Alignment between learning needs and learning goals of Mini-CEX in clerkships

Background: Defining learning goals (LG) in alignment with learning needs (LN) is one of the key purposes of formative workplace-based assessment, but studies about this topic are scarce. Summary of Work: We analysed quantitatively and qualitatively how often trainer-student pairs identified the same LN during Mini Clinical Evaluation Exercises (Mini-CEX) in clerkships and to what degree those LNs were in line with the recorded LGs. Multilevel logistic regression models were used to predict LGs by identified LNs, controlling for context variables. Summary of Results: 512 trainers and 165 students conducted 1783 Mini-CEX (98% completion rate). Concordantly, trainer-student pairs most often identified LNs in the domains ‘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), with a total of 446 LGs. Of these, the most frequent LGs were ‘physical examination’ (49% of 446 LGs) and ‘history taking’ (21%); corresponding LNs as well as context variables (e.g. clinic size) were found to be predictors of these LGs. Discussion and Conclusions: Although trainer-student pairs often agreed in their identified LNs, many assessments did not result in an aligned LG or a LG at all. Interventions are needed to enhance the proportion of (aligned) LGs in Mini-CEX in order to tap into its full potential not only as a ‘diagnostic’ but also as an ‘educational tool’. Take-home messages: The sparseness of LGs, their dependency on context variables and their partial non-alignment with students’ LNs raise the question of how the effectiveness of Mini-CEX can be further enhanced.

Mitochondrial leucine tRNA level and PTCD1 are regulated in response to leucine starvation

Pentatricopeptide repeat domain protein 1 (PTCD1) is a novel human protein that was recently shown to decrease the levels of mitochondrial leucine tRNAs. The physiological role of this regulation, however, remains unclear. Here we show that amino acid starvation by leucine deprivation significantly increased the mRNA steady-state levels of PTCD1 in human hepatocarcinoma (HepG2) cells. Amino acid starvation also increased the mitochondrially encoded leucine tRNA (tRNA(Leu(CUN))) and the mRNA for the mitochondrial leucyl-tRNA synthetase (LARS2). Despite increased PTCD1 mRNA steady-state levels, amino acid starvation decreased PTCD1 on the protein level. Decreasing PTCD1 protein concentration increases the stability of the mitochondrial leucine tRNAs, tRNA(Leu(CUN)) and tRNA(Leu(UUR)) as could be shown by RNAi experiments against PTCD1. Therefore, it is likely that decreased PTCD1 protein contributes to the increased tRNA(Leu(CUN)) levels in amino acid-starved cells. The stabilisation of the mitochondrial leucine tRNAs and the upregulation of the mitochondrial leucyl-tRNA synthetase LARS2 might play a role in adaptation of mitochondria to amino acid starvation.

Hebräisches Elementarbuch oder leichte und zum Schwerern fortschreitende hebräische Sprach-Uebungen mit einem kleinen Versuche einer hebräischen Chrestomathie

... hrsg. von Jacob Friederich Klemm ...

Hisṭorie fon der šehne kenigliche printzesin Helene welche durch eini wasr fahrṭ zo fr unglikṭi ds zi muzṭ ir brohṭ beṭlin gehn

Digitalisat der Ausg. Frankfurt an der Oder, 1782/83

Sēfer Iggeret baʿalê ḥayyîm

... neʿettāq li-lešôn aškenaz ... ʿ"y ... Ḥanôk miq-q"q Frankfurṭ Ben-Hirš

Annales typographiae Ebraicae Sabionetenses

Io. Bernhard de Rossi. Ex Ital. Lat. fecit Io. Frid. Roos

Sēfer Tam we-yāšār : dś sēfer hay-yāšār heiśṭ darum tām we-yāšār weil ez fon brias olam an rechṭ ferṭig ali maiśim der tzilṭ ... fon loisšn ha-koideš ... oif ṭaiṭš ...

Yaʿaqōv Ben-... Mātātyā hal-lēwî

Sēfer ḥaqîrôt hal-lēv

... Zelman Ben-...Šimʿôn Weṣlr mē-Fyûrdā

Nachrichṭ fon dem gegnwerṭign tzušṭand, bisherign forṭgang und eignṭlichm endtzwek der Fraiešule (ḥevrat ḥinnûk neʿārîm) tzu Berlin

di direktzion des Insṭiṭuṭs Ḥinnûk Neʿ̄arîm

Ḥamiššā ḥūmšê Tôrā bi-lšôn aškenaz : ṣe'ênā û-re'ênā benôt Ṣiyyôn bā-ʿaṭārā

še ʿiṭṭēr lākem ... Yaʿaqôv Ben- ... Yiṣḥāq ... mim-mišpaḥat rabbēnû ... be-q"q Yānôw