The sample comprised 24 patients (17 males and 7 females, mean age, 25.7±10.45years), 13 patients in group A and 11 patients in group B. The mean root mean square was significantly lower in group A than in group B (P=.007). Patient satisfaction with facial symmetry was significantly better in group A (P=.015). Mean operative time was comparable between the 2 groups (P=.918). Surgical technique (P=.011) and operative region (P=.01) were significant influence factors in 3D accuracy of surgery. Virtual planning and surgical navigation can significantly improve the 3D accuracy and patient satisfaction of bone contouring surgery for zygomaticomaxillary FD, without prolonging operative time.

Assessing student confidence in interprofessional communication during primary care advanced pharmacy practice experiences (APPEs)

Background and purposeStudents must have experience communicating and interacting with healthcare professionals throughout pharmacy school curricula to effectively develop interprofessional communication abilities and confidence. This study’s purpose was to assess student confidence in interprofessional communication utilizing a rubric and checklist inspired by the situation-background-assessment-recommendation (SBAR) technique throughout five-week primary care advanced pharmacy practice experiences (APPEs). Educational activity and settingA six-item rubric was created for student self-evaluation of interprofessional communication throughout their APPE. Students completed the rubric twice to evaluate change in confidence. Additionally, a pre-post rotation survey was developed to assess students’ comfort level rounding with healthcare professionals and interacting/intervening with other healthcare professionals to address a medication-related problem. A paired t-test was used to evaluate changes in perceived student confidence in rubric self-evaluations and pre- and post-APPE surveys. FindingsFrom May 2017 to April 2019, 93 students completed primary care APPEs with faculty authors, and 181 encounters were self-evaluated using the rubric. Forty-eight students completed all rubric sections twice; their mean self-evaluation score increased significantly from 15.25/18 to 17.10/18 (P < .001). Self-evaluation scores increased significantly on all rubric sections (P < .05) except professional language (P = .133). Student comfort level rounding with healthcare professionals and interacting/intervening with healthcare professionals to address a medication-related problem increased significantly (P < .001). SummaryInterprofessional communication practice, preceptor observations and feedback, and utilization of an interprofessional SBAR-inspired communication rubric contributed to improved student confidence in making patient care recommendations to physicians.

Self-Evaluation Differences Among Swedish Children and Adolescents Over a 30-Year Period.

International research has found changes in how today’s young people evaluate themselves. The present Swedish research contributes with new findings by distinguishing different patterns of change in self-evaluation in two age groups. The study investigates generational and gender differences in five self-evaluation dimensions in two samples, one from 1983 (N = 3052 10–16-year-old students) and one from 2013 (N = 1303 10–18-year-old students). Three age groups were analyzed. The generational comparison for primary school (ages 10–12) showed higher scores in 2013 than in 1983 for all five self-evaluation dimensions. Interactions between generation and gender were found for psychological well-being, relations to others, school competence evaluations, and the total score, demonstrating, in contrast to international research, a greater increase for girls than for boys. Noteworthy is that girls in primary school had higher scores in 2013. The generational comparison for lower secondary school (ages 13–15) demonstrated higher scores for school competence, relational self-evaluations, and a total higher score in 2013. Interactions between generation and gender were found for total, physical, and psychological well-being evaluation scores, indicating an increase for boys and a decrease for girls in 2013 compared to 1983. The gender comparison for secondary school (ages 16–18, 2013), showed gender differences for physical, psychological well-being, school competence evaluations, and for the total score to the advantage of boys. The study discusses changes in self-evaluation in relation to phenomena such as permissive child-rearing, decreased demands in school, increased self-enhancement behavior through social media, and narrow body ideals in today’s society. The study recommends that interventions directed toward groups with low self-evaluation scores should be considered.

Utilization of Video for Competency Evaluation.

Learner self-assessment and accountability are important features in nursing education. Innovative competency sessions enhance the delivery of quality care. This project investigated the addition of video into established competency evaluations for the purpose of learner review and self-evaluation. An experimental design was used to determine the effects of video on learner self-evaluation. With 95 percent confidence, the mean total self-evaluation score for those without the video was higher than for those with the video, supporting the hypothesis that those without video recall would inflate their self-evaluation scores.

Inter-Rater Reliability of Web-Based Calibrated Peer Review within a Pharmacy Curriculum

Objective. To assess the inter-rater reliability of student evaluations submitted through a web-based calibrated peer review system versus faculty evaluations in a Doctor of Pharmacy (PharmD) curriculum. Methods. Two calibrated peer review assignments were integrated into two sequential pharmacotherapy-based courses in the first professional year of the PharmD curriculum. To assess the inter-rater reliability of student peer and self-evaluations compared to faculty evaluations, 50 student submissions from each assignment were randomly selected for faculty evaluation, using the same evaluation criteria used by students. Statistical analysis was performed to assess the difference between the scores given by students versus faculty members and the correlation between the combined and individual assignment scores given by students versus faculty members. Results. Mean faculty scores did not significantly differ from student peer or self-evaluation scores. When the assignments were combined, there was a significant fair correlation between scores assigned by peers and those assigned by faculty members, and between scores assigned by students (self-evaluation) and faculty members. For individual assignments, one showed significant positive correlations for both peer and self-assessment compared to faculty, while the other assignment did not. Conclusion. Incorporating longitudinal calibrated peer review activities into the PharmD curriculum demonstrated fair inter-rater reliability between scores assigned by pharmacy student and faculty members. Further research on calibrated peer review is needed in pharmacy education to evaluate its reliability and utility. However, the current study suggests that the use of a web-based calibrated peer review system within a pharmacy curriculum could provide additional opportunities for critical evaluation and student self-assessment, as well as encourage more open-ended communication activities without increasing the grading burden on faculty members.

Promoting Healthy Eating Habits for College Students Through Creating Dietary Diaries via a Smartphone App and Social Media Interaction: Online Survey Study.

BackgroundYouth in developed countries face the contradictory health problems of obesity and an excessive desire for weight loss. Developing a better health attitude for college students is essential as this period of life establishes future lifestyle and habits. Online interaction on social media can help to improve eating habits by creating dietary diaries through a smartphone app; however, the effects of such interactions for college students have not been examined to date.ObjectiveThe aim of this study was to evaluate the potential effectiveness of social media interactions with the use of dietary diaries on a smartphone app to motivate college students in raising self-awareness of their eating habits.MethodsForty-two college students in the greater Tokyo area of Japan participated in the study by creating dietary diaries online through a smartphone app and then followed/interacted with each other using social media for 7 consecutive days in September to November 2017. Online surveys were administered at baseline, immediately after creating the dietary diaries, and at 1-month follow up. Participants rated their degree of interest and self-evaluation of eating habits using 7-point scales, and answered multiple choice questions related to their thoughts in choosing meals/drinks among 10 topics. Free descriptions about their overall experience throughout the project were also collected in the follow-up survey.ResultsData from 38 participants who completed all processes were analyzed. Over time, the mean score for degree of interest in eating habits increased from 4.6 to 6.2 (P<.001), while the self-evaluation score decreased from 4.5 to 3.6 (P<.001); these significant differences remained after 1 month (5.3, P=.002; 4.1, P=0.04, respectively). A weak negative correlation (P=.009) was observed between scores for degree of interest and self-evaluation. Participants with lower scores for degree of interest at baseline tended to increase their interest level by more than 2 points above the average (P<.001). Participants gradually thought more about their eating habits from various perspectives when choosing a meal/drink, particularly with respect to maintaining well-balanced diets and introducing diverse ingredients. Participants evaluated their experiences as interesting/fun and reported familiarity with using the smartphone app and social media as the preferred method to keep track of their eating. All participants welcomed communication with fellow participants on social media and motivated each other, in addition to monitoring their eating habits through online dietary diaries. Some participants experienced difficulty, especially when they were busy or faced a lack of internet access.ConclusionsThrough interactions on social media, college students experienced encouragement and developed an interest and critical thinking with respect to their eating habits. This approach, which embraces peer education and peer support with social media, holds promise for the future of youth health promotion. Further examination will be needed to explore how to sustain this level of heightened awareness.

Predictive factors influencing pregnancy rate in frozen embryo transfer.

PurposeTo evaluate the outcomes of embryo transfer (ET) and to identify the parameters influencing pregnancy outcomes.MethodsThis study included 938 ET cycles involving single frozen and thawed good‐quality blastocyst (Gardner grade ≥3BB) between August 2017 and January 2018. The significance of several parameters including endometrial thickness, position of the transferred air bubble, self‐evaluation score by physicians, and uterus direction at ET as predictors of clinical pregnancy was evaluated using univariate and multivariate analyses.ResultsAmong 938 ET cycles, 462 (49.3%) resulted in a clinical pregnancy. Endometrial thickness was positively associated with clinical pregnancy in a linear trend. Between the variable position of the transferred air bubble and clinical pregnancy rate showed a curvilinear relationship. Clinical pregnancy rate was higher in cases with good self‐evaluation score, whereas there was no difference between groups with different uterus directions. Univariate analysis of predictive parameters identified endometrial thickness, self‐evaluation score by physicians, and position of air bubbles as significant predictors of clinical pregnancy, of which endometrial thickness and position of air bubbles appeared to be independently related to clinical pregnancy.ConclusionEndometrial thickness and the position of transferred air bubbles influenced clinical pregnancy in ET cycles.

Is countries\u2019 transparency associated with gaps between countries\u2019 self and external evaluations for IHR core capacity?

BackgroundThis study aims to evaluate the gap between countries’ self-evaluation and external evaluation regarding core capacity of infectious disease control required by International Health Regulations and the influence factors of the gap.MethodsWe collected countries’ self-evaluated scores (International Health Regulations Monitoring tool, IHRMT) of 2016 and 2017, and external evaluation scores (Joint External Evaluation, JEE) from WHO website on 4rd and 27rd November, 2018. There were 127 and 163 countries with IHRMT scores in 2016 and in 2017, and 74 countries with JEE scores included in the analysis. The gap between countries’ self-evaluation and external evaluation was represented by the difference between condensed IHR scores and JEE. Civil liberties (CL) scores were collected as indicators of the transparency of each country. The Human Development Index (HDI) and data indicating the density of physicians and nurses (HWD) were collected to reflect countries’ development and health workforce statuses. Then, chi-square test and logistic regression were performed to determine the correlation between the gap of IHRMT and JEE, and civil liberties, human development, and health workforce status.ResultsCountries’ self-evaluation scores significantly decreased from 2016 to 2017. Countries’ external evaluation scores are consistently 1 to 1.5 lower than self-evaluation scores. There were significantly more countries with high HDI status, high CL status and high HWD status in groups with bigger gap between IHRMT and JEE. And countries with higher HDI status presented a higher risk of having bigger gap between countries’ self and external scores (OR = 3.181).ConclusionOur study result indicated that countries’ transparency represented by CL status do play a role in the gap between IHR and JEE scores. But HDI status is the key factor which significantly associated with the gap. The main reason for the gap in the current world is the different interpretation of evaluation of high HDI countries, though low CL countries tended to over-scored their capacity.

Relationship between peer evaluation and interprofessional self-evaluation in a joint healthcare team-based learning class involving three universities.

This study aimed to clarify the relationship between interprofessional self-evaluation and peer evaluation during interprofessional education (IPE) using team-based learning (TBL). We also aimed to clarify differences in interprofessional cooperation between students with high and low peer evaluation scores. In total, 483 students (grades 3-5) from nine faculties at three universities participated in a TBL-based IPE program. The students completed five interprofessional self-evaluation domains (the modified Tsukuba IPE model) before and after IPE. Students also completed peer evaluation after IPE. Students were divided into three groups by peer evaluation scores (low, middle, high), and the post-class self-evaluation scores of these groups were compared using a Kruskal-Wallis test. Multiple regression analysis was also performed. Peer evaluation comments were analyzed using a qualitative inductive method. Students in the low peer evaluation group had significantly lower scores in the "Regarding participation in group work" domain than students in the high group (P<0.05). Students in the high group received positive comments, such as [good communication] and [working cooperatively], whereas students in the low group were required to improve in two areas: [speaking up more] and [need more communication]. There was a significant relationship between peer evaluation by team members and self-evaluation for "Regarding participation in group work." Students with high peer evaluation scores participated with active attitudes, whereas students with low scores were considered passive. This study suggested that using peer evaluation may enhance students' professional cooperation by improving their communication and attitudes toward active participation.

Exploring Pre-service Teachers' Beliefs about English Teaching Competence, Perceived Competence, and Actual Competence

The present study explores what constitutes pre-service teachers’ beliefs about English teaching competence, perceived English teaching competence, and actual English teaching competence, how these variables are related, and how beliefs function in self-evaluation. Eightyeight pre-service elementary school teachers participated in the study. They were asked to perform the teaching task and respond to the surveys about beliefs and self-evaluation. The scores of beliefs, self-evaluation, and actual teaching ability were calculated and analyzed. The results are as follows: Pre-service teachers’ three variables, beliefs about English teaching competence, perceived English teaching competence, and actual English teaching competence, are separate constructs consisting of different components; there are correlations between some of these components and actual English teaching competence. Also, this study revealed that one of the components―perceived competence about their skills of designing and teaching effective English lessons―best explains actual English teaching competence. Additionally, it was found that preservice teachers make some errors when they evaluate their English teaching competence, which causes tendencies such as overestimation or underestimation of their competence, and that their beliefs play a role in these self-evaluation tendencies.

Forecasting one-day-forward wellness conditions for community-dwelling elderly with single lead short electrocardiogram signals

BackgroundThe accelerated growth of elderly population is creating a heavy burden to the healthcare system in many developed countries and regions. Electrocardiogram (ECG) analysis has been recognized as effective approach to cardiovascular disease diagnosis and widely utilized for monitoring personalized health conditions.MethodIn this study, we present a novel approach to forecasting one-day-forward wellness conditions for community-dwelling elderly by analyzing single lead short ECG signals acquired from a station-based monitoring device. More specifically, exponentially weighted moving-average (EWMA) method is employed to eliminate the high-frequency noise from original signals at first. Then, Fisher-Yates normalization approach is used to adjust the self-evaluated wellness score distribution since the scores among different individuals are skewed. Finally, both deep learning-based and traditional machine learning-based methods are utilized for building wellness forecasting models.ResultsThe experiment results show that the deep learning-based methods achieve the best fitted forecasting performance, where the forecasting accuracy and F value are 93.21% and 91.98% respectively. The deep learning-based methods, with the merit of non-hand-crafted engineering, have superior wellness forecasting performance towards the competitive traditional machine learning-based methods.ConclusionThe developed approach in this paper is effective in wellness forecasting for community-dwelling elderly, which can provide insights in terms of implementing a cost-effective approach to informing healthcare provider about health conditions of elderly in advance and taking timely interventions to reduce the risk of malignant events.

Constructing a nurse standardized training network information platform based on clinical nursing ability

Objective Based on the clinical nursing ability and the needs of nurses, a network information platform for standardized training of nurses is constructed, which is practical, comprehensive, scientific and reasonable. Methods Using semi-structured interview method to construct the questionnaire of the functional requirements of the standardized training network information platform module for nurses, using the questionnaire to investigate the standardized training nurses, clinical teachers and nursing managers to obtain the functional requirements of the standardized training network information platform module for nurses. Two rounds of Delphi expert consultation were used to determine the modules and functions of the network information platform for standardized training of nurses, and a multidisciplinary information platform team was established to initially build the network information platform. In August 2015 and August 2016, 90 new openly recruited nurses from a ClassⅢ Grade A hospital were set as the control group, and 98 new openly recruited nurses in August 2017 were set as the observation group. The control group used the traditional training method, and the observation group used the network information platform for training. Questionnaire survey was used to compare the two groups' clinical nursing ability, academic achievement and professional skill achievement. Results According to the demand, the standardized training network information platform for nurses was designed into four parts: basic module, specialized module, humanistic module and assessment module. The scores of self-evaluation, leadership of peer review, critical patients' monitoring, teaching and cooperation, planning and evaluation, communication and professional development in the observation group were significantly higher than those in the control group (P<0.05) . The professional theoretical results and professional skills results of the observation group were higher than the control group and the difference was statistically significant (P<0.05) . Conclusions Based on the clinical nursing ability, the network information platform for standardized training of nurses is constructed, and the platform is used for standardized training of nurses, which can improve the clinical nursing ability, the academic examination results and the professional skill examination results of the trained nurses. Key words: Nurses; Standardized training; Information platform; Network training; Clinical nursing skills; Demand

Effects of internet-based quiz on the teaching of Pathophysiology

Objective To explore the effects of internet-based quiz on pathophysiological teaching. Methods undergraduates from two different classes (41 of batch 2107 from nursing and 49 of batch 2016 from pharmacy) taught by the same teacher were enrolled in the study and randomized into quiz group and control group to compare their teaching effect. Indexes evaluated were scores of midterm exam and final exam, students' teaching evaluation scores and teachers' self-evaluation scores. T test for data analysis was performed by SPSS 20.0. Results the scores of each general question and the total scores of midterm exam in the quiz group were higher than those in the control group, with statistically significant differences (P<0.005), except for the scores of short-answer and discussion questions. The scores of each general question and the total scores of final exams in the quiz group were higher than those in the control group, with statistically significant differences (P<0.005). Scores of knowledge memory, learning efficiency, learning interest, learning activeness and students' evaluation for the same teacher in the quiz group were significantly higher than those in the control group. There were no significant differences between two groups in the scores of classroom management, teacher's professional ethics, teaching democracy, homework, teaching capacity and teaching interaction. When using these two teaching methods, the scores of teachers for comprehending students' study, motivating students to study, saving working time, saving resources and teachers' self-evaluation in the quiz group were higher than those in the control group, with statistically significant differences (P<0.05). There were no statistical differences between two groups in the scores of classroom management, teacher's professional ethics, teaching democracy, homework, teaching capacity and teaching interaction. Conclusion Internet-based quiz is an effective way to improve students' study, so as to improve the teaching quality. Key words: Internet; Quiz; Pathophysiology; Teaching

The role of case nursing teaching method in training nursing students′ clinical comprehensive ability

Objective To study the effect of special case nursing teaching method on improving the clinical practice ability and comprehensive ability of nursing interns. Methods In January 2017, the teaching method of specialized case nursing was implemented in Heze Municipal Hospital, Shandong Province. Before and after the implementation of the teaching method (January 2016 to December 2017), 65 nursing interns were selected to be included in the reference group and the research group respectively. The scores of medical examination, other evaluation and self-evaluation of the two groups were counted and compared. Results In terms of academic, practical and case analysis scores, the research group had (87.50±0.52), (88.45±0.63) and (84.48±0.36) scores respectively, while the control group had (76.82±0.62) , (80.56±0.45) and (73.35±0.43) scores respectively. The research group had higher scores than the control group, with a difference between the two groups, there was statistical significance (t=95.174, 73.489, 143.115, all P<0.01). In terms of his evaluation results, the scores of other evaluation satisfaction, holistic nursing ability, communication ability, discovery and problem solving ability of nursing students in the study group were (9.62±0.34), (9.45±0.63), (9.38±0.36) and (9.20±0.16) respectively, while those in the control group were (8.28±0.32) , (8.56±0.45) , (8.05±0.43) and (8.12±0.23) , there were significant differences between the two groups (t = 8.290-27.797, all P<0.01). In terms of self-assessment scores, the study group scored (8.45±0.26) , (8.78±0.32) , (8.55±0.43) , (8.74±0.34) , (9.32±0.27) , (8.46±0.33) , (8.72±0.31) respectively on the satisfaction of teachers, the recognition of teaching methods, professional identity, internship harvest, the improvement of holistic nursing ability, the improvement of discovery and problem solving ability and the improvement of communication ability. The scores of the control group were (9.35±0.40) , (7.56±0.45) , (7.15±0.63) , (7.26±0.61) , (8.26±0.32) , (7.06±0.30) , (7.37±0.69) ,the differences between the two groups were significant (t=14.389-25.309, all P<0.01). Conclusion Specialized case nursing teaching method can not only improve the theoretical knowledge, operation and case analysis ability of nursing interns, but also improve their comprehensive abilities of holistic nursing, communication, problem finding and problem solving. It can also improve the professional identity of nursing students, the satisfaction of medical staff and patients, which is beneficial to the professional development of nursing students in clinical work. Key words: Student, nursing; Specialist case nursing teaching; Clinical practice ability; Comprehensive ability

Recovery Process After Anterior Cervical Decompression in Patients With Cervical Spondylotic Myelopathy With Different Natural History.

An observational prospective cohort study. To investigate the influence of natural history on the recovery of patients with cervical spondylotic myelopathy (CSM) after anterior cervical decompression. The natural history of CSM has not been clearly elucidated, it remains unclear whether the natural history of CSM is associated with the recovery process after surgical treatment. Patients with CSM (n=117) after anterior cervical decompression were stratified variously on the basis of natural history features. Baseline and postoperative neurological functions were rated using the Japanese Orthopaedic Association (JOA) and patient-based self-evaluation (PBSE) scores. The minimum and maximum recovery times for sensory function, and motor functions of the upper and lower extremities were analyzed separately at time points 1-60 months after surgery. In all patients, the postoperative JOA and PBSE scores were significantly improved relative to baseline, in which sensory function recovered most quickly, followed by upper-extremity and lower-extremity motor functions. However, when compared with patients whose first symptom onset at the lower extremity, patients with the first onset at the upper extremity required less time to recover lower-extremity motor function, but more time to recover upper-extremity motor function. Patients with rapid progression had significantly lower preoperative and final JOA and PBSE scores compared with patients whose progression was steady or stepwise. Patients with preoperative symptoms ≥1 year had longer recovery time and poorer functional outcomes compared with those symptoms <1 year. In patients with CSM, the location of first symptom onset, progressive velocity of symptom, and duration of preoperative symptoms significantly influenced the recovery process after anterior cervical decompression. Level 2-observational prospective study.

Whose resilience matters? Like-for-like comparison of objective and subjective evaluations of resilience

Abstract As resilience continues its rise to top of the international policy agenda, development funders and practitioners are under mounting pressure to ensure that investments in resilience-building are effective and targeted at those most in need. It is here that robust resilience measurement can make valuable contributions: identifying hotspots; understanding drivers; and inferring impact. To date, resilience measurement has been dominated by objectively-oriented approaches. These rely on external definitions of resilience (often informed by outside ‘experts’, literature reviews or resilience practitioners) and measured through observation or external verification. More recently, the potential for subjective approaches has been proposed. These take a contrasting approach, soliciting people’s judgements of what resilience means to them, and getting them to self-evaluate their own resilience. While both approaches have their strength and weaknesses, little is known about how objective and subjective modes of resilience measurement compare. To shed light on this relationship, we provide like-for-like comparisons of these two approaches using a regionally representative household survey of 2308 households in Northern Uganda. In so doing, we introduce a new measurement approach named the Subjective self-Evaluated Resilience Score (SERS). Outcomes from SERS are directly compared with an objectively-evaluated approach, the Resilience Index Measurement Analysis (RIMA), widely used by resilience practitioners. Findings from the survey suggest a moderate correlation between objectively- and subjectively-evaluated resilience modules. More importantly, both approaches share similar associations with many key socio-economic drivers of resilience. However, there are notable differences between the two. In some case, the approaches differ entirely regarding contributions of important traits, including coping strategies, levels of education and exposure to prior shocks. Our results highlight the need for resilience evaluators to consider a diversity of knowledge sources and seek greater use of evidence in indicator selection. We also investigate the properties of the SERS module itself. We find that characterisations of resilience that mimic various commonly-used frameworks produce similar resilience outcomes, suggesting that debates over the exact composition of resilience-characteristics may matter little. In addition, shorter SERS modules match the performance of the full set of SERS questions, allowing for quicker administration and reduced survey burden. Lastly, we call for evaluators to consider the strengths and weaknesses of subjective and objective measurement approaches, including options for combining both formats.

Empirical evidence that concept mapping reduces neurocognitive effort during concept generation for sustainability

Sustainable development is a systems problem that requires a shift in thinking from individual parts to the relationships between them. Enabling those involved in the development process to more quickly think in systems is therefore vital to create more sustainable solutions. However, measuring the ability to think in systems is a challenge because of the limited methods to observe behavior or measure outcomes. Recent advances in neuroimaging offer a radically new approach to measure one's ability to think in systems. The specific technique, called functional near-infrared spectroscopy (fNIRS), captures the change in oxygenated blood in the cortical region of the brain, which is a proxy for elevated cognitive activation. In this study, engineering students (n = 28) performed both concept mapping (i.e., labeling concepts and drawing directional connections between them) and concept listing (i.e., generating a list of concepts without indicating relationships) related to grand challenges for sustainability. fNIRS captured the increase in oxygenated blood along the prefrontal and parietal cortex during both concept mapping and listing tasks. Self-evaluation and concept mapping scores were also captured and compared. Concept mapping led to significantly more concepts compared to concept listing. Concept mapping also required less cognitive resources (i.e., oxygenated blood) to generate more concepts. The region of the brain that received more cognitive resources is also significantly different when participants were using concept listing and mapping. Concept mapping directed more cognitive resources to the regions of the brain associated with cognitive flexibility and decreased cognitive resources in regions associated with visuospatial processing. Self-evaluation of systems thinking was negatively correlated with concept mapping scores, meaning students with high perceived ability produce worse concept maps. Global efficiency of brain networks was positively correlated to concept map scores and more accurately measure performance compared to self-evaluation. This study provides neurocognitive evidence to support the benefits of concept mapping and also demonstrates the added advantages of neuroimaging to study systems thinking.

Do family medicine clerkships complement clerkships at teaching hospitals in Japanese undergraduate medical education?: An observational study

Background: Despite recognition of the importance of primary health care, the opportunities for medical students to participate in family medicine clerkships (FMCs) are still inadequate around the world. In order for FMCs to be accepted in the undergraduate curriculum, it is necessary to clarify whether FMCs complement clerkships at teaching hospitals.Methods: Throughout the academic year 2018–2019, a total of 125 fifth-year students in Fukushima Medical University participated in an FMC. The students evaluated themselves at the beginning and end of their FMC whilst the family doctors evaluated students at the end of the FMC. The evaluations were a 5-point scale on 31 items in the following seven areas; objectives in general practice, practical skills and patient care, communication skills, patient-physician relationship, practice of team-based health care, medical practice in society and medical knowledge and problem-solving ability. A multiple regression analysis was conducted to assess whether self-evaluation was increased by clerkships at teaching hospitals where students rotated before the start of FMC. A Wilcoxon signed-rank sum test was used to assess self-evaluation changes before and after the FMC.Results: All 125 students completed the study. Pre-FMC self-evaluation scores for 19 items tended to be higher depending on when the FMC was conducted; the later the semester, the higher the score (e.g. diagnostic reasoning: first semester, 2.23; second semester, 2.48 [p = 0.11]; third semester, 2.61 [p = 0.02]). However, this tendency was not observed in the remaining 12 items: psychological and social background, home medical care, interprofessional work, healthcare system, team-based health care, participate as a member of the team, role of the physician in team collaboration, current medical situation in the community, community-based integrated care system, necessity of primary care, discover necessary tasks, and rank the tasks. In post-FMC evaluation, six of the 12 items were higher than four point in both the self-evaluations and family doctor evaluations. A significant increase was observed between the pre-and post-FMC self-evaluation scores in all 31 items (e.g. diagnostic reasoning: pre 2.2 and post 3.9 [p <0.0001]).Conclusion: The results of the present study suggest that FMCs complement clerkships at teaching hospitals.

Relationship between the elbow joint valgus instability and forearm flexor muscle strength in high school pitchers with and without symptom.

Earlier reports describe forearm flexor muscles as active stabilizers of the elbow to valgus stress during throwing motion. Given high school pitchers' history of elbow symptoms, this study assesses its relation to elbow valgus joint instability and forearm flexor muscle strength. Ultrasound examination was made for 132 high school baseball pitchers with and without valgus stress of the medial aspect of the bilateral elbows. They had completed a self-administered questionnaire related to self-satisfaction score (0-100) for pitching performance and throwing-related elbow joint pain sustained during the prior year. Using a digital manual muscle strength meter, we examined the grip strength and muscle strength of the flexor carpi ulnaris (FCU). For participants with and without a history of elbow symptom, we compared differences of ulnohumeral joint space width with and without valgus stress and grip and FCU muscle strength. For ulnohumeral joint width difference with and without valgus stress, pitchers with an elbow symptom and those without elbow symptom history on the throwing side were not significantly different. No difference was found in the grip strength or FCU muscle strength of the throwing side for each group. Positive significant association was found between FCU muscle strength on the pitching side and the self-evaluation score for pitching performance ( r = 0.27, p = 0.002). However, no association was found between the elbow valgus instability and the forearm flexor muscle strength. FCU muscle strength might influence high school baseball pitching performance.

Assessment of Emergency Medicine Resident Performance in an Adult Simulation Using a Multisource Feedback Approach.

IntroductionThe Accreditation Council for Graduate Medical Education (ACGME) specifically notes multisource feedback (MSF) as a recommended means of resident assessment in the emergency medicine (EM) Milestones. High-fidelity simulation is an environment wherein residents can receive MSF from various types of healthcare professionals. Previously, the Queen’s Simulation Assessment Tool (QSAT) has been validated for faculty to assess residents in five categories: assessment; diagnostic actions; therapeutic actions; interpersonal communication, and overall assessment. We sought to determine whether the QSAT could be used to provide MSF using a standardized simulation case.MethodsProspectively after institutional review board approval, residents from a dual ACGME/osteopathic-approved postgraduate years (PGY) 1–4 EM residency were consented for participation. We developed a standardized resuscitation after overdose case with specific 1–5 Likert anchors used by the QSAT. A PGY 2–4 resident participated in the role of team leader, who completed a QSAT as self-assessment. The team consisted of a PGY-1 peer, an emergency medical services (EMS) provider, and a nurse. Two core faculty were present to administer the simulation case and assess. Demographics were gathered from all participants completing QSATs. We analyzed QSATs by each category and on cumulative score. Hypothesis testing was performed using intraclass correlation coefficients (ICC), with 95% confidence intervals. Interpretation of ICC results was based on previously published definitions.ResultsWe enrolled 34 team leader residents along with 34 nurses. A single PGY-1, a single EMS provider and two faculty were also enrolled. Faculty provided higher cumulative QSAT scores than the other sources of MSF. QSAT scores did not increase with team leader PGY level. ICC for inter-rater reliability for all sources of MSF was 0.754 (0.572–0.867). Removing the self-evaluation scores increased inter-rater reliability to 0.838 (0.733–0.910). There was lesser agreement between faculty and nurse evaluations than from the EMS or peer evaluation.ConclusionIn this single-site cohort using an internally developed simulation case, the QSAT provided MSF with excellent reliability. Self-assessment decreases the reliability of the MSF, and our data suggest self-assessment should not be a component of MSF. Use of the QSAT for MSF may be considered as a source of data for clinical competency committees.