Clinical supervision in medical education: A citation analysis.

PURPOSE: Medical education relies on clinical supervision for critical functions, including trainee assessment and ensuring patient safety. Yet, there is substantial variance in supervision, which has led to calls for a shared definition of the concept and guidelines to inform practice. AMEE Guide No. 27 provided these desired elements and is highly cited, suggesting that translation and utilization of the Guide's knowledge is suboptimal. This study investigates utilization by systematically characterizing citations to the Guide and by describing translation of its recommendations in relation to supervision. MATERIALS AND METHODS: Citations were identified using Web of Science, Scopus, and Google Scholar. The authors coded all citations and conducted a subanalysis of studies specific to supervision. RESULTS: 583 studies were identified; 268 met inclusion criteria for general analysis of which 167 studies were further analyzed. Most studies reiterated the Guide's characterization of effective supervision, but few demonstrate how these recommendations inform innovations in supervisory practice. CONCLUSION: Translation of the Guide's recommendations regarding clinical supervision appears limited. Future research should consider the extent of knowledge translation occurring in clinical supervision literature as well as AMEE Guides. Increased attention to knowledge translation in medical education may benefit the distribution of similar knowledge products.

Task analysis of information technology-mediated medication management in outpatient care.

AIMS: Educating physicians in the procedural as well as cognitive skills of information technology (IT)-mediated medication management could be one of the missing links for the improvement of patient safety. We aimed to compose a framework of tasks that need to be addressed to optimize medication management in outpatient care. METHODS: Formal task analysis: decomposition of a complex task into a set of subtasks. First, we obtained a general description of the medication management process from exploratory interviews. Secondly, we interviewed experts in-depth to further define tasks and subtasks. SETTING: Outpatient care in different fields of medicine in six teaching and academic medical centres in the Netherlands and the United States. PARTICIPANTS: 20 experts. Tasks were divided up into procedural, cognitive and macrocognitive tasks and categorized into the three components of dynamic decision making. RESULTS: The medication management process consists of three components: (i) reviewing the medication situation; (ii) composing a treatment plan; and (iii) accomplishing and communicating a treatment and surveillance plan. Subtasks include multiple cognitive tasks such as composing a list of current medications and evaluating the reliability of sources, and procedural tasks such as documenting current medication. The identified macrocognitive tasks were: planning, integration of IT in workflow, managing uncertainties and responsibilities, and problem detection. CONCLUSIONS: All identified procedural, cognitive and macrocognitive skills should be included when designing education for IT-mediated medication management. The resulting framework supports the design of educational interventions to improve IT-mediated medication management in outpatient care.

Glucagon of caviomorphs and other tetrapods immunohistochemically investigated with two antisera against the N- and C-terminal portions of the molecule.

Pancreatic sections from diverse tetrapods, including various species of caviomorph rodents, were immunohistochemically investigated using two antisera which reacted with the N- and C-terminal portions of the glucagon molecule. While the antiserum against the N-terminal portion stained alpha cells in all the species studied, the antiserum against the C-portion failed to stain alpha cells in two caviomorphs of the Caviidae family (guinea pig and cuis) and in one of the Octodontidae family (degu). The observations in guinea pig and degu were expected, since their glucagons differ from those of many other tetrapods in the C-terminal portion of the molecule. In this paper, the cuis was added to these two species. It is noteworthy that among the caviomorphs studied herein (nine species), immunohistochemical differences were detected only in the three above-mentioned species and did not involve higher taxa, thus suggesting that these modifications are relatively recent in the evolution of this group of rodents.