Scoring Methods in Script Concordance Tests: An Exploratory Psychometric Study.

BACKGROUND: Despite the increasingly popular role of script concordance test (SCT) scoring methods in the evaluation of clinical reasoning, studies examining these methods in nursing are relatively scarce. This study explored the psychometric properties of five SCT scoring methods. METHOD: An SCT was administered to 12 experts and 43 learners. Scores were calculated using five methods and descriptive statistics. Differences in scores were assessed with the Mann-Whitney U test, and Spearman correlation coefficients were calculated for the different methods. RESULTS: The median scores of both experts and learners differed substantially according to the scoring method used. Learners' scores were statistically different from experts' scores (p < .01) for each method. Spearman coefficients (range, 0.44 to 0.95) were positive for the different methods. CONCLUSION: Further research is needed to refine the influence of SCT scoring methods for use in certifying assessment of clinical reasoning in nursing. [J Nurs Educ. 2023;62(10):549-555.].

Evaluation of a tool to improve the quality of preceptor written feedback for family medicine residents: training and use of a CanMEDS-MF competency-based criterion guide.

Background: Written feedback is essential in resident teaching, but preceptors are not always well equipped to provide relevant feedback. The purpose of this study was to evaluate the effectiveness of multi-episodic training and the use of a criterion-referenced guide for written feedback for family medicine preceptors in a French-language academic hospital. Method: Twenty-three (23) preceptors participated in the training and used the criterion-referenced guide to guide them during the written evaluation in an evaluation sheet named "Field Notes." The content of these Field Notes was analyzed according to completion, the rate of specific feedback, and the rate of feedback by CanMEDS-MF role before and after the training over a three-month period. Results: Based on the analysis of the Field Notes (n = 70 pre-test; n = 138 post-test), an increase in the percentage of completion (50% vs. 92%, z = 2.97, p = 0.0030) and specific feedback (59% vs. 92%, z = 2.47, p=0.0137) was noted. There was no significant increase in feedback by CanMEDS-MF role. Conclusions: The development of multi-episodic training and a criterion-referenced guide, created according to the CanMEDS-MF repository, suggests an improvement in comprehensive and specific written feedback in family medicine education.

Contexte: La rétroaction écrite est primordiale dans l'enseignement aux résidents, mais les précepteurs ne sont pas toujours outillés pour offrir une rétroaction pertinente. Cette étude visait à évaluer l'efficacité de formations multiépisodiques et l'utilisation d'un guide critérié pour les rétroactions écrites des précepteurs en médecine familiale d'un centre hospitalier académique francophone. Méthode: Vingt-trois (23) précepteurs ont participé aux formations et ont utilisé le guide critérié pour les guider lors de l'évaluation écrite dans une fiche évaluative nommée «feuille de route¼. Le contenu de ces feuilles de route a été analysé selon la complétion, le taux de rétroactions spécifiques et le taux de rétroactions par rôle CanMEDS-MF avant et après les formations sur une période de trois mois. Résultats: Selon l'analyse des feuilles de route (n=70 prétest ; n=138 posttest), une augmentation du pourcentage de complétion (40% vs 92%, z=3.51, p=0.0005) et de rétroactions spécifiques (59% vs 92%, z=2.47, p=0.0137) fut notée. Il n'y avait aucune augmentation significative quant aux rétroactions par rôle CanMEDS-MF. Conclusions: L'élaboration de formations multiépisodiques et d'un guide critérié, créés selon le référentiel CanMEDS-MF, suggère une amélioration de rétroactions écrites complètes et spécifiques en éducation de la médecine familiale.

Molecular Origin of the Odd-Even Effect of Macroscopic Properties of n-Alkanethiolate Self-Assembled Monolayers: Bulk or Interface?

Elucidating the influence of the monolayer interface versus bulk on the macroscopic properties (e.g., surface hydrophobicity, charge transport, and electron transfer) of organic self-assembled monolayers (SAMs) chemically anchored to metal surfaces is a challenge. This article reports the characterization of prototypical SAMs of n-alkanethiolates on gold (CH3(CH2)nSAu, n = 6-19) at the macroscopic scale by electrochemical impedance spectroscopy and contact angle goniometry, and at the molecular level, by infrared reflection absorption spectroscopy. The SAM capacitance, dielectric constant, and surface hydrophobicity exhibit dependencies on both the length (n) and parity (nodd or neven) of the polymethylene chain. The peak positions of the CH2 stretching modes indicate a progressive increase in the chain conformational order with increasing n between n = 6 and 16. SAMs of nodd have a greater degree of structural gauche defects than SAMs of neven. The peak intensities and positions of the CH3 stretching modes are chain length independent but show an odd-even alternation of the spatial orientation of the terminal CH3. The correlations between the different data trends establish that the chain length dependencies of the dielectric constant and surface hydrophobicity originate from changes in the polymethylene chain conformation (bulk), while the odd-even variation arises primarily from a difference in the chemical composition of the interface related to the terminal group orientation. These findings provide new physical insights into the structure-property relation of SAMs for the design of ultrathin film dielectrics as well as the understanding of stereostructural effects on the electrical characteristics of tunnel junctions.

Cognitive challenges of junior residents attempting to learn surgical skills by observing procedures.

BACKGROUND: Surgical observation is an integral part of surgical training. Junior residents, who have limited understanding of the procedures being performed, use observation to gain an initial exposure to surgical techniques. This study explores the challenges junior residents face from a cognitive standpoint when they are observing surgery. METHODS: Four focus groups were conducted with 18 general surgery junior residents. Transcripts from these focus groups were analyzed using a qualitative interpretative approach and the findings were explored through the lenses of discovery learning and cognitive load theory. RESULTS: Surgical observation is perceived by residents as a learning activity with rich potential. However, two main challenges were identified: directing their attention to the most pertinent element during observation and making sense of what is happening during procedures. CONCLUSIONS: This study can inform strategies to help junior residents observe surgeries more efficiently to help make surgical observation a better learning experience.

Micromechanical Redox Actuation by Self-Assembled Monolayers of Ferrocenylalkanethiolates: Evens Push More Than Odds.

Microcantilever transducers can be valuable tools for the investigation of physicochemical processes in organized molecular films. Gold-coated cantilevers are used here to investigate the electrochemomechanics of redox-active self-assembled monolayers (SAMs) of ferrocenylalkanethiolates (Fc(CH2) nS) of different alkyl chain lengths. A significant odd-even effect is observed in the surface stress and cantilever movement generated by the oxidation of the SAM-confined ferrocenes as the number of methylene units n in the SAM backbone is varied. We demonstrate that stronger alkyl chain-chain interactions are at the origin of the larger surface stresses generated by SAMs with an even versus odd n. The findings highlight the impact of subtle structural effects and weak van der Waals interactions on the mechanical actuation produced by redox reactions in self-assembled systems.

Electroactive Self-Assembled Monolayers Detect Micelle Formation.

The interfacial electrochemistry of self-assembled monolayers (SAMs) of ferrocenyldodecanethiolate on gold (FcC12SAu) electrodes is applied to detect the micellization of some common anionic surfactants, sodium n-alkyl sulfates, sodium n-alkyl sulfonates, sodium diamyl sulfosuccinate, and sodium dodecanoate, in aqueous solution by cyclic voltammetry. The apparent formal redox potential (E°'SAM) of the FcC12SAu SAM is used to track changes in the concentration of the unaggregated surfactant anions and determine the critical micelle concentration (cmc). The effect of added salt (NaF) on the sodium alkyl sulfate concentration dependence of E°'SAM is also investigated. Weakly hydrated anions, such as ClO4-, pair with the electrogenerated SAM-bound ferroceniums to neutralize the excess positive charge created at the SAM/electrolyte solution interface and stabilize the oxidized cations. E°'SAM exhibits a Nernstian-type dependence on the anion activity in solution. Aggregation of the surfactant anions into micelles above the cmc causes the free surfactant anion activity to deviate from the molar concentration of added surfactant, resulting in a break in the plot of E°'SAM versus the logarithm of the concentration of anionic surfactant. The concentration at which this deviation occurs is in good agreement with literature or experimentally determined values of the cmc. The effects of Ohmic potential drop, liquid junction potential, and surfactant adsorption behavior on E°'SAM are addressed. Ultimately, the E°'SAM response as a function of the anionic surfactant concentration exhibits the same features reported using potentiometry and surfactant ion-selective electrodes, which provide a direct measure of the free surfactant anion activity, thus making FcC12SAu SAM electrodes useful for the detection of surfactant aggregation and micelle formation.

Redox-Controlled Ion-Pairing Association of Anionic Surfactant to Ferrocene-Terminated Self-Assembled Monolayers.

The redox-induced pairing from aqueous solution of a homologous series of sodium n-alkyl sulfate (NaCnSO4) surfactants of 6, 8, 10, and 12 carbons with gold-tethered self-assembled monolayers (SAMs) of ferrocenyldodecanethiolate (FcC12SAu) is investigated by cyclic voltammetry combined with surface plasmon resonance (SPR) spectroscopy. The adsorbed layer thicknesses and surface coverages are consistent with the formation of a monolayer of CnSO4(-) at the oxidized FcC12SAu SAM/aqueous solution interface. A comparison of the anodic charge density with the SPR data indicates that approximately 60% of the adsorbed surfactant anions are paired with SAM-bound ferroceniums, suggesting an interdigitated layer structure. The ion-pairing capabilities of the longer-chain NaC12SO4, NaC10SO4, and NaC8SO4 relative to the short-chain NaC6SO4 are compared using the relative ion-pair formation constants calculated from the apparent SAM redox potentials and IC50 values obtained from competitive association experiments. A longer alkyl chain increases the overall hydrophobicity of the CnSO4(-) anion, thereby increasing its ability to pair with and stabilize the ferrocenium in the nonpolar environment of the SAM. Binary mixtures of NaC12SO4 and NaC6SO4 of different compositions are used to demonstrate that the differences in ion-pairing abilities can be exploited to selectively pair and adsorb C12SO4(-).

To quiz or not to quiz: Formative tests help detect students at risk of failing the clinical anatomy course.

Through a modified team-based learning (TBL) in the anatomy pre-clerkship curriculum, formative evaluations are utilized in the University of Ottawa Faculty of Medicine to assess and predict students' outcomes on summative examinations. The purpose of this study was to determine the efficiency of formative assessments to predict student's performance on summative examinations, during the first two semesters of medical school. Formative assessments included multiple-choice quizzes (MCQ) for each laboratory session and a practical midterm examination (MIDTERM), while the summative assessment corresponded to the final practical examination (FINAL). A moderate correlation between MCQs and FINAL (r = 0.353 and 0.301, respectively), and strong correlation between MIDTERM and FINAL assessments (r = 0.688 and 0.610, respectively) were found in the first two semesters. The MIDTERM-FINAL correlations were enhanced for students who scored under 61% in the MIDTERM (r = 0.887 and 0.717, respectively). Despite limitations, mostly related to particularities of the used tests, the analysis revealed an efficient method to identify students at risk of failing the FINAL in a TBL-based anatomy program. Future developments include the elaboration of strategies to predict and support those underperforming students.

Microcantilevers bend to the pressure of clustered redox centers.

The redox-activated deflection of microcantilevers has attracted interest for nanoactuation and chemical sensing. Microcantilever sensors are devices that transduce (bio)chemical reactions into a quantifiable nanomechanical motion via surface stress changes. Despite promising applications in analytical science, poor signal-to-noise ratios and a limited understanding of the molecular origins of the surface stress changes that cause the observed deflections remain obstacles to cantilever-based sensing becoming an established (bio)detection method, such as surface plasmon resonance and electrochemistry. We use phase-separated, binary self-assembled monolayers (SAMs) of ferrocenyldodecanethiolate and n-undecanethiolate as a model system to study the effect of the steric crowding of the redox centers on the surface stress change and cantilever deflection produced by the electrochemical oxidation of the surface-tethered ferrocene to ferrocenium. We correlate the measured surface stress change to the fraction of the clustered ferrocenyldodecanethiolate phase in the binary SAMs. The pairing of anions with the sterically crowded clustered ferroceniums induces a collective molecular reorientation which drives the cantilever deflection. The results provide fundamental insights into the response mechanism of microcantilever-based actuating and sensing technologies.

Redox-induced ion pairing of anionic surfactants with ferrocene-terminated self-assembled monolayers: Faradaic electrochemistry and surfactant aggregation at the monolayer/liquid interface.

Oxidoreduction of self-assembled monolayers (SAMs) of ferrocenyldodecanethiolate on gold in aqueous solutions of surface-active sodium n-alkyl sulfates (NaCnSO4) of 6, 8, 10, and 12 carbons is investigated by cyclic voltammetry and surface plasmon resonance. The effects of surfactant micellization and alkyl chain length on the redox response of the surface-tethered ferrocenes are examined. The SAM redox electrochemistry is sensitive to the surfactant aggregation state in solution. The nonideal behavior of the sodium alkyl sulfates at concentrations above the critical micelle concentration leads to a non-Nernstian variation of the SAM redox potential with concentration. The presence of micelles in solution results in decreased anodic-to-cathodic peak separations and anodic peak full widths at half-maximum. A longer alkyl chain length results in an increased ability of the alkyl sulfate anion to ion pair with the SAM-bound ferrocenium, resulting in oxidation of the ferrocene at lower potential. A comparison of the SAM redox potential at a fixed surfactant concentration of ideal behavior suggests a 4.5 × 10(4) difference in the ion-pairing abilities of the shorter-chain C6SO4(-) and longer-chain C12SO4(-). One-half of the available SAM-bound ferrocenes are oxidized in the NaCnSO4 electrolyte. Surfactant anions adsorb and assemble onto the SAM surface by specific ion-pairing interactions between the sulfate headgroups and oxidized ferrocenium species, forming an interdigitated monolayer in which the surfactant anions alternate between a heads-down and heads-up orientation with respect to the SAM. The work presented points to applications of ferrocenylalkanethiolate SAMs as anion-selective membranes, probes of micelle formation, and surfaces for the electrochemically switchable assembly of organosulfates.