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When providing healthcare services, healthcare students face a variety of ethical issues and conflicts daily. Such characteristics as ethical sensitivity and emotional intelligence are influential in determining an individual's performance and can prove useful in coping with challenges in life. Given the significance of these two variables in the career prospects and educational and professional lives of students, the present cross-sectional study with 486 students majoring in nursing, operating room, and anesthesia, aims to investigate the relationship between ethical sensitivity and emotional intelligence. Data were collected using demographics, ethical sensitivity, and emotional intelligence. The students' ethical sensitivity level was high, while their emotional intelligence was average. Regression analysis revealed that students' ethical sensitivity was related to their emotional intelligence and gender. There is also a significant correlation between ethical sensitivity and emotional intelligence on one hand and gender on the other: female students possess higher levels of ethical sensitivity, while male students have greater emotional intelligence. Students in nursing schools may benefit from greater insight into the concepts of ethical sensitivity and emotional intelligence and ways to enhance them.

Children with autism spectrum disorder have unique needs during medical procedures involving anesthesia. However, with early patient identification, provider champions can adapt their practice to better serve this population, thereby improving patient satisfaction and outcomes. This article describes a novel protocol developed by an anesthesia resource center to modify care for children with autism spectrum disorder and their families. This information serves as a template for perianesthesia nurses and advanced care providers to implement practice accommodations. Two case examples, based on parent interviews and chart review, are presented to exemplify this protocol.

The medical fields of anesthesiology and otolaryngology (ENT -- ears, nose, throat) are defined by overlapping clinical expertise as it relates to the management of airway issues. As a result of this shared clinical domain, interdisciplinary educational experiences provide an opportunity for collaboration and a broadened experience for resident physician learning. Our institution developed a two-week rotation in otolaryngology for first-year anesthesiology interns with the goal of utilizing interdisciplinary coaching to develop both technical and non-technical skills in airway management. The purpose of this project is to perform a formal evaluation of this rotation and share our training methods and processes.

Anatomy is an essential component of clinical anesthesiology. The use of simulated patients and alternative materials, including embalmed human bodies, have become increasingly common during resident physician training due to the deemphasis on anatomical education during undergraduate medical training. In this report, the need for a more extensive review of relevant anatomy for the practice of anesthesiology was addressed by the design, evaluation, and dissemination of a human dissection course for procedural training of anesthesiology residents. The course utilized "freedom art" embalmed human bodies that allowed trainees to perform ultrasound-based regional and neuraxial techniques followed by detailed dissections of critical anatomy. One hundred and four residents participated in workshops and small group discussions and were evaluated using pre- and post-course assessments. A variety of clinical techniques were performed on the bodies, including regional blocks and neuraxial catheter placement. Insertion of peripheral/neuraxial catheters was successful, with dissections demonstrating the expected placement. Assessment scores improved following the course (pre-course mean 52.7%, standard deviation ([delta]) 13.1%; post-course mean 72.2%, [delta] 11.6%; t-test p < 0.0001) and feedback highlighted the usefulness and clinical relevance of course content. The ability to correlate ultrasound imaging with subsequent dissections of the "blocked" area and visualization of dye staining was extremely relevant for spatial understanding of the anatomy relevant for the clinical practice of these techniques. This manuscript demonstrates successful implementation of a comprehensive course for anesthesiology resident physicians to address gaps in undergraduate anatomical education and suggests that broader adoption of dissection courses may be beneficial for training anesthesiologists.

Despite ongoing insecurity, Afghanistan has demonstrated improvement in health outcomes. Reasons for this success include a strategic public-private health service delivery model and investment in Afghan health care workforce development. Afghan universities have the primary responsibility for ensuring that an adequate health care workforce is available to private and public health care delivery settings. Most entry-level health care providers working in Afghanistan are educated within the country. However, university constraints, including faculty shortages and limited access to professional development, have affected both the flow of the health care workforce pipeline and the skill levels and competencies of those who do enter the workforce. Aware of these constraints and workforce needs, the administration at Kabul University of Medical Sciences (KUMS), working in collaboration with the Ministry of Higher Education, prioritized investment in strengthening technical and academic capabilities within four faculties (anesthesiology, dentistry, medical laboratory technology, and midwifery). KUMS partnered with the University of Minnesota in 2017 with United States Agency for International Development support through the University Support and Workforce Development Program. Together they established a unique training-of-trainers (TOT) faculty development program to improve faculty knowledge and skills specific to their technical expertise, as well as knowledge and skills in instructional design and research methods. In this article, we describe the successes and challenges associated with partnership development, implementation, and sustainability.

This study tested the hypothesis that exposure of children prior to their third birthday to procedures requiring general anesthesia is associated with an increased incidence of autism spectrum disorder (ASD) in later life. This study employed a nested, 1:2 matched-case control study design using ASD cases identified in a population-based birth cohort of children born in Olmsted County, MN from 1976 to 2000. Matching variables included sex, date of birth, and mother's age in conditional logistic regression including 499 ASD cases and 998 controls. After adjusting for birth weight and health status, there was no significant association between exposure and ASD (OR 1.27 [95% CI 0.92-1.76]), indicating that general anesthesia is not associated with an increased risk of ASD.

Dental treatment provided under general anaesthesia (DGA) is an expectation for many children and young adults (CYA) diagnosed with Autistic Spectrum Disorder (ASD). Planning and delivery of DGA requires consideration of morbidity and mortality risks and implications for families and healthcare services. One hundred patient records of CYA with special healthcare needs were analysed to examine characteristics and experience of DGA revealing that 79% of CYA had a diagnosis of ASD. Forty-seven percent of CYA diagnosed with ASD had at least one previous hospital admission for DGA. For 24% of this repeat DGA group, the previous DGA was within a two-year period. Results highlight a high rate of DGA and need to investigate more effective primary dental care strategies.

Ophthalmic examinations of developmentally delayed/autistic children are challenging. Oral midazolam may be a viable alternative to general anaesthesia for this indication. Single-centre retrospective cohort study (January 2018-March 2020). Oral midazolam (0.5 mg/kg, max 15 mg). Metrics included: patient demographics, examination completion rate, duration of stay and adverse events. 50 oral midazolam examinations were performed (45 patients). Mean age was 79.12 months. All had developmental delay (66.67% autism). Time to ophthalmic examination was 60.31 minutes. Eye examination was successfully completed in 98%. No adverse events were reported. Mean stay was 3.35 hours. Oral midazolam (0.5 mg/kg, max 15 mg) is associated with safe, successful completion of ophthalmic examinations in children previously unexaminable in clinic.

Background: Pupillometry has been studied as a physiological marker for quantifying cognitive load since the early 1960s. It has been established that small changes in pupillary size can provide an index of the cognitive load of an individual as he/she performs a mental task. The utility of pupillometry as a measure of expertise is less well established, although recent research in the fields of education, medicine and psychology indicates that differences in pupillary size during domain-specific tasks allows differentiation between experts and novices in appropriately designed experiments. Purpose: The goal of this review is to explore the existing body of evidence for the use of pupillometry as a measure of expertise and to identify its strengths and constraints within the context of expertise research in the medical sciences. Results: Pupillometry is a robust metric that allows researchers to better understand cognitive load in medical practitioners with varying levels of expertise. In medical expertise research, it has been used to study surgeons, anesthetists and emergency physicians. Its strengths include its ability to provide quantitative and objective outputs, to be measured unobtrusively with new technology and to be precisely computed as cognitive load changes over the course of completion of a task. Constraints associated with this methodology include its potential inaccuracy with changes in ambient light and pupillary accommodation as well as the need for relatively expensive equipment. Conclusion: With recent technological advances, pupillometry has become a simple and robust method for quantifying physiological changes attributable to cognitive load and is increasingly being utilized in medical education. It can be used as a reliable marker of cognitive load and has been shown to differentiate levels of expertise in medical practitioners.

Medical educators are tasked with decisions on trainee progression and credentialing for independent clinical practice, which requires robust evidence from workplace-based assessment. It is unclear how the current promotion of workplace-based assessment as a pedagogical approach to promote learning has impacted this use of assessments for decision-making; meeting both these purposes may present unforeseen challenges. In this study we explored how supervisors make decisions on trainee progress in practice. We conducted semi-structured interviews with 19 supervisors of postgraduate anesthesia training across Australia and New Zealand and undertook thematic analysis of the transcripts. Supervisors looked beyond the formal assessment portfolio when making performance decisions. They instead used assessment 'shadow systems' based on their own observation and confidential judgements from trusted colleagues. Supervisors' decision making involved expert judgement of the perceived salient aspects of performance and the standard to be attained while making allowances for the opportunities and constraints of the local learning environment. Supervisors found making progress decisions an emotional burden. When faced with difficult decisions, they found ways to share the responsibility and balance the potential consequences for the trainee with the need to protect their patients. Viewed through the lens of community of practice theory, the development of assessment 'shadow systems' indicates a lack of alignment between local workplace assessment practices and the prescribed programmatic assessment approach to high-stakes progress decisions. Avenues for improvement include cooperative development of formal assessment processes to better meet local needs or incorporating the information in 'shadow systems' into formal assessment processes.

The purpose of this study was to evaluate two online instructional design features, namely adaptation to learner prior knowledge and use of questions to enhance interactivity in online portrayals of physician-patient encounters, in the context of instructing surgical specialists to deliver perioperative tobacco interventions. An online learning module on perioperative tobacco control was developed, in formats incorporating permutations of adaptive/non-adaptive and high/low interactivity (i.e., 2 × 2 factorial design). Participants (a national sample of US anesthesiology residents) were randomly assigned to module format. Primary outcomes included tobacco knowledge, time to complete the module, and self-efficacy in delivering tobacco interventions. One hundred fourteen residents completed the module, which required a median of 60 min (interquartile range 49, 138). The difference in post-module tobacco knowledge score was similar for adaptive and non-adaptive formats [mean difference 0.3 of 10 possible (95% CI - 0.3, 1.0), p = 0.25] but time was shorter for the adaptive format [- 7 min (95% CI - 14, 0), p = 0.01] and knowledge efficiency (knowledge score divided by time) was higher [0.08 units (95% 0.03, 0.14), p = 0.004]. The level of interactivity had no significant effect on self-efficacy [- 0.1 on a 5-point scale (95% CI - 0.3, 0.1), p = 0.50] in delivering tobacco interventions (both outcomes using 5-point scales). Adapting online instruction to learners' prior knowledge appears to improve the efficiency of learning; adaptation should be implemented when feasible. Adding features that encourage learner interaction in an online course does not necessarily improve learning outcomes.

Background: It has been reported that information sources searched in systematic reviews (SRs) are insufficiently comprehensive. We analyzed information sources used in SRs, as well as how up-to-date were the searches. Methods: We searched PubMed and the Cochrane Database of Systematic Reviews (CDSR) through Wiley from 2012 to 2016 to find SRs of randomized controlled trials (RCTs) in the field of anesthesiology and pain. We analyzed information sources used and search dates. Results: We analyzed 674 SRs, including 374 non-Cochrane SRs (NCSRs) and 300 Cochrane reviews. The most commonly searched electronic databases reported in all included SRs were Embase (88.6%), MEDLINE (78.3%), CENTRAL (76.1%), CINAHL (29.1%), and PubMed (30.9%). In 303 (45%) SRs, authors reported that they searched clinical trial registries; 57 (8.5%) reported that they searched for unpublished data, 184 (27.3%) searched grey literature, 51 (7.6%) searched citations, and 546 (81%) searched references of included studies. A substantial amount of Cochrane reviews searched clinical trial registries (75.7%), compared with NCSRs (20.3%). Search date was reported in 647 SRs (96.1%). The median time between the last search date and publication for the SRs that reported search date was 10 months. For the NCSRs, median time between the last search and publication date was significantly higher compared with Cochrane reviews. Nonreporting of search date was more prevalent in NCSRs. Conclusion: SRs in the field of anesthesiology and pain often neglect to search all possible information sources, particularly in NCSRs. Cochrane reviews had more comprehensive searching and shorter search to publication time.

Increasing numbers of deaf students in the health professions require accommodations in the clinical setting to ensure effective learning and accurate communication. Although classroom learning barriers have long been identified and addressed, barriers to clinical education have been far less analyzed. Operating room clerkships, which include many competing auditory and visual stimuli, pose unique obstacles to deaf students. Disability Services worked collaboratively with other campus offices to accommodate a fourth-year medical student with almost complete hearing loss in an anesthesia clerkship who had limited knowledge of any manual language such as ASL. Accommodations implemented for the student are reviewed within the context of their successes and challenges, with the goal of providing a roadmap for future deaf graduate health sciences students in the operating room environment.

Cesarean section (CS) has been consistently associated with susceptibility to autism spectrum disorder (ASD), however, the underlying mechanism for this association remains vague. Here, we studied various pre-peri-and-neonatal factors among 347 children with ASD, 117 children with other developmental delays (DD), and 2226 age, sex and ethnicity matched controls. We found that CS is significantly associated with an increased risk of ASD but not DD (p = 0.019 and p = 0.540 respectively). Furthermore, we show that only CS performed with general anesthesia (GA) elevated the risk of ASD with no significant difference between indicated and non-indicated surgeries (aOR = 1.537; 95% CI 1.026-2.302, and aOR = 1.692; 95% CI 1.057-2.709, p[subscript diff] = 0.865). We therefore suggest that exposure to GA during CS may explain the association between CS and ASD.

Frogs are routinely used in physiology teaching laboratories to demonstrate important physiological processes. There have been recent directives that promote the use of the anesthetic MS-222 (tricaine methanesulfonate), rather than lowering body temperature with a cold water bath to prepare reptiles and amphibians for physiological experiments or euthanasia. Indeed, the most recent edition of the American Veterinary Medical Association (AVMA) "Guidelines for the Euthanasia of Animals" proclaims that chilling in water is not an appropriate method and advocates for the usage of MS-222 or other anesthetics. However, prominent researchers have responded to this position by highlighting evidence that cooling ectothermic vertebrates is, in fact, an effective and appropriate method. Furthermore, MS-222 is a known voltage-gated Na+ channel blocker, and this anesthetic's impact on the physiology of excitable tissues suggests that its use might be incompatible with experiments on nerve and muscle tissues. In the present study, I examined the effects of MS-222 at a concentration of 1.5 g/l on nerve, skeletal muscle, and cardiac muscle physiology of frogs. I found that immersion of frogs in this anesthetic blocked basic nerve and muscle physiology, making the frogs unsuitable for laboratory experiments. Applying MS-222 directly to the sciatic nerve dramatically blocked normal excitation-contraction coupling in skeletal muscle preparations, and direct application to the heart caused the organs to stop contracting. Based on these results, I conclude that MS-222 at the concentration studied may be incompatible with physiological preparations that rely on electrically excitable tissues for their normal function. Physiology educators who must use MS-222 with frogs should empirically determine an appropriate dosage and recovery time before using the anesthetic in the teaching laboratory.

Background: The Test of Masticating and Swallowing Solids (TOMASS) has been developed to provide clinicians with objective data regarding the efficiency of oral phase function and solid bolus ingestion. Aims: To determine if the TOMASS will detect changes in the oral phase of swallowing imposed by topical anaesthesia, thus providing validation of its clinical utility. Methods & Procedures: Per the standard protocol, 10 healthy participants ate one-quarter of an Arnotts Salada[superscript TM] biscuit. The number of bites per cracker, number of masticatory cycles, number of swallows and total time taken were recorded at baseline, following application of topical oral anaesthetic; this was additionally compared with a post-anaesthetic condition. Median and interquartile range (IQR) were calculated. Wilcoxon signed-rank tests were conducted to evaluate trial effect, and Friedman's tests were used to detect differences in the number of bites, number of swallows, number of chews and time taken to eat the crackers. Outcomes & Results: Results indicated that the number of both bites and swallows did not significantly change across conditions (?[superscript 2](2) = 0.105, p = 0.949, ?[superscript 2](2) = 1.357, p = 0.507); however, the number of chews for the anaesthetic condition was significantly higher when compared with the baseline (p = 0.02) and post-anaesthesia conditions (p = 0.02). Further, the durations of ingestion in the anaesthetic condition were significantly longer than the baseline (p = 0.01) and post-anaesthesia (p = 0.01) conditions. Across all measures, there were no differences between baseline and post-anaesthesia conditions. Conclusions & Implications: Although further exploration is required, these early data suggest the TOMASS is a sensitive measure in the evaluation of the oral-phase preparation of solid textures.

Purpose: Previous results show that the anesthetists' activity during the planning phase is aimed at neither identifying risks nor pinpointing the adverse events likely to occur; rather, it is to devise "manageable situations" that are adapted to their own competences. The present paper focuses on the issue of understanding how, in practice, these "manageable situations" are constructed. In particular it wonders if a link between the seniority of anesthetists and the way they design these "manageable situations" may be established. Design/methodology/approach: The paper sought to answer these questions through a qualitative study conducted in partnership with anesthetists. The method, combining interviews and case-based simulation, required that 20 anesthetists "thought aloud". Findings: Results show that the anesthetists sometimes selected a solution that they themselves and experts viewed as riskier. Why? And who selects a riskier solution? The answer is about workplace learning and the continuous development of experience-based competences. "Manageable situations" appear to be planned situations so as to propose solutions adapted not only to present competences but also for future competences to be developed. In that sense, they are part of a developmental process at work. Originality/value: These findings have implications for practice and they open pathways for further research studies. They call for rethinking the link between experience and workplace learning.

Background: General anaesthesia (GA) remains a vital modality to facilitate dental treatment for patients with special needs but there is limited literature to describe the types of patients requiring this form of care and the treatment they receive. Method: A cross-sectional clinical audit was conducted of patients treated under GA at the Day Surgery Unit of the Royal Dental Hospital of Melbourne during August 2015. Results: The majority of patients had an intellectual disability and were referred due to their inability to tolerate conventional dental treatment. These patients demonstrated high levels of treatment need requiring an average of two fillings and six extractions. Conclusions: Although these results demonstrate the value of GA in treating patients with intellectual disabilities, the level of treatment need identified raises concerns about current approaches to oral health for this cohort. Greater efforts are required towards preventive oral care for patients with special needs.

Critical thinking is pivotal for student success in health professions education. Knowing the critical thinking ability of the learner helps educators tailor curriculum to enhance critical thinking. A quantitative comparative pilot study assessed critical thinking ability for students at two distinct points in a nurse anesthesia program curriculum. Critical thinking was examined using the Health Sciences Reasoning Test (HSRT) for students at the beginning and end of the first year of didactic instruction. This pilot study serves as a foundation for additional critical thinking studies. These study results may serve to help nurse anesthesia educators improve the learning process. Nurse anesthesia educators are in an important position to improve teaching and learning through classroom activities that foster critical thinking.

Communication of feedback during teaching of practical procedures is a fine balance of structure and timing. We investigate if continuous in-task (IT) or end-task feedback (ET) is more effective in teaching spinal anaesthesia to medical students. End-task feedback was hypothesized to improve both short-term and long-term procedural learning retention as experiential learning promotes active learning after encountering errors during practice. Upon exposure to a 5-min instructional video, students randomized to IT or ET feedbacks were trained using a spinal simulator mannequin. A blinded expert tested the students using a spinal anaesthesia checklist in the short term (immediate) and long-term (average 4 months). Sixty-five students completed the training and testing. There were no differences in demographics of age or gender within IT or ET distributions. Both short-term and long-term learning retention of spinal anaesthesia ET feedback proved to be better (P < 0.01) than IT feedback. The time taken for ET students was shorter at long-term testing. End-task feedback improves both short-term and long-term procedural learning retention.

Motor skill practice is very important to improve performance of medical procedures and could be enhanced by observational practice. Observational learning could be particularly important in the medical field considering that patients' safety prevails over students' training. The mechanism of observational learning is based on the mirror neuron system, originally discovered in the monkey pre-motor cortex. Today we know that humans have a similar system, and its role is to understand and reproduce the observed actions of others. Many studies conclude that humans are able to plan and to make movements based on visual information by mapping a representation of observed actions, especially when the motor system is committed to do it. Moreover most researchers considered observational learning effective for complex skills, such as medical procedures. Additionally, observational learning could play a relevant role during anesthesia training since the learner works in pairs most of the time (dyad practice). Some teaching approaches should be taken into consideration: an implicit engagement of the observer motor system is required, immediate feedback seems to have an important effect, and a combination of observational and physical practice could be better than physical practice alone. In an environment where effectiveness and efficacy are essential, observational learning seems to fit well.

Despite the increasing popularity of e-learning systems across a variety of educational programmes, there is relatively little understanding of how students and trainees distribute their learning efforts over time. This study aimed to analyse the usage patterns of an e-learning resource designed to support specialty training. Data were collected from e-learning Anaesthesia, a web-based training programme offered by the Royal College of Anaesthetists in partnership with e-Learning for Healthcare. We constructed the time series of 45,020 records of knowledge and self-assessment sessions accessed by 2,491 trainees between August 2008 and February 2010. Analysis of the time series suggested that e-learning usage was characterised by concentrations of rapidly occurring sessions within short time frames of intense activity, separated by disproportionally long periods of reduced activity. Non-uniform temporal fluctuations of usage were pronounced especially for self-assessment sessions, the timing of which was highly correlated with examination dates. While on average trainees' involvement in knowledge sessions was larger than in self-assessment sessions, for both sessions average hourly activity and length remained stable between 9:00 am and 10:00 pm during weekdays. Average daily activity decayed as the weekend approached, but average session length did not vary significantly across the week. Combined with previous research on distributed practice, learning time distribution and test-enhanced learning, our study has implications for the improvement of long-term retention through the redistribution of knowledge sessions uniformly over time and the sustainment of frequent information retrieval and repeated testing. Findings on hourly and daily periodicities also suggest how new learning materials could be broken down into suitable components that fit learners' time constraints.

Students are introduced to spectrophotometry in comparing the antioxidant activity of pure eugenol and oil of cloves from a commercial source using a modified ferric reducing antioxidant power (FRAP) assay. The extraction of the essential oil from dried cloves is demonstrated to facilitate discussions on green chemistry. The anesthetic properties of clove oil are also explored by temporarily sedating Eugene, the "sleepy" fish.

Virtual patients are computerised representations of realistic clinical cases. They were developed to teach clinical reasoning skills through delivery of multiple standardized patient cases. The anesthesia course at The Chinese University of Hong Kong developed two novel types of virtual patients, formative assessment cases studies and storyline, to teach its final year medical students on a 2 week rotational course. Acute pain management cases were used to test if these two types of virtual patient could enhance student learning. A 2 × 2 cross over study was performed in academic year 2010-2011 on 130 students divided into four groups of 32-34. Performance was evaluated by acute pain management items set within three examinations; an end of module 60-item multiple choice paper, a short answer modified essay paper and the end of year final surgery modified essay paper. The pain management case studies were found to enhanced student performance in all three examinations, whilst the storyline virtual patient had no demonstrable effect. Student-teaching evaluation questionnaires showed that the case studies were favored more than the storyline virtual patient. Login times showed that students on average logged onto the case studies for 6 h, whereas only half the students logged on and used the storyline virtual patient. Formative assessment case studies were well liked by the students and reinforced learning of clinical algorithms through repetition and feedback, whereas the educational role of the more narrative and less interactive storyline virtual patient was less clear.

The purpose of the project was to evaluate the use of an interactive workshop designed to teach novel practical welfare techniques to beef cattle caretakers and decision makers. Following training, respondents reported being more likely to use or recommend use of local anesthesia for dehorning and castration and were more inclined to use meloxicam for pain management. Respondents also reported improvement in performing all skills taught in the workshop. These results suggest instructional techniques used to teach practical concepts/techniques relevant to beef cattle welfare led to improvements in both perceived competency and estimated likelihood that the material will be used.

Spatial abilities have been related in previous studies to three-dimensional (3D) anatomy knowledge and the performance in technical skills. The objective of this study was to relate spatial abilities to residency programs with different levels of content of 3D anatomy knowledge and technical skills. The hypothesis was that the choice of residency program is related to spatial abilities. A cohort of 210 medical graduates was enrolled in a prospective study in a 5-year experiment. Spatial abilities were measured with a redrawn Vandenberg and Kuse Mental Rotations Test (MRT) in two (MRTA) and three (MRTC) dimensions. Medical graduates were enrolled in Family Medicine (n?=?76, 36.2%), Internal Medicine (64, 30.5%), Surgery (52, 24.8%), and Anesthesia (18, 8.6%). The assumption was that the level of 3D anatomy knowledge and technical skills content was higher in Surgery and Anesthesia compared to Family Medicine and Internal Medicine. Mean MRTA score of 12.4 (±SD 4.6), 12.0 (±4.3), 14.1 (±4.3), and 14.6 (±4.0) was obtained in Family Medicine, Internal Medicine, Surgery, and Anesthesia, respectively (P =?0.0176). Similarly, mean MRTC score of 8.0 (±4.4), 7.5 (±3.6), 8.5 (±3.9), and 7.9 (±4.1) was obtained (P =?0.5647). Although there was a tendency for lower MRTA score in Family Medicine and Internal Medicine compared to Surgery and Anesthesia, no statistically significant main effect of residency, year, sex, or the interactions were observed for the MRTA and MRTC. Studied sample of medical graduates was not found to choose their residency programs based on their innate spatial abilities.

Chilling is a cost-effective and safe method of immobilising flies in "Drosophila" experiments. However, should condensation form on the plate, it would be fatal to the flies. Here we describe a modified cooling method using reusable commercial ice pack(s) (ca. 400 ml, 2-3 cm tall) rather than crushed ice. The ice pack is covered with a piece of filter paper which absorbs the condensed water formed on the cold surface, and the moistened filter paper does not wet the wings of flies inverted onto it. An ice pack (ca. 400 ml) takes effect in at least 1 h, and its height is shorter than the maximum specimen height of a dissecting microscope, so that flies can be checked while they remain on the cold surface. This method overcomes the disadvantages of the indigenous cooling anaesthetising approach and makes it practically feasible. We also describe an easy-to-make fly-transferring toolkit which will greatly facilitate fly transferral when it is combined with our chilling method. In our design, the flies were directed out of a vial by a blue pipette tip, which is inserted in a foam stopper and channelled down into another vial by a glass funnel inserted in another foam stopper which is escape-proof.

The specific neuropsychological and sensory profile found in persons with autism spectrum disorders complicate dental procedures and as a result of this, most are treated under general anesthesia or unnecessary sedation. The main goal of the present study was to evaluate the effectiveness of a short treatment and education of autistic and related communication-handicapped children-based intervention program (five sessions) to facilitate a 10-component oral assessment in children (n = 38, aged 4-9 years) and adults (n = 34, aged 19-41) with autism spectrum disorder (with or without associated intellectual disability). The assessment ranges from entering into the examination room to the evaluation of the dental occlusion. There were statistically significant differences in the number of components reached and in compliance before and after the training program.

This article examines the way the College of Nursing and Health Sciences at Barry University in Miami Shores, Florida, responded to the need to educate certified registered nurse anesthetists by incorporating educational technology into program delivery without compromising integrity and quality to meet market demand. The article discusses modalities used to deliver the master's in anesthesiology and the doctor of nurse practice. Emphasis is placed on how a blended format allows students to stay within their regions and neighborhoods and not have to relocate or lose job opportunities.

Individuals with autism can be quite challenging to treat in a routine dental-office setting, especially when extensive dental treatment and disruptive behavioral issues exist. Individuals with autism may also be at higher risk for oral disease. Frequently, general anesthesia is the only method to facilitate completion of the needed dental treatment. General anesthesia is not without complications, and unique occurrences are a necessary consideration for special-needs populations. In addition, behavior challenges may occur which can be disruptive to hospital staff. This article describes treatment needs and determines adverse events during the perioperative period for individuals with autism who have had general anesthesia for comprehensive dental treatment in the hospital.

The ultimate goal of physician education is the application of knowledge and skills to patient care. The Maintenance of Certification (MOC) for Anesthesiologists program incorporates mannequin-based simulation to help realize this goal. Results from the first 2 years of experience suggest that 583 physician participants transferred knowledge and skills from their simulated experiences into real-world practice. Participants consistently found the experience educationally valuable and clinically relevant, and reported that it led to changes in practice. This first experience with mannequin-based simulation for MOC indicates that physicians accept this teaching modality, many with enthusiasm. Simulation education addresses many of the identified intentions of current continuing medical education (CME) and can help educators realize goals for educating physician-learners. (Contains 1 table.)