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8. The Medical School Retention Game:Admission Testing vs. Highest Grades: One-nil

Author

O'Neill, Lotte Dyhrberg, Hartvigsen, Jan, Wallstedt, Birgitta, Korsholm, Lars, and Eika, B.

Subjects
education
Abstract

INTRODUCTIONVery few studies have reported on the effect of admission tests on medical school dropout.1 Recently Urlings-Strop et al. found the relative risk of dropout to be 2.6 times lower for ‘selected students’ than for ‘lottery admitted controls’.2 The main aim of our study was to evaluate the predictive validity of admission testing versus grade-based admission on dropout.METHOD This prospective cohort study followed 6 cohorts of medical students admitted to the medical school at University of Southern Denmark (USD) in 2002-2007 (N=1544). Half the students were admitted based on highest prior grades (quota 1), while the other half went through a composite non-grade based admission test (quota 2). Educational as well as social predictor variables (doctor parent, origin in the developed world, parenthood, parents live together, parent on benefit, university educated parents) were also examined. The outcome of interest was students’ dropout status 2 years after admission. Multivariate logistic regression analysis was used to model dropout.RESULTSQuota 2 (admission tested) students had a lower relative risk of dropping out of medical school within 2 years of admission compared to quota 1 students (OR=0.56, CI95% [0.39-0.80]). In addition, Danish students without traditional Gymnasium exams had higher relative risks of dropout (OR=2.49, CI95% [1.52-4.07]), as did students who did not assign a first priority to the program on the national admission form (OR= 1.88, CI95% [1.30-2.74]). None of the aforementioned social variables contributed significantly to the dropout model. Interestingly, students composite admission test scores from the quota 2 process did not predict dropout either. DISCUSSIONSelection by admission-testing appeared to have an independent, protective effect on dropout in this setting despite the lack of association between admission test scores and dropout. Pre-university grade point averages are merely broad measures of basic academic skills, and not measures of motivation for any particular program. One explanation for our result could be that, there is in fact an independent association between admission-test survival and program retention – a program specific admission test survivability factor - regardless of admission-test content, prior education, and program priority. The generalisability and other important limitations of the results (e.g. missing data, potential misclassifications, omitting potentially relevant explanatory variables, sample size, method of analysis, outcome chosen) will be discussed.CONCLUSIONSelection by admission-testing appeared to have an independent, protective effect on dropout in this setting, despite the lack of association between admission test scores and dropout. REFERENCES1. O’Neill L, Wallstedt B, Eika B, Hartvigsen J. Factors associated with dropout in medical education: a literature review. Med Educ (In press).2. Urlings-Strop LC, Stijnen T, Themmen APN, Splinter TAW. Selection of medical students: a controlled experiment. Med Educ 2009;43 (2):175–83. INTRODUCTIONVery few studies have reported on the effect of admission tests on medical school dropout.1 Recently Urlings-Strop et al. found the relative risk of dropout to be 2.6 times lower for ‘selected students’ than for ‘lottery admitted controls’.2 The main aim of our study was to evaluate the predictive validity of admission testing versus grade-based admission on dropout.METHOD This prospective cohort study followed 6 cohorts of medical students admitted to the medical school at University of Southern Denmark (USD) in 2002-2007 (N=1544). Half the students were admitted based on highest prior grades (quota 1), while the other half went through a composite non-grade based admission test (quota 2). Educational as well as social predictor variables (doctor parent, origin in the developed world, parenthood, parents live together, parent on benefit, university educated parents) were also examined. The outcome of interest was students’ dropout status 2 years after admission. Multivariate logistic regression analysis was used to model dropout.RESULTSQuota 2 (admission tested) students had a lower relative risk of dropping out of medical school within 2 years of admission compared to quota 1 students (OR=0.56, CI95% [0.39-0.80]). In addition, Danish students without traditional Gymnasium exams had higher relative risks of dropout (OR=2.49, CI95% [1.52-4.07]), as did students who did not assign a first priority to the program on the national admission form (OR= 1.88, CI95% [1.30-2.74]). None of the aforementioned social variables contributed significantly to the dropout model. Interestingly, students composite admission test scores from the quota 2 process did not predict dropout either. DISCUSSIONSelection by admission-testing appeared to have an independent, protective effect on dropout in this setting despite the lack of association between admission test scores and dropout. Pre-university grade point averages are merely broad measures of basic academic skills, and not measures of motivation for any particular program. One explanation for our result could be that, there is in fact an independent association between admission-test survival and program retention – a program specific admission test survivability factor - regardless of admission-test content, prior education, and program priority. The generalisability and other important limitations of the results (e.g. missing data, potential misclassifications, omitting potentially relevant explanatory variables, sample size, method of analysis, outcome chosen) will be discussed.CONCLUSIONSelection by admission-testing appeared to have an independent, protective effect on dropout in this setting, despite the lack of association between admission test scores and dropout. REFERENCES1.O’Neill L, Wallstedt B, Eika B, Hartvigsen J. Factors associated with dropout in medical education: a literature review. Med Educ (In press).2.Urlings-Strop LC, Stijnen T, Themmen APN, Splinter TAW. Selection of medical students: a controlled experiment. Med Educ 2009;43 (2):175–83.

Published
2011

19. Kompetencemåling i klinisk uddannelse

Author

Ringsted, CV., Eika, B., and Wallstedt, B.

Subjects
Education, Medical, Evaluation Studies as Topic, Humans, Clinical Competence, Educational Measurement
Abstract

Udgivelsesdato: 2001-Jun-25

Published
2001

22. Core curriculum in medical education

Author

Wallstedt, B, Ringsted, C V, and Eika, B

Subjects
Europe, Education, Medical, Humans, Guidelines as Topic, Clinical Competence, Curriculum, United States
Abstract

Udgivelsesdato: 2001-Jun-25

Published
2001

29. Poster session IV * Friday 10 December 2010, 14:00-18:00

Author

Mora, B., primary, Base, E., additional, Schmid, W., additional, Andreas, M., additional, Weber, U., additional, Junreitmaier, M., additional, Foerster, F., additional, Hiesmayr, M., additional, Tschernich, H. D., additional, Guldbrand, D., additional, Goetzsche, O., additional, Eika, B., additional, Fumagalli, S., additional, Francini, S., additional, Gabbai, D., additional, Pedri, S., additional, Casalone Rinaldi, M., additional, Makhanian, Y., additional, Sollami, R., additional, Tarantini, F., additional, Marchionni, N., additional, Azcarate, P. M., additional, Castano, S., additional, Rodriguez-Manero, M., additional, Arraiza, M., additional, Levy, B., additional, Barba, J., additional, Rabago, G., additional, Bastarrika, G., additional, Rus, H., additional, Radoi, M., additional, Ciurea, C., additional, Boda, D., additional, Erdei, T., additional, Denes, M., additional, Mihalcz, A., additional, Kardos, A., additional, Foldesi, C. S., additional, Temesvari, A., additional, Lengyel, M., additional, Cameli, M., additional, Lisi, M., additional, Righini, F., additional, Ballo, P., additional, Henein, M., additional, Mondillo, S., additional, Nistri, S., additional, Galderisi, M., additional, Ballo, P. C., additional, Pagliani, L., additional, Olivotto, I., additional, Santoro, A., additional, Papesso, B., additional, Innelli, P., additional, Cecchi, F., additional, Hristova, K., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Nesheva, N., additional, Ivanovic, B., additional, Tadic, M. T., additional, Simic, D. S., additional, Rao, C. M., additional, Aguglia, D., additional, Casciola, G., additional, Imbesi, C., additional, Marvelli, A., additional, Sgro, M., additional, Benedetto, D., additional, Tripepi, G., additional, Zoccali, C., additional, Benedetto, F. A., additional, Mantziari, L., additional, Kamperidis, V., additional, Damvopoulou, E., additional, Ventoulis, I., additional, Giannakoulas, G., additional, Paraskevaidis, S., additional, Vassilikos, V., additional, Karvounis, H., additional, Styliadis, I. H., additional, Sonder, T. K., additional, Loegstrup, B. B., additional, Lambrechtsen, J., additional, Van Bortel, L. M., additional, Segers, P., additional, Egstrup, K., additional, Tho, A., additional, Moceri, P., additional, Bertora, D., additional, Gibelin, P., additional, Cho, E. J., additional, Choi, K. Y., additional, Kim, B. J., additional, Kim, D. B., additional, Jang, S. W., additional, Park, C. S., additional, Jung, H. O., additional, Jeon, H. K., additional, Youn, H. J., additional, Kim, J. H., additional, Donal, E., additional, Coquerel, N., additional, Bodi, S., additional, Thebault, C., additional, Kervio, G., additional, Carre, F., additional, Daly, M. J., additional, Fairley, S. L., additional, Doherty, R., additional, Ashfield, K., additional, Kirkpatrick, R., additional, Smith, B., additional, Buchanan, J., additional, Hill, L., additional, Dixon, L. J., additional, Rosca, M., additional, O' Connor, K., additional, Magne, J., additional, Romano, G., additional, Calin, A., additional, Popescu, B. A., additional, Beladan, C. C., additional, Pierard, L., additional, Ginghina, C., additional, Lancellotti, P., additional, Bochenek, T., additional, Wita, K., additional, Tabor, Z., additional, Grabka, M., additional, Elzbieciak, M., additional, Trusz-Gluza, M., additional, Moreau, O., additional, Leclercq, C., additional, Sahlen, A., additional, Shahgaldi, K., additional, Aminoff, A., additional, Aagaard, P., additional, Manouras, A., additional, Winter, R., additional, Ehrenborg, E., additional, Braunschweig, F., additional, Bedetti, G., additional, Gargani, L., additional, Pizzi, C., additional, Sicari, R., additional, Picano, E., additional, Zhang, J., additional, Zhang, H. B., additional, Duan, Y. Y., additional, Chen, L. L., additional, Li, J., additional, Liu, L. W., additional, Zhu, T., additional, Li, H. L., additional, Su, H. L., additional, Zhou, X. D., additional, Ruiz Ortiz, M., additional, Mesa Rubio, D., additional, Delgado Ortega, M., additional, Romo Penas, E., additional, Toledano Degado, F., additional, Leon Del Pino, C., additional, Lopez Aguilera, J., additional, Villanueva Fernandez, E., additional, Cejudo Diaz Del Campo, L., additional, Suarez De Lezo, J., additional, Abergel, E., additional, Simon, M., additional, Dehant, P., additional, Bogino, E., additional, Jimenez, M., additional, Verdier, J. C., additional, Chauvel, C., additional, Albertsen, A. E., additional, Nielsen, J. C., additional, Mortensen, P. T., additional, Egeblad, H., additional, Nasr, G. M., additional, Tawfik, S., additional, Omar, A., additional, Olofsson, M., additional, Boman, K., additional, Rezzoug, N., additional, Vaes, B., additional, Degryse, J., additional, Vanoverschelde, J.-L., additional, Pasquet, A. A., additional, Poggio, D., additional, Bonadies, M., additional, Pacher, V., additional, Mazzetti, S., additional, Grillo, M., additional, D'elia, E., additional, Khouri, T., additional, Specchia, G., additional, Mornos, C., additional, Rusinaru, D., additional, Cozma, D., additional, Ionac, A., additional, Petrescu, L., additional, Rotzak, R., additional, Rosenman, Y., additional, Patterson, R. D., additional, Ratnatheepan, S., additional, Bogle, R. G., additional, Goebel, B., additional, Gjesdal, O., additional, Kottke, D., additional, Otto, S., additional, Jung, C., additional, Edvardsen, T., additional, Figulla, H. R., additional, Poerner, T. C., additional, Otsuka, T., additional, Suzuki, M., additional, Yoshikawa, H., additional, Hashimoto, G., additional, Itou, N., additional, Ono, T., additional, Yamamoto, M., additional, Osaki, T., additional, Tsuchida, T., additional, Sugi, K., additional, Wolber, T., additional, Haegeli, L., additional, Huerlimann, D., additional, Brunckhorst, C., additional, Duru, F., additional, Wu, Z. M., additional, Shu, X. H., additional, Dong, L. L., additional, Fan, B., additional, Ge, J. B., additional, Greutmann, M., additional, Tobler, D., additional, Biaggi, P., additional, Mah, M., additional, Crean, A., additional, Oechslin, E. N., additional, Silversides, C. K., additional, Giusca, S., additional, Jurcut, R., additional, Ghiorghiu, I., additional, Coman, I. M., additional, Amzulescu, M., additional, Ionescu, R., additional, Delcroix, M., additional, Voigt, J. U., additional, Piatkowski, R., additional, Kochanowski, J., additional, Scislo, P., additional, Grabowski, M., additional, Marchel, M., additional, Roik, M., additional, Kosior, D., additional, Opolski, G., additional, Maceira Gonzalez, A. M., additional, Cosin-Sales, J., additional, Dalli, E., additional, Igual, B., additional, Monmeneu, J. V., additional, Lopez-Lereu, P., additional, Estornell, J., additional, Ruvira, J., additional, Sotillo, J., additional, Stevanovic, A., additional, Toncev, A., additional, Dimkovic, S., additional, Dekleva, M., additional, Paunovic, N., additional, Toncev, D., additional, Sekularac, N., additional, Yildirimturk, O., additional, Helvacioglu, F. F., additional, Tayyareci, Y., additional, Yurdakul, S., additional, Demiroglu, I. C. C., additional, Aytekin, S., additional, Pinedo Gago, M., additional, Amat Santos, I., additional, Revilla Orodea, A., additional, Lopez Diaz, J., additional, Arnold, R., additional, De La Fuente Galan, L., additional, Recio Platero, A., additional, Gomez Salvador, I., additional, Puerto Sanz, A., additional, San Roman Calvar, J. A., additional, Yotti, R., additional, Bermejo, J., additional, Mombiela, T., additional, Benito, Y., additional, Sanchez, P. L., additional, Solis, J., additional, Prieto, R., additional, Fernandez-Aviles, F., additional, Zilberszac, R., additional, Gabriel, H., additional, Graf, S., additional, Mundigler, G., additional, Maurer, G., additional, Rosenhek, R., additional, Zito, C., additional, Salvia, J., additional, Longordo, C., additional, Donato, D., additional, Alati, E., additional, Miceli, M., additional, Pardeo, A., additional, Arcidiaco, S., additional, Oreto, G., additional, Carerj, S., additional, Hadjimiltiades, S., additional, Sianos, G., additional, Anastasiadis, K., additional, Grosomanidis, V., additional, Efthimiadis, G., additional, Parcharidis, G., additional, Yousry, M., additional, Rickenlund, A., additional, Petrini, J., additional, Gustafsson, T., additional, Liska, J., additional, Hamsten, A., additional, Eriksson, P., additional, Franco-Cereceda, A., additional, Eriksson, M. J., additional, Caidahl, K., additional, Mizia-Stec, K., additional, Pysz, P., additional, Jasinski, M., additional, Drzewiecka-Gerber, A., additional, Krejca, M., additional, Bochenek, A., additional, Wos, S., additional, Gasior, Z., additional, Tendera, M., additional, Niki, K., additional, Sugawara, M., additional, Takamisawa, I., additional, Watanabe, H., additional, Sumiyoshi, T., additional, Hosoda, S., additional, Ida, T., additional, Takanashi, S., additional, Olsen, N. T., additional, Sogaard, P., additional, Jons, C., additional, Mogelvang, R., additional, Larsson, H. B. W., additional, Goetze, J. P., additional, Nielsen, O. W., additional, Fritz-Hansen, T., additional, Sayar, N., additional, Orhan, A. L., additional, Erer, H. B., additional, Eren, M., additional, Atmaca, H., additional, Yilmaz, H. Y., additional, Cakmak, N., additional, Altay, S., additional, Terzi, S., additional, Yesilcimen, K., additional, Garcia Orta, R., additional, Moreno, E., additional, Lopez, M., additional, Uribe, I., additional, Vidal, M., additional, Ruiz-Lopez, M. F., additional, Gonzalez-Molina, M., additional, Oyonarte, J. M., additional, Lopez, S., additional, Azpitarte, J., additional, Szymanski, C., additional, Levine, R. A., additional, Zheng, H., additional, Handschumacher, M. D., additional, Tawakol, A., additional, Hung, J., additional, Le Ven, F., additional, Etienne, Y., additional, Jobic, Y., additional, Frachon, I., additional, Castellant, P., additional, Fatemi, M., additional, Blanc, J. J., additional, Tribouilloy, C., additional, Grigioni, F., additional, Avierinos, J.-F., additional, Barbieri, A., additional, Buiciuc, O., additional, Enriquez-Sarano, M., additional, Said, K., additional, Farag, A. K., additional, El-Ramly, M., additional, Rizk, H., additional, Iorio, A., additional, Pinamonti, B., additional, Bobbo, M., additional, Merlo, M., additional, Massa, L., additional, Faganello, G., additional, Di Lenarda, A., additional, Sinagra, G., additional, Margato, R., additional, Ribeiro, H., additional, Ferreira, C., additional, Matias, A., additional, Fontes, P., additional, Moreira, J. I., additional, Milan, A., additional, Puglisi, E., additional, Magnino, C., additional, Fabbri, A., additional, Leone, D., additional, Vairo, A., additional, Crudo, V., additional, Iannaccone, A., additional, Milazzo, V., additional, Veglio, F., additional, Maroz-Vadalazhskaya, N., additional, Ostrovskiy, I., additional, Imbalzano, E., additional, Saitta, A., additional, Cusma-Piccione, M., additional, Di Bella, G., additional, Nava, R., additional, Ferro, M., additional, Falanga, G., additional, Frigy, A., additional, Buzogany, J., additional, Szabados, C. S., additional, Dan, L., additional, Carasca, E., additional, Ikonomidis, I., additional, Lekakis, J., additional, Tzortzis, S., additional, Kremastinos, D. T., additional, Papadopoulos, C., additional, Paraskevaidis, I., additional, Triantafyllidi, H., additional, Trivilou, P., additional, Venetsanou, K., additional, Anastasiou-Nana, M., additional, Wierzbowska-Drabik, K., additional, Kurpesa, M., additional, Trzos, E., additional, Rechcinski, T., additional, Mozdzan, M., additional, Kasprzak, J. D., additional, Kosmala, W., additional, Kotwica, T., additional, Przewlocka-Kosmala, M., additional, Mysiak, A., additional, Skultetyova, D., additional, Filipova, S., additional, Chnupa, P., additional, Pechlivanidis, G., additional, Dimitroula, H., additional, Tsai, W.-C., additional, Liu, Y.-W., additional, Lin, C.-C., additional, Huang, Y.-Y., additional, Tsai, L.-M., additional, Park, S. M., additional, Kim, Y. H., additional, Shin, S. M., additional, Shim, W. J., additional, Gonzalez Mansilla, A., additional, Torres Macho, J., additional, Sanchez Sanchez, V., additional, Diez, P., additional, Delgado, J., additional, Borruel, S., additional, Saenz De La Calzada, C., additional, Pyxaras, S., additional, Valentincic, M., additional, Barbati, G., additional, Lo Giudice, F., additional, Perkan, A., additional, Magnani, S., additional, Palecek, T., additional, Ambroz, D., additional, Jansa, P., additional, Lindner, J., additional, Vitovec, M., additional, Polacek, P., additional, Jiratova, K., additional, Linhart, A., additional, Baskurt, M., additional, Dogan, G. M., additional, Abaci, O., additional, Kaya, A., additional, Kucukoglu, S., additional, Duszanska, A., additional, Kukulski, T., additional, Skoczylas, I., additional, Majsnerowska, A., additional, Nowowiejska-Wiewiora, A., additional, Streb, W., additional, Szulik, M., additional, Polonski, L., additional, Kalarus, Z., additional, Yerly, P. O., additional, Prella, M., additional, Joly, A., additional, Nicod, L., additional, Aubert, J. D., additional, Aebischer, N., additional, Dores, H., additional, Leal, S., additional, Rosario, I., additional, Correia, M. J., additional, Monge, J., additional, Grilo, A. M., additional, Arroja, I., additional, Fonseca, C., additional, Aleixo, A., additional, Silva, A., additional, Perez-David, E., additional, Sanchez-Alegre, M., additional, Gomez Anta, I., additional, De La Torre, J., additional, Alarcon, J., additional, Garcia Robles, J. A., additional, Lafuente, J., additional, Garcia Alonso, C. J., additional, Vallejo Camazon, N., additional, Gonzalez Guardia, A., additional, Nunez, R., additional, Bosch Carabante, C., additional, Mateu, L., additional, Gual Capllonch, F., additional, Ferrer Sistach, E., additional, Lopez Ayerbe, J., additional, Bayes Genis, A., additional, Tomaszewski, A., additional, Kutarski, A., additional, Tomaszewski, M., additional, Bramos, D., additional, Kalantaridou, A., additional, Takos, D., additional, Skaltsiotis, E., additional, Trika, C., additional, Tsirikos, N., additional, Pamboukas, C., additional, Kottis, G., additional, Toumanidis, S., additional, Aggeli, C., additional, Felekos, I., additional, Roussakis, G., additional, Kazazaki, C., additional, Lampropoulos, K., additional, Lagoudakou, S., additional, Stergiou, C., additional, Pitsavos, C., additional, Stefanadis, C., additional, Kihara, C., additional, Murata, K., additional, Wada, Y., additional, Tanaka, T., additional, Uchida, K., additional, Okuda, S., additional, Susa, T., additional, Matsuzaki, M., additional, Abrahamsson, A., additional, Gudmundsson, P., additional, Brodin, L., additional, Knebel, F., additional, Schattke, S., additional, Sanad, W., additional, Schimke, I., additional, Schroeckh, S., additional, Brechtel, L., additional, Lock, J., additional, Makauskiene, R., additional, Baumann, G., additional, Borges, A. C., additional, Moelmen-Hansen, H. E., additional, Wisloff, U., additional, Aamot, I. L., additional, Stoylen, A., additional, Ingul, C. B., additional, Estensen, M.-E., additional, Beitnes, J. O., additional, Grindheim, G., additional, Henriksen, T., additional, Aaberge, L., additional, Smiseth, O. A., additional, Gullestad, L., additional, Aakhus, S., additional, Agoston, G., additional, Moggi Pignone, A., additional, Capati, E., additional, Badano, L., additional, Moreo, A., additional, Bombardieri, S., additional, Varga, A., additional, Carrideo, M., additional, Faricelli, S., additional, Corazzini, A., additional, Ippedico, R., additional, Ruggieri, B., additional, Di Blasio, A., additional, D'angelo, E., additional, Di Baldassarre, A., additional, Ripari, P., additional, Gallina, S., additional, Kentrschynskyj, A., additional, Hylander, B., additional, Jacobson, S., additional, Pagels, A., additional, Dumitrescu, S. I., additional, Tintoiu, I., additional, Greere, V., additional, Cristian, G., additional, Chiriac, L., additional, Pinte, F., additional, Droc, I., additional, Neagoe, G., additional, Stanciu, S., additional, Voicu, V. A., additional, Kuch-Wocial, A., additional, Pruszczyk, P., additional, Szmigielski, C. A., additional, Szulc, M., additional, Styczynski, G., additional, Sinski, M., additional, Kaczynska, A., additional, Ryabikov, A., additional, Malyutina, S., additional, Halcox, J., additional, Bobak, M., additional, Nikitin, Y. U., additional, Marmot, M., additional, Barbosa, D., additional, Kiss, G., additional, Orderud, F., additional, Amundsen, B., additional, Jasaityte, R., additional, Loeckx, D., additional, Claus, P., additional, Torp, H., additional, D'hooge, J., additional, Kuhl, J. T., additional, Lonborg, J., additional, Fuchs, A., additional, Andersen, M., additional, Vejlstrup, N., additional, Engstrom, T., additional, Moller, J. E., additional, Kofoed, K. F., additional, Smith, L. A., additional, Bhan, A., additional, Paul, M., additional, Monaghan, M. J., additional, Zaborska, B., additional, Stec, S., additional, Sikora-Frac, M., additional, Krynski, T., additional, Kulakowski, P., additional, Pushparajah, K., additional, Dashwood, D., additional, Barlow, A., additional, Nugent, K., additional, Miller, O., additional, Simpson, J., additional, Valeur, N., additional, Ersboll, M. K., additional, Kjaergaard, J., additional, Greibe, R., additional, Risum, N., additional, Hassager, C., additional, Kober, L., additional, Popovic, D., additional, Nedeljkovic, I., additional, Petrovic, M., additional, Vujisic-Tesic, B., additional, Arandjelovic, A., additional, Stojiljkovic, S., additional, Jakovljevic, B., additional, Damjanovic, S., additional, Ostojic, M., additional, Agrios, I. A., additional, Bramos, D. B., additional, Skaltsiotis, H. S., additional, Takos, D. T., additional, Kaladaridis, A., additional, Vasiladiotis, N. V., additional, Kottis, G. K., additional, Antoniou, A. A., additional, Pamboucas, C. P., additional, Toumanidis, S. T. T., additional, Locorotondo, G., additional, Porto, I., additional, Paraggio, L., additional, Fedele, E., additional, Barchetta, S., additional, De Caterina, A. R., additional, Rebuzzi, A. G., additional, Crea, F., additional, Galiuto, L., additional, Lipiec, P., additional, Szymczyk, E., additional, Michalski, B., additional, Wozniakowski, B., additional, Stefanczyk, L., additional, Rotkiewicz, A., additional, Shim, A., additional, Vainer, J., additional, Habets, J., additional, Lousberg, A., additional, Pont De, C., additional, Waltenberger, J., additional, Farouk, H., additional, Heshmat, H., additional, Adel, A., additional, El Chilali, K., additional, Baghdady, Y., additional, Sorour, K., additional, Gustafsson, U., additional, Larsson, M., additional, Bjallmark, A., additional, Lindqvist, P., additional, A'roch, R., additional, Haney, M., additional, Waldenstrom, A., additional, Mladenovic, Z., additional, Tavciovski, D., additional, Mijailovic, Z., additional, Djordjevic - Dikic, A., additional, Obradovic, S., additional, Matunovic, R., additional, Jovic, Z., additional, Djuric, P., additional, Aase, S., additional, Dalen, H., additional, Sarkola, T., additional, Redington, A. N., additional, Keeley, F., additional, Bradley, T., additional, Jaeggi, E., additional, and Sahlen, H., additional

Published
2010
Full Text
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30. Poster session III * Friday 10 December 2010, 08:30-12:30

Author

Guldbrand, D., primary, Goetzsche, O., additional, Eika, B., additional, Watanabe, N., additional, Taniguchi, M., additional, Akagi, T., additional, Koide, N., additional, Sano, S., additional, Orbovic, B., additional, Obrenovic-Kircanski, B., additional, Ristic, S., additional, Soskic, L. J., additional, Alhabshan, F., additional, Jijeh, A., additional, Abo Remsh, H., additional, Alkhaldi, A., additional, Najm, H. K., additional, Gasior, Z., additional, Skowerski, M., additional, Kulach, A., additional, Szymanski, L., additional, Sosnowski, M., additional, Wang, M., additional, Siu, C. W., additional, Lee, K., additional, Yue, W. S., additional, Yan, G. H., additional, Lee, S., additional, Lau, C. P., additional, Tse, H. F., additional, O'connor, K., additional, Rosca, M., additional, Magne, J., additional, Romano, G., additional, Moonen, M., additional, Pierard, L. A., additional, Lancellotti, P., additional, Floria, M., additional, De Roy, L., additional, Blommaert, D., additional, Jamart, J., additional, Dormal, F., additional, Lacrosse, M., additional, Arsenescu Georgescu, C., additional, Mizariene, V., additional, Bucyte, S., additional, Bertasiute, A., additional, Pociute, E., additional, Zaliaduonyte-Peksiene, D., additional, Baronaite-Dudoniene, K., additional, Sileikiene, R., additional, Vaskelyte, J., additional, Jurkevicius, R., additional, Dencker, M., additional, Thorsson, O., additional, Karlsson, M. K., additional, Linden, C., additional, Wollmer, P., additional, Andersen, L. B., additional, Catalano, O., additional, Perotti, M. R., additional, Colombo, E., additional, De Giorgi, M., additional, Cattaneo, M., additional, Cobelli, F., additional, Priori, S. G., additional, Ober, C., additional, Iancu Adrian, I. A., additional, Andreea Parv, P. A., additional, Cadis Horatiu, C. H., additional, Ober Mihai, O. M., additional, Chmielecki, M., additional, Fijalkowski, M., additional, Galaska, R., additional, Dubaniewicz, W., additional, Lewicki, L., additional, Targonski, R., additional, Ciecwierz, D., additional, Puchalski, W., additional, Koprowski, A., additional, Rynkiewicz, A., additional, Hristova, K., additional, La Gerche, A., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Kempny, A., additional, Diller, G. P., additional, Orwat, S., additional, Kaleschke, G., additional, Kerckhoff, G., additional, Schmidt, R., additional, Radke, R. M., additional, Baumgartner, H., additional, Smarz, K., additional, Zaborska, B., additional, Jaxa-Chamiec, T., additional, Maciejewski, P., additional, Budaj, A., additional, Kiotsekoglou, A., additional, Govind, S. C., additional, Gadiyaram, V., additional, Moggridge, J. C., additional, Govindan, M., additional, Gopal, A. S., additional, Ramesh, S. S., additional, Brodin, L. A., additional, Saha, S. K., additional, Ramzy, I. S., additional, Lindqvist, P., additional, Lam, Y. Y., additional, Duncan, A. M., additional, Henein, M. Y., additional, Craciunescu, I. S., additional, Serban, M., additional, Iancu, M., additional, Revnic, C., additional, Popescu, B. A., additional, Alexandru, D., additional, Rogoz, D., additional, Uscatescu, V., additional, Ginghina, C., additional, Careri, G., additional, Di Monaco, A., additional, Nerla, R., additional, Tarzia, P., additional, Lamendola, P., additional, Sestito, A., additional, Lanza, G. A., additional, Crea, F., additional, Giannini, F., additional, Pinamonti, B., additional, Santangelo, S., additional, Perkan, A., additional, Vitrella, G., additional, Rakar, S., additional, Merlo, M., additional, Della Grazia, E., additional, Salvi, A., additional, Sinagra, G., additional, Scislo, P., additional, Kochanowski, J., additional, Piatkowski, R., additional, Roik, M., additional, Postula, M., additional, Opolski, G., additional, Castillo, J., additional, Herszkowicz, N., additional, Ferreira, C., additional, Lonnebakken, M. T., additional, Staal, E. M., additional, Nordrehaug, J. E., additional, Gerdts, E., additional, Przewlocka-Kosmala, M., additional, Orda, A., additional, Karolko, B., additional, Bajraktari, G., additional, Gustafsson, U., additional, Holmgren, A., additional, Frattini, S., additional, Faggiano, P., additional, Zilioli, V., additional, Locantore, E., additional, Longhi, S., additional, Bellandi, F., additional, Faden, G., additional, Triggiani, M., additional, Dei Cas, L., additional, Seo, S. M., additional, Jung, H. O., additional, An, S. H., additional, Jung, S. Y., additional, Park, C. S., additional, Jeon, H. K., additional, Youn, H. J., additional, Chung, W. B., additional, Kim, J. H., additional, Uhm, J. S., additional, Mampuya, W., additional, Brochu, M. C., additional, Do, D. H., additional, Essadiqi, B., additional, Farand, P., additional, Lepage, S., additional, Daly, M. J., additional, Monaghan, M., additional, Hamilton, A., additional, Lockhart, C., additional, Kodoth, V., additional, Maguire, C., additional, Morton, A., additional, Manoharan, G., additional, Spence, M. S., additional, Streb, W., additional, Mitrega, K., additional, Nowak, J., additional, Duszanska, A., additional, Szulik, M., additional, Kalinowski, M., additional, Kukulski, T., additional, Kalarus, Z., additional, Calvo Iglesias, F. E., additional, Solla-Ruiz, I., additional, Villanueva-Benito, I., additional, Paredes-Galan, E., additional, Bravo-Amaro, M., additional, Iniguez-Romo, A., additional, Yildirimturk, O., additional, Helvacioglu, F. F., additional, Tayyareci, Y., additional, Yurdakul, S., additional, Demiroglu, I. C., additional, Aytekin, S., additional, Enache, R., additional, Piazza, R., additional, Muraru, D., additional, Roman-Pognuz, A., additional, Calin, A., additional, Leiballi, E., additional, Antonini-Canterin, F., additional, Nicolosi, G. L., additional, Ridard, C., additional, Bellouin, A., additional, Thebault, C., additional, Laurent, M., additional, Donal, E., additional, Sutandar, A., additional, Siswanto, B. B., additional, Irmalita, I., additional, Harimurti, G., additional, Saxena, A., additional, Ramakrishnan, S., additional, Roy, A., additional, Krishnan, A., additional, Misra, P., additional, Bhargava, B., additional, Poole-Wilson, P. A., additional, Loegstrup, B. B., additional, Andersen, H. R., additional, Poulsen, S. H., additional, Klaaborg, K. E., additional, Egeblad, H. E., additional, Gu, X., additional, Gu, X. Y., additional, He, Y. H., additional, Li, Z. A., additional, Han, J. C., additional, Chen, J., additional, Mansencal, N., additional, Mitry, E., additional, Rougier, P., additional, Dubourg, O., additional, Villarraga, H., additional, Adjei-Twum, K., additional, Cudjoe, T. K. M., additional, Clavell, A., additional, Schears, R. M., additional, Cabrera Bueno, F., additional, Molina Mora, M. J., additional, Fernandez Pastor, J., additional, Linde Estrella, A., additional, Pena Hernandez, J. L., additional, Isasti Aizpurua, G., additional, Carrasco Chinchilla, F., additional, Barrera Cordero, A., additional, Alzueta Rodriguez, F. J., additional, De Teresa Galvan, E., additional, Gaetano Contegiacomo, G. C., additional, Francesco Pollice, F. P., additional, Paolo Pollice, P. P., additional, Kontos, M. C., additional, Shin, D. H., additional, Yoo, S. Y., additional, Lee, C. K., additional, Jang, J. K., additional, Jung, S. I., additional, Song, S. I., additional, Seo, S. I., additional, Cheong, S. S., additional, Peteiro, J., additional, Perez-Perez, A., additional, Bouzas-Mosquera, A., additional, Pineiro, M., additional, Pazos, P., additional, Campo, R., additional, Castro-Beiras, A., additional, Gaibazzi, N., additional, Rigo, F., additional, Sartorio, D., additional, Reverberi, C., additional, Sitia, S., additional, Tomasoni, L., additional, Gianturco, L., additional, Ghio, L., additional, Stella, D., additional, Greco, P., additional, De Gennaro Colonna, V., additional, Turiel, M., additional, Cicala, S., additional, Magagnin, V., additional, Caiani, E., additional, Kyrzopoulos, S., additional, Tsiapras, D., additional, Domproglou, G., additional, Avramidou, E., additional, Voudris, V., additional, Wierzbowska-Drabik, K., additional, Lipiec, P., additional, Chrzanowski, L., additional, Roszczyk, N., additional, Kupczynska, K., additional, Kasprzak, J. D., additional, Sachpekidis, V., additional, Bhan, A., additional, Gianstefani, S., additional, Reiken, J., additional, Paul, M., additional, Pearson, P., additional, Harries, D., additional, Monaghan, M. J., additional, Dale, K., additional, Stoylen, A., additional, Kodali, V., additional, Toole, R., additional, Raju, P., additional, Mcintosh, R. A., additional, Silberbauer, J., additional, Baumann, O., additional, Patel, N. R., additional, Sulke, N., additional, Trivedi, U., additional, Hyde, J., additional, Venn, G., additional, Lloyd, G., additional, Wejner-Mik, P., additional, Wierzbowska, K., additional, Lowenstein, J. A., additional, Caniggia, C., additional, Garcia, A., additional, Amor, M., additional, Casso, N., additional, Lowenstein Haber, D., additional, Porley, C., additional, Zambrana, G., additional, Daru, V., additional, Deljanin Ilic, M., additional, Ilic, S., additional, Kalimanovska Ostric, D., additional, Stoickov, V., additional, Zdravkovic, M., additional, Paraskevaidis, I., additional, Ikonomidis, I., additional, Parissis, J., additional, Papadopoulos, C., additional, Stasinos, V., additional, Bistola, V., additional, Anastasiou-Nana, M., additional, Gudin Uriel, M., additional, Balaguer Malfagon, J. R., additional, Perez Bosca, J. L., additional, Ridocci Soriano, F., additional, Martinez Alzamora, N., additional, Paya Serrano, R., additional, Ciampi, Q., additional, Pratali, L., additional, Della Porta, M., additional, Petruzziello, B., additional, Villari, B., additional, Picano, E., additional, Sicari, R., additional, Rosner, A., additional, Avenarius, D., additional, Malm, S., additional, Iqbal, A., additional, Baltabaeva, A., additional, Sutherland, G. R., additional, Bijnens, B., additional, Myrmel, T., additional, Andersen, M., additional, Gustafsson, F., additional, Secher, N. H., additional, Brassard, P., additional, Jensen, A. S., additional, Hassager, C., additional, Madsen, P. L., additional, Moller, J. E., additional, Coutu, M., additional, Greentree, D., additional, Normandin, D., additional, Brun, H., additional, Dipchand, A., additional, Koopman, L., additional, Fackoury, C. T., additional, Truong, S., additional, Manlhiot, C., additional, Mertens, L., additional, Baroni, M., additional, Mariani, M., additional, Chabane, H. K., additional, Berti, S., additional, Ripoli, A., additional, Storti, S., additional, Glauber, M., additional, Scopelliti, P. A., additional, Antongiovanni, G. B., additional, Personeni, D., additional, Saino, A., additional, Tespili, M., additional, Jung, P., additional, Mueller, M., additional, Jander, F., additional, Sohn, H. Y., additional, Rieber, J., additional, Schneider, P., additional, Klauss, V., additional, Agricola, E., additional, Slavich, M., additional, Stella, S., additional, Ancona, M., additional, Oppizzi, M., additional, Bertoglio, L., additional, Melissano, G., additional, Margonato, A., additional, Chiesa, R., additional, Cejudo Diaz Del Campo, L., additional, Mesa Rubio, D., additional, Ruiz Ortiz, M., additional, Delgado Ortega, M., additional, Villanueva Fernandez, E., additional, Lopez Aguilera, J., additional, Toledano Delgado, F., additional, Pan Alvarez-Ossorio, M., additional, Suarez De Lezo Cruz Conde, J., additional, Lafuente, M., additional, Butz, T., additional, Meissner, A., additional, Lang, C. N., additional, Prull, M. W., additional, Plehn, G., additional, Trappe, H. J., additional, Nair, S. V., additional, Lee, L., additional, Mcleod, I., additional, Whyte, G., additional, Shrimpton, J., additional, Hildick Smith, D., additional, James, P. R., additional, Slikkerveer, J., additional, Appelman, Y. E. A., additional, Veen, G., additional, Porter, T. R., additional, Kamp, O., additional, Colonna, P., additional, Ten Cate, F. J., additional, Bokor, D., additional, Daponte, A., additional, Cocciolo, M., additional, Bona, M., additional, Sacchi, S., additional, Becher, H., additional, Chai, S. C., additional, Tan, P. J., additional, Goh, Y. S., additional, Ong, S. H., additional, Chow, J., additional, Lee, L. L., additional, Goh, P. P., additional, Tong, K. L., additional, Kakihara, R., additional, Naruse, C., additional, Hironaka, H., additional, Tsuzuku, T., additional, Ozawa, K., additional, Tomaszuk-Kazberuk, A., additional, Sobkowicz, B., additional, Malyszko, J., additional, Malyszko, J. S., additional, Sawicki, R., additional, Hirnle, T., additional, Dobrzycki, S., additional, Mysliwiec, M., additional, Musial, W. J., additional, Mathias, W., additional, Kowatsch, I., additional, Saroute, A. L. R., additional, Osorio, A. F. F., additional, Sbano, J. C. N., additional, Ramires, J. A. F., additional, Tsutsui, J. M., additional, Sakata, K., additional, Ito, H., additional, Ishii, K., additional, Sakuma, T., additional, Iwakura, K., additional, Yoshino, H., additional, Yoshikawa, J., additional, Shahgaldi, K., additional, Lopez, A., additional, Fernstrom, B., additional, Sahlen, A., additional, Winter, R., additional, Kovalova, S., additional, Necas, J., additional, Amundsen, B. H., additional, Jasaityte, R., additional, Kiss, G., additional, Barbosa, D., additional, D'hooge, J., additional, Torp, H., additional, Szmigielski, C. A., additional, Newton, J. D., additional, Rajpoot, K., additional, Noble, J. A., additional, Kerber, R., additional, Koopman, L. P., additional, Slorach, C., additional, Chahal, N., additional, Hui, W., additional, Sarkola, T., additional, Bradley, T. J., additional, Jaeggi, E. T., additional, Mccrindle, B. W., additional, Staron, A., additional, Jasinski, M., additional, Wos, S., additional, Sengupta, P., additional, Hayat, D., additional, Kloeckner, M., additional, Nahum, J., additional, Dussault, C., additional, Dubois Rande, J. L., additional, Gueret, P., additional, Lim, P., additional, King, G. J., additional, Brown, A., additional, Ho, E., additional, Amuntaser, I., additional, Bennet, K., additional, Mc Elhome, N., additional, Murphy, R. T., additional, Cooper, R. M., additional, Somauroo, J. D., additional, Shave, R. E., additional, Williams, K. L., additional, Forster, J., additional, George, C., additional, Bett, T., additional, George, K. P., additional, D'andrea, A., additional, Riegler, L., additional, Cocchia, R., additional, Golia, E., additional, Gravino, R., additional, Salerno, G., additional, Citro, R., additional, Caso, P. I. O., additional, Bossone, E., additional, Calabro', R., additional, Crispi, F., additional, Figueras, F., additional, Bartrons, J., additional, Eixarch, E., additional, Le Noble, F., additional, Ahmed, A., additional, Gratacos, E., additional, Shang, Q., additional, Yip, W. K., additional, Tam, L. S., additional, Zhang, Q., additional, Li, C. M., additional, Wang, T., additional, Ma, C. Y., additional, Li, K. M., additional, Yu, C. M., additional, Dahlslett, T., additional, Helland, I., additional, Edvardsen, T., additional, Skulstad, H., additional, Magda, L. S., additional, Florescu, M., additional, Ciobanu, A., additional, Dulgheru, R., additional, Mincu, R., additional, Vinereanu, D., additional, Luckie, M., additional, Chacko, S., additional, Nair, S., additional, Mamas, M., additional, Khattar, R. S., additional, El-Omar, M., additional, Kuch-Wocial, A., additional, Pruszczyk, P., additional, Szulc, M., additional, Styczynski, G., additional, Sinski, M., additional, Kaczynska, A., additional, Vela, Z., additional, Haliti, E., additional, Hyseni, V., additional, Olloni, R., additional, Rexhepaj, N., additional, Elezi, S., additional, Onaindia, J. J., additional, Quintana, O., additional, Cacicedo, A., additional, Velasco, S., additional, Alarcon, J. J., additional, Morillas, M., additional, Rumoroso, J. R., additional, Zumalde, J., additional, Lekuona, I., additional, Laraudogoitia Zaldumbide, E., additional, Poniku, A., additional, Ahmeti, A., additional, Duncan, R. F., additional, Mccomb, J. M., additional, Pemberton, J., additional, Lord, S. W., additional, Leong, D., additional, Plummer, C., additional, Macgowan, G., additional, Grubb, N., additional, Leung, M., additional, Kenny, A., additional, Prinz, C., additional, Voigt, J. U., additional, Zaidi, A., additional, Heatley, M., additional, Abildstrom, S. Z., additional, Hvelplund, A., additional, Berning, J., additional, Govind, S., additional, Brodin, L., additional, Gopal, A., additional, Castaldi, B., additional, Di Salvo, G., additional, Santoro, G., additional, Gaio, G., additional, Palladino, M. T., additional, Iacono, C., additional, Pacileo, G., additional, Russo, M. G., additional, Calabro, R., additional, Wang, Y. S., additional, Dong, L. L., additional, Shu, X. H., additional, Pan, C. Z., additional, Zhou, D. X., additional, Sen, T., additional, Tufekcioglu, O., additional, Ozdemir, M., additional, Tuncez, A., additional, Uygur, B., additional, Golbasi, Z., additional, Kisacik, H., additional, Delfino, L., additional, De Leo, F. D., additional, Chiappa, L. C., additional, Abdel Ghani, B., additional, Schiavina, R., additional, Salvade, P., additional, Morganti, A., additional, Bedogni, F., additional, Mahia, P., additional, Gutierrez, L., additional, Pineda, V., additional, Garcia, B., additional, Otaegui, I., additional, Rodriguez, J. F., additional, Gonzalez, M. T., additional, Descalzo, M., additional, Evangelista, A., additional, Garcia-Dorado, D., additional, Bruin De- Bon, H. A. C. M., additional, Van Den Brink, R. B. A., additional, Surie, S., additional, Bresser, P., additional, Vleugels, J., additional, Eckmann, H. M., additional, Samson, D. A., additional, Bouma, B. J., additional, Dedobbeleer, C., additional, Antoine, M., additional, Remmelink, M., additional, Unger, P., additional, Roosens, B., additional, Hmila, I., additional, Hernot, S., additional, Droogmans, S., additional, Van Camp, G., additional, Lahoutte, T., additional, Muyldermans, S., additional, Cosyns, B., additional, Feltes, G., additional, Serra, V., additional, Azevedo, O., additional, Barbado, J., additional, Herrera, J., additional, Rivera, A., additional, Paniagua, J., additional, Valverde, V., additional, Torras, J., additional, Arriba, G., additional, Christodoulides, T., additional, Ioannides, M., additional, Simamonian, K., additional, Yiangou, K., additional, Myrianthefs, M., additional, Nicolaides, E., additional, Pandolfo, M., additional, Kleijn, S. A., additional, Aly, M. F. A. A., additional, Terwee, C. B., additional, Van Rossum, A. C., additional, Delgado, V., additional, Shanks, M., additional, Siebelink, H. M., additional, Sieders, A., additional, Lamb, H., additional, Ajmone Marsan, N., additional, Westenberg, J., additional, De Roos, A., additional, Schuijf, J. D., additional, Bax, J. J., additional, Anwar, A. M., additional, Nosir, Y., additional, Chamsi-Pasha, H., additional, Tschernich, H. D., additional, Seeburger, J., additional, Borger, M., additional, Mukherjee, C., additional, Mohr, F. W., additional, Ender, J., additional, Obase, K., additional, Okura, H., additional, Yamada, R., additional, Miyamoto, Y., additional, Saito, K., additional, Imai, K., additional, Hayashida, A., additional, and Yoshida, K., additional

Published
2010
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37. Medical faculty and curriculum design-- 'No, no, it's like this: you give your lectures ...'.

Author

Morcke AM and Eika B

Abstract

Background and aims: The purpose of this study was to understand more completely the (tacit) curriculum design models of medical faculty. We report on two research questions: (1) Can medical faculty give an account of their curriculum design assumptions? and (2) What are their assumptions concerning curriculum design? Method: We conducted an explorative, qualitative case study. We interviewed educational decision makers at the three Danish medical schools and associate professors from different courses concerning curriculum design. We carried out four individual, in-depth interviews and four focus groups with 20 participants in all. Results and conclusions: Only one decision maker had an explicit curriculum design model. However, all participants had assumptions concerning curriculum design. We displayed their assumptions as five essentially different and increasingly complex models: the method-driven, pragmatically driven content-driven, outcome-driven and vision-driven curriculum design models. In the five models, the role of learning outcomes differs. The differences range from a belief that learning outcomes are essential, to a belief that learning outcomes are unimportant, to a belief that learning outcomes are incompatible with higher education. Finally, we found that teachers do not necessarily play a clear, central role in curriculum design. [ABSTRACT FROM AUTHOR]

Published
2009
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40. Type 1 regulatory T cells are associated with persistent split erythroid/lymphoid chimerism after allogeneic hematopoietic stem cell transplantation for thalassemia

Author

Giorgia Serafini, Marco Andreani, Manuela Testi, MariaRosa Battarra, Andrea Bontadini, Eika Biral, Katharina Fleischhauer, Sarah Marktel, Guido Lucarelli, Maria Grazia Roncarolo, and Rosa Bacchetta

Subjects
Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Background Thalassemia major can be cured with allogeneic hematopoietic stem cell transplantation. Persistent mixed chimerism develops in around 10% of transplanted thalassemic patients, but the biological mechanisms underlying this phenomenon are poorly understood.Design and Methods The presence of interleukin-10-producing T cells in the peripheral blood of eight patients with persistent mixed chimerism and five with full donor chimerism was investigated. A detailed characterization was then performed, by T-cell cloning, of the effector and regulatory T-cell repertoire of one patient with persistent mixed chimerism, who developed stable split erythroid/lymphoid chimerism after a hematopoietic stem cell transplant from an HLA-matched unrelated donor.Results Higher levels of interleukin-10 were produced by peripheral blood mononuclear cells from patients with persistent mixed chimerism than by the same cells from patients with complete donor chimerism or normal donors. T-cell clones of both host and donor origin could be isolated from the peripheral blood of one, selected patient with persistent mixed chimerism. Together with effector T-cell clones reactive against host or donor alloantigens, regulatory T-cell clones with a cytokine secretion profile typical of type 1 regulatory cells were identified at high frequencies. Type 1 regulatory cell clones, of both donor and host origin, were able to inhibit the function of effector T cells of either donor or host origin in vitro.Conclusions Overall these results suggest that interleukin-10 and type 1 regulatory cells are associated with persistent mixed chimerism and may play an important role in sustaining long-term tolerance in vivo. These data provide new insights into the mechanisms of peripheral tolerance in chimeric patients and support the use of cellular therapy with regulatory T cells following hematopoietic stem cell transplantation.

Published
2009
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41. Limited intervention improves technical skill in focus assessed transthoracic echocardiography among novice examiners

Author

Frederiksen Christian, Juhl-Olsen Peter, Nielsen Dorte, Eika Berit, and Sloth Erik

Subjects
Point-of-care, Bedside, Ultrasound, Echocardiography, Learning, Special aspects of education, LC8-6691, Medicine
Abstract

Abstract Background Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE) and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation. Methods Twenty-one physicians with no previous training in FATE or echocardiography (Novices) participated in the study and a reference group of three examiners with more than 10 years of experience in echocardiography (Experts) was included. Novices received an initial theoretical and practical introduction (2 hours), after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation) of the same two healthy volunteers from the baseline examination was performed. Results At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p = 0.005). 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4) and mean global image rating after intervention was 75.0 (CI 72.9-77.0), p = 0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9). Conclusions Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation.

Published
2012
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42. Standards of resuscitation during inter-hospital transportation: the effects of structured team briefing or guideline review - A randomised, controlled simulation study of two micro-interventions

Author

Christensen Erika F, Høyer Christian B, and Eika Berit

Subjects
Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Junior physicians are sometimes sent in ambulances with critically ill patients who require urgent transfer to another hospital. Unfamiliar surroundings and personnel, time pressure, and lack of experience may imply a risk of insufficient treatment during transportation as this can cause the physician to loose the expected overview of the situation. While health care professionals are expected to follow complex algorithms when resuscitating, stress can compromise both solo-performance and teamwork. Aim To examine whether inter-hospital resuscitation improved with a structured team briefing between physician and ambulance crew in preparation for transfer vs. review of resuscitation guidelines. The effect parameters were physician team leadership (requesting help, delegating tasks), time to resuscitation key elements (chest compressions, defibrillation, ventilations, medication, or a combination of these termed "the first meaningful action"), and hands-off ratio. Methods Participants: 46 physicians graduated within 5 years. Design: A simulation intervention study with a control group and two interventions (structured team briefing or review of guidelines). Scenario: Cardiac arrest during simulated inter-hospital transfer. Results Forty-six candidates participated: 16 (control), 13 (review), and 17 (team briefing). Reviewing guidelines delayed requesting help to 162 seconds, compared to 21 seconds in control and team briefing groups (p = 0.021). Help was not requested in 15% of cases; never requesting help was associated with an increased hands-off ratio, from 39% if the driver's assistance was requested to 54% if not (p < 0.01). No statistically significant differences were found between groups regarding time to first chest compression, defibrillation, ventilation, drug administration, or the combined "time to first meaningful action". Conclusion Neither review nor team briefing improved the time to resuscitation key elements. Review led to an eight-fold increase in the delay to requesting help. The association between never requesting help and an increased hands-off ratio underpins the importance of prioritising available resources. Other medical and non-medical domains have benefited from the use of guidelines reviews and structured team briefings. Reviewing guidelines may compromise the ability to focus on aspects such as team leading and delegating tasks and warrants the need for further studies focusing on how to avoid this cognitive impairment.

Published
2011
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43. Learning Curves for Training in Ultrasonography-Based Examination of Umbilical Catheter Placement: A Piglet Study.

Author

Kaae R, Kyng KJ, Frederiksen CA, Sloth E, Rosthøj S, Kerrn-Jespersen S, Eika B, Sørensen JL, and Henriksen TB

Subjects
Animals, Catheterization, Catheters, Swine, Ultrasonography, Learning Curve, Point-of-Care Systems
Abstract

Background: The training required for accurate assessment of umbilical catheter placement by ultrasonography (US) is unknown., Objective: To describe the learning curve and provide an estimate of the accuracy of physicians' US examinations (US skills) and self-confidence when examining umbilical catheter tip placement., Methods: Twenty-one physicians with minimal experience in US completed a 1.5-hour eLearning module. Ten piglets with catheters inserted in the umbilical vessels were used as training objects. Following eLearning each physician performed up to twelve 10-min US examinations of the piglets. Expert examinations were reference standards. Sensitivity and specificity of physicians' skills in detecting catheter tip placement by US was used to describe the learning curve. Self-confidence was reported by Likert scale after each examination., Results: Physicians' detection of a correctly placed and misplaced umbilical artery catheter tip increased by an odds ratio of 1.6 (95% CI: 1.1, 2.3) and 3.6 (95% CI: 1.7, 7.8) per examination performed. A sensitivity of 0.97 (95% CI: 0.80, 0.99) and specificity of 0.95 (95% CI: 0.84, 0.99) was reached after 6 examinations. For the venous catheter, US skills in detecting a misplaced catheter tip increased with an odds ratio of 2.4 (95% CI: 1.2, 4.8) per US examination. Overall, performance and self-confidence plateaus were reached after 6 examinations., Conclusion: We found steep learning curves for targeted US examination of umbilical catheter placement. eLearning followed by 6 examinations was found to be adequate training to perform with a sufficiently high accuracy and self-confidence to allow for point-of-care use., (© 2019 S. Karger AG, Basel.)

Published
2020
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44. The validity of student tutors' judgments in early detection of struggling in medical school. A prospective cohort study.

Author

O'Neill LD, Morcke AM, and Eika B

Subjects
Adult, Denmark, Female, Humans, Male, Prospective Studies, Anatomy education, Education, Medical, Undergraduate, Educational Measurement, Judgment, Students, Medical psychology, Teaching organization & administration, Underachievement
Abstract

Early identification and support of strugglers in medical education is generally recommended in the research literature, though very little evidence of the diagnostic qualities of early teacher judgments in medical education currently exists. The aim of this study was to examine the validity of early diagnosis of struggling in medical school based on informal teacher judgements of in-class behavior. The study design was a prospective cohort study and the outcomes/truth criteria were anatomy failure and medical school drop out. Six weeks into an anatomy course, student tutors attempted to identify medical students, who they reckoned would fail the anatomy course or drop out, based on their everyday experiences with students in a large group educational setting. In addition, they were asked to describe the indicators of struggling they observed. Sixteen student tutors evaluated 429 medical students for signs of struggling. By week six, the student tutors were able to detect approximately 1/4-1/3 of the students who eventually failed or dropped out, and for ¾ of the strugglers they identified, they were correct in their judgments. Informal student tutor's judgements showed incremental validity for both outcomes when controlling for grades obtained in preceeding exams. Lack of participation, lack of commitment, poor academic performance, poor social interactions and general signs of distress were the main indicators of struggling identified. Teachers' informal judgements of in-class behavior may be an untapped source of information in the early identification of struggling medical students with added value above and beyond formal testing.

Published
2016
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45. Distributed practice. The more the merrier? A randomised bronchoscopy simulation study.

Author

Bjerrum AS, Eika B, Charles P, and Hilberg O

Subjects
Educational Measurement, Humans, User-Computer Interface, Bronchoscopy methods, Clinical Competence, Education, Medical, Graduate methods, Simulation Training
Abstract

Introduction: The distribution of practice affects the acquisition of skills. Distributed practice has shown to be more effective for skills acquisition than massed training. However, it remains unknown as to which is the most effective distributed practice schedule for learning bronchoscopy skills through simulation training. This study compares two distributed practice schedules: One-day distributed practice and weekly distributed practice., Method: Twenty physicians in training were randomly assigned to one-day distributed or weekly distributed bronchoscopy simulation practice. Performance was assessed with a pre-test, a post-test after each practice session, and a 4-week retention test using previously validated simulator measures. Data were analysed with repeated measures ANOVA., Results: No interaction was found between group and test (F(4,72) <1.68, p>0.16), except for the measure 'percent-segments-entered', and no main effect of group was found for any of the measures (F(1,72)< 0.87, p>0.36), which indicates that there was no difference between the learning curves of the one-day distributed practice schedule and the weekly distributed practice schedule., Discussion: We found no difference in effectiveness of bronchoscopy skills acquisition between the one-day distributed practice and the weekly distributed practice. This finding suggests that the choice of bronchoscopy training practice may be guided by what best suits the clinical practice.

Published
2016
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46. Time matters--realism in resuscitation training.

Author

Krogh KB, Høyer CB, Ostergaard D, and Eika B

Subjects
Adult, Female, Follow-Up Studies, Humans, Male, Prospective Studies, Single-Blind Method, Cardiopulmonary Resuscitation education, Education, Medical methods, Heart Arrest therapy, Manikins, Students, Medical
Abstract

Background: The advanced life support guidelines recommend 2min of cardiopulmonary resuscitation (CPR) and minimal hands-off time to ensure sufficient cardiac and cerebral perfusion. We have observed doctors who shorten the CPR intervals during resuscitation attempts. During simulation-based resuscitation training, the recommended 2-min CPR cycles are often deliberately decreased in order to increase the number of scenarios. The aim of this study was to test if keeping 2-min CPR cycles during resuscitation training ensures better adherence to time during resuscitation in a simulated setting., Methods: This study was designed as a randomised control trial. Fifty-four 4th-year medical students with no prior advanced resuscitation training participated in an extra-curricular one-day advanced life support course. Participants were either randomised to simulation-based training using real-time (120s) or shortened CPR cycles (30-45s instead of 120s) in the scenarios. Adherence to time was measured using the European Resuscitation Council's Cardiac Arrest Simulation Test (CASTest) in retention tests conducted one and 12 weeks after the course., Results: The real-time group adhered significantly better to the recommended 2-min CPR cycles (time-120s) (mean 13; standard derivation (SD) 8) than the shortened CPR cycle group (mean 45; SD 19) when tested (p<0.001.), Conclusion: This study indicates that time is an important part of fidelity. Variables critical for performance, like adherence to time in resuscitation, should therefore be kept realistic during training to optimise outcome., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Published
2014
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47. Dyad practice is efficient practice: a randomised bronchoscopy simulation study.

Author

Bjerrum AS, Eika B, Charles P, and Hilberg O

Subjects
Analysis of Variance, Clinical Competence, Educational Measurement, Female, Humans, Male, Students, Medical, Teaching methods, Bronchoscopy education, Computer Simulation, Cooperative Behavior, Education, Medical methods, Practice, Psychological
Abstract

Context: Medical simulation training requires effective and efficient training strategies. Dyad practice may be a training strategy worth pursuing because it has been proven effective and efficient in motor skills learning. In dyad practice two participants collaborate in learning a task they will eventually perform individually. In order to explore the effects of dyad practice in a medical simulation setting, this study examined the effectiveness and efficiency of dyad practice compared with individual practice in the learning of bronchoscopy through simulation-based training., Methods: A total of 36 students of medicine were randomly assigned to either individual practice or dyad practice. The training setting included video-based instruction, 10 bronchoscopy simulator cases and instructor feedback. Participants in the dyad practice group alternated between physical and observational practice and hence physically undertook only half of the training cases undertaken by participants who practised individually. Pre-, post- and delayed (3 weeks) retention tests were used to assess skills according to previously validated simulator measures. Data were analysed using repeated-measures analysis of variance (anova) on each dependent measure., Results: A significant main effect of test was found for all measures (F2,67  > 23.32, p < 0.001), indicating improvement in performance from pre-tests to post-tests and retention tests. No interaction was found between test and group (F2,67  < 0.26, p > 0.49), indicating parallel learning curves. Most importantly, no main effect of group was found for any of the measures, indicating no difference between learning curves (F1,34  = 2.08, p < 0.16)., Conclusions: Individual practice and dyad practice did not differ in their effectiveness for the acquisition of bronchoscopy skills through supervised simulation training. However, dyad practice proved more efficient than individual practice because two participants practising in dyads learned as much as one participant practising individually but required the same instructor resources and training time as the single learner., (© 2014 John Wiley & Sons Ltd.)

Published
2014
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48. Outcome (competency) based education: an exploration of its origins, theoretical basis, and empirical evidence.

Author

Morcke AM, Dornan T, and Eika B

Subjects
History, 20th Century, Competency-Based Education history, Education, Medical, Undergraduate, Empirical Research, Models, Theoretical
Abstract

Outcome based or competency based education (OBE) is so firmly established in undergraduate medical education that it might not seem necessary to ask why it was included in recommendations for the future, like the Flexner centenary report. Uncritical acceptance may not, however, deliver its greatest benefits. Our aim was to explore the underpinnings of OBE: its historical origins, theoretical basis, and empirical evidence of its effects in order to answer the question: How can predetermined learning outcomes influence undergraduate medical education? This literature review had three components: A review of historical landmarks in the evolution of OBE; a review of conceptual frameworks and theories; and a systematic review of empirical publications from 1999 to 2010 that reported data concerning the effects of learning outcomes on undergraduate medical education. OBE had its origins in behaviourist theories of learning. It is tightly linked to the assessment and regulation of proficiency, but less clearly linked to teaching and learning activities. Over time, there have been cycles of advocacy for, then criticism of, OBE. A recurring critique concerns the place of complex personal and professional attributes as "competencies". OBE has been adopted by consensus in the face of weak empirical evidence. OBE, which has been advocated for over 50 years, can contribute usefully to defining requisite knowledge and skills, and blueprinting assessments. Its applicability to more complex aspects of clinical performance is not clear. OBE, we conclude, provides a valuable approach to some, but not all, important aspects of undergraduate medical education.

Published
2013
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50. Effects of modelling examples in complex procedural skills training: a randomised study.

Author

Bjerrum AS, Hilberg O, van Gog T, Charles P, and Eika B

Subjects
Adult, Analysis of Variance, Curriculum, Education, Medical, Undergraduate methods, Female, Humans, Male, Retention, Psychology, Young Adult, Bronchoscopy education, Computer-Assisted Instruction methods, Educational Measurement
Abstract

Context: Learning complex procedural skills, such as bronchoscopy, through simulation training, imposes a high cognitive load on novices. Example-based learning has been shown to be an effective way to reduce cognitive load and enhance learning outcomes. Prior research has shown that modelling examples, in which a human model demonstrates the skill to a learner, were effective for learning basic surgical skills. However, principles derived from simple skills training do not necessarily generalise to more complex skills. Therefore, the present study examined the effectiveness of integrating modelling examples into simulation training for a more complex procedural skill - bronchoscopy. Moreover, this study extended previous simulation studies by using a physical demonstration rather than video-based modelling examples., Methods: Forty-eight medical students were randomised into a modelling group and a control group. They all practised on eight bronchoscopy simulation cases individually, followed by standardised feedback from an instructor. Additionally, the modelling group watched three modelling examples of the simulated bronchoscopy, performed by the instructor. These modelling examples were interspersed between cases. Assessments were carried out at pre-, post- and 3-week retention tests with simulator-measured performance metrics. The primary outcome measure was the percentage of segments entered/minute. Other measures were wall collisions, red-out, the percentage of segments entered and the time to completion. Group differences were examined using repeated measures analysis of variance (anova)., Results: A clear learning curve was observed for both groups, but as hypothesised, the modelling group outperformed the control group on all parameters except the percentage of segments entered on the post-test and retained this superiority at the retention test. For the primary outcome measure, the percentage of segments entered/minute, the modelling group achieved a 46% higher score at the post-test and a 43% higher score at the retention test., Conclusions: The present study shows, that integrating modelling examples into the curriculum of bronchoscopy simulation training optimises the role of the instructor and enhances novices' learning outcomes, presumably by optimising cognitive load during training., (© 2013 John Wiley & Sons Ltd.)

Published
2013
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