Running Memory for Clinical Handoffs: A Look at Active and Passive Processing.

OBJECTIVE: The goal of the present study was to examine the effects of domain-relevant expertise on running memory and the ability to process handoffs of information. In addition, the role of active or passive processing was examined. BACKGROUND: Currently, there is little research that addresses how individuals with different levels of expertise process information in running memory when the information is needed to perform a real-world task. METHOD: Three groups of participants differing in their level of clinical expertise (novice, intermediate, and expert) performed an abstract running memory span task and two tasks resembling real-world activities, a clinical handoff task and an air traffic control (ATC) handoff task. For all tasks, list length and the amount of information to be recalled were manipulated. RESULTS: Regarding processing strategy, all participants used passive processing for the running memory span and ATC tasks. The novices also used passive processing for the clinical task. The experts, however, appeared to use more active processing, and the intermediates fell in between. CONCLUSION: Overall, the results indicated that individuals with clinical expertise and a developed mental model rely more on active processing of incoming information for the clinical task while individuals with little or no knowledge rely on passive processing. APPLICATION: The results have implications about how training should be developed to aid less experienced personnel identify what information should be included in a handoff and what should not.

A randomized, double-blind study comparing the efficacy of selenium sulfide shampoo 1% and ciclopirox shampoo 1% as adjunctive treatments for tinea capitis in children.

Our objective was to compare the efficacy of selenium sulfide shampoo 1% and ciclopirox shampoo 1% as adjunctive treatments for tinea capitis in children. Forty children aged 1-11 years with clinically diagnosed tinea capitis were randomized to receive selenium sulfide shampoo 1% or ciclopirox shampoo 1% twice a week as adjuncts to an 8-week course of ultramicronized griseofulvin dosed at 10-12 mg/kg/day. At weeks 2, 4, and 8, subjects returned to the clinic for evaluation and scalp cultures. Subjects then returned for follow-up visits 4 weeks after completing treatment. Overall, by 8 weeks, 30 of 33 (90.9%) treated children demonstrated mycological cure. Selenium sulfide shampoo 1% and ciclopirox shampoo 1% were equally effective as adjunctive treatments for tinea capitis in children in our study.

Medical student evaluation using augmented standardized patients: new development and results.

Standardized patients (SPs), individuals who realistically portray patients, are widely used in medical education to teach and assess communication skills, eliciting a history, performing a physical exam, and other important clinical skills. They are typically healthy individuals with few or no abnormal physical findings. One limitation is that each SP can only portray a limited set of physical symptoms. We have developed a functioning prototype that uses sound-based augmented reality (AR) to expand the capabilities of an SP to exhibit physically-manifested abnormalities. The previous research and evaluation of this prototype have been published in medicine meets virtual reality conference in January 2006. Current research has combined a virtual crackle sound with a healthy SP's real breath sound at end of inspiration in real time. The technology used is intended to correlate the inspiration timing of SP's. A learner will hear this simulated sound through an electronic-stethoscope wirelessly.

Medical student evaluation using augmented standardized patients: preliminary results.

Standardized patients (SPs), individuals trained to realistically portray patients, are commonly used to teach and assess medical students. The range of clinical problems an SP can portray, however, is limited. They are typically healthy individuals with few or no abnormal physical findings. We have developed a functioning prototype that uses sound-based augmented reality to expand the capabilities of an SP to exhibit physically-manifested abnormalities. The primary purpose of this paper is to describe this prototype and report on its use in a study using medical students evaluated in a required annual Observed Structured Clinical Examination (OSCE). Presented is an overview of the prototype, a detailed description of the study, final results from the study, and conclusions drawn about the validity of using augmented SPs as a reliable medical assessment tool.