Acute kidney injury without need for dialysis, incidence, its impact on long-term stroke survival and progression to chronic kidney disease.

Introduction: Patients who had a stroke are at increased risk of sepsis, dehydration and fluctuations in blood pressure, which may result in acute kidney injury (AKI). The impact of AKI on long-term stroke survival has not been studied well.

Objective: We aimed to identify incidence of AKI during acute stroke, follow-up period and its impact on long-term survival and development of chronic kidney disease (CKD).

A Call to Action From the California Consortium for the Assessment of Clinical Competence: Making the Case for Regional Collaboration.

The discontinuation of the United States Medical Licensing Examination Step 2 Clinical Skills Examination emphasizes the need for other reliable standardized assessments of medical student clinical skills. For 30 years, the California Consortium for the Assessment of Clinical Competence (CCACC) has collaborated in the development of clinical skills assessments and has become a valuable resource for clinicians, standardized patient educators, psychometricians, and medical educators. There are many merits to strong multi-institutional partnerships, including the integration of data across multiple schools to provide feedback to both students and curricula, pooled test performance statistics for analysis and quality assurance, shared best practices and resources, individual professional development, and opportunities for research and scholarship.

Iris Manifestations in Inadequately Treated Chronic Recurrent Vogt-Koyanagi-Harada Disease.

Purpose: To describe the iris changes in chronic recurrent Vogt-Koyanagi-Harada Disease (VKH).

Methods: Retrospective case series. Clinical features of 3 VKH patients who developed bilateral depigmentation of the iris are described.

Comparative evaluation of three dengue duo rapid test kits to detect NS1, IgM, and IgG associated with acute dengue in children in Myanmar.

Dengue is an increasing public health concern worldwide and requires efficient laboratory diagnostics. We evaluated three commercially available dengue rapid diagnostic tests-the Humasis Dengue Combo NS1 & IgG/IgM (Humasis, Korea), SD Bioline Dengue Duo NS1 Ag & IgG/IgM (SD Bioline, Korea), and CareUS Dengue Combo NS1 and IgM/IgG kits (WellsBio, Korea)-and compared them to reference immunoglobulin M (IgM) or immunoglobulin G (IgG) ELISAs and quantitative reverse transcription polymerase chain reaction (qRT-PCR) assays. In total, 109 dengue-positive samples from children with acute symptomatic dengue and 63 dengue-negative samples from febrile and asymptomatic individuals were collected.

Impact of glucose-6-phosphate dehydrogenase deficiency on dengue infection in Myanmar children.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency may affect the clinical presentation of dengue due to the altered redox state in immune cells. We aimed to determine the association between G6PD deficiency and severity of dengue infection in paediatric patients in Myanmar. A cross-sectional study was conducted among paediatric patients aged 2-13 years with dengue in Yankin Children Hospital, Myanmar.

Post-stroke seizure-Do the locations, types and managements of stroke matter?

Objective: To determine the incidence of post-stroke seizures and the associated risk factors in a government-restructured hospital in Singapore.

Methods: This retrospective study included consecutive patients (age ≥21 years) admitted to the stroke rehabilitation facility at Changi General Hospital, Singapore, between June 2008 and May 2017, with a minimum post-discharge follow-up of 6 months. Patients with known epilepsy central nervous system infection or tumor, a history of neurosurgery and or missing data were excluded from study.

An Exploration of Residents' Implicit Biases Towards Depression-a Pilot Study.

Background: Implicit attitudes are outside of conscious awareness and are thought to affect automatic responses outside of one's deliberate control, with the potential to impact physician-patient relationships.

Objective: To measure the nature and extent of implicit biases towards depression in internal medicine and psychiatry residents.

Design: Descriptive and comparative study.

Internal Medicine Residents' Attitudes Toward Simulated Depressed Cardiac Patients During an Objective Structured Clinical Examination: A Randomized Study.

Background: Physician biases toward mental conditions such as depression have been shown to adversely affect medical outcomes.

Objective: To explore the relationship between residents' explicit bias toward depressed patients and their clinical skills on a cardiac case during an objective structured clinical exam (OSCE).

Design: Prospective parallel randomized controlled study.

Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

Purpose: To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs).

Method: Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring.

Commentary: Racism and Bias in Health Professions Education: How Educators, Faculty Developers, and Researchers Can Make a Difference.

The Research in Medical Education (RIME) Program Planning Committee is committed to advancing scholarship in and promoting dialogue about the critical issues of racism and bias in health professions education (HPE). From the call for studies focused on underrepresented learners and faculty in medicine to the invited 2016 RIME plenary address by Dr. Camara Jones, the committee strongly believes that dismantling racism is critical to the future of HPE.

Scholarly Conversations in Medical Education.

This supplement includes the eight research papers accepted by the 2016 Research in Medical Education Program Planning Committee. In this Commentary, the authors use "conversations in medical education" as a guiding metaphor to explore what these papers contribute to the current scholarly discourse in medical education. They organize their discussion around two domains: the topic of study and the methodological approach.

Epidemiology of Uveitis in a Tertiary Eye Center in Myanmar.

Purpose: To identify the characteristics of uveitis in a tertiary eye center in Myanmar.

Methods: A retrospective study was undertaken to obtain the characteristics of uveitis in a tertiary eye center in Myanmar from September 2013 to September 2014, using a standard clinical protocol and tailored laboratory investigations.

Results: A total of 139 patients were included in this epidemiologic study; 71 (51.

Adapting the McMaster-Ottawa scale and developing behavioral anchors for assessing performance in an interprofessional Team Observed Structured Clinical Encounter.

Background: Current scales for interprofessional team performance do not provide adequate behavioral anchors for performance evaluation. The Team Observed Structured Clinical Encounter (TOSCE) provides an opportunity to adapt and develop an existing scale for this purpose. We aimed to test the feasibility of using a retooled scale to rate performance in a standardized patient encounter and to assess faculty ability to accurately rate both individual students and teams.

A comparison of medical students' learning approaches between the first and fourth years.

Objectives: We hypothesized that medical students exposed to a case-based curriculum in years 1 and 2 and clinical cases in the year 3 clerkship would demonstrate a longitudinal increase in the deep approach to learning and a decrease in the surface apathetic approach.

Methods: A cohort of first-year medical students completed the Approaches and Study Skills Inventory for Students at the beginning of their first term and again at the beginning of their fourth year. Approaches and Study Skills Inventory for Students scores were aggregated into three main learning approach scales: deep, strategic, and surface apathetic.

Assessing 3rd year medical students' interprofessional collaborative practice behaviors during a standardized patient encounter: A multi-institutional, cross-sectional study.

Background: To understand how third-year medical student interprofessional collaborative practice (IPCP) is affected by self-efficacy and interprofessional experiences (extracurricular experiences and formal curricula).

Methods: The authors measured learner IPCP using an objective structured clinical examination (OSCE) with a standardized nurse (SN) and standardized patient (SP) during a statewide clinical performance examination. At four California medical schools from April to August 2012, SPs and SNs rated learner IPCP (10 items, range 0-100) and patient-centered communication (10 items, range 0-100).

Measurement of perceptions of educational environment in evidence-based medicine.

In recent years, there has been a renewed interest in measuring perceptions regarding different aspects of the medical educational environment. A reliable tool was developed for measuring perceptions of the educational environment as it relates to evidence-based medicine as part of a multicountry randomised controlled trial to evaluate the effectiveness of a clinically integrated evidence-based medicine course. Participants from 10 specialties completed the questionnaire.

Effectiveness of a clinically integrated e-learning course in evidence-based medicine for reproductive health training: a randomized trial.

Context: For evidence-based practice to embed culturally in the workplace, teaching of evidence-based medicine (EBM) should be clinically integrated. In low-middle-income countries (LMICs) there is a scarcity of EBM-trained clinical tutors, lack of protected time for teaching EBM, and poor access to relevant databases in languages other than English.

Objective: To evaluate the effects of a clinically integrated e-learning EBM course incorporating the World Health Organization (WHO) Reproductive Health Library (RHL) on knowledge, skills, and educational environment compared with traditional EBM teaching.

A comparison of two standard-setting approaches in high-stakes clinical performance assessment using generalizability theory.

Purpose: Scoring clinical assessments in a reliable and valid manner using criterion-referenced standards remains an important issue and directly affects decisions made regarding examinee proficiency. This generalizability study of students' clinical performance examination (CPX) scores examines the reliability of those scores and of their interpretation, particularly according to a newly introduced, "critical actions" criterion-referenced standard and scoring approach.

Method: The authors applied a generalizability framework to the performance scores of 477 third-year students attending three different medical schools in 2008.

The relationship between medical students' learning approaches and performance on a summative high-stakes clinical performance examination.

Background: A learning approach embeds the intention of the student when starting a task and the learning processes and strategies used to carry out a task. Student approaches to learning have been categorized as deep, strategic, and surface.

Aim: To explore the relationships among medical students' learning approaches, gender, and performance on a summative high-stakes clinical performance examination (CPX).

Effect of feedback from standardized patients on medical students' performance and perceptions of the neurological examination.

Background: Feedback can have a powerful influence on the performance of learners, and has traditionally been provided by faculty.

Aim: This study set out to explore whether feedback from a standardized patient (SP) can improve students' performance of the neurological examination.

Methods: A randomized controlled design was used with final year medical students.

Effect of educational interventions and medical school policies on medical students' attitudes toward pharmaceutical marketing practices: a multi-institutional study.

Purpose: To determine the effect of educational interventions on medical students' attitudes toward pharmaceutical industry marketing practices and whether restrictive medical school policies governing medicine-industry interactions are associated with student support for banning such interactions.

Method: Prospective cohort study involving the graduating classes of 2009 (intervention, n=474) and 2010 (control, n=459) at four U.S.

A cluster randomized controlled trial to evaluate the effectiveness of the clinically integrated RHL evidence -based medicine course.

Background And Objectives: Evidence-based health care requires clinicians to engage with use of evidence in decision-making at the workplace. A learner-centred, problem-based course that integrates e-learning in the clinical setting has been developed for application in obstetrics and gynaecology units. The course content uses the WHO reproductive health library (RHL) as the resource for systematic reviews.