A comparative analysis of student, educator, and simulated parent ratings of video-recorded medical student consultations in pediatrics.

BACKGROUND: Simulation-based education (SBE) affords learners opportunities to develop communication skills, including those related to pediatrics. Feedback is an integral part of SBE, and while much research into feedback from multiple sources exists, the findings are mixed. The aim of this comparative study was to replicate some of this work in a novel area, pediatric medical education, to better understand how multisource feedback (self, educator, and simulated parent) may inform learning and curriculum design. METHODS: During their pediatric rotation, medical students participated in a consultation with a simulated parent, engaged in video-assisted self-reflection, and received feedback from both an educator and the simulated parent through an e-learning platform. The Pediatric Consultation Skills Assessment Tool (PCAT) was used for self-assessment and educator feedback, and the Consultation and Relational Empathy (CARE) measure was used for simulated parent feedback. RESULTS: Our results showed that high-performing students underrated their performance, and low-performing students overrated their performance. Feedback from multiple sources helps to identify both areas of weakness in student performance and areas of weakness in student self-appraisal. Overall, general areas of weakness identified for the learners related to making contingency plans and providing easy-to-understand explanations for simulated parents. Some simulated parent feedback did not align with educator and student ratings, highlighting the value of including the simulated parent perspective. Our findings question whether a third party can reliably judge the simulated parent's level of understanding. CONCLUSION: Multisource feedback allows students to develop layered insights into their performance and supports self-appraisal. Aggregating feedback through an e-learning platform allows educators to gain greater insights into the strengths and weakness of students and design a more tailored teaching plan to support student needs.

Harmonized global maps of above and belowground biomass carbon density in the year 2010.

Remotely sensed biomass carbon density maps are widely used for myriad scientific and policy applications, but all remain limited in scope. They often only represent a single vegetation type and rarely account for carbon stocks in belowground biomass. To date, no global product integrates these disparate estimates into an all-encompassing map at a scale appropriate for many modelling or decision-making applications. We developed an approach for harmonizing vegetation-specific maps of both above and belowground biomass into a single, comprehensive representation of each. We overlaid input maps and allocated their estimates in proportion to the relative spatial extent of each vegetation type using ancillary maps of percent tree cover and landcover, and a rule-based decision schema. The resulting maps consistently and seamlessly report biomass carbon density estimates across a wide range of vegetation types in 2010 with quantified uncertainty. They do so for the globe at an unprecedented 300-meter spatial resolution and can be used to more holistically account for diverse vegetation carbon stocks in global analyses and greenhouse gas inventories.

Identifying potential synergies and trade-offs for meeting food security and climate change objectives in sub-Saharan Africa.

Potential interactions between food production and climate mitigation are explored for two situations in sub-Saharan Africa, where deforestation and land degradation overlap with hunger and poverty. Three agriculture intensification scenarios for supplying nitrogen to increase crop production (mineral fertilizer, herbaceous legume cover crops--green manures--and agroforestry--legume improved tree fallows) are compared to baseline food production, land requirements to meet basic caloric requirements, and greenhouse gas emissions. At low population densities and high land availability, food security and climate mitigation goals are met with all intensification scenarios, resulting in surplus crop area for reforestation. In contrast, for high population density and small farm sizes, attaining food security and reducing greenhouse gas emissions require mineral fertilizers to make land available for reforestation; green manure or improved tree fallows do not provide sufficient increases in yields to permit reforestation. Tree fallows sequester significant carbon on cropland, but green manures result in net carbon dioxide equivalent emissions because of nitrogen additions. Although these results are encouraging, agricultural intensification in sub-Saharan Africa with mineral fertilizers, green manures, or improved tree fallows will remain low without policies that address access, costs, and lack of incentives. Carbon financing for small-holder agriculture could increase the likelihood of success of Reducing Emissions from Deforestation and Forest Degradation in Developing Countries programs and climate change mitigation but also promote food security in the region.