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BackgroundConcept inventories (CIs) have become widely used tools for assessing students’ learning and assisting with educational decisions. Over the past three decades, CI developers have utilized various design approaches and methodologies. As a result, it can be challenging for those developing new CIs to identify the most effective and appropriate methods and approaches. This scoping review aimed to identify and map key design stages, summarize methodologies, identify design gaps and provide guidance for future efforts in the development and validation of CI tools.MethodsA preliminary literature review combined theoretical thematic analysis (deductive, researcher-driven) focusing on specific data aspects, and inductive thematic analysis (data-driven), using emerging themes independent of specific research questions or theoretical interests. Expert discussions complemented the analysis process.ResultsThe scoping review analyzed 106 CI articles and identified five key development stages: define the construct, determine and validate content domain; identify misconceptions; item formation and response processes design; test item selection and validation; and test application and refinement. A descriptive design model was developed using a mixed-method approach, incorporating expert input, literature review, student-oriented analysis, and statistical tests. Various psychometric assessments were employed to validate the test and its items. Substantial gaps were noted in defining and determining the validity and reliability of CI tools, and in the evidence required to establish these attributes.ConclusionThe growing interest in utilizing CIs for educational purposes has highlighted the importance of identifying and refining the most effective design stages and methodologies. CI developers need comprehensive guidance to establish and evaluate the validity and reliability of their instruments. Future research should focus on establishing a unified typology of CI instrument validity and reliability requirements, as well as the types of evidence needed to meet these standards. This effort could optimize the effectiveness of CI tools, foster a cohesive evaluation approach, and bridge existing gaps.

Introduction/backgroundCourse evaluation in health education is a common practice yet few comprehensive evaluations of health education exist that measure the impact and outcomes these programs have on developing health graduate capabilities.Aim/objectivesTo explore how curricula contribute to health graduate capabilities and what factors contribute to the development of these capabilities.MethodsUsing contribution analysis evaluation, a six-step iterative process, key stakeholders in the six selected courses were engaged in an iterative theory-driven evaluation. The researchers collectively developed a postulated theory-of-change. Then evidence from existing relevant documents were extracted using documentary analysis. Collated findings were presented to academic staff, industry representatives and graduates, where additional data was sought through focus group discussions - one for each discipline. The focus group data were used to validate the theory-of-change. Data analysis was conducted iteratively, refining the theory of change from one course to the next.ResultsThe complexity in teaching and learning, contributed by human, organizational and curriculum factors was highlighted. Advances in knowledge, skills, attitudes and graduate capabilities are non-linear and integrated into curriculum. Work integrated learning significantly contributes to knowledge consolidation and forming professional identities for health professional courses. Workplace culture and educators’ passion impact on the quality of teaching and learning yet are rarely considered as evidence of impact.DiscussionCapturing the episodic and contextual learning moments is important to describe success and for reflection for improvement. Evidence of impact of elements of courses on future graduate capabilities was limited with the focus of evaluation data on satisfaction.ConclusionContribution analysis has been a useful evaluation method to explore the complexity of the factors in learning and teaching that influence graduate capabilities in health-related courses.

IntroductionCore concepts are foundational, discipline-based ideas considered necessary for students to learn, remember, understand, and apply. To evaluate the extent to which a concept is “core,” experts often rate concepts using various criteria, such as importance, complexity, and timeliness. However, there is a lack of validity evidence for core concepts criteria.MethodsUsing a three-facet Many-Facet Rasch Measurement (MFRM) model, we analyzed 7,558 ratings provided by 21 experts/raters for 74 pharmacology core concepts using five criteria measured on a five-point scale.ResultsAll of the criteria had Infit or Outfit MnSq values within the expected range (0.5

Adenosine A1 receptors (A1R) are a potential target for cardiac injury treatment due to their cardioprotective/antihypertrophic actions, but drug development has been hampered by on-target side effects such as bradycardia and altered renal hemodynamics. Biased agonism has emerged as an attractive mechanism for A1R-mediated cardioprotection that is haemodynamically safe. Here we investigate the pre-clinical pharmacology, efficacy and side-effect profile of the A1R agonist neladenoson, shown to be safe but ineffective in phase IIb trials for the treatment of heart failure. We compare this agent with the well-characterized, pan-adenosine receptor (AR) agonist NECA, capadenoson, and the A1R biased agonist VCP746, previously shown to be safe and cardioprotective in pre-clinical models of heart failure. We show that like VCP746, neladenoson is biased away from Ca2+ influx relative to NECA and the cAMP pathway at the A1R, a profile predictive of a lack of adenosine-like side effects. Additionally, neladenoson was also biased away from the MAPK pathway at the A1R. In contrast to VCP746, which displays more ‘adenosine-like’ signaling at the A2BR, neladenoson was a highly selective A1R agonist, with biased, weak agonism at the A2BR. Together these results show that unwanted hemodynamic effects of A1R agonists can be avoided by compounds biased away from Ca2+ influx relative to cAMP, relative to NECA. The failure of neladenoson to reach primary endpoints in clinical trials suggests that A1R-mediated cAMP inhibition may be a poor indicator of effectiveness in chronic heart failure. This study provides additional information that can aid future screening and/or design of improved AR agonists that are safe and efficacious in treating heart failure in patients.

Adenosine is a ubiquitous molecule with key regulatory and cytoprotective mechanisms at times of metabolic imbalance in the body. Among a plethora of physiological actions, adenosine has an important role in attenuating ischaemia-reperfusion injury and modulating the ensuing fibrosis and tissue remodeling following myocardial damage. Adenosine exerts these actions through interaction with four adenosine G protein-coupled receptors expressed in the heart. The adenosine A2B receptor (A2BAR) is the most abundant adenosine receptor (AR) in cardiac fibroblasts and is largely responsible for the influence of adenosine on cardiac fibrosis. In vitro and in vivo studies demonstrate that acute A2BAR stimulation can decrease fibrosis through the inhibition of fibroblast proliferation and reduction in collagen synthesis. However, in contrast, there is also evidence that chronic A2BAR antagonism reduces tissue fibrosis. This review explores the opposing pro- and anti-fibrotic activity attributed to the activation of cardiac ARs and investigates the therapeutic potential of targeting ARs for the treatment of cardiac fibrosis.