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Core EPA

Martin Klapheke, Teresa Johnson, Morayma Cubero
OBJECTIVE: Within 10 years, the Association of American Medical Colleges envisions graduating medical students will be entrusted by their school to perform 13 core entrustable professional activities (EPAs) without direct supervision. The authors focused on eight EPAs that appear most relevant to clinical training during the psychiatry clerkship at their institution to evaluate whether students assess themselves as making progress in EPAs during this clerkship, to see how students' self-assessments compare with the clerkship director's assessments, and to see if weaknesses in the curriculum were found...
March 17, 2017: Academic Psychiatry
Ruth C Merrifield, Chady Stephan, Jamie Lead
The fate, behavior, and impact of engineered nanoparticles (NPs) in toxicological and environmental media are driven by complex processes which are difficult to quantify. A key limitation is the ability to perform measurements at low and environmentally relevant concentrations, since concentration may be a key factor determining fate and effects. Here, we use single particle inductively coupled mass spectroscopy (SP-ICP-MS) to measure directly NP diameter and particle number concentration of suspensions containing gold-silver core-shell (Au@Ag) NPs in EPA moderately hard water (MHW) and MHW containing 2...
March 1, 2017: Environmental Science & Technology
Laura R Thompson, Cynthia G Leung, Brad Green, Jonathan Lipps, Troy Schaffernocker, Cynthia Ledford, John Davis, David P Way, Nicholas E Kman
INTRODUCTION: Medical schools in the United States are encouraged to prepare and certify the entrustment of medical students to perform 13 core entrustable professional activities (EPAs) prior to graduation. Entrustment is defined as the informed belief that the learner is qualified to autonomously perform specific patient-care activities. Core EPA-10 is the entrustment of a graduate to care for the emergent patient. The purpose of this project was to design a realistic performance assessment method for evaluating fourth-year medical students on EPA-10...
January 2017: Western Journal of Emergency Medicine
Lisa G Criscione-Schreiber, Calvin R Brown, Kenneth S O'Rourke, Howard A Fuchs, Chaim Putterman, Irene J Tan, Joanne Valeriano-Marcet, Evelyn Hsieh, Sarah Zirkle, Marcy B Bolster
OBJECTIVE: Measurement is necessary to gauge improvement. U.S. training programs have not previously used shared standards to assess trainees' mastery of the knowledge, skills, and attitudes necessary to practice rheumatology competently. In 2014, the Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS) began requiring semi-annual evaluation of all medicine subspecialty fellows on 23 Internal Medicine Subspecialty Reporting Milestones. Since these Reporting Milestones are not subspecialty-specific, Rheumatology Curricular Milestones were needed to guide rheumatology fellowship training programs and fellows on the training journey from Internist to Rheumatologist...
November 11, 2016: Arthritis Care & Research
P G Shelton, Irma Corral, Brandon Kyle
Restructuring of undergraduate medical education (UGME) has occurred from time to time over the past century. Many influences, including the persuasive report of Abraham Flexner in 1910, acted to reorganize medical education in the early twentieth century [1, 2]. In his report, Flexner called on American medical schools to enact higher graduation standards and to stringently adhere to the protocols of mainstream science in their teaching. Prior to this report, UGME had changed little over the previous century but over the last several decades, reform within medical education has become routine...
November 5, 2016: Psychiatric Quarterly
Aaron Ross Flakemore, Bunmi Sherifat Malau-Aduli, Peter David Nichols, Aduli Enoch Othniel Malau-Aduli
This study evaluated omega-3 intramuscular fatty acids in the longissimus thoracis et lumborum of commercially prepared Australian lamb loin chops. Meats, denuded of external fats were cooked by means of conductive dry-heat using a fry grilling hot plate, to a core temperature of 70°C. An untrained consumer panel assessed meat appearance, aroma, tenderness, juiciness, taste and overall liking. Results showed no compositional alterations (P>0.05) to omega-3 fatty acids due to cooking treatment, whereas on absolute terms (mg/100g muscle) omega-3 fatty acids significantly (P<0...
January 2017: Meat Science
Nienke Wisman-Zwarter, Marieke van der Schaaf, Olle Ten Cate, Gersten Jonker, Wilton A van Klei, Reinier G Hoff
BACKGROUND: True competency-based medical education should produce graduates meeting fixed standards of competence. Current postgraduate programmes are usually based on a pre-determined length of time in training making them poorly suited for an individual approach. The concept of entrustable professional activities (EPAs) enables a more flexible, personalised and less time-dependent approach to training programmes. An EPA is a unit of professional practice, to be entrusted to a trainee to execute without supervision once they demonstrate sufficient competence...
August 2016: European Journal of Anaesthesiology
Takayuki Ohwada, Tetsuro Yokokawa, Yuki Kanno, Yu Hotsuki, Takayuki Sakamoto, Kenichi Watanabe, Kazuhiko Nakazato, Yasuchika Takeishi
N-3 polyunsaturated fatty acids (PUFAs) are thought to have protective effects against cardiovascular disease. Here, we report the relationship between serum PUFA concentrations and plaque composition, as evaluated by virtual histology-intravascular ultrasound (VH-IVUS). Consecutive patients (n=61) who underwent percutaneous coronary intervention (PCI) were pre-operatively examined using VH-IVUS to assess the composition of culprit plaques. Gray-scale IVUS and VH-IVUS data of fibrous, fibro-fatty, necrotic core, and dense calcium regions of plaques were estimated at the minimal luminal area sites of culprit lesions...
June 2016: Data in Brief
Robert Englander, Timothy Flynn, Stephanie Call, Carol Carraccio, Lynn Cleary, Tracy B Fulton, Maureen J Garrity, Steven A Lieberman, Brenessa Lindeman, Monica L Lypson, Rebecca M Minter, Jay Rosenfield, Joe Thomas, Mark C Wilson, Carol A Aschenbrener
Currently, no standard defines the clinical skills that medical students must demonstrate upon graduation. The Liaison Committee on Medical Education bases its standards on required subject matter and student experiences rather than on observable educational outcomes. The absence of such established outcomes for MD graduates contributes to the gap between program directors' expectations and new residents' performance.In response, in 2013, the Association of American Medical Colleges convened a panel of experts from undergraduate and graduate medical education to define the professional activities that every resident should be able to do without direct supervision on day one of residency, regardless of specialty...
April 19, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Sangeeta Lamba, Bryan Wilson, Brenda Natal, Roxanne Nagurka, Michael Anana, Harsh Sule
BACKGROUND: An increasing number of students rank Emergency Medicine (EM) as a top specialty choice, requiring medical schools to provide adequate exposure to EM. The Core Entrustable Professional Activities (EPAs) for Entering Residency by the Association of American Medical Colleges combined with the Milestone Project for EM residency training has attempted to standardize the undergraduate and graduate medical education goals. However, it remains unclear as to how the EPAs correlate to the milestones, and who owns the process of ensuring that an entering EM resident has competency at a certain minimum level...
2016: Advances in Medical Education and Practice
Nadezhda D Gillett, Yangdong Pan, Kalina M Manoylov, Rosalina Stancheva, Christine L Weilhoefer
Despite their recognized contribution to species richness, the importance of rare taxa richness in bioassessment is unclear. This study aimed to characterize the environmental factors affecting the number of rare diatom taxa in western U.S. streams and rivers, and to evaluate whether this number can be used to differentiate streams with contrasting human disturbance. Three different categories of rare taxa were used: satellite (taxa with low occurrence and low abundance), rural (taxa with high occurrence and low abundance), and urban (taxa with low occurrence and high abundance)...
June 2011: Journal of Phycology
Cornelis T M van Houwelingen, Anna H Moerman, Roelof G A Ettema, Helianthe S M Kort, Olle Ten Cate
BACKGROUND: Telehealth is viewed as a major strategy to address the increasing demand for care and a shrinking care professional population. However, most nurses are not trained or are insufficiently trained to use these technologies effectively. Therefore, the potential of telehealth fails to reach full utilization. A better understanding of nursing telehealth entrustable professional activities (NT-EPAs) and the required competencies can contribute to the development of nursing telehealth education...
April 2016: Nurse Education Today
Carol Carraccio, Robert Englander, Joseph Gilhooly, Richard Mink, Dena Hofkosh, Michael A Barone, Eric S Holmboe
The transition to competency-based medical education (CBME) and adoption of the foundational domains of competence by the Accreditation Council for Graduate Medical Education, Association of American Medical Colleges (AAMC), and American Board of Medical Specialties' certification and maintenance of certification (MOC) programs provided an unprecedented opportunity for the pediatrics community to create a model of learning and assessment across the continuum. Two frameworks for assessment in CBME have been promoted: (1) entrustable professional activities (EPAs) and (2) milestones that define a developmental trajectory for individual competencies...
March 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Lara Boatti, Fabio Rapallo, Aldo Viarengo, Francesco Marsano
Governmental agencies ( and the scientific community have reported on the high toxicity due to mercury. Indeed, exposure to mercury can cause severe injury to the central nervous system and kidney in humans. Beyond its recognized toxicity, little is known regarding the molecular mechanisms involved in the actions of this heavy metal. Mercury has been also observed to form insoluble fibrous protein aggregates in the cell nucleus. We used D. discoideum to evaluate micronuclei formation and, since mercury is able to induce oxidative stress that could bring to protein aggregation, we assessed nuclear protein carbonylation by Western Blot...
February 2017: Environmental Toxicology
T O McGarity
The United States in the early 1980s faced a crisis of confidence in the institutions that it had created to protect public health and the environment from the risks posed by toxic chemicals. Although the political climate of the times had a lot to do with the loss of public confidence in agencies like the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA) and the Occupational Safety and Health Administration (OSHA), perhaps the most profound crack in the institutional edifice was the revelation that much (or at least some, depending upon whom you believed) of the scientific basis for past health and environmental decisions was grounded in invalid and even fraudulent health and safety studies...
September 1989: Accountability in Research
Pierre-André Michaud, Patrick Jucker-Kupper, The Profiles Working Group
The Joint Commission of the Swiss Medical Schools (SMIFK/CIMS) decided in 2000 to establish a Swiss Catalogue of Learning Objectives (SCLO) for undergraduate medical training, which was adapted from a similar Dutch blueprint. A second version of the SCLO was developed and launched in 2008. The catalogue is a prerequisite for the accreditation of the curricula of the six Swiss medical faculties and defines the contents of the Federal Licensing Examination (FLE). Given the evolution of the field of medicine and of medical education, the SMIFK/CIMS has decided to embark on a total revision of the SCLO...
2016: Swiss Medical Weekly
Debra L Klamen, Reed G Williams, Nicole Roberts, Anna T Cianciolo
BACKGROUND: The idea of competency-based education sounds great on paper. Who wouldn't argue for a standardized set of performance-based assessments to assure competency in graduating students and residents? Even so, conceptual concerns have already been raised about this new system and there is yet no evidence to refute their veracity. AIMS: We argue that practical concerns deserve equal consideration, and present evidence strongly suggesting these concerns should be taken seriously...
September 2016: Medical Teacher
Lulu Song, Kang Mao, Xiaodong Zhou, Jiming Hu
In this work, we propose for the first time a simple and novel approach based on SERS and As (III) -aptamer for detection of As (III) with excellent selectivity and sensitivity. To maintain the wonderful SERS substrate, Au@Ag shell-core nanoparticle has been successfully synthesized by seeds growth method. As-prepared Au@Ag not only has well-dispersed but also obtains high SERS efficiency. The novel As (III) biosensor has an excellent linear correlation with the concentration of As (III) ranging from 0.5 to 10 ppb...
2016: Talanta
O Bertrand, L Mondamert, C Grosbois, E Dhivert, X Bourrain, J Labanowski, M Desmet
During the 20th century, the local economy of the Upper Loire Basin (ULB) was essentially based on industrial coal mining extraction. One of the major French coal districts with associated urban/industrial activities and numerous coking/gas plants were developed in the Ondaine-Furan subbasins, two tributaries of the upper Loire main stream. To determine the compositional assemblage, the level and the potential sources of contamination, the historical sedimentary chronicle of the 16 US EPA priority polycyclic aromatic hydrocarbons (PAHs) has been investigated...
December 2015: Environmental Pollution
Ana Carolina Ruiz-Fernández, Julián Mauricio Betancourt Portela, José Luis Sericano, Joan-Albert Sanchez-Cabeza, Luisa Fernanda Espinosa, José Gilberto Cardoso-Mohedano, Libia Hascibe Pérez-Bernal, Jesús Antonio Garay Tinoco
The oldest refinery and the major petrochemical complexes of Mexico are located in the lower reach of the Coatzacoalcos River, considered the most polluted coastal area of Mexico. A (210)Pb-dated sediment core, from the continental shelf of the Coatzacoalcos River, was studied to assess the contamination impact by the oil industry in the southern Gulf of Mexico. The sedimentary record showed the prevalence of petrogenic PAHs between 1950s and 1970s, a period during which waste discharges from the oil industry were not regulated...
February 2016: Chemosphere
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