Harnessing a knowledge translation framework to implement an undergraduate medical education intervention: A longitudinal study.

Introduction: Implementation of evidence-informed educational interventions (EEI) involves applying and adapting theoretical and scientific knowledge to a specific context. Knowledge translation (KT) approaches can both facilitate and structure the process. The purpose of this paper is to describe lessons learned from applying a KT approach to help implement an EEI for clinical reasoning in medical students.

Comparison of Assessment by a Virtual Patient and by Clinician-Educators of Medical Students' History-Taking Skills: Exploratory Descriptive Study.

Background: A virtual patient (VP) can be a useful tool to foster the development of medical history-taking skills without the inherent constraints of the bedside setting. Although VPs hold the promise of contributing to the development of students' skills, documenting and assessing skills acquired through a VP is a challenge.

Objective: We propose a framework for the automated assessment of medical history taking within a VP software and then test this framework by comparing VP scores with the judgment of 10 clinician-educators (CEs).

Does providing the correct diagnosis as feedback after self-explanation improve medical students diagnostic performance?

Background: Self-explanation without feedback has been shown to improve medical students' diagnostic reasoning. While feedback is generally seen as beneficial for learning, available evidence of the value of its combination with self-explanation is conflicting. This study investigated the effect on medical students' diagnostic performance of adding immediate or delayed content-feedback to self-explanation while solving cases.

Self-explanation in learning clinical reasoning: the added value of examples and prompts.

Context: Recent studies suggest that self-explanation (SE) while diagnosing cases fosters the development of clinical reasoning in medical students; however, the conditions that optimise the impact of SE remain unknown. The example-based learning framework justifies an exploration of students' use of their own SEs combined with the study of examples. This study aimed to assess the impact on medical students' diagnostic performance of: (i) combining students' SEs with their listening to examples of residents' SEs, and (ii) the addition of prompts (specific questions) while working with examples.

Does medical students' diagnostic performance improve by observing examples of self-explanation provided by peers or experts?

Educational strategies that promote the development of clinical reasoning in students remain scarce. Generating self-explanations (SE) engages students in active learning and has shown to be an effective technique to improve clinical reasoning in clerks. Example-based learning has been shown to support the development of accurate knowledge representations.

Students' self-explanations while solving unfamiliar cases: the role of biomedical knowledge.

Objective: General guidelines for teaching clinical reasoning have received much attention, despite a paucity of instructional approaches with demonstrated effectiveness. As suggested in a recent experimental study, self-explanation while solving clinical cases may be an effective strategy to foster reasoning in clinical clerks dealing with less familiar cases. However, the mechanisms that mediate this benefit have not been specifically investigated.

The influence of medical students' self-explanations on diagnostic performance.

Context: Skill in clinical reasoning is a highly valued attribute of doctors, but instructional approaches to foster medical students' clinical reasoning skills remain scarce. Self-explanation is an instructional procedure, the positive effects of which on learning have been demonstrated in a variety of domains, but which remain largely unexplored in medical education.

Objectives: The purpose of this study was to investigate the effects of self-explanation on students' learning of clinical reasoning during clerkships and to examine whether these effects are affected by topic familiarity.

A physician-centred intervention to shorten hospital stay: a pilot study.

Background: Studies of length of stay (LOS) in hospital usually focus on physician-independent factors. In this study, the authors identified physician-dependent factors and tested an intervention aimed at them to determine its effect on LOS.

Methods: A prospective comparison of LOS on 2 general medical wards in a tertiary care teaching hospital before and after the intervention.

A donor-derived asialo-GM1+ cell induces depression of B-cell genesis during systemic graft-versus-host disease.

The nature of the effector cell(s) responsible for the depression of B-cell genesis in the bone marrow of mice undergoing systemic graft-versus-host disease (GVHD) has been examined. Donor C57BL/6 (B6) mice were treated in vivo with either a single injection of anti-asialo GM1 antibody (anti-ASGM1) to eliminate naturally occurring (endogenous) ASGM1+ cells or B6xAF1 (B6AF1) lymphoid cells followed by anti-ASGM1 to eliminate both endogenous and "induced" ASGM1+ cells. Lymphoid cells from donor mice after the elimination of endogenous ASGM1+ cells produced severe GVHD and concomitant depression of B-cell genesis when injected into B6AF1 recipients.

Reduced tumor necrosis factor alpha production in lipopolysaccharide-treated whole blood from patients in the intensive care unit.

Objective: To determine the cytokine response to lipopolysaccharide in patients in the intensive care unit.

Patients: Patients in a mixed medical/surgical intensive care unit with fever and a de novo clinical dysfunction of at least one organ system.

Methods: Whole blood from patients and from laboratory controls was stimulated with 8 ng/mL of lipopolysaccharide (Escherichia coli 0111:B4) at 37 degrees C, and tumor necrosis factor alpha (TNF-alpha) was measured using enzyme linked immunosorbent assay at 4, 8, and 24 hours.