Designing a search strategy to identify and retrieve articles onevidence-based health care using MEDLINE

Thepractice of evidence-based health care requires that information on methodology be identifiedfrom databases such as MEDLINE. Up until this year there have been no designated medicalsubject headings (MeSH) for evidence-based health care. ‘EVIDENCE-BASEDMEDICINE’ appears as a MeSH term from 1997. The absence of designated MeSH forthis concept prior to 1997 provides a challenge to the searcher. This paper describes the creationof a MEDLINE search strategy to retrieve articles on the methods of evidence-based health carepublished prior to the introduction of the new term, where an optimal combination of free-textand MeSH terms is required to identify relevant material. The study examines both free-text andsubject heading searching and attempts an optimal balance of sensitivity and specificity. It beginsby examining separate free-text and subject heading searches. Sensitivity of the subject headingsearch was 33% and specificity 80%, while the free-text search produced asensitivity of 50% and a specificity of 67%. The final strategy, combining bothapproaches, was more successful with sensitivity reaching between 82 and 90% andspecificity 83%. It is therefore possible to devise a search strategy to retrieve articles on themethods of evidence-based health care with relatively successful rates of sensitivity andspecificity. The limitations of MEDLINE, however, necessitate the use of additional approachesin identifying articles on the methods of evidence-based health care.     

Sexual Harassment as [Dys]Functional Process: A Feminist Standpoint Analysis

Researchers have approached the study of sexual harassment as though it were dysfunctional. However, a feminist standpoint theory analysis would suggest that it functions differently for men and women. A study using discussion groups and stimulated recall interviews was conducted in a large health care organization. A thematic analysis revealed a primary theme of sexual harassment as a [dys]functional process. For the male participants, sexual behavior served as a coping mechanism for stress, as a form of therapeutic care, and to create and demonstrate camaraderie. For the women participants, sexual behavior tended to be either nonfunctional or dysfunctional. They did not associate it with stress reduction, therapeutic touch, and viewed group camaraderie as a means of prevention. Implications are discussed.     

Organizational Power and the Institutional Review Board

In this essay, we respond to the narratives and essays in this issue by examining organizational power issues related to researchers and institutional research boards (IRBs). Rather than taking a singular perspective on power, we use multiple perspectives and suggest that the cumulative analyses provide the best understanding of IRBs and organizational power.     

The relationship between individual instructional characteristics and the overall assessment of teaching effectiveness across different instructional contexts

There is an ongoing debate in the student evaluation of teaching literature about whether an overall rating or factorial dimensions of teaching effectiveness should be used in personnel decisions. Marsh and his colleagues have advocated the use of a weighted average approach to computing overall evaluations. A policy-capturing experiment was carried out where students in three different instructional contexts made overall evaluations of hypothetical instructors based on a manipulation of the teaching factors in Marsh's SEEQ. The results indicated (1) amount learned was consistently the most important factor affecting overall evaluations; (2) course difficulty was consistently the least important factor affecting overall evaluations; and (3) there was a strong similarity among the three groups in the relative importance of the various teaching factors in arriving at an overall evaluation. The implications of this research are discussed, as well as directions for future research.     

How to encourage a lifelong learner? The complex relation between learning strategies and assessment in a medical curriculum

Abstract

To foster lifelong learning skills, we need new didactic approaches with aligned assessment methods. Therefore, we investigated whether the outcomes of a project assignment show a different relation to learning strategies than a longitudinal knowledge-based assessment. We studied learning strategies of first year students of medicine and biomedical sciences (n?=?248) and performed hierarchical regression analyses for the learning strategies and grades of the longitudinal knowledge-based test and project assignment. Scores of students, measured with the Motivated Strategies for Learning Questionnaire (Likert scale 1–7), were relatively low for critical thinking (3.53), compared to rehearsal (4.40), elaboration (4.82), organisation (4.69) and metacognitive self-regulation (4.33). Knowledge based tests showed a significant relation to elaboration (p?<?0.01). For the project-based assessment, we did not find a significant relation to any learning strategy (p?=?0.074). Explained variance of the grades was low for all learning strategies (R² < 0.043). Different types of assessment did not discriminate between students with high or low scores on learning strategies associated with lifelong learning. An explanation is that the curriculum is not aligned with assessment, or students do not benefit in terms of grades. We conclude that, if assessment is to drive lifelong learning skills, this is not self-evident.     

Factors underlying students' decisions to use mobile devices in clinical settings

University policies prohibiting use of mobile devices by medical students during clinical placements are contradicted by regular use by physicians. Consequently, many students use their mobile devices, which can be beneficial for learning but may put patient privacy at risk. This study explores the reasons underlying students' decisions about using mobile devices in clinical settings. We used a mixed-methods sequential explanatory design involving a questionnaire and focus groups. Qualitative data from the questionnaire and focus groups was analysed through thematic analysis. We found students were aware of the risks mobile devices posed to professionalism and medical practice. Despite prohibitions, many made individual decisions to use mobile devices because the benefits outweighed the risks. These students were influenced by an organised, strategic approach to learning and a motivation to comply with the beliefs and behaviours of their medical teams and conform to physicians' directives in order to participate in their community of practice. Many students appear to be transferring everyday use of mobile devices to clinical settings. There is a need to understand and promote aspects of learning that are enhanced by mobile devices in clinical settings, while articulating clear guidelines and boundaries compatible with the professional behaviour expected of students.     

Considerations for the use of functional principal components analysis in sports biomechanics: examples from on-water rowing

The proliferation of new biomechanical technology in laboratory and field settings facilitates the capture of data-sets consisting of complex time-series. An understanding of the appropriate statistical approaches for analysing and interpreting these data-sets is required and the functional data analysis (FDA) family of statistical techniques has emerged in the biomechanical literature. Given the use of FDA is currently in its infancy with biomechanical data, this paper will form the first of a two part series aiming to address practical issues surrounding the application of FDA techniques in biomechanics. This work focuses on functional principal components analysis (fPCA), which is explored using existing literature and sample data from an on-water rowing database. In particular methodological considerations for the implementation of fPCA such as temporal normalisation of data, removal of unwanted forms of variation in a data-set and documented methods for preserving the original temporal properties within a set of curves are explored in detail as a part of this review. Limitations and strengths of the technique are outlined and recommendations are provided to encourage the appropriate use of fPCA within the field of applied sports biomechanics.     

Understanding key performance indicators for breast support: An analysis of breast support effects on biomechanical,physiological and subjective measures during running

To assess the effectiveness of breast support previous studies monitored breast kinematics and kinetics, subjective feedback, muscle activity (EMG), ground reaction forces (GRFs) and physiological measures in isolation. Comparing these variables within one study will establish the key performance variables that distinguish between breast supports during activities such as running. This study investigates the effects of changes in breast support on biomechanical, physiological and subjective measures during running. Ten females (34D) ran for 10 min in high and low breast supports, and for 2 min bare breasted (2.8 m·s^?1). Breast and body kinematics, EMG, expired air and heart rate were recorded. GRFs were recorded during 10 m overground runs (2.8 m·s^?1) and subjective feedback obtained after each condition. Of the 62 variables measured, 22 kinematic and subjective variables were influenced by changes in breast support. Willingness to exercise, time lag and superio-inferior breast velocity were most affected. GRFs, EMG and physiological variables were unaffected by breast support changes during running. Breast displacement reduction, although previously advocated, was not the most sensitive variable to breast support changes during running. Instead breast support products should be assessed using a battery of performance indicators, including the key kinematic and subjective variables identified here.