Examination Skills Research Articles

Predicting aortic stenosis progression using a video-based deep learning model of aortic stenosis built for single-view two-dimensional echocardiography

Abstract Background We have recently described a deep learning (DL) model that relies on 2-dimensional parasternal long axis (PLAX) videos from transthoracic echocardiography (TTE) without Doppler imaging to identify severe aortic stenosis (AS) at the point-of-care. However, the timely diagnosis of AS has traditionally required skilled examination with Doppler imaging at regular time intervals. Purpose To explore the role of a DL model previously trained to detect severe AS based on 2D-PLAX videos in predicting the rate of AS progression among patients with no, mild, or moderate AS. Methods In this retrospective cohort study, a random sample of 2354 individuals undergoing serial monitoring with at least two separate TTEs and available Doppler parameters of AS severity (peak aortic valve velocity, AV Vmax) between 2016 and 2021 in the Yale-New Haven Health system were included. Eligible participants had a left ventricular ejection fraction (LVEF) >=50% and no evidence of severe AS at baseline. After automated selection of PLAX videos using an automated view classifier, the baseline deep learning-based AS probability index (DL-ASi) was calculated for each patient. The absolute change in the AV Vmax was divided by the time difference between each pair of consecutive TTE studies, and then averaged to derive the mean rate of AS progression. The association between the baseline DL-ASi and the mean rate of AS progression was assessed using ordinary least squares regression with adjustment for the patient’s sex, age, and baseline LVEF and AV Vmax. To visualize the interaction between the baseline DL-ASi and AV Vmax in predicting the rate of AS progression, an interaction term was included and a contour plot was plotted for both men and women. Results We included 8473 TTE studies from 2354 unique individuals (mean age 70±14 years, n=1138 [48.3%] women) performed over a median 2.5 (IQR 1.4-3.7) years (A). Higher DL-ASi at baseline was independently associated with a more rapid rate of AS progression (βadj 0.27 [95% CI 0.20-0.33, P<0.001]). The rates of AV Vmax progression ranged from 0.06±0.01 m/sec/year in the <0.2 DL-ASi group, to 0.29±0.04 m/sec/year in the ≥0.8 DL-ASi group (B). Contour plots illustrate how, for a given AV Vmax value, DL-ASi stratified the risk of AS progression in women and men (C). Conclusion In individuals with mild to moderate AS or no AS, a DL model trained to detect features of severe AS identifies individuals with a higher rate of AS severity progression, as assessed by the mean rate of AV Vmax change. This represents a promising approach for the longitudinal, point-of-care monitoring of patients with non-severe AS outside specialized centers.

Are We Currently Teaching the Correct Ophthalmology Examination Skills in Undergraduate Medical Education?

Are We Currently Teaching the Correct Ophthalmology Examination Skills in Undergraduate Medical Education?

Exam prediction and the general Practice Registrar Competency Assessment Grid (GPR-CAG)

ABSTRACT Background In GP training, identifying early predictors of poor summative examination performance can be challenging. We aimed to establish whether external clinical teaching visit (ECTV) performance, measured using a validated instrument (GP Registrar Competency Assessment Grid, GPR-CAG) is predictive of Royal Australian College of General Practitioners (RACGP) Fellowship examination performance. Methods A retrospective cohort study including GP registrars in New South Wales/Australian Capital Territory with ECTV data recorded during their first training term (GPT1), between 2014 and 2018, who attempted at least one Fellowship examination. Independent variables of interest included the four GPR-CAG factors assessed in GPT1 (‘patient-centredness/caring’, ‘formulating hypotheses/management plans’, ‘professional responsibilities’, ‘physical examination skills’). Outcomes of interest included individual scores of the three summative examinations (Applied Knowledge Test (AKT); Key Feature Problem (KFP); and the Objective Structured Clinical Examination (OSCE)) and overall Pass/Fail status. Univariable and multivariable regression analyses were performed. Results Univariably, there were statistically significant associations (p < 0.01) between all four GPR-CAG factors and all four summative examination outcomes, except for ‘formulating hypotheses/management plans’ and OSCE score (p = 0.07). On multivariable analysis, each factor was significantly associated (p < 0.05) with at least one exam outcome, and ‘physical examination skills’ was significantly associated (p < 0.05) with all four exam outcomes. Discussion ECTV performance, via GPR-CAG scores, is predictive of RACGP Fellowship exam performance. The univariable findings highlight the pragmatic utility of ECTVs in flagging registrars who are at-risk of poor exam performance, facilitating early intervention. The multivariable associations of GPR-CAG scores and examination performance suggest that these scores provide predictive ability beyond that of other known predictors.

VENUM (Vascular Education iN Undergraduate Medicine): a multicentre evaluation of undergraduate vascular education in the UK.

Vascular surgery is a recognised surgical subspecialty covering an array of circulatory conditions predominately affecting geriatric and diabetic patients. As such, a wide breadth of clinicians will see patients with vascular pathologies, but it is unclear how detailed their knowledge base is. Key to this is the education of medical students, which has been poorly documented during undergraduate training in the UK. VENUM aimed to establish students' perceptions of vascular surgery and their confidence in performing vascular objective structured clinical examination (OCSE) skills. During the academic year of 2022/2023, final-year medical students were invited to complete a JISC survey (collaborative authorship). Seventy-seven research leads were recruited to disseminate the survey. Quantitative and thematic analysis was used to assess the data. In total, 240 final-year medical students completed the survey (54% female; 26 medical schools represented). Forty-five per cent of students reported never having had a vascular placement, 24% had never completed a vascular-focused clinical examination and 26% reported low confidence in performing ankle brachial pressure index measurement. An assessment of peripheral arterial disease morbidity was answered correctly in 17% of respondents compared with 92% for angina (chi-square test p<0.001). Students perceived the specialty to be non-inclusive and that early exposure to vascular surgery was required for better engagement with the specialty. Students have experienced little exposure to vascular surgery. This may affect future recruitment to vascular surgery and overall knowledge of vascular conditions in UK-trained doctors, which may affect long-term patient management.

The Rising Tide of Point-of-Care Ultrasound (POCUS) in Medical Education: An Essential Skillset for Undergraduate and Graduate Medical Education.

As point-of-care ultrasound (POCUS) becomes an integral component of healthcare, both undergraduate and graduate medical POCUS education is urgently necessary in curricula. Despite the apparent need of POCUS curricula, there remains a lingering question: Are there evidence-based benefits to POCUS training in undergraduate and/or graduate medical education settings? Qualitative review of research was conducted to identify common themes for benefits of POCUS and the requirements and/or characteristics for effective POCUS educational curricula. Results for undergraduate medical education were separated into preclinical and clinical education. In preclinical POCUS education, POCUS education improves anatomy education and physical examination skills for sonographic assessment of abdominal, reproductive, cardiovascular, and renal structures. Further enhancement can be achieved via simulation devices that are generalized ultrasound simulation mannequins, one defined body region such as the abdomen, or local regions of interest such as the femoral triangle. In clinical undergraduate POCUS education, benefits involved greater performance on knowledge tests and general ultrasound competency in emergency medicine, surgical, family medicine, and physical medicine and rehabilitation clerkships. These studies also found improved comprehension of specific POCUS examinations such as those for ultrasound-guided injections, FAST, eFAST, and RUSH. Further integration of POCUS education into graduate medical education was found to successfully improve ultrasound knowledge and competency in both academic and military internal medicine residencies. One limitation of this study is that this article is a review resulting in no specific intervention being introduced. The resultant hypothesis of this systematic review cannot be tested; rather evidence-based recommendations are restricted to the currently available literature within the searched databases. From this review, it was found that the inclusion of a properly integrated POCUS curriculum can result in greater confidence in ultrasound use, increased knowledge of anatomy and basic sciences for various organ systems, improved ultrasound knowledge and performance in clinical clerkships, and offers improved confidence and knowledge in ultrasound during residency.

Ortaokul Öğrencilerinin Ev Ödevi Yönetim Becerilerinin Çeşitli Değişkenler Açısından İncelenmesi

Bu araştırmanın amacı, ortaokul öğrencilerinin ev ödevi yönetim becerilerini çeşitli değişkenlere göre incelemektir. Araştırmada tarama modeli kullanılmıştır. Araştırmanın örneklemini Rize iline bağlı ilçelerdeki 514 ortaokul öğrencisi oluşturmaktadır. Araştırma sonuçlarına göre öğrencilerin ev ödevi yönetim becerilerinin yüksek düzeyde olduğu tespit edilmiştir. Öğrencilerin ev ödevi yönetim becerileri cinsiyet, sınıf, baba eğitim durumu ve not ortalaması değişkenlerine göre anlamlı ölçüde farklılaşırken anne baba medeni durumu, anne eğitim durumu, aylık gelir, kendine ait oda durumu ve teknolojik alete sahip olma durumu değişkenlerine göre anlamlı bir farklılık göstermemektedir. Araştırma sonucuna göre sınıf düzeyi arttıkça ödev yönetim becerileri azaldığı için özellikle 7. ve 8. sınıf öğrencilerine ev ödevi yönetim süreçleri ile ilgili eğitim verilmesi önerilmektedir.

COMPARISON OF THE PHYSICAL EXAMINATION SKILLS LEARNING PROCESS BEFORE AND DURING COVID-19 PANDEMIC BASED ON EXPERIENTIAL LEARNING THEORY: A MIXED-METHOD STUDY

Background: COVID-19 pandemic has changed learning physical examination skills. Online learning physical examination skills are challenging because it needs standard practice facilities, and students need opportunities to practice. Physical examination skills are essential in clinical medical practice, but research before pandemic demonstrated students’ lack of skills acquisition. Evaluation is needed to determine the differences in the learning process before and during pandemic. This study aims to compare the learning physical examination skills process before and during COVID-19 pandemic and find recommendations for the future.Methods: This research was a mixed-method study with a convergent design. The samples are students and lecturers in the Faculty of Medicine Universitas Pendidikan Ganesha. Quantitative data was obtained from a developed questionnaire about students’ perception of the physical examination skills learning process, then analyzed descriptively and using the ANOVA test. Qualitative data was obtained by interview, then analyzed using thematic analysis.Results: There are significant differences in the learning process of face-to-face, online, and blended physical examination skills (p&lt;0.05) but no difference between face-to-face and blended. Interview results have seven themes, four themes about difference in the learning process based on Kolb Experiential Learning Theory, other themes about preparation before learning, factors in the learning process, and recommendations.Conclusion: Differences in the physical examination skills learning process are in the skills demonstration, practice opportunities, feedback, and interactions. If learning physical examination skills is carried out face-to-face, online, or blended in the future, it will have different needs to be considered in the design and implementation.

Does the Number of Stimuli Influence the Formation of the Endogenous Components of the Event-Related Auditory Evoked Potentials?

Introduction The number of stimuli is important to determine the quality of auditory evoked potential records. However, there is no consensus on that number in studies, especially in the sample studied. Objectives To investigate the influence of the number of rare stimuli on forming N2 and P3 components, with different types of acoustic stimuli. Methods Cross-sectional, descriptive, comparative study, approved by the ethics committee of the institution. The sample comprised 20 normal hearing adults of both sexes, aged 18 to 29 years old, with normal scores in the mental state examination and auditory processing skills. The event-related auditory evoked potentials were performed with nonverbal (1 kHz versus 2 kHz) and verbal stimuli (/BA/ versus /DA/). The number of rare stimuli varied randomly in the recordings, with 10, 20, 30, 40, and 50 presentations. Results P3 latency was significantly higher for nonverbal stimuli with 50 rare stimuli. N2 latency did not show any difference between the type and number of stimuli. The absolute P3 and N2-P3 amplitudes showed significant differences for both types of stimuli, with higher amplitude for 10 rare stimuli, in contrast with the other ones. The linear tendency test indicated significance only for the amplitude - as the number of rare stimuli increased, the amplitude tended to decrease. Conclusion The components were identifiable in the different numbers of rare stimuli and types of stimuli. The P3 and N2-P3 latency and amplitude increased with fewer verbal and nonverbal stimuli. Recording protocols must consider the number of rare stimuli.

The Effectiveness of Applying the V-Shape Map Strategy on the Level of Skill Performance of Some Handball Skills among Students of the College of Physical Education and Sports Sciences, Misan University

The purpose of this study was to determine the efficacy of teaching according to the V-shape strategy in developing cognitive achievement and the level of skill performance of certain handball skills among students of the Faculty of Physical Education and Sports Sciences at Misan University. The study employed an experimental methodology. A handball skills examination was administered (defensive movements, shooting accuracy while falling, shooting accuracy during high jumps, continuous drifting, passing, and ball reception), it consists of five tests administered to a sample of twenty second-year students from the College of Physical Education and Sports Sciences at Misan University. The students were divided into two groups: an experimental group in which ten students studied using the Vshape strategy, and a control group in which ten students studied in the conventional manner. The findings indicated that there were statistically significant disparities, at a significance level of 0.05, between the mean scores of the students from the two study groups in terms of cognitive achievement and handball skills, with the experimental group demonstrating superior performance. The study proposes the adoption of the V-shape strategy for instructing handball, emphasizing the importance of training educators in its implementation, integrating it into curriculum design, and conducting further research to evaluate its efficacy in teaching scientific concepts and unexplored variables beyond the scope of this study.

Synergy of on-surface and in-air trajectories: Exploratory analysis of forensic online signatures implementing lessons learned from biometrics

With the increased use of digital devices, forensic document examiners (FDEs) encounter increasing number of dynamic or online signatures during their physical examinations. This shift expands the possibility of examinations and creates new challenges for FDEs. As such, FDEs require new examination skills using data science-based analyses with artificial intelligence and machine-learning techniques. In recent years, automated signature verification has gained significant interest in biometric research and could be useful in forensic investigations. However, the use of complex black-box systems inconveniencing FDEs in explaining the rationale behind their final assessment, especially when dealing with limited signature samples and various types of forged signatures. Therefore, a new forensic method is needed to assist FDEs’ analysis. To tackle these challenges and incorporate lessons learned from biometrics into forensics, this study proposes a novel forensic online signature analysis method. The proposed method uses a single-template strategy based on recent scientific findings in biometrics while updating the strategy for forensic use. This strategy creates a mean-template set from known signature samples that serve as a writer’s signature master pattern. Consequently, FDEs can evaluate intra-writer and inter-item variations using the mean-template set and a questioned signature. Furthermore, to take advantage of recent digital devices, we focused on both on-surface and in-air trajectories of online signatures, which could improve the discriminative power because in-air trajectories are invisible for imposters. Finally, we demonstrate the effectiveness and applicability of the proposed method in a forensic scenario using a public forensic online signature dataset.

THE PROBLEM OF NON-DISCRIMINATORY EDUCATIONAL SPACE IN THE FUTURE TEACHERS TRAINING SYSTEM

The article is devoted to the content of theoretical and practical training of future teachers on the problem of non-discriminatory educational space within the author’s course “Non-discriminatory educational space”. The content of the theoretical training of future teachers on the specified problem should reflect the content of the lexical-semantic groups of the non-discriminatory educational space, which include the following: legislative imperative regarding human rights, child rights, national minorities rights, gender equality, non-discrimination in education, education of children with special educational needs and inclusive education, anti-discrimination examination of textbooks, etc.; scientific, educational, methodical, visual materials that investigate, highlight and shape the opinion of society on the concepts of gender identity, ethnic origin and citizenship, migration, multiculturalism, social affiliation, place of residence, family composition, religious and political beliefs, etc.; concepts of tolerance and anti-bullying, etc.; concepts of critical, inclusive, feminist, gender pedagogy, etc.; non-discriminatory language in education: gender-sensitive, non-sexist and non-androcentric, feminitives, etc. Theoretical training involves the formation of awareness of the phenomena of non-discrimination and anti-discrimination in education, the normative and legal basis of non-discrimination in education, the scientific and methodological basis of the strategy of non-discrimination in education, gender attitudes and gender competence of the pedagogical community, linguistic sexism and gender-sensitive/non-discriminatory language, theoretical and methodological principles of gender and anti-discrimination examination of textbooks. Practical training of future teachers on the problem of non-discriminatory educational space involves forming in them the skills of anti-discrimination examination of the textbooks for primary school and creation educational content on the basis of non-discrimination.&#x0D; Keywords: professional teacher training; non-discriminatory educational space; non-discriminatory approach in education; creation of non-discriminatory educational content; thesaurus of non-discriminatory education; non-discriminatory teaching; educational and methodological content on the basis of non-discrimination; diversification of educational programs.

Motivational simulated teaching of clinical skills using formative assessment methods for medical undergraduate students: between-group evaluation of a simulated course in a Chinese medical college

ObjectivesTeaching clinical skills is an important component of educational programmes for medical undergraduates. However, the extension of the interval between the completion of the course and qualification examination affects the...

Examination of Conflict Resolution Skills of Female Administrators in Educational Organizations

Purpose: The main purpose of this study is to present a general picture of the attitudes and behaviors of female administrators in conflict situations in schools.&#x0D; Design/Methodology/Approach: In this study, what kind of conflicts are experienced in schools, What kind of solutions women administrators adopt when resolving conflicts with higher authorities, teachers, parents and students, emotions experienced during and after the conflict and the positive and negative effects of female school administrators in conflict situations compared to male school administrators were examined in the light of the answers collected from 20 participants by semi-structured interview method.&#x0D; Findings: Research results; reveals that female administrators are positive in conflict situations in the school environment and meet the expectations of teachers.&#x0D; Highlights: It is thought that the effects of female managers will be positive, especially in situations that await a solution such as conflict and cause disruption of the functioning of organizations.

Education Research: Qualitative Assessment of Virtual Teaching of the Neurological Examination to Students Reveals Importance of Technique, Process, and Documentation.

Virtual teaching sessions during the coronavirus disease 2019 pandemic were challenging for students and teachers but were also an opportunity to find creative ways to teach physical examination skills, including the neurologic examination. We examined expert opinions of the pros and cons that arise using a virtual platform to teach the neurologic examination and strategies to best address these challenges. This was a qualitative study incorporating a focus group of faculty and resident neurologists. Data were coded using conventional content analysis. An interpretivist, social constructionist approach was used to look for interesting or novel ideas, rather than testing a specific hypothesis. Three independent auditors performed a dependability and confirmability audit to confirm that the themes accurately reflected the data. A single focus group was used. Four of the 6 participants were faculty neurologists and 2 were neurology residents. Five themes were identified: (1) learning the neurologic examination is complex, (2) lack of physical contact is the most important drawback of virtual teaching, (3) virtual teaching can effectively emphasize the organization of the examination, (4) virtual sessions can facilitate combined teaching of technique and demonstration of abnormalities, and (5) virtual platforms do not necessarily imply reduced participation. Teaching the neurologic examination is a multifaceted process that should emphasize not only technique but also an overall approach to performing and documenting the examination. Many aspects of the neurologic examination can be appropriately taught virtually using various strategies, although there may always be some limitations. Virtual education can play a useful role for future curriculum design and global education.

Examination of Communication Skills of Communication Faculty Students in Terms of Various Variables

Çevresindeki insanlarla etkili iletişim kurabilen kişiler hem sosyal hayatlarında hem eğitim hayatlarında hem de mesleki yaşantılarında daha başarılı olmaktadırlar. Bu çalışmada İletişim Fakültesi öğrencilerinin iletişim becerilerinin cinsiyet, bölüm, sınıf ve genel not ortalaması değişkenleri açısından incelenmesi amaçlanmıştır. Çalışma nicel genel tarama modellerinden kesitsel bir araştırmadır. Araştırmanın evrenini Bolu Abant İzzet Baysal Üniversitesi İletişim Fakültesi’nde öğrenim gören öğrenciler oluştururken; örneklemini ise bu evrenden basit tesadüfi örnekleme yöntemi ile seçilen 440 öğrenci oluşturmaktadır. Katılımcılardan elde edilen verilerin analizi sonucunda İletişim İlkeleri ve Temel Beceriler ile cinsiyet arasında (t= 3,88; p&lt; ,001) ve yine Etkin Dinleme ve Sözel Olmayan İletişim Becerisi ile cinsiyet arasında (t= 4,10; p&lt; ,001) anlamlı bir farklılaşma olduğu tespit edilmiştir. Diğer taraftan bölüm ve bulunulan sınıfın katılımcıların iletişim becerileri üzerinde anlamlı bir farklılaşmaya yol açmadığı görülmüştür.

Assessment of Periodontal Examination and Diagnostic Skills through Objective Structured Clinical Examination: An Observational Assessment Tool

Assessment of Periodontal Examination and Diagnostic Skills through Objective Structured Clinical Examination: An Observational Assessment Tool

Newborn Screening for Developmental Dysplasia of Hip—A Survey for Knowledge and Skills Among Physicians in Delhi-NCR Region, India

Introduction Developmental dysplasia of hip (DDH) is a developmental disorder leading to life-long disability in child unless diagnosed early and treated well in time. This condition is also included under the screening and early intervention services provided by “Rashtriya Bal Swasthya Karyakram” of National Health Mission in India. The present study was done to assess knowledge, perceptions, and self-confidence of pediatricians/neonatologists, obstetricians, primary care physicians (PCPs), and the orthopedic surgeons regarding the newborn screening for DDH. Materials and Methods This cross-sectional study used a prestructured validated online questionnaire in English language. Total 158 physicians, practicing in various private and government, teaching, and nonteaching institutions from Delhi-NCR region (54 pediatrician/neonatologists, 60 PCPs, 30 orthopedic surgeons, and 14 obstetricians), responded to the survey. Questions related to biodemographic details, specialty, professional experience, knowledge about the risk factors of DDH, appropriate timing(s) for screening DDH and the modalities used, and natural course of untreated severe and mild DDH were asked. Participants were required to self-assign a grade (score 0-10) for both knowledge and clinical examination skills with reference to screening of DDH. Data was analyzed using SPSS (version 23.0) software. P value &lt;0.05 was considered significant. Results Only 18% pediatricians, 27% PCPs, 20% orthopedic surgeons, and none of the obstetrician could identify all risk factors for DDH ( P = 0.159). Only 24% physicians knew that the natural evolution of untreated severe DDH is bad with need for multiple surgeries throughout life and only 17% knew that the most common natural evolution of untreated mild hip dysplasia at birth is good with minimal functional sequelae without the need for surgery. Only 56% pediatricians mentioned correctly that the first screening for DDH needs to be done at birth before discharge from the hospital. Orthopedic surgeons, obstetricians, and PCPs were comparable to pediatricians in this knowledge ( P ≥ 0.05). Only 52% pediatricians were aware of both Barlow and Ortolani clinical maneuvers and 18% did not know about any of these tests. Among orthopedic surgeons, 60% knew about both these tests and among obstetricians, only 14% knew about both these tests. Self-assigned score for both knowledge and clinical examination skills were unsatisfactory in all groups, the range of median score being 5 to 7 and 2 to 6, respectively. Clinical examination skills scores were significantly lower among obstetricians than the other groups ( P = 0.001; Kruskal-Wallis test). Clinical examination skills scores were significantly lower than the knowledge scores among PCPs, orthopedic surgeons, and obstetricians ( P = 0.001, 0.026, and 0.005, respectively; Wilcoxon Signed-Rank test). Conclusion Knowledge was unsatisfactory among all physicians, regardless of their specialty. Self-assigned scores for clinical examination skills, which is a surrogate of self-confidence and likely to affect the practices, were also unsatisfactory among all physicians, regardless of their specialty. The findings of this study indicate an immediate need of attention for continuing education and handholding of all stakeholders who are directly responsible for screening and early diagnosis of DDH at birth and early infancy. Such a pertinent issue should be incorporated as a core knowledge as well as skill competencies in both undergraduate and postgraduate medical education curriculum.

Covariational reasoning and item context affect language in undergraduate mass balance written explanations.

Mass balance (MB) reasoning offers a rich topic for examination of students' scientific thinking and skills, as it requires students to account for multiple inputs and outputs within a system and apply covariational reasoning. Using previously validated constructed response prompts for MB, we examined 1,920 student-constructed responses (CRs) aligned to an emerging learning progression to determine how student language changes from low (1) to high (4) covariational reasoning levels. As students' abilities and thinking change with Context, we used the same general prompt in six physiological contexts. We asked how Level and Context affect student language and what language is conserved across Contexts at higher reasoning Levels. Using diversity methods, we found student language becomes more similar as covariational reasoning level increases. Using text analysis, we found context-dependent words at each Level; however, the type of context words changed. Specifically, at Level 1, students used context words that are tangential to MB reasoning, while Level 4 responses used words that specify inputs and outputs for the given Item Context. Further, at Level 4, students shared 30% of language across the six contexts and leveraged context-independent words including rate, equal, and some form of slower/lower/smaller. Together, these data demonstrate that Context affects undergraduate MB language at all covariational reasoning levels, but that the language becomes more specific and similar as Level increases. These findings encourage instructors to foster context-independent, comparative, and summative language during instruction to functionally build MB and covariational reasoning skills across contexts.NEW & NOTEWORTHY This article builds on the work of Scott et al. (Scott EE, Cerchiara J, McFarland JL, Wenderoth MP, Doherty JH. J Res Sci Teach 1: 37, 2023) and Shiroda et al. (Shiroda M, Fleming MP, Haudek KC. Front Educ 8: 989836, 2023) to quantitatively examine student language in written explanations of mass balance across six contexts using constructed response assessments. These results present an evaluation of student mass balance language and provide researchers and practitioners with tools to assist students in constructing scientific mass balance reasoning explanations.

Severe aortic stenosis detection by deep learning applied to echocardiography.

Early diagnosis of aortic stenosis (AS) is critical to prevent morbidity and mortality but requires skilled examination with Doppler imaging. This study reports the development and validation of a novel deep learning model that relies on two-dimensional (2D) parasternal long axis videos from transthoracic echocardiography without Doppler imaging to identify severe AS, suitable for point-of-care ultrasonography. In a training set of 5257 studies (17 570 videos) from 2016 to 2020 [Yale-New Haven Hospital (YNHH), Connecticut], an ensemble of three-dimensional convolutional neural networks was developed to detect severe AS, leveraging self-supervised contrastive pretraining for label-efficient model development. This deep learning model was validated in a temporally distinct set of 2040 consecutive studies from 2021 from YNHH as well as two geographically distinct cohorts of 4226 and 3072 studies, from California and other hospitals in New England, respectively. The deep learning model achieved an area under the receiver operating characteristic curve (AUROC) of 0.978 (95% CI: 0.966, 0.988) for detecting severe AS in the temporally distinct test set, maintaining its diagnostic performance in geographically distinct cohorts [0.952 AUROC (95% CI: 0.941, 0.963) in California and 0.942 AUROC (95% CI: 0.909, 0.966) in New England]. The model was interpretable with saliency maps identifying the aortic valve, mitral annulus, and left atrium as the predictive regions. Among non-severe AS cases, predicted probabilities were associated with worse quantitative metrics of AS suggesting an association with various stages of AS severity. This study developed and externally validated an automated approach for severe AS detection using single-view 2D echocardiography, with potential utility for point-of-care screening.

Workshop for Basic Gynaecological Examinations: Improving Medical Student Learning through Clinical Simulation.

This study was designed to evaluate whether the Workshop on Basic Principles for Clinical Gynaecological Exploration, offered to medical students, improves theoretical-practical knowledge, safety, confidence, global satisfaction and the achievement of the proposed objectives in the area of gynaecological clinical examinations. This was a quasi-experimental pre-post-learning study carried out at the Gynaecology and Obstetrics department of Gregorio Marañón Hospital in Madrid (Spain). The volunteer participants were 4th-year students earning a degree in Medicine during the 2020-2021 and 2021-2022 academic years. The study period was divided into the following stages: pre-workshop, intra-workshop and 2 weeks post-workshop. In the pre-workshop stage, students completed a brief online course to prepare for the workshop. The effectiveness of the workshop was evaluated through multiple-choice tests and self-administered questionnaires to assess self-assurance, self-confidence, self-satisfaction and the achievement of the objectives. Of the 277 students invited in both academic years, 256 attended the workshop (92.4%), with a total participation in the different stages of the study greater than 70%. A total of 82.5% of the students in the 2020-2021 academic year and 80.6% of students in the 2021-2022 academic year did not have any type of experience performing gynaecological clinical examinations. Between the pre-workshop and 2 weeks post-workshop stages, there was significant improvement in theoretical-practical knowledge (improvement mean = 1.38 and 1.21 in 2020-2021 and 2021-2022 academic years, respectively). The security and confidence of the students prior to the workshop were low (average scores less than 5 points) in both academic years. However, post-workshop scores for satisfaction and the achievement of objectives were high in the two academic years; all the values approached or exceeded 8 points. Our students, after outstanding participation, evaluated the BPCGE, and improved their theoretical and practical knowledge, as well as their skills in a gynaecological clinical examination. Moreover, in their view, after the workshop, they felt very satisfied, far outreaching the proposed aims. In addition, excellent results were maintained over time, year after year.