Childhood cognitive skill trajectories and suicide by mid-adulthood: an investigation of the 1958 British Birth Cohort.

BACKGROUND: Poor cognitive abilities and low intellectual quotient (IQ) are associated with an increased risk of suicide attempts and suicide mortality. However, knowledge of how this association develops across the life-course is limited. Our study aims to establish whether individuals who died by suicide by mid-adulthood are distinguishable by their child-to-adolescence cognitive trajectories. METHODS: Participants were from the 1958 British Birth Cohort and were assessed for academic performance at ages 7, 11, and 16 and intelligence at 11 years. Suicides occurring by September 2012 were identified from linked national death certificates. We compared mean mathematics and reading abilities and rate of change across 7-16 years for individuals who died by suicide v. those still alive, with and without adjustment for potential early-life confounding factors. Analyses were based on 14 505 participants. RESULTS: Fifty-five participants (48 males) had died by suicide by age 54 years. While males who died by suicide did not differ from participants still alive in reading scores at age 7 [effect size (g) = -0.04, p = 0.759], their reading scores had a less steep improvement up to age 16 compared to other participants. Adjustments for early-life confounding factors explained these differences. A similar pattern was observed for mathematics scores. There was no difference between individuals who died by suicide v. participants still alive on intelligence at 11 years. CONCLUSIONS: While no differences in tests of academic performance and IQ were observed, individuals who died by suicide had a less steep improvement in reading abilities over time compared to same-age peers.

Educating Students with Autism Spectrum Disorders: Is Teacher Certification Area Associated with Academic Outcomes?

Although typically taught by special educators, few studies have examined if certification area is associated with academic outcomes for students with autism spectrum disorders (ASDs). The purpose of this study was to determine whether students with ASD scored better on language arts and mathematics state assessments depending on teacher certification, and whether these associations varied by assessment type. We analyzed 3 years of state administrative data from students with ASD in grades 4-8 receiving special education services. Results showed students taking the regular or alternate assessment had similar academic outcomes regardless of teacher certification. Students who were taught by special education certified teachers and took the modified assessment had lower academic outcomes. Implications for practice, policy, and research are discussed.

Inconsistency in Faculty and Student Perceptions of DNP and PhD Leader Scholarly Activity.

OBJECTIVE: We aimed to quantify faculty and student perceptions of scholarly activities for doctor of nursing practice (DNP) and PhD leaders. BACKGROUND: The American Association of Colleges of Nursing describes DNP as a practice-focused degree and PhD as a research-focused degree. In 2016, the Council on Graduate Education for Administration in Nursing (now Association for Leadership Science in Nursing) published in the Journal of Nursing Administration sample practice objectives for DNP and research objectives for PhD leaders. METHODS: Using the published objectives, we surveyed faculty and students to quantify congruence with the publication and consistency within groups. The data informed intraprofessional education constructed using action research. RESULTS: There was low congruence between faculty and student responses with the article. PhD faculty had the least, and PhD students, the greatest, consistency in survey responses. CONCLUSIONS: Confusion exists within our faculty and students around differentiating PhD and DNP scholarly activities. Data supported need to clarify scholarly role boundaries through intraprofessional education.

Admissions Is Not Enough: The Racial Achievement Gap in Medical Education.

The achievement gap is a disparity in academic and standardized test performance that exists between White and underrepresented minority (URM) students that begins as early as preschool and worsens as students progress through the educational system. Medical education is not immune to this inequality. URM medical students are more likely to experience delayed graduation and course failure, even after accounting for science grade point average and Medical College Admission Test performance. Moreover, URM students are more likely to earn lower scores on licensing examinations, which can have a significant impact on their career trajectory, including specialty choice and residency competitiveness. After the release of preliminary recommendations from the Invitational Conference on USMLE Scoring (InCUS) and public commentary on these recommendations, the National Board of Medical Examiners and Federation of State Medical Boards announced that the United States Medical Licensing Examination (USMLE) Step 1 would transition from a 3-digit numeric score to pass/fail scoring. Given that another of InCUS's recommendations was to "minimize racial demographic differences that exist in USMLE performance," it is paramount to consider the impact of this scoring change on URM medical students specifically. Holistic admissions are a step in the right direction of acknowledging that URM students often travel a further distance to reach medical school. However, when residency programs emphasize USMLE performance (or any standardized test score) despite persistent test score gaps, medical education contributes to the disproportionate harm URM students face and bolsters segregation across medical specialties. This Perspective provides a brief explanation of the achievement gap, its psychological consequences, and its consequences in medical education; discusses the potential effect of the Step 1 scoring change on URM medical students; and provides a review of strategies to redress this disparity.

Presencia de la Medicina de Urgencias y Emergencias en el examen de médico interno residente (MIR) en España: análisis evolutivo durante el periodo 2010-2019 / Emergency medicine questions on the entrance examination for medical internships and residency training in Spain: analysis of changes between 2010 and 2019

OBJETIVO: Investigar la presencia del cuerpo doctrinal de la Medicina de Urgencias y Emergencias (MUE) en el examen de acceso a médico interno residente (MIR) en España y su evolución en el tiempo. MÉTODO: Estudio longitudinal retrospectivo. Tres investigadores revisaron independientemente las preguntas de los exámenes MIR de los últimos 10 años (2010-2019) y las clasificaron por acuerdo mayoritario como directamente, indirectamente o no relacionadas con la MUE. La temática de las preguntas directamente relacionadas con la MUE se clasificó según el índice del libro de texto de MUE de Tintinalli y según la clasificación de las áreas de la base Science Citation Index Expanded (SCIE) de la Web of Science. La evolución temporal de la presencia y la temática de la MUE se analizó mediante regresión lineal simple. RESULTADOS: Se revisaron 2.300 preguntas: 487 (22%) estaban directamente relacionadas con la MUE (313 citaban específicamente el escenario de urgencias o emergencias). La presencia de preguntas directamente relacionadas con la MUE se mantuvo constante entre 2010-2019 (p = 0,172). Siguiendo la clasificación de Tintinalli, las temáticas más frecuentes de estas preguntas fueron urgencias cardiovasculares (12,2%), infecciosas (11,1%) y gastrointestinales (10,9%), sin cambios significativos entre 2010-2019, mientras que siguiendo la clasificación del SCIE, estas temáticas fueron urgencias (11,9%, que aumentó significativamente durante el periodo, p = 0,005), cardiovascular (11,3%, que descendió, p = 0,037) y enfermedades infecciosas (10,7%, sin cambios durante el periodo). CONCLUSIÓN: La MUE, a pesar de no estar reconocida como una especialidad formativa por la vía MIR, tiene una elevada relevancia para la administración sanitaria a la hora de seleccionar a los MIR, que inician su formación especializada en el sistema público de salud, a juzgar por su elevada presencia en el examen anual al que se somete a los candidatos

OBJETIVE: To investigate the presence of fundamental concepts in emergency medicine on the entrance examination taken by candidates for medical internships and residency training in Spain, and to identify changes over time. METHODS: Longitudinal retrospective study. Three independent researchers reviewed questions on the entrance examinations of the past 10 years (2010-2019) and classified them as directly, indirectly, or not related to emergency medicine. The topics of directly related questions were also classified according to the categories listed in Tintinalli's Emergency Medicine and subject areas in the Citation Index Expanded (SCIE) of the Web of Science. Changes in the number of questions and range of topics were analyzed with simple linear regression models. RESULTS: A total of 2300 questions were reviewed; 487 (22%) were directly related to emergency medicine, and 313 of them specifically referred to an emergency or urgent care setting. The proportion of directly related questions held steady over the 10-year period (P=.172). The most frequently mentioned categories listed by Tintinalli were cardiovascular (12.2%), infectious (11.1%), and gastrointestinal (10.9%) emergencies, and no significant differences were noted over time. However, proportions assigned to the SCIE categories did change over time, as follows. Questions about emergency care in general (11.9% during the period overall) increased significantly with time(P=.005) whereas cardiovascular questions (11.3%) decreased (P=.037). The proportion of infectious disease topics remained the same (10.7%). CONCLUSION: Even though emergency medicine is not a recognized specialty for medical residency training in the public health system, questions on emergencies are considered important for evaluating candidates, judging by the high percentage of questions on the examinations

Identificación de patrones instruccionales de mediación relacionados con progresos en comprensión lectora en contextos de desventaja sociocultural / Identifying instructional mediation patterns related with progress in reading comprehension in contexts of sociocultural disadvantage

Identificar factores instruccionales específicos relacionados con progresos en comprensión lectora es esencial para optimizar el aprendizaje y orientar la intervención, especialmente en contextos de desventaja socio-cultural o dificultades de aprendizaje. Este estudio pretende identificar patrones instruccionales de mediación eficaces en la explicación del progreso en comprensión. Se grabaron, transcribieron y analizaron sistemáticamente 82 sesiones-clase, y se registraron pautas de mediación relativas a diferentes procesos lectores. Los patrones de mediación fueron analizados mediante codificación y categorización del contenido con el programa Maxqdea-7. Fueron consideradas 19 categorías, que aglutinaron 178 unidades de información significativas (pautas/conductas de mediación). La muestra estuvo compuesta por 21 docentes y 821 estudiantes de tercero a octavo grado de Educación Básica de escuelas públicas de Chile ubicadas en contextos de-privados socialmente. El progreso lector se midió con la prueba estandarizada CL-PT, aplicada al principio y al final del curso escolar. Los resultados permitieron identificar pautas específicas de mediación significativas en la explicación del progreso, especialmente el patrón M_17 (Mediación del uso de estrategias para la activación e integración de conocimientos previos) explicaba el 26% de la varianza (r = .55, p < .01; R2ajustado = .26, F (1, 19) = 8.19, p = .01). Se discuten las implicaciones educativas de estos resultados

Identifying specific instructional factors related to progress in reading comprehension is essential to optimize learning and guide intervention, especially in contexts of sociocultural disadvantage or learning difficulties. This study aims to identify effective mediational instructional patterns in the explanation of progress in reading comprehension. Teaching guidelines were systematically recorded in relation to different reading processes. Eighty-two sessions were recorded, transcribed and analyzed by coding and categorizing the content of the sessions through the Maxqdea-7 program. Nineteen categories were considered, which comprised 178 significant units of information (mediation guidelines). The sample consisted of 21 teachers and 821 students from third to the eighth grade of public schools of Chile located in deprived contexts. Reading progress was measured with the standardized CL-PT test, which was applied at the beginning and end of the school year. The results have allowed identifying mediation patterns with a significant relevance in the explanation of reading progress, especially the pattern M_P17 (Mediation of the use of strategies for the activation and integration of previous knowledge) managed to explain 26% of the variance in the progress (r = .55, p < .01; R2adjusted = .26, F(1, 19) = 8.19, p = .01). The educational implications of these results are discussed

Relación entre expediente académico y resultado en la prueba MIR en los estudios de medicina de la UPF-UAB / Relationship between final academic record and result in the MIR test in the UPF-UAB medicine studies

INTRODUCCIÓN: La prueba de acceso para la formación de médicos internos residentes (MIR) ha sido reconocida por su equidad, pero no ha estado exenta de críticas, especialmente por centrarse mayoritariamente en aspectos cognitivos. Además, dicha prueba se aprecia como un distorsionador en los estudios de medicina. OBJETIVO: Conocer la relación entre el expediente académico y el resultado en la prueba MIR de los graduados en medicina de los estudios conjuntos de la Universitat Pompeu Fabra (UPF) y la Universitat Autònoma de Barcelona (UAB). Sujetos y métodos: El estudio se realizó con todos los graduados de las primeras cuatro promociones de los estudios cita-dos. Para ello se registraron las calificaciones de los expedientes finales de los graduados y el número de orden obtenido en la prueba MIR. RESULTADOS: En ambos sexos y en todas las promociones se encontró una relación positiva y significativa entre expediente académico y resultado en el examen MIR. CONCLUSIONES: El mejor predictor de éxito en la prueba MIR es el éxito en los estudios realizados durante la carrera. Se recomienda informar a los estudiantes de este hecho para reducir la distorsión que produce el examen MIR en su comporta-miento académico

INTRODUCTION: The exam to access for the selection of a medical specialty in Spain (MIR test) has been recognized for its equity, but has not been without criticism especially for focusing mainly on cognitive aspects. In addition, this test is seen as a distorter in medicine studies. AIM: To know the relationship between the final academic record and the result in the MIR test of graduates in medicine from the joint studies of the Universitat Pompeu Fabra (UPF) and the Universitat Autònoma de Barcelona (UAB). Subjects and methods: The study was conducted with all graduates of the first four promotions of the studies cited. For this, the qualifications of the final files of the graduates were registered, as well as the order number obtained in the MIR test. RESULTS: In both sexes and in all the promotions a positive and significant relationship between academic record and result in the MIR exam was found. CONCLUSIONS: It is concluded that the best predictor of success in the MIR test is the success in studies conducted during the career. It is recommended to inform students of this fact to reduce the distortion produced by the MIR exam in their academic behaviour

Consensus Guidelines for Digital Scholarship in Academic Promotion.

INTRODUCTION: As scholarship moves into the digital sphere, applicant and promotion and tenure (P&T) committee members lack formal guidance on evaluating the impact of digital scholarly work. The P&T process requires the appraisal of individual scholarly impact in comparison to scholars across institutions and disciplines. As dissemination methods evolve in the digital era, we must adapt traditional P&T processes to include emerging forms of digital scholarship. METHODS: We conducted a blended, expert consensus procedure using a nominal group process to create a consensus document at the Council of Emergency Medicine Residency Directors Academic Assembly on April 1, 2019. RESULTS: We discussed consensus guidelines for evaluation and promotion of digital scholarship with the intent to develop specific, evidence-supported recommendations to P&T committees and applicants. These recommendations included the following: demonstrate scholarship criteria; provide external evidence of impact; and include digital peer-review roles. As traditional scholarship continues to evolve within the digital realm, academic medicine should adapt how that scholarship is evaluated. P&T committees in academic medicine are at the epicenter for supporting this changing paradigm in scholarship. CONCLUSION: P&T committees can critically appraise the quality and impact of digital scholarship using specific, validated tools. Applicants for appointment and promotion should highlight and prepare their digital scholarship to specifically address quality, impact, breadth, and relevance. It is our goal to provide specific, timely guidance for both stakeholders to recognize the value of digital scholarship in advancing our field.

Effects of a Single Concussion During the School Year on the Academic Performance and Neuropsychological Functioning of High School Athletes.

There are very few studies examining the effects of sports-related concussion (SRC) on objective measures of school performance, such as grades or test scores. In this research, the grade point averages (GPAs) and scores of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) of athletes who sustained an SRC during the school year were compared with those of athletes who did not have an SRC. Multivariate analysis of variance (MANOVA) revealed a significant linear decline in GPA of both groups across the school year, but indicated no difference in the GPA decline between the concussion and no concussion groups. The GPAs of the concussion and no concussion groups were not significantly different across the school year. Finally, no differences were found between the pre- and post-concussion ImPACT scores of the concussed athletes. This study found that an SRC during the school year did not affect the academic performance or neurocognitive test scores of high school athletes.

The impact of the introduction of bilingual learning on sixth grade educational achievement levels.

Bilingualism was implemented in the Community of Madrid (Spain) more than ten years ago, through the incorporation of the English language in the teaching methods of certain schools. Since that time, various research projects have been carried out, with the objective of comparing the academic performance of students in bilingual schools with those in non-bilingual schools. The present paper makes use of primary education data from the Department of Education and Research for the Community of Madrid in an effort to analyze whether or not bilingualism results in the relative improvement of educational outcomes achieved in primary schools in the Region of Madrid, in Spain. More specifically, the data used is from sixth grade classrooms, given that, generally speaking, in this grade all schools give a standardized test which measures academic performance in Math, Science and Technology, Spanish Language Arts and English Language Arts. Our assessment makes use of a multinomial logit model, and includes the most common variables found in the research on the determination of educational outcomes (variables related to whether or not schools are bilingual, which is the main focus of this paper), as well as other less common variables considered to be relevant. These include absenteeism, satisfaction levels among families and students, and the percentage of students in second chance programs. The results show that bilingualism does not lower children performance in the subjects taught in English or in the subjects taught in Spanish. Academic performance in Mathematics, Science and Technology, and Spanish Language Arts is similar with respect to those schools which are not bilingual. However, results in English are significantly higher in bilingual schools when compared to non-bilingual schools.

Working with underperformance in surgical training: Educational strategies for supervisors.

Underperformance is a significant challenge for surgical educators. This paper outlines some educational strategies to manage the very complex demands presented by underperformance during training in the workplace. Preventative approaches include: setting expectations with early conversations; conscious attention to the workplace curriculum; and building trainee evaluative judgement through assessment and feedback. Once underperformance has been identified, other approaches including: developing a joint action plan; reducing or increasing feedback opportunities; and ensuring the trainee remains motivated. While these strategies cannot prevent failure, they offer the trainee opportunities to succeed.

Students' perceptions of factors for academic failure in pre-clinical years of a medical school.

OBJECTIVE: To identify and explore medical students' perceptions about their academic failure. METHODS: The qualitative study was conducted at Shifa College of Medicine, Islamabad, Pakistan, from December 2016 to January 2017, and comprised medical students. Two focus group discussions and 5 semi-structured interviews were conducted with students who had obtained <50% marks in their first professional examinations. Key words and important points in the written text were highlighted, coded, themed and categorised. Data was analysed manually. RESULTS: There were 22 students in the two focus group discussions; 13(59%) males and 9(41%) females. Of the 5 interviewees, 3(60%) were males and 2(40%) were females. Variable factors related to failure ranged from curriculum, assessment, environment, educators and personal factors to issues relating to stress and time management, learning resources, financial support, living away from home, poor attendance, peer pressure during small group discussions and indoctrination by parents. CONCLUSIONS: Both personal and environmental factors were found to be affecting academic performance of medical students.