The mini-clinical evaluation exercise during medical clerkships: are learning needs and learning goals aligned?

OBJECTIVES The generation of learning goals (LGs) that are aligned with learning needs (LNs) is one of the main purposes of formative workplace-based assessment. In this study, we aimed to analyse how often trainer–student pairs identified corresponding LNs in mini-clinical evaluation exercise (mini-CEX) encounters and to what degree these LNs aligned with recorded LGs, taking into account the social environment (e.g. clinic size) in which the mini-CEX was conducted. METHODS Retrospective analyses of adapted mini-CEX forms (trainers’ and students’ assessments) completed by all Year 4 medical students during clerkships were performed. Learning needs were defined by the lowest score(s) assigned to one or more of the mini-CEX domains. Learning goals were categorised qualitatively according to their correspondence with the six mini-CEX domains (e.g. history taking, professionalism). Following descriptive analyses of LNs and LGs, multi-level logistic regression models were used to predict LGs by identified LNs and social context variables. RESULTS A total of 512 trainers and 165 students conducted 1783 mini-CEXs (98% completion rate). Concordantly, trainer–student pairs most often identified LNs in the domains of ‘clinical reasoning’ (23% of 1167 complete forms), ‘organisation/efficiency’ (20%) and ‘physical examination’ (20%). At least one ‘defined’ LG was noted on 313 student forms (18% of 1710). Of the 446 LGs noted in total, the most frequently noted were ‘physical examination’ (49%) and ‘history taking’ (21%). Corresponding LNs as well as social context factors (e.g. clinic size) were found to be predictors of these LGs. CONCLUSIONS Although trainer–student pairs often agreed in the LNs they identified, many assessments did not result in aligned LGs. The sparseness of LGs, their dependency on social context and their partial non-alignment with students’ LNs raise questions about how the full potential of the mini-CEX as not only a ‘diagnostic’ but also an ‘educational’ tool can be exploited.

Securing one's livelihood. Philanthropy in a mixed economy of welfare in the early 20th century

Since the late 19th century different social actors have played an important role in providing social security in Switzerland. Cooperatives, philanthropic organisations, social insurances, and the poor relief of the communes were all part of a "mixed economy of welfare". This article examines how the different actors in this "mixed economy" worked together, and asks what forms of help they supplied. It raises the question of whether a dichotomy between public and private forms of relief can be traced in the Swiss case. Did democratically legitimised processes of redistribution shape the social security system? Or was social security rather funded by private relief programs? The author argues that in the early 20th century, a complex public-private mix structured the Swiss welfare state and the poor often depended on both public and private funding. In this system, financially potent philanthropic organisations successfully contested the legal power of public actors.

“Crye Fredome”? Medievalism and Twenty-First-Century Scottish National Identity

It is a well-documented fact that the Middle Ages have had a long history of instrumentalisation by nationalisms. 19th-century Eu¬rope in particular witnessed an origins craze during the process of nation-building. In the post-Shoah, post-modern West, on the other hand, we might expect this kind of medievalist master nar¬rative to have been consigned to the dustbin of history. And yet, as nationalism surges again in Europe, negotiations of national identi¬ties in medieval dress seem to have become fashionable once more. In order to come to terms with the fragmented and often contradictory presence of the Middle Ages in these discourses of national identity, I propose we consider medievalism a utilitarian product of the cultural memory. Rather than representing any ‘real’ Middle Ages, then, medievalism tailors available knowledge of the medieval past to the diverse social needs and ideologies of the present. This paper looks at a selection of Scottish examples of present-day medievalism in an attempt to investigate, in particular, the place of the medieval Wars of Scottish Independence in contemporary negotiations of ‘Scottishness’. Both the relationships envisioned between self and other and the role played by ‘the land’ in these cultural, social and political instances of national introspection offer starting points for critical inquiry. Moreover, the analysis of a scholarly intervention in the run-up to the 2014 Scottish independence referendum indicates an intriguing dialogue of academic and non-academic voices in the context of Scottish medievalist cultural memory. We thus find a wide array of uses of the Scottish Middle Ages, some of which feed into the burgeoning nationalism of recent years, while others offer more pensive and ambivalent answers to the question of what it means to be Scottish in the 21st century.

Texas Medical Center --- Its Origins

This document details the people and institutions who were instrumental in the establishment and development of the Texas Medical Center (TMC). Biographical information about the founders, role the M. D. Anderson Foundation, and opening of the main institutions in the early 1950s is detailed. A copy of a speech given in 1958 by W. B. Bates, one of the trustees of the M. D. Anderson Foundation, on the history and development of the TMC is significant because he was one of the founders of the TMC. This document was commissioned by the Houston Chamber of Commerce in 1971 as the Texas Medical Center began a new phase of expansion with the pending addition of The University of Texas Medical School at Houston. It includes information about each of the 21 institutions which comprised the TMC at that time.

Transverse drainages of the Susquehanna River basin, Pennsylvania, USA

While large-scale transverse drainages (TDs) such as those of the Susquehanna River above Harrisburg, PA, have been recognized since the 19th century, there have been no systematic surveys done of TDs since that of Ver Steeg's in 1930. Here, the results are presented of a topographic and statistical analysis of TDs in the Susquehanna River basin using Google Earth and associated overlays. 653 TDs were identified in the study area, 95% of which contain streams with discharges of less than 10 m3/s. TD depths ranged from a 23 m deep water gap near Blain, PA, to the 539 m deep gorge of the Juniata River through Jacks Mountain. Although TD depth tended to increase with stream size, many small streams were located in deep gaps, and eight streams with discharges of 10 m3/s or less were found in gorges whose depths matched or exceeded the deepest TD of the Susquehanna, the largest stream in the basin. Streams of less than 10 m3/s made up the majority of TDs regardless of the rock type capping the breached structure. Overall, TDs through sandstone-capped ridges were deeper than those topped by shales, and TDs in both sandstones and shales displayed a lognormal distribution of depths, which may be indicative of a preferred value. Stream flow direction was primarily perpendicular to local structural strike, with 47% of streams flowing NW and 53% flowing SE. 19% of the TDs were found to be in alignment with at least one other TD, with aligned segment lengths ranging from .5 to 14.8 km. The majority of TDs were in rocks of Paleozoic age. The techniques described here allow the frequency and distribution of TDs to be quantified so that they can be integrated into models of basin evolution.

Lipid biomarkers in the Enol Lake (Asturias, Northern Spain): coupled natural and human induced environmental history

The lipid content of three cores from Lake Enol (Picos de Europa National Park, Asturias, Northern Spain) was studied. The n-alkane profiles indicated a major input from terrigenous plants [predominance of high molecular weight (HMW) alkanes] since ca. 1695 AD to the water body, although the uppermost cm revealed a predominance of organic matter (OM) derived from algae, as the most abundant alkane was C17. Three units revealing different environmental conditions were defined. Unit A (ca. 1695–1860 AD) in the lowermost parts of ENO13-10 (< 12 cm) and ENO13-15 (< 28 cm) was identified and was characterized by higher OM input and evidence of minimal degradation (high CPI values, predominance of HMW n-alkanoic acids and good correspondence between the predominant n-alkane and n-alkanoic acid chains). These findings could be linked to the Little Ice Age, when cold and humid conditions may have favored an increase in total organic carbon (TOC) and n-alkane and n-alkanoic acid content (greater terrigenous OM in-wash), and may have also reduced bacterial activity. In Unit B (ca. 1860–1980 AD) the lack of correspondence between the n-alkane and n-alkanoic acid profiles of ENO13-10 (12–4 cm) and ENO13-15 (28–8 cm) suggested a certain preferential microbial synthesis of long chain saturated fatty acids from primary OM and/or bacterial activity, coinciding with a decrease in OM input, which could be linked to the global warming that started in the second half of the 19th century. In ENO13-7 the low OM input (low TOC) was accompanied by some bacterial degradation (predominance ofHMWn-alkanoic acids but with a bimodal distribution) in the lowermost 16–5 cm. Evidence of considerable phytoplankton productivity and microbial activity was especially significant in Unit C (ca. 1980–2013 AD) identified in the uppermost part of all three cores (5 cm in ENO13-7, 4 cm in ENO13-10 and 8 cm in ENO13-15), coinciding with higher concentrations of n-alkanes and n-alkanoic acids, which were considered to be linked to warmer and drier conditions, as well as to greater anthropogenic influence in modern times. Plant sterols, such as b-sitosterol, campesterol and stigmasterol, were significantly present in the cores. In addition, fecal stanols, such as 24-ethylcoprostanol from herbivores, were present, thereby indicating a continuous and significant pollution input derived from these animals since the 17th century, being more important in the last 20 years.

Black History Month Exhibit: Opening Doors: Contemporary African American Academic Surgeons

Opening Doors: Contemporary African American Academic Surgeons is an exhibition celebrating the contributions of African American academic surgeons to medicine and medical education. It tells the stories of four pioneering African American surgeons and educators who exemplify excellence in their fields and believe in continuing the journey of excellence through the education and mentoring younger physicians and surgeons. Through contemporary and historical images, the exhibition takes the visitor on a journey through the lives and achievements of these academic surgeons, and provides a glimpse into the stories of those that came before them and those that continue the tradition today. The exhibition will open at Inman E. Page Library, January 21st, 2016 and close on February 27, 2016.

Sites of Chemistry in the Nineteenth Century

The three articles in this special issue of Ambix were among the twenty-one papers presented at the conference “Sites of Chemistry in the Nineteenth Century,” held in Valencia at the Institute for the History of Medicine and Science ‘López Piñero’ in July 2012. This meeting was the second of the series of conferences organised as part of the project Sites of Chemistry, 1600–2000, the aim of which was to investigate the wide and diverse range of physical spaces and places where chemistry has been practised from the early modern period to the twentieth century.

Index of Harvard graduates in the classes of 1642-1772, (manuscript notebook), ca. 1772-1791

Notebook containing an alphabetical index of Harvard graduates from 1642 to 1772. The author is unidentified, but the handwriting appears to be that of Harvard President Samuel Langdon (president from 1774 - 1780). The names are arranged alphabetically by surname. Each entry includes the graduate's name, additional degrees (Master, STD, MD, etc.), the year of graduation, and an asterisk if the individual was deceased. The asterisks are included for some graduates who died in 1791, indicating the work was created and updated between 1772 and 1791.

Questiones propositae pro modulo discutiendae Comitiis publicis Harvardini Collegii quod est divin. provid. Cantabrigiae Nov-Anglorum a Laureae Magistralis candidatis, 1660-1753

The bound volume holds handwritten transcriptions of selected Harvard Commencement Quaestiones copied by Isaac Mansfield (Harvard AB 1742). The manuscript volume includes from the 1708 Quaestiones onward, the notation "N.B." next to questions performed by the candidate during the Commencement exercises; the original printed Quaestiones sheets do not note this information. The volume includes Quaestiones transcriptions for which no original broadsides are known to still exists.

Medical Curriculum Change at Queen's-affiliated Medical Colleges: 1881 – 1910

This study explores the curriculum at Queen’s-affiliated medical colleges, specifically The Royal College of Physicians and Surgeons, Kingston, the Kingston Women’s Medical College, and Queen’s Medical College, from 1881 to 1910, using the textbooks prescribed by these institutions as primary sources. The central question encompasses what factors primarily motivated the curriculum at Queen’s-affiliated medical colleges to change. Within the historiographical scholarship on Queen’s College, this question has not yet been addressed and, to my knowledge, this is the first medical education history to specifically address textbooks as part of a medical school curriculum. During this period, these institutions experienced reorganizational shifts, such as the reunification of Queen’s Medical College with The Royal College of Physicians and Surgeons, Kingston, as well as the introduction and subsequent exclusion of female students. Within this context, this study examines how the forces of scientific innovation and co-education impacted the curriculum during the period under study, as measured by textbook change, specifically in the courses of obstetrics and gynaecology, the theory and practice of medicine, and surgery. To what degree was curriculum in these courses responsive to scientific inventions and discoveries, changing therapeutic practices, and possible gender biases? From 1881 to 1910, innovations such as x-ray and anaesthesia became commonplace within medical practice. Some technologies gained acceptance in the curriculum, while others fell out of favour. This study tracks these scientific discoveries through the textbooks used at Queen’s-affiliated medical colleges in order to demonstrate how the evolving nature of medicine was represented in the curriculum. To address how gender influenced the curriculum, textbooks from the Kingston Women’s Medical College and The Royal College of Physicians and Surgeons, Kingston, were compared. For two out of the three examined courses, it was found that sections of textbooks discussing various topics at the Kingston Women’s Medical College contained significantly more detail than their corresponding sections within The Royal College’s textbooks. It was speculated that the instructors preferred to teach their female students through textbooks, rather than lectures.

A history of education in New Mexico. Pertinent advice to students. Education and its relations to the discovery, conquest, civilization and colonization of New Mexico; the minister of God and the teacher,

Mode of access: Internet.

Collectanea antiqua : etchings and notices of ancient remains, illustrative of the habits, customs, and history of past ages /

Vol. 3-7 bear imprint: Printed for subscribers only & not published.

A history of religious education in the Episcopal Church to 1835,

Bibliography: p. [331]-348.