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ABSTRACTCollaborative learning groups are frequently used in hospitality undergraduate pedagogy to build the crucial industry competence of teamwork skills. Although research has investigated the effects of collaborative learning, it is sparse in examining its process. The process-orientation approach helps educators design and implement collaborative learning environments to mitigate the challenges associated with group work. This single embedded design case study focused on process-orientation to uncover the factors of a collaborative learning group: the individual learner (teamwork orientation), task (complexity, support, guidance, assessment), and team (size, roles, composition). Data were collected through student focus groups (n = 66), professor interviews (n = 12), and student surveys (n = 410). The findings provide insights into stakeholder experiences and offer strategies that professors can implement to enhance learning in the collaborative environment.

This article reports results of a nurse-driven fluid management protocol in a medical-surgical intensive care unit (ICU). Use of static measures such as central venous pressure monitoring, heart rate, blood pressure, and urine output is poor predictors of fluid responsiveness and can result in inappropriate fluid administration. Indiscriminate administration of fluid can result in prolonged mechanical ventilation time, increased vasopressor requirements, increased length of stay, and greater costs. Use of dynamic preload parameters such as stroke volume variation (SVV), pulse pressure variation, or changes in stroke volume with a passive leg raise has been shown to be more accurate predictors of fluid responsiveness. Improved patient outcomes including decreased length of hospital stay, reduction in kidney injury, decreased mechanical ventilation time and requirements, and reduced vasopressor requirements have been demonstrated by using dynamic preload parameters. ICU nurses were educated on cardiac output and dynamic preload parameters and a nurse-driven fluid replacement protocol was established. Knowledge scores, confidence scores, and patient outcomes were measured pre- and post-implementation. The results indicated that there was no change in knowledge scores between pre- and postimplementation groups (mean = 80%). There was a statistically significant increase in nurse confidence in using SVV (P= .003); however, this change is not clinically significant. There was no statistically significant difference in other confidence categories. The study indicated that ICU nurses were resistant to adoption of a nurse-driven fluid management protocol. While anesthesia clinicians are familiar with technologies to evaluate fluid responsiveness in the perioperative setting, the new technology posed challenges to ICU confidence. This project demonstrates that traditional methods of nursing education did not provide the support needed for implementation of a novel approach to fluid management, and that there is a need for further improvement in educational strategies.

Because rates of clinically significant hematomas are low and did not differ between patients undergoing antithrombotic therapy and those not undergoing antithrombotic therapy, stopping antithrombotic therapy before image-guided core needle breast biopsies may be unnecessary.

Cystine is the chief sulfur-containing amino acid of protein molecules, and it is an important source of sulfur in the metabolism. Cystinuria is an uncommon autosomal recessive disorder of metabolism [...], Until recently, treatment options for patients with cystine calculi were not favorable. Using holmium:yttrium-aluminum-garnet (YAG) losers to frogment cystine calculi, however, may provide a minimally invasive and cost-effective alternative to current treatments. This article describes cystine calculi and the diagnostic methods and current medical and surgical interventions used to treat patients and discusses the differences between flash lamp pulsed dye losers and holmium: YAG losers. Preoperative, intraoperative, and postoperative considerations for loser ureterolithotripsy of cystine calculi also are discussed. AORN J 64 (Dec 1996) 924-930.

The 2023–2024 Academic Affairs Committee was charged to create a sense of urgency around the concept of Competency-Based Pharmacy Education and develop a “readiness for change” instrument that is based on the 5 essential elements that make up the definition of Competency-Based Pharmacy Education. This report describes the process undertaken by the committee to determine the societal needs of pharmacists and current state of pharmacy practice and pharmacy education. The practice gaps in pharmacy education and the key drivers needed to close these gaps are evaluated. To complete the charges, the committee conducted evidence-based literature reviews and completed a series of focus groups with stakeholders and thought leaders with experience in competency-based education.

Objectives.While pharmacy education updates learning as new information arises, changes to learning experiences can trail behind current practices and technology. There have been multiple calls for radical changes in how health professions education is delivered to ensure patients are receiving high-quality care. Competency-based education has been one way discussed in the literature for how to handle this need to develop students who have a willingness to learn and can problem-solve. The goal of this review is to examine whether competency-based education is needed to drive the profession of pharmacy forward. Findings.To address, we collaboratively identified stakeholder perspectives to evaluate the need. The following stakeholders achieved consensus among the committee members: patients/society, learners, workplace/profession, and academic institutions. Summary.Based on those perspectives, needs, and gaps to address those needs were identified and are presented in this review.

This study examined the brain areas involved in combining words into larger units when there are few or no morphosyntactic cues. We manipulated constituent length in word strings of the same length under two conditions: Mandarin sentence, which had sparse morphosyntactic cues, and nominal phrase that had no morphosyntactic cues [e.g., ((honey mustard) (chicken burger))]. Contrasting sentences to word lists revealed a network that largely overlapped with the one reported in languages with rich morphosyntactic cues, including left IFGorb/IFGtri and areas along left STG/STS. Both conditions showed increased activation in left IFGtri/IFGorb in functional ROIs defined based on previous study in sentence processing, while the nominal phrases additionally revealed a constituent length effect in bilateral dorsal IFGtri, left IFGoper, left pMTG/pSTG, left IPL, and several subcortical areas, which might reflect an increased reliance on semantic and pragmatic information. Moreover, in upper left IFGtri/IFGoper and left thalamus/caudate, this effect increased with the participants' tendency to combine nouns into phrases. The absence of syntactic constraints on linguistic composition might highlight individual differences in cognitive control, which helps to integrate non-syntactic information.

The subfamily Dolichotinae (Rodentia, Caviidae) includes two living species (Dolichotis patagonumand D. salinicola) of cursorial, long-legged rodents that inhabit semiarid thorn scrubs and shrublands in southern South America. Some authors consider that the morphological differences between D. patagonumand D. salinicolawarrant circumscription of the latter in its own genus, Pediolagus. Based on a phylogeny and divergence times grounded on molecular data, as well as a qualitative and quantitative assessment of morphological differences, the distinction between Dolichotisand Pediolagusis equal to or greater than differences seen for other intergeneric comparisons within Cavioidea. Based on these results, we argue that the taxonomic designations of Dolichotisand Pediolagusshould be retained.

Pharmacists utilize clinical reasoning (CR) to improve patient outcomes via medication optimization. It is critical to develop these skills in student pharmacists, yet optimal pedagogies to teach and assess CR are unknown. Peer feedback may be used to develop CR in student pharmacists, but a certain feedback quality must be reached to be effective. This study sought to evaluate if student pharmacists could provide similar quality peer feedback compared to pharmacy resident teaching assistant (TA) feedback.