Home About us Contact
|
Home About us Contact | ||
|
|
||
Top Half (top + half)
Selected AbstractsEvolution of Academic Emergency Medicine over a Decade (1991-2001)ACADEMIC EMERGENCY MEDICINE, Issue 10 2002E. John Gallagher MD Abstract Objective: To test the hypothesis that emergency medicine (EM) has made significant, quantifiable progress within U.S. academic medicine over the past ten years, 1991-2001. Methods: Baseline (7/1/1991) and comparison (7/1/2001) data sets contained all Liaison Committee on Medical Education (LCME)-accredited schools, Association of Academic Chairs of Emergency Medicine (AACEM)-recognized academic departments of EM, Residency Review Committee (RRC)-accredited EM residencies, and Association of American Medical Colleges (AAMC)-designated academic medical centers. The increase over ten years in the two primary variables of academic departmental status, and EM residencies located at academic medical centers, was examined in the aggregate, then stratified by medical schools grouped by academic rank. Differences over time are expressed as simple proportions, bounded by 95% confidence intervals (95% CIs). Results: Between 1991 and 2001, the proportion of academic departments of EM at medical schools increased from 18% to 48% (95% CI for difference of 30%= 19% to 41%). The proportion of EM residencies at academic medical centers increased from 42% to 66% (95% CI for a difference of 24%= 11% to 36%). The largest increment of 37% (95% CI = 22% to 52%) in academic departments of EM, and of 36% (95% CI = 20% to 52%) in EM residencies located at academic medical centers, occurred within medical schools whose academic rank was above the median. Conclusions: A quantitatively and statistically significant increase in academic departments of EM within medical schools and EM residency programs at academic medical centers has occurred over the past decade. Half of all medical schools now have academic departments of EM, and two-thirds of academic medical centers house EM residency programs. This has taken place largely within institutions whose academic ranking places them among the top half of all U.S. medical schools. [source] Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skillsMEDICAL EDUCATION, Issue 9 2000Mark Albanese Objectives A recent review of problem-based learning's effect on knowledge and clinical skills updated findings reported in 1993. The author argues that effect sizes (ES) seen with PBL have not lived up to expectations (0.8,1.0) and the theoretical basis for PBL, contextual learning theory, is weak. The purposes of this study were to analyse what constitutes reasonable ES in terms of the impacts on individuals and published reports, and to elaborate upon various theories pertaining to PBL. Design Normal theory is used to demonstrate what various ESs would mean for individual change and a large meta-analysis of over 10 000 studies is referred to in identifying typical ESs. Additional theories bearing upon PBL are presented. Results Effect sizes of 0.8,1.0 would require some students to move from the bottom quartile to the top half of the class or more. The average ES reported in the literature was 0.50 and many commonly used and accepted medical procedures and therapies are based upon studies with ESs below 0.50. Conclusions Effect sizes of 0.8,1.0 are an unreasonable expectation from PBL because, firstly, the degree of changes that would be required of individuals would be excessive, secondly, leading up to medical school, students are groomed and selected for success in a traditional curriculum, expecting them to do better in a PBL curriculum than a traditional curriculum is an unreasonable expectation, and, thirdly, the average study reported in the literature and many commonly used and accepted medical procedures and therapies are based upon studies having lesser ESs. Information-processing theory, Cooperative learning, Self-determination theory and Control theory are suggested as providing better theoretical support for PBL than Contextual learning theory. Even if knowledge acquisition and clinical skills are not improved by PBL, the enhanced work environment for students and faculty that has been consistently found with PBL is a worthwhile goal. [source] Variance scaling in shallow-cumulus-topped mixed layersTHE QUARTERLY JOURNAL OF THE ROYAL METEOROLOGICAL SOCIETY, Issue 628 2007R. A. J. Neggers Abstract Scaling of thermodynamic variance in shallow-cumulus-topped mixed layers is studied using large-eddy simulation (LES). First, the performance of the top-down scaling (the turbulent flux at mixed-layer top divided by w*) is evaluated for transient shallow-cumulus convection over land. The results indicate that this scaling fails to capture all the variance in the top half of the mixed layer when shallow cumulus clouds are present. A variance-budget analysis is then performed, to derive a new scaling for the variance at mixed-layer top, which differs from the standard top-down scaling by a factor of one Richardson number. The essential new features of the proposed scaling are that the local vertical gradient is retained and that a balance is assumed between gradient production of variance and removal by transport and dissipation, using an adjustment time-scale given by w*/h. Evaluation against LES for a range of different cases, including a dry convective boundary layer as well as steady-state marine and transient continental shallow cumulus, reveals a data-collapse of the newly-scaled variance, for all hours and all cases in the top half of the mixed layer. The corresponding vertical structure is shown to resemble a power-law function. The results suggest that the structure of variance in the dry convective boundary layer is similar to that in the sub-cloud mixed layer. In transient situations, the scaling reproduces the time-development of variance at sub-cloud mixed-layer top. The new cloud-base variance scale is then further interpreted in the context of statistical cloud schemes, which depend on the variance as the second moment of the associated probability density function. The results suggest that the area fraction of the moist convective thermals uniquely depends on the ratio of cloud-base transition-layer depth to sub-cloud mixed-layer depth. This puts ,valve'- or ventilation-type closures for the cloud-base mass flux in the context of the variance budget for the sub-cloud layer. Copyright © 2007 Royal Meteorological Society [source] Student attitudes to surgical teaching in provincial hospitalsAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2003Martin H. Bruening ABSTRACT Objective:The ever-increasing pressure on metropolitan teaching hospitals to rationalise budgets and increase productivity has resulted in a dwindling amount of teaching opportunity for the medical student population. One solution to the problem was to utilise a largely untapped resource in South Australia, namely the provincial hospitals, however, student opinion regarding such a radical change had yet to be determined. Design:A questionnaire was circulated among an entire year group of medical students who would be undertaking the revised surgical curriculum with rural attachments. Setting:In October 1997, a decision was made by the Department of Surgery at the University of Adelaide to proceed with optional rural surgical attachments in 1998. Subjects:The survey was distributed to the 125 members of the 1997 fifth year medical student group. Results:A total of 92 questionnaires were returned giving a response rate of 75%. Thirty-nine students ranked a rural term in their top half of preferences, while a further 18 indicated that they would go to a rural centre if they had to. Conclusion:Despite having little warning of the impending changes to their surgical curriculum, the majority of students who responded to the questionnaire stated that they would be willing to venture to the country locations. Before planning significant changes to an established curriculum, the student group should be consulted to gauge their opinion. What is already known:Within the medical literature, studies have been performed with regard to student opinions regarding postgraduate internships in rural locations, but to our knowledge, this survey represents the first study into student opinion with particular reference to rural surgical attachments prior to their commencement within a medical school curriculum. What this study adds:As a result of this study, it can now be concluded that a considerable amount of interest exists within the student population to undertake rural surgical rotations. [source] | ||||||||||