bluuebunny/crossref_metadata_2025 huggingface dataset:
Science Fiction as a Basis for Global Curriculum Visions
Authors: Gough Noel
Published: September 2018

Most Anglophone curriculum scholars who participated in the reconceptualization of their field during and since the late 1960s are likely to acknowledge the generativity of Joseph Schwab’s landmark essay, “The practical: a language for curriculum,” in which he argues that effective curriculum decision-making requires the anticipatory generation of alternatives, reasoning that such decision-making neccesitates that there be available to practical deliberation the greatest possible number and fresh diversity of alternative solutions to problems. For this reason, the literature and media known generically as SF (an initialization that encompasses not only science fiction but also many other “sf” terms) are generative resources for the anticipatory generation of global curriculum visions. From its 19th-century archetypes in the works of Mary Shelley, Jules Verne, and H. G. Wells, to its 20th- and 21st-century manifestations in multimedia franchises focused on space travel and exploration (Star Trek, Star Wars), genetic modification and mutation (X-Men, Spider Man) and artificial intelligence (AI, Ghost in the Shell), SF consistently demonstrates that imagined and material worlds are always already so entwined that they cannot be understood in isolation. In their exemplifications of the arts of anticipation, SF texts across a wide variety of media exercise the speculative imagination and exemplify conceptual tools for understanding and negotiating the global milieux of contemporary curriculum theorizing and decision-making.
Key Instances of Holistic Curriculum as an Alternative to National Curriculum
Authors: Miller John P.
Published: September 2018

Holistic education as a field of inquiry began in the 1980s. Previously this field was referred to as humanistic education, confluent education, affective education, or transpersonal education. The work of Carl Rogers and Abraham Maslow inspired many educators working in these areas. In 1988 The Holistic Education Review under the editorship of Ron Miller was first published along with The Holistic Curriculum by John Miller. However, as a field of practice holistic education can first be found in Indigenous education. Historically, Socrates, Rousseau, Pestalozzi, Froebel, Bronson Alcott, and Tolstoy can be viewed as working from a holistic frame.

What is that frame? It is educating the whole person: body, mind, and spirit. At every level, education tends to focus on skills and a narrow view of the intellect. The body receives little attention while the spiritual life of the student is ignored. One image of the student from this approach is as a brain on a stick. In contrast, the holistic curriculum attempts to reach the head, hands, and heart of the student.

The other main principle of holistic education is connectedness. Connectedness is one of the fundamental realities of nature. In contrast, the curriculum at every level, except perhaps for kindergarten, is fragmented as knowledge is broken down into courses, units, lessons, and bits of information. Rarely are there attempts to show how knowledge is interconnected. Holistic education seeks to be in harmony with how things actually are by focusing on connections. Six connections are at the core of the holistic curriculum: connections to the earth, community, subject integration, intuition/logic, body/mind, and soul. There are many models of holistic education in practice. They range from more structured approaches, such as Waldorf education, to schools such as the Sudbury Valley School that give students a great deal of choice. Despite these differences these schools view the child as a whole human being.
The Intersection of Gender and Race in the American School Superintendency
Authors: Katz Susan J. , Smith Eva C.
Published: September 2018

Significant research telling the stories of women’s experiences in the superintendency has only been conducted since the 1980s. Much of that research has been focused on White women, with fewer studies related to female leaders of color. By the beginning of the new century, there were more women in the pipeline for the superintendency—more women in graduate educational leadership programs, more women in the elementary principalship, and more women in central office positions. While increases have been made throughout the years, females only made up 27% of the superintendency, up only 2% from 2010. This stands in direct contrast to the female-dominated teaching force; given that the position of teacher is the first in the pathway toward the superintendency, women are clearly underrepresented as superintendents across the United States. This problem has been a topic for researchers, practicing academics, and doctoral students who conduct studies to understand what hinders women from accessing the superintendency in greater numbers.
Queer Pedagogy
Authors: Thomas-Reid Matthew
Published: September 2018

Queer pedagogy is an approach to educational praxis and curricula emerging in the late 20th century, drawing from the theoretical traditions of poststructuralism, queer theory, and critical pedagogy. The ideas put forth by key figures in queer theory, including principally Michel Foucault and Judith Butler, were adopted in the early 1990s by to posit an approach to education that seeks to challenge heteronormative structures and assumptions in K–12 and higher education curricula, pedagogy, and policy.

Queer pedagogy, much like the queer theory that informs it, draws on the lived experience of the queer, wonky, or non-normative as a lens through which to consider educational phenomena. Queer pedagogy seeks to both uncover and disrupt hidden curricula of heteronormativity as well as to develop classroom landscapes and experiences that create safety for queer participants.

In unpacking queer pedagogy, three forms of the word “queer” emerge: queer-as-a-noun, queer-as-an-adjective, and queer-as-a-verb. Queer pedagogy involves exploring the noun form, or “being” queer, and how queer identities intersect and impact educational spaces. The word “queer” can also become an adjective that describes moments when heteronormative perceptions become blurred by the presence of these queer identities. In praxis, queer pedagogy embraces a proactive use of queer as a verb; a teacher might use queer pedagogy to trouble traditional heteronormative notions about curricula and pedagogy. This queer praxis, or queer as a verb, involves three primary foci: safety for queer students and teachers; engagement by queer students; and finally, understanding of queer issues, culture, and history.
Ethnic Minority Education in China
Authors: Wu Mei , Lee MaryJo Benton , Parkay Forrest W. , Pitre Paul E.
Published: September 2018

The introduction of bilingual education, the institution of preferential policies, and the implementation of 9-year compulsory schooling and its strengthening measures have resulted in educational attainments that are significant for a country with the size and diversity of China. The percentage of the ethnic minority students receiving education has increased greatly since the founding of the People’s Republic of China (PRC) in 1949; however, bilingual education is still challenging because of an inadequate supply of qualified teachers and other resources. Preferential policies created educational opportunities for ethnic minorities but did not improve educational quality. Instead, these policies created disparities among different ethnic groups and the Han who live in ethnic minority areas. China’s minority groups are diverse, and its policymaking mechanisms are highly centralized. Designing programs that allow ethnic minorities to benefit from the PRC’s rapid economic development will continue to be a challenge.
Remote and Rural Education in Australia and the Pacific
Authors: Crump Stephen , Twyford Kylie , Koroivulaono Theresa
Published: September 2018

Remote and rural education is a resonating issue worldwide, given the new and emerging capabilities of digitization to reduce barriers of distance, time, and space, particularly for Oceania. Issues based on achieving equitable educational access and participation that ameliorates the disadvantages for many students in remote and rural locations of Australasia and the Pacific, compared to those in urban classrooms, are pertinent. Nonetheless, students in remote and rural locations also show great resilience and have built up a trove of informal knowledge from the demands of daily life requiring a high degree of independence and maturity. This is evident in the distance education School of the Air in Australia, the University of the South Pacific, and the Marshall Islands College in the North Pacific. These sites provide insights into strength-based reform strategies intended to improve rural and remote education and training and, consequently, work and life choices.
Technology Proficiency in Teaching and Facilitating
Authors: Saad Norazlinda , Sankaran Surendran
Published: September 2018

Technology proficiency is the ability to use technology to communicate effectively and professionally, organize information, produce high-quality products, and enhance thinking skills. In classroom settings, technology proficiency refers to the ability of teachers to integrate technology to teach and facilitate, as well as to improve learning, productivity, and performance. These abilities are needed to participate in a technological world. Technology proficiency enables teachers to identify and explore a wide variety of technological tools and devices in order to determine and select those that best respond to teaching and learning contents. Among teachers, basic proficiency in information technologies is typically used to communicate electronically, organize activities and information, and create documents in schools or higher-education institutions.

Proficiency in using technological tools and devices can be achieved through experience and instruction. It is necessary to introduce experimentation into teaching practices and maintain accessible technological tools and devices. Technology proficiency seems relevant to many aspects of the teaching profession, such as lesson preparation and development of teaching kids. Other aspects that impact teacher decisions to introduce technology into teaching and learning activities are teachers’ beliefs about the way the subject should be taught and the skills associated with teacher competence in managing classroom activities using technology tools and devices. Therefore, teachers must be able to apply the technological knowledge and skills required in professional job roles and responsibilities in order to achieve the expected outputs.

As an educator in the 21st century, it is imperative to integrate technology into the curriculum for a variety of reasons. Students need to be exposed to and be familiar with technologies in order to compete in the world marketplace, and they need to be able to integrate them in dynamic social environments. The world is dominated by technology in all forms, and to be successful, students must possess 21st-century skills. In addition, technology proficiency improves efficiency in teaching and facilitating. Being more efficient usually means that teachers have more time, and it allows additional space for innovation, planning, conversing, thinking, and creativity. Technology can be instrumental in making teachers more efficient.
Contingency and Situational Approaches to Educational Leadership
Authors: Tsolka Athanasia
Published: September 2018

In the context of educational leadership, the application of contingency and situational theory underlines the importance of analyzing the current situation and the variables that affect the organization’s framework so that a manager can be effective. Whichever education system we are referring to, it is virtually meaningless to study leadership styles without recognizing the significance of the school context. School is a complex organization, an open system which appears to be a very uncertain environment. In order for leadership to be effective in this uncertain environment, the leaders should adopt a holistic approach. Many leaders avoid high uncertainty by applying standard operating procedures and making traditional bureaucratic responses in every case. Contingency and situational theory could give school leaders the opportunity for a solid basis in further refining management policies and practices.

Contingency theory is based on the assumption that no single leadership style is appropriate in all situations. According to this theory, leadership style is quite inflexible. Thus, organizational effectiveness depends on matching internal organizational characteristics with environmental conditions. Therefore, effective leadership depends on whether the leader’s style matches the needs of the individual case. This theory applies better to educational systems where principal selection is done through an open recruitment process. One useful tool of this theory is contingency planning or forecasting. On the other hand, situational theory dictates that leaders adapt their style to match their staff’s characteristics and requirements. In education systems where the recruitment and selection of school principals lies with central government, situational theory can be a useful tool for the principals. When principals are placed in a new school, they should choose the best course of action based upon the current circumstances. Flexibility is key in managing a team effectively. The main difference between the two theories is that in the first case we put the right person in the right job while in the second leaders adjust their style depending on school context.
Teacher-Principal Trust
Authors: Amzat Ismail Hussein
Published: September 2018

Trust is the keystone to creating enduring relationships and interconnectedness among people. Trust also plays a pivotal role in human social and organizational interactions. Trust is needed for any organization to create good networks. It is an impetus for cressating relationships with employees, as well as for building healthy societies. To be trusted in an organization, a leader such as a school principal must possess integrity, truthfulness, and transparency. Therefore, when defining trust, the role of trust in schools and what a school principal must do to be trusted by teachers should be explored. It is worth knowing what a trusting principal does or means to a school and the impact on a school, teaching, and learning.
Organizational Theory and Culture in Education
Authors: Saad Norazlinda , Kaur Paramjit
Published: September 2018

Organizational theory involves various approaches to analyzing organizations and attempts to explain the mechanisms of organizations. Organizations embody structured social units that need to achieve aims and needs as well as pursue shared goals. Organizational theory is made up of various disciplines and bodies of knowledge. Some of the theories of organization include classical theory, neoclassical theory, contingency theory, human relations theory, and modern systems theory. These theories are based on multiple perspectives including modern and postmodernist views. In education management and policy, it is necessary to understood organizational theory within the micro and macro realms of the education settings. Another factor that affects organizational theory within educational settings is organizational culture. Organizational culture is made up of a system of shared assumptions, beliefs, and values that governs how people in organizations behave and act. In organizations, shared values and beliefs that evolve over time strongly influence how members function and perform their duties and tasks in the organization.. Organizations develop and maintain a specific unique culture that acts as a guide and molds the behavior and roles of the members of the organization. Organizational culture can be further understood by examining it on multiple levels including artifacts of the organization, advocated values, and underlying assumptions within the organization. Various principles that govern organizational culture may help explain organizations and their members. It is also pertinent to observe how organizational culture affects practices and principles of organizations as well as how organizational culture governs members and aims of organizations. The various organizational theories and the organizational culture perspective can help provide a more comprehensive understanding of organizations and their members and practices, especially within educational settings and contexts.
Markets and Corporations
Authors: Martin Keir James Cecil
Published: September 2018

Corporations are among the most important of the institutions that shape lives across the globe. They often have a “taken for granted” character, both in everyday discourse and in economic or management theory, where they are often described as an inevitable outcome of the natural working of markets. Anthropological analysis suggests that neither the markets that are seen as their foundation nor corporations as social entities can be understood in this manner. Instead, their existence has to be seen as contingent on particular social relations and as being the outcome of long processes of historic conflict. The extent to which, at the start of the 21st century, corporations satisfactorily fulfill their supposed purpose of managing debt obligations in order to stimulate economic growth is particularly open to question. This was traditionally the justification for the establishment of corporations as separate legal actors in economic markets. Some 150 years on, other sociocultural relations and perspectives shape their boundaries and activities in a manner that means that their purpose and character can no longer be assumed on the basis of such axiomatic premises. Instead, their actions can be explained only on the basis of historic and ethnographic analysis of the contests over the limits of relational obligation that shape their boundaries.
Challenges for Natural Hazard and Risk Management in Mountain Regions of Europe
Authors: Keiler Margreth , Fuchs Sven
Published: September 2018

European mountain regions are diverse, from gently rolling hills to high mountain areas, and from low populated rural areas to urban regions or from communities dependent on agricultural productions to hubs of tourist industry. Communities in European mountain regions are threatened by different hazard types: for example floods, landslides, or glacial hazards, mostly in a multi-hazard environment. Due to climate change and socioeconomic developments they are challenged by emerging and spatially as well as temporally highly dynamic risks. Consequently, over decades societies in European mountain ranges developed different hazard and risk management strategies on a national to local level, which are presented below focusing on the European Alps.

Until the late 19th century, the paradigm of hazard protection was related to engineering measures, mostly implemented in the catchments, and new authorities responsible for mitigation were founded. From the 19th century, more integrative strategies became prominent, becoming manifest in the 1960s with land-use management strategies targeted at a separation of hazardous areas and areas used for settlement and economic purpose. In research and in the application, the concept of hazard mitigation was step by step replaced by the concept of risk. The concept of risk includes three components (or drivers), apart from hazard analysis also the assessment and evaluation of exposure and vulnerability; thus, it addresses in the management of risk reduction all three components. These three drivers are all dynamic, while the concept of risk itself is thus far a static approach. The dynamic of risk drivers is a result of both climate change and socioeconomic change, leading through different combinations either to an increase or a decrease in risk. Consequently, natural hazard and risk management, defined since the 21st century using the complexity paradigm, should acknowledge such dynamics. Moreover, researchers from different disciplines as well as practitioners have to meet the challenges of sustainable development in the European mountains. Thus, they should consider the effects of dynamics in risk drivers (e.g., increasing exposure, increasing vulnerability, changes in magnitude, and frequency of hazard events), and possible effects on development areas. These challenges, furthermore, can be better met in the future by concepts of risk governance, including but not limited to improved land management strategies and adaptive risk management.
New Data Completing the Spectrum of theMa,RMia, andRMjaGenes for Resistance to Root-Knot Nematodes (Meloidogynespp.) inPrunus
Authors: Duval Henri , Van Ghelder Cyril , Portier Ulysse , Confolent Carole , Meza Pablo , Esmenjaud Daniel
Published: September 2018

Root-knot nematodes (RKN) (Meloidogyne spp.) are worldwide pests that affect a considerable number of plants, among which stone fruit (Prunus spp.) are severely attacked. Prevalent RKN species are Meloidogyne arenaria, M. incognita, and M. javanica in stone fruit but the emergent M. ethiopica and M. enterolobii are also reported to challenge perennial crops. In Prunus spp., the complete-spectrum resistance (R) gene Ma from plum and the more restricted-spectrum R genes RMia from peach and RMja from almond completely inhibit nematode multiplication and gall formation of the RKN species that they control. This study aimed to update the resistance spectra of these three major genes by evaluating their activity toward one isolate of the yet-untested RKN species mentioned above. To state whether a given gene controls a particular species, the principle of our experiment was to genotype with appropriate markers a number of individuals segregating for this gene and then to phenotype these individuals. A perfect matching of the genotype and the phenotype of individuals indicates that the gene of interest is active against and, thus, controls the corresponding isolate of this RKN species. Segregating materials used were an Ma F1 plum progeny, an RMia F2 peach progeny, and an RMja F2 almond progeny. In addition to previous data, our results establish a clear spectrum for each of the three genes toward isolates from both the three prevalent species and the two emerging species. Ultimately, our results reveal that (i) Ma controls all of them, (ii) RMja controls all species except M. incognita and M. floridensis, and (iii) RMia controls M. arenaria, M. incognita, and M. ethiopica but not M. javanica or M. enterolobii. Our data should have wide implications for RKN resistance management and breeding and for deciphering the molecular mechanisms of the spectrum of RKN R genes.
Diversity and Virulence ofAlternariaspp. Causing Potato Early Blight and Brown Spot in Wisconsin
Authors: Ding Shunping , Meinholz Kiana , Cleveland Kenneth , Jordan Stephen A. , Gevens Amanda J.
Published: September 2018

Early blight, caused by Alternaria solani, along with brown spot, caused by A. alternata, have the potential to reduce quality and yield in potato production globally. Prior to this study, the incidence, disease impact, and fungicide resistance attributes of A. alternata in Wisconsin were poorly understood. Potato pathogens were isolated from foliar lesions at three commercial locations in Wisconsin in 2012 and 2017 and were initially morphologically identified as A. solani (n = 33) and A. alternata (n = 40). Identifications were further corroborated with the phylogenetic analysis of the internal transcribed spacer (ITS), translation elongation factor 1 (TEF1), gapdh, Alt a 1, and OPA10-2. A multigene phylogeny of ITS, TEF1, gapdh, and Alt a 1 showed five genotypes of A. alternata and one single genotype of A. solani. We demonstrated that the A. alternata isolates were virulent on potato cultivars Russet Burbank (P < 0.013) and Atlantic (P < 0.0073), though they caused less disease than A. solani (P < 0.0001 and P < 0.0001, respectively). A. alternata caused little disease on the breeding line 24-24-12 (P = 0.9929), and A. solani caused fewer disease symptoms on 24-24-12 than on Russet Burbank (P < 0.0001) or Atlantic (P < 0.0001). Breeding line 24-24-12 may be a promising source of potential resistance for the two diseases. There was no significant difference in virulence of different A. alternata genotypes, and no significant difference in virulence or genotype clustering among isolates from the three locations. Isolates of A. alternata that induced chlorosis caused larger lesion areas than isolates that did not in Russet Burbank (P < 0.0001), Atlantic (P < 0.0001), and 24-24-12 (P = 0.0365). There was no significant difference in virulence between quinone outside inhibitor (QoI)-sensitive and QoI-resistant isolates of A. alternata. This study enhanced our understanding of potato early blight and brown spot in Wisconsin, and suggested that A. alternata in addition to A. solani should be carefully monitored and possibly uniquely managed in order to achieve overall disease control.
Impact of Operating Room Etiquette Video on Medical Student Comfort in the Gynecologic OR
Authors: Melnyk Alexandra , Stuparich Mallory , Lee Jessica , Donnellan Nicole
Published: September 2018

PURPOSE:

To assess if enhanced orientation to the gynecologic operating room (OR) by brief video intervention affects medical students' comfort and self-rated performance in the OR.

BACKGROUND:

A large percentage of third year medical education is spent in the OR, an environment that many students have never previously experienced. We identified a deficit in OR orientation in the clerkship, and made a brief video reviewing scrubbing technique, gowning/gloving, patient positioning, and skin preparation.

METHODS:

Third and fourth year medical students participating in the OBGYN clerkship at Magee-Womens Hospital were recruited during orientation. Participants completed a pre-test survey, self-assessments of daily OR performance and a posttest survey after their final exam. All students watched the video once during orientation and were provided online access to the video.

RESULTS:

We recruited 71 OBGYN clerkship students. Most students accessed the video one or zero times during the rotation. Students were divided into those with no prior surgical rotation experience and those with prior experience. Medical students demonstrated self-reported improvement in using personal protective equipment (PPE), gowning/gloving, full surgical scrub, and donning PPE with and without assistance (P<.0001). Students without previous experience demonstrated greater improvement than those with experience in using PPE (P=.0003), gowning/gloving, full surgical scrub, and donning with assistance (P<.0001).

DISCUSSION:

The majority of students reported improved comfort in the gynecologic OR by having access to the video. This video can be implemented as part of the clerkship curriculum, made available to surgical naïve students, and broadened for use in other surgical clerkships.
Abortion Practice After Routine Training: A Prospective Cohort Study
Authors: Turk Jema , Koenemann Katheryn , Landy Uta , Steinauer Jody
Published: September 2018

PURPOSE:

To explore Ryan Program graduates; post-residency practice in abortion care.

BACKGROUND:

The Ryan Program supports residency programs to integrate abortion into training. In 2012 we commenced a prospective cohort study of graduated residents.

METHODS:

Residents complete web-based surveys after the family planning rotation and consent to participate in future studies. In 2016, we surveyed ob-gyns 2+ years after residency about their current practice. Post-rotation and post-residency surveys were matched and then de-identified.

RESULTS:

Sixty percent (394) who consented to participate responded. Nearly all graduates did abortions during residency (median of 31, including medical and procedural techniques). 86% fully participated in training, while 14% opted out for personal or religious reasons. 33% percent overall, and 40% of those who intended to, do abortions in current practice (median of 12 per month). An additional 36% do not do abortions but wish to, and 16% do not nor desire to provide abortion care. Physicians doing abortions are more likely to have fully participated (42% vs. 8%, P=.00) and did more abortions in training than those not doing abortions (median 32 vs. 16, P=.00). Those without an academic affiliation (n=134) are less likely to do abortions (23% vs. 45%, P=.00) and more likely to want to integrate abortion care (56% vs. 44%, P=.02).

DISCUSSION:

One-third of ob-gyns who trained in Ryan programs include abortion care in their practice. An additional third are unable to despite intending to at the time of their training. Further studies are needed to understand the barriers to integrating abortion care into practice.
How Clerkship Students Learn Procedural Skills
Authors: Martir Janel , Everett Elise
Published: September 2018

PURPOSE:

To assess how clerkship students at the Larner College of Medicine receive instruction in procedural skills during their clerkship in obstetrics and gynecology

BACKGROUND:

Achieving competence in procedural skills is an important but overlooked aspect of formal medical education. The Association of Professors of Gynecology and Obstetrics (APGO) defined nine basic clinical skills to be incorporated into clerkship curriculums in the United States. Clerkship students are expected to gain competency in these skills.

METHODS:

An online 16-question survey was distributed to third and fourth-year medical students. The survey listed the nine basic skills. For each skill, students indicated how they received procedural instruction. Data was collected anonymously. The survey was approved by the medical school IRB committee before distribution.

RESULTS:

We received a response rate of 43%. Per skill, the instructor varied with either residents or attendings as the primary educators. The most preferred method of instruction was a resident-led workshop and the second most preferred was an acting-intern led workshop. More than 65% and 75% of students indicated that their confidence in performing the skill would have increased with more instruction and with more practice respectively.

DISCUSSION:

Results show that clerkship students rely on residents as teachers and suggest the potential role of acting interns as educators. These findings demonstrate the importance of developing, implementing, maintaining and assessing a robust Resident and Medical Student as Teacher curriculums to equip residents and senior medical students with a teaching skills set to facilitate the learning of the acquisition of technical skills for clerkship students.
Creating a Win–Win: Medical Students as Assets in the Ambulatory Clinic
Authors: Zuo Stephanie , Valle Orlando , Salas Rachel , Gamaldo Charlene , Patel Silka
Published: September 2018

PURPOSE:

To determine whether exemplary OBGYN clinician educators maintain productivity with medical students in the ambulatory setting and if so, to design a clinic workflow to optimize medical student involvement in outpatient clinics.

BACKGROUND:

With the challenges of integrating clinical, documentation, and teaching responsibilities, it is not surprising that 40% of Hopkins OBGYN faculty feel that medical students decrease productivity (68% response). Yet recent research actually reports evidence of increases in physician productivity with medical student involvement in an outpatient Neurology clinic (Tanner et al, 2017).

METHODS:

Through a novel exemplary clinician educator program known as the “Osler Attending Preceptor in OBGYN,” six attendings were chosen based on student surveys and interviewed. Qualitative analysis was performed on interview data. Physician productivity data from the 2016-2017 academic year was obtained from department administrators.

RESULTS:

The six Osler Attendings (OAs) were generalists, and three are actively involved in the medical student clerkship. OAs at one suburban clinic billed on average 18-32% more work-adjusted RVUs when a student was present in clinic. Data analysis for OAs at two hospital-based clinics will be completed in the next month. Additionally, OA productivity with and without a medical student will be compared to non-OA designated faculty controls. Using an iterative feedback process, we designed ideal workflow models for OBGYN clinic and procedure-only visits, with a plan to pilot these workflows in the next year to determine efficacy.

DISCUSSION:

When utilized effectively, medical students are an asset to physician productivity in the outpatient setting.
Assessment of a Sexual Health Curriculum for High School Students Delivered by OBGYN Residents
Authors: Kendall Kristen , Nelson Erica
Published: September 2018

PURPOSE:

The purpose of the project was to build a curriculum for high school students on sexual health including reproduction, contraception, pregnancy and sexually transmitted infections. This curriculum was delivered to the students by the SIU OBGYN residents. We evaluated the knowledge and attitudes of students, knowledge, skills and attitudes of the residents focussing on what their perceptions of the students.

BACKGROUND:

The teenage pregnancy and sexually transmitted infection rates for teens in the Sangamon County are higher than national averages. The residents expressed an interest in reaching out to schools. High school health teachers were contacted and overwhelmingly agreed to have the residents participate in health classes about reproductive health.

METHODS:

We built a curriculum based on ACOG materials and best practices for reproductive health. Needs assessments to measure knowledge and attitudes were given to a sample of high school students on reproductive topics. Another assessment was given to residents to gage skills in teaching as well as attitudes towards teen. Assessments of knowledge after the sessions were given to the students. Teachers were asked to rate the sessions and provide feedback. Residents completed a follow-up assessment.

RESULTS:

Students have large gaps in reproductive knowledge but have the perception they are knowledgeable. Accurate knowledge improved. Teaches overwhelmingly were satisfied with the material presented and the format. Residents had high satisfaction rates for this activity and better perceptions of students.

DISCUSSION:

Residents effectively administered a reproductive health care curriculum to high school students that was informative, well received and changed attitudes of students, teachers and residents.
Identifying and Addressing Medical Student Mistreatment in the OB/GYN Clerkship
Authors: Kappy Michelle , Holman Beth , Santen Sally , Skinner Bethany , Kempner Samantha , Hammoud Maya
Published: September 2018

PURPOSE:

To describe the University of Michigan's approach to collecting and addressing medical student mistreatment data in the OB/GYN clerkship.

BACKGROUND:

The learning environment of medical students has become an important topic of discussion within professional organizations such as the AAMC and LCME. Medical schools have been charged with mitigating medical student mistreatment and enacting steps to promote a positive learning environment.

METHODS:

We collected the data on student mistreatment from end-of-rotation evaluations, teaching evaluations, and an online reporting system available to medical students. This data was then reported in a stepwise approach to faculty and residents.

RESULTS:

In response to the question, “Students are treated in a professional/respectful manner in this clerkship,” as rated by a 5-point scale (strongly disagree to strongly agree), OB/GYN received scores of 3.55 and 3.61 in 2016 and 2017 academic years respectively (range 3.49-3.83 on all the other clerkships). A total of 32 narrative comments were submitted by 340 students related to mistreatment or unprofessional behavior. Frequent themes included students being treated as ‘stupid’ or discouraged from asking questions (8 comments), being treated in an unprofessional manner by staff (7 comments), feeling ignored or marginalized by faculty (4 comments), and faculty unprofessional behavior towards others (4 comments).

DISCUSSION:

The students on the OB/GYN clerkship report a high rate of mistreatment. Efforts are being made to intentionally communicate those results to educators in order to improve the learning environment for medical students.
Improved Strategies for Teaching Surgical Skills to Medical Students: Simulation and Beyond
Authors: Welch Eva , Jordan Sali , McLeod Francine , Marko Emily , Sheridan Michael
Published: September 2018

PURPOSE:

Develop a curriculum to optimize surgical skills and to increase operating room (OR) opportunities for medical students.

BACKGROUND:

Simulation-based strategies for teaching surgical skills are evolving. Using an innovative task trainer, we compared one-on-one deliberate practice to video-based self-guidance in the performance of two-handed knot tying and subcuticular suturing during the OBGYN clerkship.

METHODS:

A randomized prospective trial compared two groups of third year medical students in the same clerkship rotations. Group A received one-on-one deliberate practice undergoing three sessions with an instructor and Group B received unlimited access to video-based self-guided practice over six weeks. At the end of the clerkship, surgical performance was assessed using the validated checklist. Self-reported data regarding OR experience was collected using a specifically designed phone application.

RESULTS:

Fifty-nine students participated in the study. Group A demonstrated a statistically significant improvement in two-handed knot tying and subcuticular suturing in pre-post assessments (knot-tying +4.34, P<.001; suturing +19.4, P<.001). Group B demonstrated a statistically significant improvement (knot-tying +6.03, P<.001; suturing +22.3, P<.001). No significant differences were found between groups in overall knot-tying (P=.13), suturing (P=.14), hours practiced (P=.90), or number of OR cases (P=.49).

DISCUSSION:

The use of simulation significantly improved surgical skills for all students from baseline. No differences were found between one-on-one deliberate practice and video-based self-guided practice. Both instructional strategies provided equal efficacy in teaching surgical skills and optimizing surgical performance for students during the OBGYN clerkship.
Improvement in CREOG Scores Through Focused Review Sessions
Authors: Cook Ian , Marcum Miriam , Xu Yan , Qi Ya , McQuerry Kristen , DeSimone Christopher
Published: September 2018

PURPOSE:

To determine if focused review sessions lead to improvement in CREOG scores.

BACKGROUND:

In 2013, faculty at the University of Kentucky developed a Gynecologic Oncology (GYO) review aimed at improving resident scores.

METHODS:

Each year, residents voluntarily participated in five review sessions on major topics in GYO. Sessions consisted of a pre-test (approximately 15 questions) followed by a discussion that emphasized the key concepts for that subject. From 2014-2017, GYO scores were compared between residents who attended (A) over 50% of the sessions and those who did not (NA). Scores from 2010-2013 were collected as a control group (C). SAS (9.4) was used to analyze the data via ANOVA with repeated measures and least square difference pairwise comparisons. Significance was defined as P<.05.

RESULTS:

Data was collected on 153 tests from 55 residents (80 from 2010-13 and 73 from 2014-17). The mean scores for GYO and overall test increased with each resident year (P<.0001). Attendance revealed a statistically significant improvement on GYO scores when compared to NA (P=.0001) and C (P=.0008). There was no difference between C and NA (P=.3875). Those who attended also scored significantly higher on overall test scores compared to NA (P=.0002). There was no difference between A and C (P=.1747). For those residents who attended multiple years of review sessions, there was no significant improvement in GYO or overall scores compared to less frequent attendees.

DISCUSSION:

Our findings support the hypothesis that focused review sessions improved resident comprehension as reflected by CREOG scores.
Piloting a Resident-Oriented Leadership Training Program Using the Leadership Observation and Feedback Tool (LOFT)
Authors: Santoro Nanette , Jones Kelsey , Allshouse Amanda , Alston Meredith , Landry Elaine , Aagaard Eva
Published: September 2018

PURPOSE:

To pilot a leadership training program for residents designed to develop interprofessional and team management skills.

BACKGROUND:

Leadership in medicine is increasingly important, however many residency programs lack curricula on how to effectively lead and work on a team of healthcare professionals.

METHODS:

Myers-Briggs Personality Inventory and debriefing were performed prior to intervention for all participants as a preparatory step. Pilot curriculum consisted of 360-feedback, and four 30-minute, interactive, didactic sessions addressing topics in leadership. Residents were randomized to: 1) feedback-only, 2) didactic sessions-only, 3) both, and 4) neither (controls). 360 feedback was obtained using the LOFT, a 29-item questionnaire designed to assess resident leadership behaviors. Evaluations were completed before and after a rotation by 2 to 5 raters (supervisors, peers, and subordinates blinded to randomization status). Trained human resource professionals conveyed 360 feedback. Faculty gave didactics in groups of 1-6 residents. We compared change in LOFT score, adjusted for baseline, between randomization groups in a linear mixed-effects model.

RESULTS:

Twenty-nine residents completed the pilot and 5-10 per group were available for analysis. Total LOFT score improved (mean change 4.9 points; P<.001), however, improvement did not significantly differ among any treatment group or controls. Similarly, improvement in each LOFT domain (coaching:1.62, P=.002, project management:1.81, P<.001, and self-control: 1.41, P<.001), was significant but not different by randomization group. Among residents with the lowest quartile of average baseline LOFT, feedback was associated with significantly more improvement than no feedback (3.61, P=.001). Didactic sessions were not associated with significant improvement overall or by domain.

DISCUSSION:

Performance feedback has the potential to improve resident leadership behavior as assessed by 360 evaluation. In this pilot study, significant improvement was only observed amongst those with the most room for improvement.
Use of Forum Theater to Improve the Clinical Learning Environment
Authors: Harris Benjamin , Arnold Jade , Knudsen Nancy , Muasher Lisa
Published: September 2018

PURPOSE:

To practice difficult conversations between teachers and learners utilizing Forum Theater techniques exploring differences in perceptions of mistreatment.

BACKGROUND:

Reports of student mistreatment remain unacceptably high at Duke University School of Medicine. Addressing the learning environment with lectures, anonymous reporting and personal coaches has had little effect. The humanities have been used for building empathy in physicians. In interactive or Forum Theater, spectators have opportunities to express opinions and make decisions while the actors incorporate the suggestions as they re-play a scene over again. The technique of Forum Theater has been used for medical faculty development for improving handling of student multiculturalism with positive results.

METHODS:

After IRB approval, 2 Forum theater sessions were held as OB-Gyn Grand Rounds with scenes depicting interactive challenges. The learning environment dean led discussion on the scenes before re-enactment with audience input. A brief survey was collected on the Playbill regarding demographics, mistreatment attitudes and opinions on Forum Theater. Replies between students and residents were compared with Fishers Exact analysis.

RESULTS:

110 attendees participated in 2 Forum Theater sessions. 41 participants completed surveys-12 medical students, 17 residents, 4 fellows and 8 faculty. Students agreed with statements that medical student mistreatment is prevalent at the school and in the department significantly more often than the residents. (P<.05) There were no differences between responses on the learning environment in the clerkship. 83% of participants reported that Forum theater raised mistreatment awareness and could improve the learning environment.

DISCUSSION:

Forum Theater holds promise as a tool for addressing learning environment challenges.
Development of a Comprehensive Clerkship Assessment Tool
Authors: Bodine Andrea M.
Published: September 2018

Local Mentor:

Michael Plevyak, MD

APGO Advisor:

Lee A. Learman, MD, PhD

PROBLEM:

The medical school curriculum, core competencies, learning objectives, and assessment tool should align with the 14 Entrustable Professional Activities (EPAs) required for medical licensure in 2020.

METHODS:

A new “EPA Assessment Tool” was developed to address the 9 EPAs to be achieved during the third-year clerkship. Tool development was guided by a literature search to identify publications and existing evaluation tools pertinent to EPAs, competencies, medical education curriculum, osteopathic curriculum, APGO medical student objectives, ACGME milestones, NBME requirements, and institutional clerkship objectives. The EPA Assessment Tool includes 20 qualitative items representing six competency domains with responses that are classified using a rubric to one of four levels (from unsatisfactory to high honors). Reliability and validity will be assessed by comparing the EPA Assessment Tool scores with traditional evaluation scores from the same evaluators, a global assessment question, and Comprehensive Osteopathic Medical Achievement Test scores for the first three clerkship rotations. Feasibility will be assessed by evaluator ratings and evaluation completeness. IRB approval/exemption was obtained for the participating sites.

CONTEXT:

The tool was pilot-tested at Berkshire Medical Center for eight students in all disciplines, and at Eastern CT Health Network for two Ob/Gyn students.

OUTCOME/LESSONS LEARNED:

Preliminary data suggest no difference between forms. Evaluators express concern regarding decreased ease of use. Continued use of the tool and knowledge of the milestones will increase evaluator's familiarity and comfort. The pilot study will continue for the remainder of the 2017-18 academic year to gain further data for reliability and validity analysis.
Implementation and Evaluation of a Structured Program to Promote Resident Scholarly Activity
Authors: Chaudhry Taimur
Published: September 2018

Local Mentor:

Mark B. Woodland, MS, MD

APGO Advisor:

Kimberly Kenton, MD

PROBLEM:

The annual Accreditation Council for Graduate Medical Education (ACGME) Resident Surveys for our independent academic medical center (IAMC) indicated that our OB/GYN residents were not satisfied with opportunities for scholarly activity.

INTERVENTION:

After financial and programmatic support was secured from the department chair, the faculty made a commitment to attend bimonthly 2-hour research/QI meetings with the residents during their protected didactic time. Also, the department employed an experienced clinical researcher to facilitate access to statistical support for the residents.

CONTEXT:

The ACGME Common Program Requirements mandate that residents should participate in scholarly activity. Our ACGME Resident Surveys indicated that the residents were not satisfied with opportunities for scholarly activity. As a result, our Program Evaluation Committee decided that this was an opportunity to improve the educational experience of the residents.

OUTCOME/LESSONS LEARNED:

Within 8 months of implementation of this program, the ACGME Resident Surveys demonstrated improved resident satisfaction with opportunities for scholarly activity from 25% in 2016 to 73% in 2017. There was also increased resident participation in QI projects and residents were getting involved earlier in their training.