Can We Learn in the Sandbox Together?: Interprofessional Case Conferences as Facilitation Tools

Duke Medicine utilized interprofessional case conferences (ICCs) from 2008-2012 with the objective of modeling and facilitating development of teamwork skills among diverse health profession students, including physical therapy, physician assistant, medical doctor and nursing. The purpose of this publication was to describe the operational process used to develop and implement the ICCs and measure the success of the ICCs in order to shape future work. The ICCs were offered to develop skills and attitudes essential for participation in healthcare teams. Students were facilitated by faculty of different professions to conduct a comprehensive historical assessment of a standardized patient (SP), determine pertinent physical and lab assessments to undertake, and develop and share a comprehensive management plan. Cases included patient problems that were authentic and relevant to each professional student in attendance. The main barriers to implementation are outlined and the focus on the process of working together is highlighted. Evaluation showed high satisfaction rates among participants and the outcomes from these experiences are presented. The limitations of these results are discussed and recommendations for future assessment are emphasized. The ICCs demonstrated that students will come together voluntarily to learn in teams, even at a research-focused institution, and express benefit from the collaborative exercise.

Overview of FEED, the feeding experiments end-user database.

The Feeding Experiments End-user Database (FEED) is a research tool developed by the Mammalian Feeding Working Group at the National Evolutionary Synthesis Center that permits synthetic, evolutionary analyses of the physiology of mammalian feeding. The tasks of the Working Group are to compile physiologic data sets into a uniform digital format stored at a central source, develop a standardized terminology for describing and organizing the data, and carry out a set of novel analyses using FEED. FEED contains raw physiologic data linked to extensive metadata. It serves as an archive for a large number of existing data sets and a repository for future data sets. The metadata are stored as text and images that describe experimental protocols, research subjects, and anatomical information. The metadata incorporate controlled vocabularies to allow consistent use of the terms used to describe and organize the physiologic data. The planned analyses address long-standing questions concerning the phylogenetic distribution of phenotypes involving muscle anatomy and feeding physiology among mammals, the presence and nature of motor pattern conservation in the mammalian feeding muscles, and the extent to which suckling constrains the evolution of feeding behavior in adult mammals. We expect FEED to be a growing digital archive that will facilitate new research into understanding the evolution of feeding anatomy.

Facilitation shifts paradigms and can amplify coastal Restoration efforts

Restoration has been elevated as an important strategy to reverse the decline of coastal wetlands worldwide. Current practice in restoration science emphasizes minimizing competition between outplanted propagules to maximize planting success. This paradigm persists despite the fact that foundational theory in ecology demonstrates that positive species interactions are key to organism success under high physical stress, such as recolonization of bare substrate. As evidence of how entrenched this restoration paradigm is, our survey of 25 restoration organizations in 14 states in the United States revealed that >95% of these agencies assume minimizing negative interactions (i.e., competition) between outplants will maximize propagule growth. Restoration experiments in both Western and Eastern Atlantic salt marshes demonstrate, however, that a simple change in planting configuration (placing propagules next to, rather than at a distance from, each other) results in harnessing facilitation and increased yields by 107% on average. Thus, small adjustments in restoration design may catalyze untapped positive species interactions, resulting in significantly higher restoration success with no added cost. As positive interactions between organisms commonly occur in coastal ecosystems (especially in more physically stressful areas like uncolonized substrate) and conservation resources are limited, transformation of the coastal restoration paradigm to incorporate facilitation theory may enhance conservation efforts, shoreline defense, and provisioning of ecosystem services such as fisheries production.