Fellowship Accreditation: Experiences From Health Care Simulation Experts.

Background The field of health care simulation continues to grow, accompanied by a proliferation of fellowship programs, leading to fellowship accreditation efforts. There is controversy around the best approach to accreditation. Objective The authors sought to understand perspectives of simulation leaders on fellowship accreditation to best inform the growth and maturation of fellowship accreditation. Methods In 2020, simulation leaders identified through snowball sampling were invited to participate in a qualitative study. During one-on-one semistructured interviews, participants were asked about experiences as simulation leaders and their perspective on the purpose and impact of accreditation. The interviews were audio recorded and transcribed. Thematic analysis informed by a phenomenology framework was performed using a masked open coding technique with iterative refinement. The resulting codes were organized into themes and subthemes. Results A total of 45 simulation experts participated in interviews ranging from 25 to 67 minutes. Participants described discord and lack of consensus regarding simulation fellowship accreditation, which included a spectrum of opinions ranging from readiness for accreditation pathways to concern and avoidance. Participants also highlighted how context drove the perception of accreditation value for programs and individuals, including access to resources and capital. Finally, potential impacts from accreditation included standardization of training programs, workforce concerns, and implications for professional societies. Conclusions Simulation leaders underscored how the value of accreditation is dependent on context. Additional subthemes included reputation and resource variability, balancing standardization with flexibility and innovation, and implications for professional societies.

Quantifying beetle-mediated effects on gas fluxes from dung pats.

Agriculture is one of the largest contributors of the anthropogenic greenhouse gases (GHGs) responsible for global warming. Measurements of gas fluxes from dung pats suggest that dung is a source of GHGs, but whether these emissions are modified by arthropods has not been studied. A closed chamber system was used to measure the fluxes of carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) from dung pats with and without dung beetles on a grass sward. The presence of dung beetles significantly affected the fluxes of GHGs from dung pats. Most importantly, fresh dung pats emitted higher amounts of CO2 and lower amounts of CH4 per day in the presence than absence of beetles. Emissions of N2O showed a distinct peak three weeks after the start of the experiment--a pattern detected only in the presence of beetles. When summed over the main grazing season (June-July), total emissions of CH4 proved significantly lower, and total emissions of N2O significantly higher in the presence than absence of beetles. While clearly conditional on the experimental conditions, the patterns observed here reveal a potential impact of dung beetles on gas fluxes realized at a small spatial scale, and thereby suggest that arthropods may have an overall effect on gas fluxes from agriculture. Dissecting the exact mechanisms behind these effects, mapping out the range of conditions under which they occur, and quantifying effect sizes under variable environmental conditions emerge as key priorities for further research.