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Background: Targeted interventions among vulnerable youth populations represent an important approach to the reduction of health inequalities. We must, however, ensure that impacts are not unequally distributed according to the range of resources available to them. We explore these concerns among youth in vocational training to be enrolled in a smoking cessation intervention by describing (1) their socio-economic profile and (2) the association between their socioeconomic characteristics, their smoking practices, and key factors that could be targeted in interventions. Methods: A total of 234 young people aged 15–20 years were recruited in three centers in the Lorraine region in France in 2016–2017 as part of the Social Network and Tobacco Cessation (Réseau social et sevrage tabagique [RESIST]) study. We measured participants’ socio-economic characteristics using their parents’ education and occupational grade. We examined the associations of these characteristics with participants’ smoking habits, intention to quit, nicotine dependence, presence of smokers in their network, and representation of a young smoker. We examined the associations between variables with bivariate tests depending on the nature of the variables. Results: Participants were more likely to be from a socio-professional background more modest than the national average (56% versus 33%), but still exhibited considerable socioeconomic variability. Smoking status did not vary significantly according to the educational level of the participants’ parents (from 52% to 57%, P = 0.78) or occupational grade (from 52% to 58%, P = 0.35). Compared to participants whose parents had completed a professional or pre-university degree, participants with parents in the lowest education category were less likely to report not intending to quit (P = 0.01) and more likely to report seriously considering to quit in the next six months (P = 0.03) and to have already tried to quit but failed (P = 0.01). Conclusion: It is tempting to define youth in vocational training as a homogeneous group, especially when they share the same school environment, employment status, and income. Our results, however, highlight substantial variability in their socioeconomic profiles and smoking characteristics. Researchers are encouraged to further consider these equity issues to contribute to the reduction of health inequalities. © 2018 Elsevier Masson SAS

[No abstract available]

The power of intentional and reflective experience in international service-learning, internships, and other pathways, effectively inspires and prepares students for next-generation global leadership. Service-learning often includes cross-cultural engagement which is particularly powerful. © 2018 Wiley Periodicals, Inc.

Few students at institutions that do not have scholarly research as central to their mission have the opportunity to explore experimental design and data analysis through investigative research. Laboratory courses are often the only opportunities to apply scientific knowledge, but traditionally rely on "cookbook" labs that often only demonstrate concepts. Much of the discussion regarding the need for research experiences in undergraduate education has focused on the impact on encouraging science students into research careers. However, it is clear that the need for opportunities in investigative research is just as critical for pre-health professional students as it is for students entering into primarily research careers, for future evidencebased practice and translating research to practice. Thus, healthcare pre-professionals need exposure to experimental methodologies prior to their professional education, as a foundation for their coursework and eventual practice. The challenge is to provide such experiences at community colleges and primarily undergraduate institutions. To assist faculty in implementing research into their undergraduate curriculum and to expand the discussion, we propose models for implementing research into the curriculum-course contained; multi-semester experience; research paired; course adjunctive; and independent study/club activity- and provide case studies used in courses taken by science majors and pre-health professionals. © 2018 Association of Schools of Allied Health Professions, Wash., DC.

Objective: The aim of this study was to investigate if there is an independent association between substance use and satisfaction in vocational education. Methods: A cross-sectional study of 5 688 first-year apprentices from 49 vocational schools, mean age 19.4 years (SD=3.9 years) was undertaken. Data were analysed using multilevel linear regression analysis. Predictors were use of tobacco, alcohol, cannabis and pharmaceuticals as well as personal characteristics (sex, age, migration background, educational level, financial status, chronic diseases, psychological distress, physical activity, media use, personality) and vocational/firm characteristics (firm size, number of apprentices, perceived quality of mentoring, amount of pay, vocational field, working conditions, over- and underload, housing situation, number of previous apprenticeships, first choice). Vocational satisfaction was used as primary outcome. Results: Satisfaction was most strongly associated with perceived quality of mentoring, judgement that the chosen education was first choice and working climate in the training company. In addition, only problematic alcohol use remained significant in the multivariate analysis. There was no association in the adjusted model between vocational satisfaction and daily tobacco use or problematic use of cannabis and pharmaceuticals. Conclusions: Results suggest that problematic alcohol use could be an independent risk factor for problems in vocational education. © Georg Thieme Verlag KGStuttgart · New York.

This study used the eye-tracking method to explore how the level of expertise influences reading, and solving, two written patient cases on cardiac failure and pulmonary embolus. Eye-tracking is a fairly commonly used method in medical education research, but it has been primarily applied to studies analyzing the processing of visualizations, such as medical images or patient video cases. Third-year medical students (n = 39) and residents (n = 13) read two patient case texts in an eye-tracking laboratory. The analysis focused on the diagnosis made, the total visit duration per text slide, and eye-movement indicators regarding task-relevant and task-redundant areas of the patient case text. The results showed that almost all participants (48/52) made the correct diagnosis of the first patient case, whereas all the residents, but only 17 students, correctly diagnosed the second case. The residents were efficient patient-case-solvers: they reached the correct diagnoses, and processed the cases faster and with a lower number of fixations than did the students. Further, the students and residents demonstrated different reading patterns with regard to which slides they proportionally paid most attention. The observed differences could be utilized in medical education to model expert reasoning and to teach the manner in which a good medical text is constructed. Eye-tracking methodology appears to have a great deal of potential in evaluating performance and growing diagnostic expertise in reading medical texts. However, further research using medical texts as stimuli is required. Anat Sci Educ 10: 23–33. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists

Context: Visual expertise is the superior visual skill shown when executing domain-specific visual tasks. Understanding visual expertise is important in order to understand how the interpretation of medical images may be best learned and taught. In the context of this article, we focus on the visual skill of medical image diagnosis and, more specifically, on the methodological set-ups routinely used in visual expertise research. Methods: We offer a critique of commonly used methods and propose three challenges for future research to open up new avenues for studying characteristics of visual expertise in medical image diagnosis. The first challenge addresses theory development. Novel prospects in modelling visual expertise can emerge when we reflect on cognitive and socio-cultural epistemologies in visual expertise research, when we engage in statistical validations of existing theoretical assumptions and when we include social and socio-cultural processes in expertise development. The second challenge addresses the recording and analysis of longitudinal data. If we assume that the development of expertise is a long-term phenomenon, then it follows that future research can engage in advanced statistical modelling of longitudinal expertise data that extends the routine use of cross-sectional material through, for example, animations and dynamic visualisations of developmental data. The third challenge addresses the combination of methods. Alternatives to current practices can integrate qualitative and quantitative approaches in mixed-method designs, embrace relevant yet underused data sources and understand the need for multidisciplinary research teams. Conclusion: Embracing alternative epistemological and methodological approaches for studying visual expertise can lead to a more balanced and robust future for understanding superior visual skills in medical image diagnosis as well as other medical fields. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education

Objective To evaluate of the number of registered competency assessments in the portfolios of orthopaedic residents in the Netherlands, for whom a competency-based training programme is mandatory. Design National cohort study. Method We collected data regarding the registered assessments of all orthopaedic residents who finished their training between 2012-2015. We determined the number of registered assessments of 'standard orthopaedic treatments' (evaluating residents' competency in 70 different orthopaedic treatments), objective structured clinical skills evaluations (OSCEs), critically appraised topics (CATs), and 360 degree feedback appraisals. We compared the number of registered assessments in the portfolios with the minimum requirements laid down by the training curriculum. Results A total of 196 residents finished their training between 2012 and 2015. These residents finished their training with a mean (i.e., percentage of minimally required number of assessments) of 17.0 (34%) 'standard orthopaedic treatments' (level 4 or 5), 13.6 (34%) OSCEs, 2.6 (33%) CATs and 0.2 (4%) 360 degree feedback. Conclusion On average, only one-Third of the minimally required number of assessments were registered in the portfolios of orthopaedic residents (OSCEs and standard orthopaedic treatments level 4 or 5). These revelations show that action is needed to improve the way in which the progress of residents is monitored. These findings are going to have an effect on the new curriculum which must be more practical and less complex. Additionally, external quality control will focus more on residents at the end of their training and on the training region involved. This information may serve as a framework for postgraduate training programmes in other scientific associations which also find themselves in the same process of modernisation.

Background: In the UK, evidence of written reflection is part of licensing and revalidation for general practitioners (GPS). However, there is little evidence of specific benefits compared to other forms of reflective practice. Aim: To seek GPS' and general practice (GP) trainees' views on the role of written reflection in learning and assessment. Design and setting: An online survey of 1005 GPS and GP trainees (GPTs) in the UK. Method: An anonymous questionnaire containing 38 attitudinal items was administered. Descriptive statistics were used to analyse Likert scale responses, thematic analysis for free-text responses. Results: In total 544 GPS and 461 GPTs completed the survey, with 842 (83.8%) agreeing they find verbal reflection with a colleague more useful than written reflection. Three quarters disagreed that written reflection is a way of identifying poorly performing GPS. Over 70% of respondents stated that summative, written reflection is a time-consuming, boxticking exercise which distracts from other learning. They question its validity as part of assessment and state that its use may contribute to current difficulties with recruitment and retention to GP. Conclusions: For many GPS, written reflection is an onerous process rather than beneficial to their learning, indicating its continued use in assessment needs to be critically examined. © 2017 informa UK Limited, trading as taylor and francis Group.

Dermatology residents perform consults on hospitalized patients, but are often limited in their ability to follow-up with these patients after discharge, leading to inadequate follow-up and understanding of post-discharge transitions of care. In 2013, a discharge continuity clinic (DCC) staffed by the inpatient consult dermatology resident and attending dermatologist was established at one of the four adult hospital sites residents rotate through in the Harvard Combined Dermatology Residency Program. Resident perceptions about the DCC and their educational experience on inpatient consult rotations with a DCC and without a DCC were obtained using a cross-sectional survey instrument in June 2016. Self-reported data from a multi-year cohort of dermatology residents (n = 14 of 20, 70% response rate) reveals that the DCC enabled resident autonomy and resident satisfaction in care of their patients, insight into the disease-related challenges and the broader social context during transitions of care from inpatient to outpatient settings, and more enriching learning experiences than inpatient consult rotations without a DCC. Dermatology residents self-report participation in an inpatient consult rotation with a DCC supports their autonomy and achievement of post-discharge transitions-of-care competencies. © 2016 by the article author(s).