Computer-based summative assessment of clinical reasoning in clerkships: A mixed-method comparison of key feature problems with case-based multiple choice questions

Background: It is yet unclear if there are differences between using electronic key feature problems (KFPs) or electronic case-based multiple choice questions (cbMCQ) for the assessment of clinical decision making. Summary of Work: Fifth year medical students were exposed to clerkships which ended with a summative exam. Assessment of knowledge per exam was done by 6-9 KFPs, 9-20 cbMCQ and 9-28 MC questions. Each KFP consisted of a case vignette and three key features (KF) using “long menu” as question format. We sought students’ perceptions of the KFPs and cbMCQs in focus groups (n of students=39). Furthermore statistical data of 11 exams (n of students=377) concerning the KFPs and (cb)MCQs were compared. Summary of Results: The analysis of the focus groups resulted in four themes reflecting students’ perceptions of KFPs and their comparison with (cb)MCQ: KFPs were perceived as (i) more realistic, (ii) more difficult, (iii) more motivating for the intense study of clinical reasoning than (cb)MCQ and (iv) showed an overall good acceptance when some preconditions are taken into account. The statistical analysis revealed that there was no difference in difficulty; however KFP showed a higher discrimination and reliability (G-coefficient) even when corrected for testing times. Correlation of the different exam parts was intermediate. Conclusions: Students perceived the KFPs as more motivating for the study of clinical reasoning. Statistically KFPs showed a higher discrimination and higher reliability than cbMCQs. Take-home messages: Including KFPs with long menu questions into summative clerkship exams seems to offer positive educational effects.

Computerbasierte Prüfung von klinischem Denken in der klinischen Ausbildung: Ein Mixed-Method Vergleich von Key Feature Problemen mit fallbasierten Multiple Choice Typ A Fragen

Fragestellung/Einleitung: Es ist unklar inwiefern Unterschiede bestehen im Einsatz von Key Feature Problemen (KFP) mit Long Menu Fragen und fallbasierten Typ A Fragen (FTA) für die Überprüfung des klinischen Denkens (Clinical Reasoning) in der klinischen Ausbildung von Medizinstudierenden. Methoden: Medizinstudierende des fünften Studienjahres nahmen an ihrer klinischen Pädiatrie-Rotation teil, die mit einer summativen Prüfung endete. Die Überprüfung des Wissen wurde pro Prüfung elektronisch mit 6-9 KFP [1], [3], 9-20 FTA und 9-28 nichtfallbasierten Multiple Choice Fragen (NFTA) durchgeführt. Jedes KFP bestand aus einer Fallvignette und drei Key Features und nutzen ein sog. Long Menu [4] als Antwortformat. Wir untersuchten die Perzeption der KFP und FTA in Focus Gruppen [2] (n of students=39). Weiterhin wurden die statistischen Kennwerte der KFP und FTA von 11 Prüfungen (n of students=377) verglichen. Ergebnisse: Die Analyse der Fokusgruppen resultierte in vier Themen, die die Perzeption der KFP und deren Vergleich mit FTA darstellten: KFP wurden als 1. realistischer, 2. schwerer, und 3. motivierender für das intensive Selbststudium des klinischen Denkens als FTA aufgenommen und zeigten 4. insgesamt eine gute Akzeptanz sofern gewisse Voraussetzungen berücksichtigt werden. Die statistische Auswertung zeigte keinen Unterschied im Schwierigkeitsgrad; jedoch zeigten die KFP eine höhere Diskrimination und Reliabilität (G-coefficient) selbst wenn für die Prüfungszeit korrigiert wurde. Die Korrelation der verschiedenen Prüfungsteile war mittel. Diskussion/Schlussfolgerung: Die Studierenden erfuhren die KFP als motivierenden für das Selbststudium des klinischen Denkens. Statistisch zeigten die KFP eine grössere Diskrimination und höhere Relibilität als die FTA. Der Einbezug von KFP mit Long Menu in Prüfungen des klinischen Studienabschnitts erscheint vielversprechend und einen „educational effect“ zu haben.

Who cares about my feature request?

Previous studies on issue tracking systems for open source software (OSS) focused mainly on requests for bug fixes. However, requests to add a new feature or an improvement to an OSS project are often also made in an issue tracking system. These inquiries are particularly important because they determine the further development of the software. This study examines if there is any difference between requests of the IBM developer community and other sources in terms of the likelihood of successful implementation. Our study consists of a case study of the issue tracking system BugZilla in the Eclipse integrated development environment (IDE). Our hypothesis, which was that feature requests from outsiders have less chances of being implemented, than feature requests from IBM developers, was confirmed.

Automatic Stabilizer Feature of Fixed Exchange Rate Regimes in Emerging Markets

This paper shows that countries characterized by a financial accelerator mechanism may reverse the usual finding of the literature -- flexible exchange rate regimes do a worse job of insulating open economies from external shocks. I obtain this result with a calibrated small open economy model that endogenizes foreign interest rates by linking them to the banking sector's foreign currency leverage. This relationship renders exchange rate policy more important compared to the usual exogeneity assumption. I find empirical support for this prediction using the Local Projections method. Finally, 2nd order approximation to the model finds larger welfare losses under flexible regimes.

A MOLECULAR APPROACH FOR DETECTING GENETIC DAMAGE USING THE ECO R1 FAMILY OF HUMAN DNA (SEQUENCING)

A clone of the primary Eco R1 family of human DNA sequences has been used as an indicator sequence for detecting alterations induced by a toxic agent. Specific clones of this family have been examined and compared to the consensus sequence to determine the normal variability of this family. Though variations were observed, data indicated that such clones can be used to study induced DNA modifications. This DNA was exposed to the toxic agent dimethyl sulfate under various conditions and a distinct pattern of aberrations was shown to occur. It is suggested that this approach be used to characterize patterns of damage induced by various agents in the ultimate development of a system capable of monitoring human genotoxic exposure. ^

Radiomics of NSCLC: Quantitative CT Image Feature Characterization and Tumor Shrinkage Prediction

Radiomics is the high-throughput extraction and analysis of quantitative image features. For non-small cell lung cancer (NSCLC) patients, radiomics can be applied to standard of care computed tomography (CT) images to improve tumor diagnosis, staging, and response assessment. The first objective of this work was to show that CT image features extracted from pre-treatment NSCLC tumors could be used to predict tumor shrinkage in response to therapy. This is important since tumor shrinkage is an important cancer treatment endpoint that is correlated with probability of disease progression and overall survival. Accurate prediction of tumor shrinkage could also lead to individually customized treatment plans. To accomplish this objective, 64 stage NSCLC patients with similar treatments were all imaged using the same CT scanner and protocol. Quantitative image features were extracted and principal component regression with simulated annealing subset selection was used to predict shrinkage. Cross validation and permutation tests were used to validate the results. The optimal model gave a strong correlation between the observed and predicted shrinkages with . The second objective of this work was to identify sets of NSCLC CT image features that are reproducible, non-redundant, and informative across multiple machines. Feature sets with these qualities are needed for NSCLC radiomics models to be robust to machine variation and spurious correlation. To accomplish this objective, test-retest CT image pairs were obtained from 56 NSCLC patients imaged on three CT machines from two institutions. For each machine, quantitative image features with concordance correlation coefficient values greater than 0.90 were considered reproducible. Multi-machine reproducible feature sets were created by taking the intersection of individual machine reproducible feature sets. Redundant features were removed through hierarchical clustering. The findings showed that image feature reproducibility and redundancy depended on both the CT machine and the CT image type (average cine 4D-CT imaging vs. end-exhale cine 4D-CT imaging vs. helical inspiratory breath-hold 3D CT). For each image type, a set of cross-machine reproducible, non-redundant, and informative image features was identified. Compared to end-exhale 4D-CT and breath-hold 3D-CT, average 4D-CT derived image features showed superior multi-machine reproducibility and are the best candidates for clinical correlation.

Coordenadas de lo posmoderno : un texto fundacional: El nombre de la rosa de U. Eco

Fil: Corti, Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas

El asedio : Eco del mundo novelesco de Arturo Pérez Reverte

El asedio (2010), de Arturo Pérez Reverte, ofrece una multiplicidad de entradas posibles, ya que se trata de una voluminosa novela coral, que concentra la experiencia de su autor. Proponemos, para este encuentro, un enfoque centrado en analizar los universos de los personajes y su trabazón caleidoscópica. Pérez Reverte utiliza siempre una tercera persona que se cuela en las zonas oscuras y recónditas de tipos humanos inmersos en una ciudad y un tiempo hostiles: Cádiz en 1811. Despliega las condiciones de asedio militar a ese territorio, que se replican de variados modos en individuos asediados por sus propios conflictos. La naturalidad con la que los personajes se encuentran en puntos de unión y de fuga conforma una telaraña, cuyos hilos representan la trabazón de esta novela de novelas

Reflexiones desde la eco-antropología sobre el terroir

El Terroir constituye en la actualidad un concepto clave en el pensamiento sobre la producción de alimentos y de bebidas de calidad. En este texto, consideramos esta noción con un punto de vista eco-antropológico apoyándonos sobre ejemplos sacados principalmente de la historia y de la actualidad de ciertos vinos. Estudiamos sucesivamente su construcción, sus usos (en particular en el marco de los procesos de denominación de origen) y sus representaciones.

Reflexiones desde la eco-antropología sobre el terroir

El Terroir constituye en la actualidad un concepto clave en el pensamiento sobre la producción de alimentos y de bebidas de calidad. En este texto, consideramos esta noción con un punto de vista eco-antropológico apoyándonos sobre ejemplos sacados principalmente de la historia y de la actualidad de ciertos vinos. Estudiamos sucesivamente su construcción, sus usos (en particular en el marco de los procesos de denominación de origen) y sus representaciones.

El asedio : Eco del mundo novelesco de Arturo Pérez Reverte

El asedio (2010), de Arturo Pérez Reverte, ofrece una multiplicidad de entradas posibles, ya que se trata de una voluminosa novela coral, que concentra la experiencia de su autor. Proponemos, para este encuentro, un enfoque centrado en analizar los universos de los personajes y su trabazón caleidoscópica. Pérez Reverte utiliza siempre una tercera persona que se cuela en las zonas oscuras y recónditas de tipos humanos inmersos en una ciudad y un tiempo hostiles: Cádiz en 1811. Despliega las condiciones de asedio militar a ese territorio, que se replican de variados modos en individuos asediados por sus propios conflictos. La naturalidad con la que los personajes se encuentran en puntos de unión y de fuga conforma una telaraña, cuyos hilos representan la trabazón de esta novela de novelas

El asedio : Eco del mundo novelesco de Arturo Pérez Reverte

El asedio (2010), de Arturo Pérez Reverte, ofrece una multiplicidad de entradas posibles, ya que se trata de una voluminosa novela coral, que concentra la experiencia de su autor. Proponemos, para este encuentro, un enfoque centrado en analizar los universos de los personajes y su trabazón caleidoscópica. Pérez Reverte utiliza siempre una tercera persona que se cuela en las zonas oscuras y recónditas de tipos humanos inmersos en una ciudad y un tiempo hostiles: Cádiz en 1811. Despliega las condiciones de asedio militar a ese territorio, que se replican de variados modos en individuos asediados por sus propios conflictos. La naturalidad con la que los personajes se encuentran en puntos de unión y de fuga conforma una telaraña, cuyos hilos representan la trabazón de esta novela de novelas