Are evaluations in simulated medical encounters reliable among rater types? A comparison between standardized patient and outside observer ratings of OSCEs.

Objective: By analyzing Objective Structured Clinical Examination (OSCE) evaluations of first-year interns' communication with standardized patients (SP), our study aimed to examine the differences between ratings of SPs and a set of outside observers with training in healthcare communication.

Methods: Immediately following completion of OSCEs, SPs evaluated interns' communication skills using 30 items. Later, two observers independently coded video recordings using the same items.

Impact of Simulation on Critical Care Fellows' Electroencephalography Learning.

Introduction Continuous electroencephalography (EEG) is an important monitoring modality in the intensive care unit and a key skill for critical care fellows (CCFs) to learn. Our objective was to evaluate with CCFs an EEG educational curriculum on a web-based simulator. Methods This prospective cohort study was conducted at a major academic medical center in Florida.

A Comparison of Central Venous Access to the Internal Jugular Vein and Two Standard Approaches to the Subclavian Vein: A Study of Cross-Sectional Areas Using Computed Tomography Scans.

Introduction The supraclavicular approach to the subclavian vein has been cited as having many advantages to the infraclavicular approach, including a larger short-axis cross-sectional area, a greater margin of safety, and fewer complications. Methods To examine whether a larger short-axis cross-sectional area of the subclavian vein at the supraclavicular fossa is a potential explanation for the reduction in attempts with the supraclavicular approach seen in a previous study, we examined computed tomography scans from 50 patients (24 M, 26 F). The short-axis cross-sectional areas of the subclavian vein at the mid-clavicular line, the subclavian vein in the supraclavicular fossa, and the internal jugular vein at the level of the thyroid cartilage were calculated.

Impact of Match Violations on Applicants' Perceptions and Rankings of Residency Programs.

Introduction The National Resident Matching Program (NRMP) requires all Match participants to adhere to a strict code of conduct known as the Match Participation Agreement, yet Match violations continue to occur. We sought to determine how interview experiences, including Match violations, impact applicants' perceptions and rankings of residency programs. Methods An electronic survey was sent to all accredited medical school Deans of Student Affairs and Association of American Medical Colleges Student Representatives for distribution to fourth-year medical students.

The RITE of Passage: Learning Styles and Residency In-Service Training Examination (RITE) Scores.

Introduction The objective of the pilot study was to determine the association between learning preferences and improvement in the American Academy of Neurology Residency In-Service Training Examination (RITE) scores from postgraduate year 2 (PGY-2) to postgraduate year 3 (PGY-3) in neurology residents. Methods Neurology residents at the University of Florida were approached to participate, and their consent was obtained. VARK inventory, representing four modalities (visual, aural, read/write, kinesthetic) of learning preferences, was completed by participants.

Objective predictors of intern performance.

Background: Residency programs select medical students for interviews and employment using metrics such as the United States Medical Licensing Examination (USMLE) scores, grade-point average (GPA), and class rank/quartile. It is unclear whether these metrics predict performance as an intern. This study tested the hypothesis that performance on these metrics would predict intern performance.

Prevalence and extent of industry support for program directors of surgical fellowships in the United States.

Background: Fellowship program directors have a considerable influence on the future practice patterns of their trainees. Multiple studies have demonstrated that industry can also exert substantial influence on the practice patterns of physicians as a whole. The purpose of this study is to quantify industry support of fellowship program directors across surgical subspecialties and to assess the prevalence of this support within specific subspecialties.

An online, interactive, screen-based simulator for learning basic EEG interpretation.

Objective: Develop and pilot test a simulator that presents ten commonly encountered representative clinical contexts for trainees to learn basic electroencephalogram (EEG) interpretation skills.

Methods: We created an interactive web-based training simulator that allows self-paced, asynchronous learning and assessment of basic EEG interpretation skills. The simulator uses the information retrieval process via a free-response text box to enhance learning.

Isolation gowns as a potential work hazard.

Objectives: Isolation gowns are used as a barrier to bacterial transmission from patient to provider and vice versa. If an isolation gown is ineffective, the patient and provider have a potential breach of safety and increased infection risk. This study compared the bacterial permeability of differently rated, commonly uses isolation gowns to assess their effectiveness in preventing simulated bacterial transmittance, and thus contamination, from patient to provider.

Application of an objective structured clinical examination to evaluate and monitor intern's proficiency of hand hygiene and personal protective equipment use in the United States.

Purpose: To determine if an objective structured clinical examination (OSCE) could be used to evaluate and monitor hand hygiene and personal protective equipment (PPE) proficiency for medical interns in the United States.

Methods: Interns in July 2015 (N=123, Cohort 1) without OSCE-based contact precaution evaluation and teaching were evaluated early 2016 by OSCE for hand hygiene and PPE proficiency. They performed poorly.

Gender differences among surgical fellowship program directors.

Background: Although women are increasingly represented in American surgery, data regarding sex and academic rank of the leadership of fellowship programs are lacking.

Methods: Demographics and academic ranks for fellowship program directors were analyzed for 811 surgery fellowship programs across 14 specialties. Associations between academic rank and sex were assessed using a χ independence test.

Gender Diversity in General Surgery Residency Leadership.

Objective: This study aimed to evaluate the proportion and characteristics of women who serve in general surgery program director (PD) and associate program director (APD) positions in the United States.

Design: General surgery programs (n = 276) and directors were identified using the Association for Program Directors in Surgery website; information was cross-referenced with American Medical Association FREIDA and Accreditation Council for Graduate Medical Education databases, current to July 1, 2017. Each program's website was accessed to determine the gender and academic ranking of faculty.

Bench to Bedside: The Effectiveness of a Professional Development Program Focused on Biomedical Sciences and Action Research.

A three-year, National Institutes of Health-funded residential project at a southeastern research university immersed 83 secondary science teachers in a summer institute called "Bench to Bedside." Teachers were provided with knowledge, skills, experiences, and incentives to improve their science teaching and increase their awareness of scientific processes, technologies, and careers by examining the translational medicine continuum of basic to clinical research. This was done with the help of medical school researchers, clinical personnel, biotechnology entrepreneurs, program mentors, and prior year participants.

A mixed-reality part-task trainer for subclavian venous access.

Introduction: Mixed-reality (MR) procedural simulators combine virtual and physical components and visualization software that can be used for debriefing and offer an alternative to learn subclavian central venous access (SCVA). We present a SCVA MR simulator, a part-task trainer, which can assist in the training of medical personnel.

Methods: Sixty-five participants were involved in the following: (1) a simulation trial 1; (2) a teaching intervention followed by trial 2 (with the simulator's visualization software); and (3) trial 3, a final simulation assessment.

Automated, real-time fresh gas flow recommendations alter isoflurane consumption during the maintenance phase of anesthesia in a simulator-based study.

Background: The Low Flow Wizard (LFW) provides real-time guidance for user optimization of fresh gas flow (FGF) settings during general inhaled anesthesia. The LFW can continuously inform users whether it determines their FGF to be too little, efficient, or too much, and its color-coded recommendations respond in real time to changes in FGF performed by users. Our study objective was to determine whether the LFW feature, as implemented in the Dräger Apollo workstation, alters FGF selection and thereby volatile anesthetic consumption without affecting patient care.

Detecting Social Desirability Bias Using Factor Mixture Models.

Based on the conceptualization that social desirable bias (SDB) is a discrete event resulting from an interaction between a scale's items, the testing situation, and the respondent's latent trait on a social desirability factor, we present a method that makes use of factor mixture models to identify which examinees are most likely to provide biased responses, which items elicit the most socially desirable responses, and which external variables predict SDB. Problems associated with the common use of correlation coefficients based on scales' total scores to diagnose SDB and partial correlations to correct for SDB are discussed. The method is demonstrated with an analysis of SDB in the Attitude toward Interprofessional Service-Learning scale with a sample of students from health-related fields.