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Epistemic beliefs are one's assumptions about knowledge and knowing. Given the research in educational psychology that established epistemic beliefs as reliable predictors of student success, we devised a pedagogical intervention to improve students' epistemic beliefs. In this study, we examined the effectiveness of the reflective writing task as a means of changing how students think about what is known. Students from two upper-level psychology classes (Cognitive and Research Methods) took a general epistemic belief survey by rating their agreements with 38 items at three different times in a semester (first-day, pre-reflective-writing task, and post-reflective-writing task). Day 1 responses were utilized to validate the survey items using principal component analysis--three variables (Knowledge Construction and Modification-KCM, Structure of Knowledge-KST, and Meaning of Successful Students-SS) emerged. The intervention successfully improved students' beliefs specific to Structure of Knowledge-KST and Meaning of Successful Students-SS, beliefs that predict student learning. This study suggests that even short interventions have the potential to influence students' beliefs about knowledge, which have been shown to have demonstrable effects on their academic success.

Introduction: The emergency department (ED) serves as the primary access point to the healthcare system. ED throughput efficiency is critical. The percentage of patients who leave before treatment completion (LBTC) is an important marker of department efficiency. Our study aimed to assess the impact of an ED phlebotomist, dedicated to obtaining blood specimen collection on waiting patients, on LBTC rates.Methods: This study was conducted as a retrospective observational analysis over approximately 18 months (October 5, 2015-March 31, 2017) for patients evaluated by a triage provider with a door-to-room (DtR) time of > 20 minutes (min). LBTC rates were compared in 10-min DtR increments for when the ED phlebotomist collected the patient’s specimen vs not.Results: Of 71,942 patient encounters occurring during the study period, 17,349 (24.1%) met study inclusion criteria. Of these, 1842 (10.6%) had blood specimen collection performed by ED phlebotomy. The overall LBTC rate for encounters included in the analysis was 5.26% (95% confidence interval [CI], 4.94%-5.60%). Weighting the LBTC rates for each 10-min DtR interval using the fixed effects model led to an overall LBTC rate of 2.74% (95% CI, 2.09%-3.59%) for patient encounters with ED phlebotomist collection vs 5.31% (95% CI, 4.97%-5.67%) in those which did not, yielding a relative reduction of 48% (95% CI, 34%-63%). The effect of the phlebotomist on LBTC rates increased as DtR times increased. The difference in the rate of the rise of LBTC percentages, per 10-min interval, was 0.50% (95% CI, 0.19%-0.81%) higher for non-ED phlebotomist encounters vs phlebotomist encounters.Conclusion: ED phlebotomy demonstrated a significant reduction in ED LBTC rates. Further, as DtR times increased, the impact of ED phlebotomy became increasingly significant. Adult EDs with increased rates of LBTC patient encounters may want to consider the implementation of ED phlebotomy.

Pulmonary embolism is associated with significant mortality and impaired long-term functional outcomes. Timely identification and treatment is crucial for successful management. Unfortunately, prompt diagnosis can be challenging in patients without overt signs of cardiovascular compromise. Point-of-care cardiac ultrasound (POCCUS) can be used to identify signs of acute pulmonary embolism, risk stratify patients for adverse outcomes and assess response to therapy. This report describes a patient with submassive pulmonary embolism and evidence of acute right ventricular strain on POCCUS successfully treated with thrombolytic therapy. The dynamic changes observed on point-of-care ultrasound are presented.

Despite multiple advantages, subclavian vein (SCV) cannulation via the traditional landmark approach has become less used in comparison to ultrasound (US) guided internal jugular catheterization due to a higher rate of mechanical complications. A growing body of evidence indicates that SCV catheterization with real-time US guidance can be accomplished safely and efficiently. While several cannulation approaches with real-time US guidance have been described, available literature suggests that the infraclavicular, longitudinal “in-plane” technique may be preferred. This approach allows for direct visualization of needle advancement, which reduces risk of complications and improves successful placement. Infraclavicular SCV cannulation requires simultaneous use of US during needle advancement, but for an inexperienced operator, it is more easily learned compared to the traditional landmark approach. In this article, we review the evidence supporting the use of US guidance for SCV catheterization and discuss technical aspects of the procedure itself.

The technology policies included on instructors' syllabi vary greatly and, in some cases, may unfavorably influence students' perceptions of the instructor. To examine this hypothesis, we randomly assigned college students enrolled in psychology courses at two different institutions (N = 163) to groups in which they viewed different syllabi for a community psychology course. The syllabi varied by the hypothetical instructor's technology policy (encouraging of appropriate technology use in the classroom, discouraging of all technology use, or a mixture of both) and instructor gender. Results showed that students rated instructors similarly on the Competency/Communication factor across all conditions but rated them significantly lower on the Rapport factor when the syllabus included a discouraging technology policy. Rapport ratings were also associated with students' self-reported dependence on technology. High instructor Rapport was associated with high levels of students' technology dependency in the encouraging technology policy condition (r = 0.29, p < 0.05), but low levels of technology dependency in the discouraging condition (r = -0.31, p < 0.05). Our findings suggest that if instructors include technology policies on their syllabi that restrict inappropriate technology use, they should also indicate situations in which technology use is appropriate.

Ultrasound (US) can enhance anatomy education, yet is incorporated into few non-medical anatomy programs. This study is the first to evaluate the impact of US training in gross anatomy for non-medical students in the United States. All 32 master's students enrolled in gross anatomy with the anatomy-centered ultrasound (ACUS) curriculum were recruited. Mean Likert ratings on pre- and post-course surveys (100% response rates) were compared to evaluate the effectiveness of the ACUS curriculum in developing US confidence, and gauge its impact on views of US. Post-course, students reported significantly higher (P < 0.001) mean confidence ratings in five US skills (pre-course versus post-course mean): obtaining scans (3.13 ± 1.04 versus 4.03 ±0.78), optimizing images (2.78 ±1.07 versus 3.75 ±0.92), recognizing artifacts (2.94 ±0.95 versus 3.97 ±0.69), distinguishing tissue types (2.88 ±0.98 versus 4.09 ±0.69), and identifying structures (2.97 ±0.86 versus 4.03 ±0.59), demonstrating the success of the ACUS curriculum in students with limited prior experience. Views on the value of US to anatomy education and to students' future careers remained positive after the course. End-of-semester quiz performance (91% response rate) provided data on educational outcomes. The average score was 79%, with a 90% average on questions about distinguishing tissues/artifacts, demonstrating positive learning outcomes and retention. The anatomy-centered ultrasound curriculum significantly increased confidence with and knowledge of US among non-medical anatomy students with limited prior training. Non-medical students greatly value the contributions that US makes to anatomy education and to their future careers. It is feasible to enhance anatomy education outside of medical training by incorporating US.

Emotions experienced during online academic examinations may differ from emotions experienced in the traditional classroom testing situation. Students in a "Psychology of Learning" course (n = 61) completed assessments of emotions before and after a quiz in each of the following settings: online at their own choice of time and location; online in a library computer lab at a fixed time; and in the regular classroom setting. Students low in classroom test anxiety had significantly higher test anxiety levels when taking a quiz online, whereas students who experienced high levels of anxiety in the classroom had similarly high levels of test anxiety across all conditions. Notably, the correlation between test anxiety and performance was weaker in the online conditions than in the classroom condition. Furthermore, the online assessment of student learning may be accompanied by significant changes in emotion. (Contains 2 tables, 1 figure, and 1 footnote.)

In recent years, colleges have been moving from traditional, classroom-based student evaluations of instruction to online evaluations. Because of the importance of these evaluations in decisions regarding retention, promotion and tenure, instructors are justifiably concerned about how this trend might affect their ratings. We recruited faculty members who were teaching two or more sections of the same course in a single semester and assigned at least one section to receive online evaluations and the other section(s) to receive classroom evaluations. We hypothesised that the online evaluations would yield a lower response rate than the classroom administration. We also predicted that there would be no significant differences in the overall ratings, the number of written comments, and the valence (positive/neutral/negative) of students' comments. A total of 32 instructors participated in the study over two semesters, providing evaluation data from 2057 students. As expected, online evaluations had a significantly lower response rate than classroom evaluations. Additionally, there were no differences in the mean ratings, the percentage of students who provided written comments or the proportion of comments in the three valence categories. Thus, even with the lower response rate for online evaluations, the two administration formats seemed to produce comparable data.

Increased use of course management software to administer course exams online for face-to-face classes raises the question of how well test anxiety and other emotions generalize from the classroom to an online setting. We hypothesized that administering regular course exams in an online format would reduce test anxiety experienced at the time of the exam and improve exam scores. We recruited 69 participants from a psychology course to take classroom- and online-delivered exams, using a counterbalanced crossover design. We found that students who normally experience high levels of test anxiety in the classroom had reduced test anxiety when taking online exams, while the reverse was true for those low in classroom anxiety. Furthermore, the relationship between test anxiety and exam performance was weaker in an online setting than in the classroom. We recommend that instructors evaluate the potential impact of these findings when considering offering examinations online. (Contains 2 tables and 1 figure.)

This study addressed how trait levels of classroom shyness can influence conformity when students answer opinion questions in different ways. "We recruited 128 introductory psychology students to indicate their opinion on 50 controversial questions by raising their hand or anonymously pressing a button on a keypad ("clicker")". Compared to hand-raising, keypad responses had greater variability, suggesting that students were less likely to conform to the group's opinion. Students who typically experience shame and anxiety in class did not conform any more than other students did, but they felt more uncomfortable raising their hands and indicated a stronger preference for using keypads when answering controversial questions. (Contains 2 notes and 2 tables.)

We compared an electronic audience response system (clickers) to standard lecture, hand-raising, and response card methods of student feedback in simulated introductory psychology classes. After hearing the same 30-min psychology lecture, participants in the clicker group had the highest classroom participation, followed by the response card group, both of which were significantly higher than the hand-raising group. Participants in the clicker group also reported greater positive emotion during the lecture and were more likely to respond honestly to in-class review questions. (Contains 3 tables.)