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"Humans"

Background: As plastic surgery programs transition toward competency-based medical education curricula, it is important to critically assess current methods of evaluating trainee competence. The purpose of this systematic review was to identify and evaluate assessment tools for technical and nontechnical competencies in plastic surgery. Methods: A systematic search using keywords related to competency-based medical education, assessment, and plastic surgery was conducted. Two independent reviewers extracted data pertaining to study characteristics, study design, and psychometric properties. Data pertaining to the establishment of competence and barriers to tool implementation were noted. Results: Twenty-three studies were included in this review. Technical competencies were assessed in 16 studies. Nontechnical competencies were assessed in five studies. Two studies assessed both technical and nontechnical competence. Six tools were implemented in a simulated setting and 17 tools were implemented in a clinical setting. Thirteen studies (57 percent) did not report reliability scores and nine (39 percent) did not report validity scores. Two tools established clear definitions for competence. Common barriers to implementation included high demands on resources and time, uncertainty about simulation transferability, and assessor burnout. Conclusions: A number of tools exist to assess a range of plastic surgery skills, in both clinical and simulated settings. There is a need to determine the trans-ferability of simulated assessments to clinical practice, as most available tools are simulation-based. Although additional psychometric testing of current assessment tools is required, particularly in the nontechnical domain, this review provides a base on which to build assessment frameworks that will support plastic surgery's transition to competency-based medical education. © © 2018 by the American Society of Plastic Surgeons.

Evidence suggests that wider sociological structures, which embody particular values and ways of relating, can make a sustainable living and working problematic. This chapter introduces ideology critique, an innovative methodological perspective crossing the fields of theology, cultural studies and politics to examine and disturb the subtle and hidden 'spirit' which is evoked when we engage with everyday objects and interactions. Such a 'spirit', or ideology, embodies particular models of how humans relate to other humans, animals and the planet more broadly. This chapter aims, first, to document and demonstrate the subtleties of how the hidden 'spirit' can render attempts at sustainable working futile in the context of education, and then, second, to demonstrate how it can be used to intentionally evoke alternative 'spirits' which afford new relationality amongst humans, animals and the planet. In a broader sense, therefore, this chapter explores how concepts and political commitments from the humanities, such as ideology critique and 'spirit', can help (1) analyse how wider social structures shape our values and beliefs in relation to sustainable learning, living and working, (2) explain how these behaviours are held in place over time and (3) provoke insight into how we might seek to disrupt and change such persistent social structures. © Springer International Publishing AG, part of Springer Nature 2019.

Allied health professionals concur that a sound knowledge of practical gross anatomy is vital for the clinician, however, human anatomy courses in allied health programs have been identified as high-risk for attrition and failure. While anatomists and clinicians agree that learning anatomy via human cadaveric instruction is the preferred method, students vary in their reaction to the cadaveric learning experience and have differing levels of anatomy self-efficacy. This study investigated whether student self-efficacy had an effect on student usage of supplemental instructional videos and whether the use of videos had an impact on student self-efficacy and/or learning. Anatomy self-efficacy differed based on gender and prior performance. Student usage of the videos varied widely and students with lower self-efficacy were more inclined to use the resources. The provision of the videos did not improve overall cohort performance as compared to a historical cohort, however, those students that accessed all video sets experienced a greater normalized learning gain compared to students that used none or one of the four sets of videos. Student reports and usage patterns indicate that the videos were primarily used for practical class preparation and revision. Potentially, the videos represent a passive mode of teaching whereas active learning has been demonstrated to result in greater learning gains. Adapting the videos into interactive tutorials which will provide opportunity for feedback and the development of students' self-evaluation may be more appropriate. Anat Sci Educ 11: 461–470. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists

[No abstract available]

This manuscript is an outgrowth of an invited panel presentation at the national Association for Psychologists in Academic Health Centers Conference in 2017 on Interprofessional Education (IPE). IPE is a structured and transformative educational strategy designed to provide active learning experiences where trainees from diverse healthcare professions gain shared content knowledge plus collaboration skills as they learn about, from, and with each other. Collaboration skills include understanding professional role distinctions and overlap, effective team-based communication, shared values/ethics and respect for each other’s expertise, and teamwork dynamics. It is increasingly important to expand training beyond the intraprofessional activities in which psychology trainees engage to prepare them to participate in interprofessional collaborative care. As healthcare systems move to team-based collaborative practice and value-based reimbursement models, the profession of psychology needs leaders at every academic health center to facilitate the design and/or implementation of IPE activities. The panel of psychologists presented roles that psychologists play in IPE institutional program design and implementation, graduate training programs, and the perspectives of an early career psychologist and psychology trainee. Opportunities and challenges are highlighted, culminating in a call to action. Psychologists must embrace their identity as health professionals and engage their learners in IPE so that the emerging cognitive schemata of healthcare that is developed includes the profession of psychology. Otherwise, healthcare teams and health professionals will not understand the value, roles, or potential contributions of psychologists in enhancing patient care outcomes, ultimately jeopardizing psychologists’ referrals, involvement in healthcare delivery, and career opportunities. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

Public interest in the benefits of music for people with dementia has rapidly increased in recent years. In addition to clinical work with clients, music therapists are often required to support and train staff, families, and volunteers and skill-share some music therapeutic skills. Six music therapy researchers from six countries agreed it was timely to organize a roundtable and share their indirect music therapy practice and examples of skill-sharing in dementia care. This article was developed following the roundtable at the World Congress of Music Therapy in 2017 and further discussion among the authors. This process highlighted the diversity and complexity of indirect music therapy practice and skill-sharing, but some common components emerged, including: 1) the importance of making clinical decisions about when direct music therapy is necessary and when indirect music therapy is appropriate, 2) supporting the transition from direct music therapy to indirect music therapy, 3) the value of music therapy skill-sharing in training care home staff, 4) the need for considering potential risks and burdens of indirect music therapy practice, and 5) expanding the role of music therapist and cultivating cross-professional dialogues to support organizational changes. In indirect music therapy practice, a therapist typically works with carers and supporters to strengthen their relationships with people with dementia and help them further develop their self-awareness and sense of competence. However, the ultimate goal of indirect music therapy practice in dementia care remains the wellbeing of people living with dementia. © American Music Therapy Association 2018. All rights reserved.

Background: Australian and international guidelines recommend benzodiazepines and related drugs (hereafter “benzodiazepines”) as second-line, short-term medications only. Most benzodiazepines are prescribed by general practitioners (GPs; family physicians). Australian GP registrars (“trainees” or “residents” participating in a post-hospital training, apprenticeship-like, practice-based vocational training program), like senior GPs, prescribe benzodiazepines at high rates. Education within a training program, and experience in general practice, would be expected to reduce benzodiazepine prescribing. Objective: To establish if registrars’ prescribing of benzodiazepines decreases with time within a GP training program Design: Longitudinal analysis from the Registrar Clinical Encounters in Training multi-site cohort study Participants: Registrars of five of Australia’s 17 Regional Training Providers. Analyses were restricted to patients ≥ 16 years. Main Measures: The main outcome factor was prescription of a benzodiazepine. Conditional logistic regression was used, with registrar included as a fixed effect, to assess within-registrar changes in benzodiazepine-prescribing rates. The “time” predictor variable was “training term” (6-month duration Terms 1–4). To contextualize these “within-registrar” changes, a mixed effects logistic regression model was used, including a random effect for registrar, to assess within-program changes in benzodiazepine-prescribing rates over time. The “time” predictor variable was “year” (2010–2015). Key Results: Over 12 terms of data collection, 2010–2015, 1161 registrars (response rate 96%) provided data on 136,809 face-to-face office-based consultations. Two thousand six hundred thirty-two benzodiazepines were prescribed (for 1.2% of all problems managed). In the multivariable model, there was a significant reduction in within-program benzodiazepine prescribing over time (year) (p = < 0.001, OR = 0.94, CI = 0.90, 0.97). However, there was no significant change in ‘within-registrar’ prescribing over time (registrar Term) (p = 0.92, OR = 1.00 [95% CI = 0.94–1.06]). Conclusions: Despite a welcome temporal trend for reductions in overall benzodiazepine prescribing from 2010 to 2015, there is still room for improvement and our findings suggest a lack of effect of specific GP vocational training program education and, thus, an opportunity for targeted education. © 2018, Society of General Internal Medicine.

Transplant Procurement Management and the University of Barcelona has offered a Master of Donation and Transplantation degree since 2004. The aim of this study is to analyze the number of participants, their profiles, and scores to evaluate improving measures introduced since 2011, when the modular structure was stablished. The data is organized in 3 groups: number of participants, profile, and scores in each module. The variables for the profile are gender, nationality, and background. According to the number of participants, 127 professionals were trained since 2011, with a decrease in the last classes (21; 20; 15). Regarding their profiles, from 2011 until 2016 the proportion of women was higher (63.13%). The background heterogeneity was an average of 4 different backgrounds in each edition, and medicine was most frequent background for students (58.27%). Participants were from 37 countries, mostly from the United States (45.6%) and Europe (40.9%). As for the scores, participants were evaluated in 4 modules (Donation, Transplantation, Management, and Tissue Banking), an internship, and a final master dissertation. The Donation module presented the lowest score (7.45/10) and the Transplantation module the highest (8.22/10). Considering that the main characteristics of the master's degree are the participants’ internationality and heterogeneity, improvement measures must continue focusing on flexibility in the module selection and promoting the online modality. © 2018 Elsevier Inc.

Vignettes are short, descriptive stories of an incident of practice. They contain realistic contents and can therefore be a trigger for learning processes. The overall goal of this study is to develop work task vignettes as a trigger for learning processes and the professional development of geriatric nurses. First, the authors analyzed how vignettes have to be designed to use them as a trigger for learning processes and professional development. Second, based on these requirements, the authors developed four vignettes describing the work tasks of geriatric nursing staff and validated them in an interview study with 12 experts in the domain of geriatric nursing. Results indicate that the design of vignettes based on criteria for their style and content and the validation of the vignettes in an interview study with experts is an appropriate way to generate vignettes that can be used for learning and professional development. © 2018, © 2018 Taylor & Francis.

OBJECTIVE: Morbidity and mortality (M&M) conference is a mainstay of surgical education. However, its effectiveness is poorly described. The purpose of this study was to demonstrate the feasibility of a real-time audience response system for learner assessment during M&M. DESIGN: We integrated a web-based audience response system into weekly M&M conference. First, this platform collected qualitative responses about the role of M&M. Then, we used the platform to direct questions to attendees in real time. Questions focused on surgical risk estimation and classifying root causes. Responses were grouped by training and compared to a validated risk tool's prediction. Root cause assignment concordance was statistically compared using Cohen's kappa between the pluralities of faculty responses to that of trainees. SETTING: General surgical residency program based at a tertiary academic medical center. PARTICIPANTS: Affiliated categorical residents, preliminary residents, and clinical fellows. RESULTS: We enrolled 110 participants (38 faculty, 31 senior trainees, and 41 trainees). The majority of respondents (75.9%) cited education as the purpose of M&M, and all of respondents stated education as their personal motivation. Audience response questions were integrated into 34 unique case presentations. Mean absolute differences between predicted complication rates and attendees’ predictions were highest for faculty (−9.4%, p = 0.009) and lowest for junior residents (−1.8%, p = 0.385). When assigning root cause of each morbidity, concordance between faculty and trainees was low to moderate (K = 0.41). CONCLUSIONS: Assessment of learning during M&M can be performed in real time with discrimination observed by learner experience level. These data support development of this response platform to trend learner performance over time and to monitor targeted educational interventions at future M&Ms. © 2018