Taking Stock and Looking Ahead: Evolution of Accreditation Feedback for Simulation Centers Over 8 Years Using Epistemic Network Analysis.

Introduction: Since 2005, the American College of Surgeons Accredited Educational Institutes has provided accreditation of surgically focused simulation centers with the added benefit of identifying best practices defined as areas far exceeding the accreditation standards or novel methods of advancing high-quality, impactful education. This study aimed to examine the evolution of the best practices observed by accreditors during site visits over the 8-year period.

Methods: Accreditation included the completion of an application form followed by a site visit by a simulation expert and review of all materials by an accreditation committee to identify areas out of compliance along with areas far exceeding accreditation standards.

Evaluating how residents talk and what it means for surgical performance in the simulation lab.

Background: This paper explores a method for assessing intraoperative performance by modeling how surgeons integrate skills and knowledge through discourse.

Methods: Senior residents (N = 11) were recorded while performing a simulated laparoscopic ventral hernia (LVH) repair. Audio transcripts were coded for five discourse elements related to knowledge, skills, and operative independence.

Using epistemic network analysis to identify targets for educational interventions in trauma team communication.

Background: Epistemic Network Analysis (ENA) is a technique for modeling and comparing the structure of connections between elements in coded data. We hypothesized that connections among team discourse elements as modeled by ENA would predict the quality of team performance in trauma simulation.

Methods: The Modified Non-technical Skills Scale for Trauma (T-NOTECHS) was used to score a simulation-based trauma team resuscitation.

The hands and head of a surgeon: Modeling operative competency with multimodal epistemic network analysis.

Background: This paper explores a method for assessing intraoperative performance by modeling how surgeons integrate psychomotor, procedural, and cognitive skills to manage errors.

Methods: Audio-video data were collected from general surgery residents (N = 45) performing a simulated laparoscopic ventral hernia repair. Errors were identified using a standard checklist, and speech was coded for elements related to error recognition and management.

Procedural Simulations and Reflective Practice: Meeting the Need.

The medical profession continues to learn about the ways in which simulations can help to improve education and training. In addition, simulation is constantly evaluated regarding the many ways it can help to improve the abilities of surgeons throughout their course of training and practice. The goal of this study is to review the importance of reflection on clinical practice in situating surgeons as lifelong learners and explore the role that simulation can play in that process.

A novel paradigm for engineering education: virtual internships with individualized mentoring and assessment of engineering thinking.

Engineering virtual internships are a novel paradigm for providing authentic engineering experiences in the first-year curriculum. They are both individualized and accommodate large numbers of students. As we describe in this report, this approach can (a) enable students to solve complex engineering problems in a mentored, collaborative environment; (b) allow educators to assess engineering thinking; and (c) provide an introductory experience that students enjoy and find valuable.

"Children with half-starved bodies" and the assessment of malnutrition in the United States, 1890-1950.

Malnutrition was one of the most significant children's health issues of the early twentieth century, but it also engendered considerable controversy. Just how many children were truly malnourished, and how could they be reliably identified? Despite the failures of numerous diagnostic methods-even the definition of malnutrition defied consensus-health authorities remained convinced that malnutrition was a serious and widespread problem. Indeed, the imprecision that surrounded the condition allowed it to be used metaphorically to advance a broad range of professional, social, and public health agendas.

The schism between medical and public health education: a historical perspective.

The separation of "medicine" and "public health" in academic institutions limits the potential synergies that an integrated educational model could offer. The roots of this separation are deeply imbedded in history. During the past two centuries, there have been repeated efforts to integrate public health education into the core training of physicians, usually in response to a perceived short-term crisis, and without widespread, lasting success.

A longitudinal study of bone-mineral content and intestinal calcium absorption in patients with chronic renal failure.

In 14 nondialyzed patients with chronic renal failure (CRF) and at the start of treatment a glomerular filtration rate (GFR) of 14--47 ml/min changes in bone mineral mass (BMM), expressed in percentage of the initial value, showed a significant correlation with the mean GFR during an observation period of 16 +/- 2 mo. During a predialysis period of 6 mo BMM decreased to 97.8 +/- 3.

Intestinal calcium absorption, serum phosphate, and parathyroid hormone in patients with chronic renal failure and osteodystrophy before and during hemodialysis.

In 34 patients with chronic renal failure (CRF), fractional 47calcium absorption (Fa47Ca) was measured by an external counting method. A significant correlation was found with impairment of renal function, as expressed by the creatinine clearance. There was also a significant correlation of Fa47Ca with the serum phosphate (SeP) level and of immunoreactive parathyroid hormone (iPTH) with renal function.

A comparative study of two methods of measurement of fractional calcium absorption: results in normal individuals and patients with various disturbances of calcium metabolism.

Two methods of measurement of fractional calcium absorption have been compared in the same individuals. There is a significant correlation between fractional 47Ca absorption as measured with a blood counting method and with an external counting method after intravenous and oral administration of 47Ca (P less than 0.001).