Assessment of Middle Ear Anatomy Teaching Methodologies Using Microscopy versus Endoscopy: A Randomized Comparative Study

Teaching methodologies for the anatomy of the middle ear have not been investigated greatly due to the middle ear’s highly complex structure and hidden location inside of the temporal bone. The aim of this randomized study was to quantitatively compare the suitability of using microscope- and endoscope-based methods for teaching the anatomy of the middle ear. We hypothesize that the endoscopic approach will be more efficient compared to the microscopic approach. To answer the study questions, 33 sixth-year medical students, residents and otorhinolaryngology specialists were randomized either into the endoscopy or the microscopy group. Their anatomical knowledge was assessed using a structured anatomical knowledge test before and after each session. Each participant received tutoring on a human cadaveric specimen using one of the two methods. They then performed a hands-on dissection. After 2–4 weeks, the same educational curriculum was repeated using the other technique. The mean gains in anatomical knowledge for the specialists, residents, and medical students were +19.0%, +34.6%, and +23.4%, respectively. Multivariate analyses identified a statistically significant increase in performance for the endoscopic method compared to the microscopic technique (P < 0.001). For the recall of anatomical structures during dissection, the endoscopic method outperformed the microscopic technique independently of the randomization or the prior training level of the attendees (P < 0.001). In conclusion, the endoscopic approach to middle ear anatomy education is associated to an improved gain in knowledge as compared to the microscopic approach. The participants subjectively preferred the endoscope for educational purposes.     

Validation of the swimming competence questionnaire for children

ABSTRACT

Two studies were employed to test the reliability and validity of the Swimming Competence Questionnaire (SCQ) among primary school children. Study 1 was a cross-sectional survey in 4959 primary school children. Study 2 was a pre-post-test quasi-experiment among 1609 primary school children who underwent a 20-lesson learn-to-swim programme. In Study 1, exploratory structural equation modelling revealed excellent goodness-of-fit and scale reliability for a two-factor model comprising distance and skill factors, which supported the construct and convergent validity. SCQ scores were significantly and positively correlated with swimming outcomes (i.e., self-efficacy, intention, swimming frequency), which supported SCQ’s concurrent and criterion validity. Average variance extracted for the SCQ factors exceeded cut-off criteria supporting discriminant validity. In Study 2, pre-test SCQ scores correlated significantly and positively with the SCQ scores, self-efficacy, intention, and swimming frequency at post-test, which supported SCQ’s test-retest reliability and predictive validity. Positive intraclass correlation between SCQ scores and coach ratings at post-test provided evidence for SCQ’s inter-rater reliability. SCQ scores significantly improved at post-test, which supported SCQ’s ecological validity. In conclusion, findings indicate that the SCQ is a valid and reliable measure to assess primary school children’s swimming competence, in terms of swimming distance and basic water survival skills.     

PTSD symptom cluster profiles of youth who have experienced sexual or physical abuse

The research examined whether youth (6–17 years old) who were referred for treatment due to sexual, physical, or both types of abuse presented with distinct profiles of PTSD DSM-IV-TR symptom clusters. When examining data for the 749 youth participants, five PTSD symptom cluster profiles were identified with each profile representing approximately 20% of the youth. The five profiles were also differentiated with respect to being referred for physical or sexual abuse, age, parental ratings of internalizing symptoms, and self-reported depression. The youth referred for treatment in the aftermath of child sexual, physical, or both sexual and physical abuse presented with different profiles of PTSD symptom clusters thereby suggesting a need for individualized tailoring of evidenced-based treatments. Two cognitive behavioral approaches, designed for traumatized children and either their nonoffending or offending parents, were described for treating youth with the distinct PTSD profiles.     

Evidence-based practice instruction by faculty members and librarians in North American optometry and ophthalmology programs

North American optometry and ophthalmology faculty members and vision science librarians were surveyed online (14% response rate) about teaching evidence-based practice (EBP). Similar to studies of other health care programs, all five EBP steps (Ask, Acquire, Appraise, Apply, Assess) were taught to varying degrees. Optometry and ophthalmology EBP educators may want to place further emphasis on (1) the Apply and Assess steps, (2) faculty- and student-generated questions and self-assessment in clinical settings, (3) online teaching strategies, (4) programmatic integration of EBP learning objectives, and (5) collaboration between faculty members and librarians.     

Associations between individual and collective efficacy beliefs and students' bystander behavior

This study examined whether defending and passive bystanding during peer victimization episodes were associated with individual- and classroom-level efficacy to stop peer victimization. Self-report survey data were analyzed from 1,467 Swedish fourth-grade students (mean age = 10.55) from 100 classrooms in 63 schools. Multilevel analyses revealed that, when witnessing peer victimization, students more often defended victims if they were high in defender self-efficacy and if they belonged to classrooms high in collective efficacy. In contrast, students were more likely to remain passive if they were low in defender self-efficacy and if they belonged to classrooms low in collective efficacy. Taken together, our findings suggest that efficacy beliefs both at the individual and at the classroom level contribute to explaining variability in students' bystander behaviors, which has potential implications for prevention and intervention work.     

Public health practitioners' information access and use patterns in the Maryland (USA) public health departments of Anne Arundel and Wicomico Counties

PURPOSE: To increase understanding of the information needs and use of public health practitioners. SETTING: From June 2005 to May 2006, the library offered a course in public health information resources to eighteen practitioners in two counties, access to the library's licensed electronic resources through a tailored web portal, and consulting services. EVALUATION METHOD: We combined usage statistics from the web portal, self-report and observational data collected during training and shadowing of participants. CONCLUSIONS: The data from this project indicate that usage of licensed information resources and services is infrequent but broad ranging. A few users register at the high end of the usage range, but one use of one high quality article can have a significant impact on policy decisions. Time and competing responsibilities often constrain the retrieval and use of resources for evidence-based decision making and an informationist or power-user model may be more appropriate than training all practitioners to integrate searching into their workflow. This study indicates (i) that evidence-based public health practice requires seamless and broadly based information access; and (ii) that the currently existing patchwork does not support the level of use or take into account the time constraints of information needs for public health practice.     

Standardization of search methods for guideline development: an international survey of evidence-based guideline development groups

BACKGROUND: Effective literature searching is particularly important for clinical practice guideline development. Sophisticated searching and filtering mechanisms are needed to help ensure that all relevant research is reviewed. PURPOSE: To assess the methods used for the selection of evidence for guideline development by evidence-based guideline development organizations. METHODS: A semistructured questionnaire assessing the databases, search filters and evaluation methods used for literature retrieval was distributed to eight major organizations involved in evidence-based guideline development. RESULTS: All of the organizations used search filters as part of guideline development. The medline database was the primary source accessed for literature retrieval. The OVID or SilverPlatter interfaces were used in preference to the freely accessed PubMed interface. The Cochrane Library, embase, cinahl and psycinfo databases were also frequently used by the organizations. All organizations reported the intention to improve and validate their filters for finding literature specifically relevant for guidelines. DISCUSSION: In the first international survey of its kind, eight major guideline development organizations indicated a strong interest in identifying, improving and standardizing search filters to improve guideline development. It is to be hoped that this will result in the standardization of, and open access to, search filters, an improvement in literature searching outcomes and greater collaboration among guideline development organizations.