On embedding assessments of self-regulated learning into licensure activities in the health professions: a call to action.

How well have healthcare professionals and trainees been prepared for the inevitable demands for new learning that will arise in their future? Given the rapidity with which 'core healthcare knowledge' changes, medical educators have a responsibility to audit whether trainees have developed the capacity to effectively self-regulate their learning. Trainees who engage in effective self-regulated learning (SRL) skillfully monitor and control their cognition, motivation, behaviour, and environment to adaptively meet demands for new learning. However, medical curricula rarely assess trainees' capacity to engage in these strategic processes.

Point-of-Care Lung Ultrasound for Differentiating COVID-19 From Influenza.

Background and objectives Patients infected with influenza and COVID-19 exhibit similar clinical presentations; thus, a point-of-care test to differentiate between the diseases is needed. Here, we sought to identify features of point-of-care lung ultrasound (LUS) that can discriminate between influenza and COVID-19. Methods In this prospective, cross-sectional study, LUS clips of patients presenting to the emergency department (ED) with viral-like symptoms were collected via a 10-zone scanning protocol.

Effectiveness of simulation-based training for obstetric internal medicine: Impact of cognitive load and emotions on knowledge acquisition and retention.

Background: Simulation-based training's impact on learning outcomes may be related to cognitive load or emotions during training. We evaluated the association of validated measures of cognitive load and emotion with learning outcomes in simulation-based obstetric internal medicine cases.

Methods: All internal medicine learners (n = 15) who completed the knowledge test pre-training, post-training (knowledge acquisition), and at 3-6 months (knowledge retention) for all three simulation cases were included.

First year internal medicine residents' self-report point-of-care ultrasound knowledge and skills: what (Little) difference three years make.

Background: With increasing availability of point-of-care ultrasound (POCUS) education in medical schools, it is unclear whether or not learning needs of junior medical residents have evolved over time.

Methods: We invited all postgraduate year (PGY)-1 residents at three Canadian internal medicine residency training programs in 2019 to complete a survey previously completed by 47 Canadian Internal Medicine PGY-1 s in 2016. Using a five-point Likert scale, participants rated perceived applicability of POCUS to the practice of internal medicine and self-reported skills in 15 diagnostic POCUS applications and 9 procedures.

Assessment of technical and nontechnical skills in surgical residents.

Background: Surgical competence encompasses both technical and nontechnical skills. This study seeks to evaluate the validity evidence for a comprehensive surgical skills examination and to examine the relationship between technical and nontechnical skills.

Methods: Six examination stations assessing both technical and nontechnical skills, conducted yearly for surgical trainees (n = 120) between 2010 and 2014 are included.

Safety and efficacy of tranexamic acid in bleeding paediatric trauma patients: a systematic review protocol.

Introduction: Trauma is the leading cause of death among children aged 1-18. Studies indicate that better control of bleeding could potentially prevent 10-20% of trauma-related deaths. The antifibrinolytic agent tranexamic acid (TxA) has shown promise in haemorrhage control in adult trauma patients.

Cognitive load imposed by ultrasound-facilitated teaching does not adversely affect gross anatomy learning outcomes.

Ultrasonography is increasingly used in medical education, but its impact on learning outcomes is unclear. Adding ultrasound may facilitate learning, but may also potentially overwhelm novice learners. Based upon the framework of cognitive load theory, this study seeks to evaluate the relationship between cognitive load associated with using ultrasound and learning outcomes.

Defining Competencies for Ultrasound-Guided Bedside Procedures: Consensus Opinions From Canadian Physicians.

Objectives: This study sought to define the competencies in ultrasound knowledge and skills that are essential for medical trainees to master to perform ultrasound-guided central venous catheterization, thoracentesis, and paracentesis.

Methods: Experts in the 3 procedures were identified by a snowball technique through 3 Canadian tertiary academic health centers. Experts completed 2 rounds of surveys, including an 88-item central venous catheterization survey, a 96-item thoracentesis survey, and an 89-item paracentesis survey.

Use of an error-focused checklist to identify incompetence in lumbar puncture performances.

Context: Checklists are commonly used in the assessment of procedural competence. However, on most checklists, high scores are often unable to rule out incompetence as the commission of a few serious procedural errors typically results in only a minimal reduction in performance score. We hypothesised that checklists constructed based on procedural errors may be better at identifying incompetence.

Validation of the 25-Item Stanford Faculty Development Program Tool on Clinical Teaching Effectiveness.

Unlabelled: CONSTRUCT: The 25-item Stanford Faculty Development Program Tool on Clinical Teaching Effectiveness assesses clinical teaching effectiveness.

Background: Valid and reliable rating of teaching effectiveness is helpful for providing faculty with feedback. The 25-item Stanford Faculty Development Program Tool on Clinical Teaching Effectiveness was intended to evaluate seven dimensions of clinical teaching.

Diagnosing technical competence in six bedside procedures: comparing checklists and a global rating scale in the assessment of resident performance.

Purpose: To compare procedure-specific checklists and a global rating scale in assessing technical competence.

Method: Two trained raters used procedure-specific checklists and a global rating scale to independently evaluate 218 video-recorded performances of six bedside procedures of varying complexity for technical competence. The procedures were completed by 47 residents participating in a formative simulation-based objective structured clinical examination at the University of Calgary in 2011.

Barriers to goals of care discussions with seriously ill hospitalized patients and their families: a multicenter survey of clinicians.

Importance: Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored to existing barriers.

Objective: To determine, from the perspective of hospital-based clinicians, (1) barriers impeding communication and decision making about goals of care with seriously ill hospitalized patients and their families and (2) their own willingness and the acceptability for other clinicians to engage in this process.

Part versus whole: a randomized trial of central venous catheterization education.

Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention.

A systematic review of validity evidence for checklists versus global rating scales in simulation-based assessment.

Context: The relative advantages and disadvantages of checklists and global rating scales (GRSs) have long been debated. To compare the merits of these scale types, we conducted a systematic review of the validity evidence for checklists and GRSs in the context of simulation-based assessment of health professionals.

Methods: We conducted a systematic review of multiple databases including MEDLINE, EMBASE and Scopus to February 2013.

An argument for using additional bedside tools, such as bedside ultrasound, for volume status assessment in hospitalized medical patients: a needs assessment survey.

The frequency at which housestaff need to assess volume status on medical inpatients is unknown. In this brief report, we invited 39 housestaff, over 13 randomly selected dates, to complete a 25-item survey. Participants (n = 31, 79%) logged a total of 455 hours, reporting 197 pages or telephone requests received regarding medical inpatients.

Cognitive load imposed by knobology may adversely affect learners' perception of utility in using ultrasonography to learn physical examination skills, but not anatomy.

Ultrasonography is increasingly used for teaching anatomy and physical examination skills but its effect on cognitive load is unknown. This study aimed to determine ultrasound's perceived utility for learning, and to investigate the effect of cognitive load on its perceived utility. Consenting first-year medical students (n = 137) completed ultrasound training that includes a didactic component and four ultrasound-guided anatomy and physical examination teaching sessions.

Measuring competence in central venous catheterization: a systematic-review.

Objectives: Central venous catheterization is a complex procedural skill. This study evaluates existing published tools on this procedure and systematically summarizes key competencies for the assessment of this technical skill.

Methods: Using a previously published meta-analysis search strategy, we conducted a systematic review of published assessment tools using the electronic databases PubMed, MEDLINE, Education Resource Information Center (ERIC), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica, and Cochrane Central Register of Controlled Trials.

Notes From the Field: Direct Observation Versus Rating by Videos for the Assessment of Central Venous Catheterization Skills.

Blinded assessments of technical skills using video-recordings may offer more objective assessments than direct observations. This study seeks to compare these two modalities. Two trained assessors independently assessed 18 central venous catheterization performances by direct observation and video-recorded assessments using two tools.

Feasibility of scenario-based simulation training versus traditional workshops in continuing medical education: a randomized controlled trial.

Introduction: Although simulation-based training is increasingly used for medical education, its benefits in continuing medical education (CME) are less established. This study seeks to evaluate the feasibility of incorporating simulation-based training into a CME conference and compare its effectiveness with the traditional workshop in improving knowledge and self-reported confidence.

Methods: Participants (N=27) were group randomized to either a simulation-based workshop or a traditional case-based workshop.

Comparing the use of global rating scale with checklists for the assessment of central venous catheterization skills using simulation.

The use of checklists is recommended for the assessment of competency in central venous catheterization (CVC) insertion. To explore the use of a global rating scale in the assessment of CVC skills, this study seeks to compare its use with two checklists, within the context of a formative examination using simulation. Video-recorded performances of CVC insertion by 34 first-year medical residents were reviewed by two independent, trained evaluators.

Use of simulation-based education to improve outcomes of central venous catheterization: a systematic review and meta-analysis.

Purpose: Central venous catheterization (CVC) is increasingly taught by simulation. The authors reviewed the literature on the effects of simulation training in CVC on learner and clinical outcomes.

Method: The authors searched computerized databases (1950 to May 2010), reference lists, and considered studies with a control group (without simulation education intervention).

Who is teaching and supervising our junior residents' central venous catheterizations?

Background: The extent to which medical residents are involved in the teaching and supervision of medical procedures is unknown. This study aims to evaluate the teaching and supervision of junior residents in central venous catheterization (CVC) by resident-teachers.

Methods: All PGY-1 internal medicine residents at two Canadian academic institutions were invited to complete a survey on their CVC experience, teaching, and supervision prior to their enrolment in a simulator CVC training curriculum.

Use of simulator-based medical procedural curriculum: the learner's perspectives.

Background: Simulation is increasingly used for teaching medical procedures. The goal of this study was to assess learner preferences for how simulators should be used in a procedural curriculum.

Methods: A 26-item survey was constructed to assess the optimal use of simulators for the teaching of medical procedures in an internal medicine residency curriculum.