From admissions to licensure: education data associations from a multi-centre undergraduate medical education collaboration.

This paper reports the findings of a Canada based multi-institutional study designed to investigate the relationships between admissions criteria, in-program assessments, and performance on licensing exams. The study's objective is to provide valuable insights for improving educational practices across different institutions. Data were gathered from six medical schools: McMaster University, the Northern Ontario School of Medicine University, Queen's University, University of Ottawa, University of Toronto, and Western University. The dataset includes graduates who undertook the Medical Council of Canada Qualifying Examination Part 1 (MCCQE1) between 2015 and 2017. The data were categorized into five distinct sections: demographic information as well as four matrices: admissions, course performance, objective structured clinical examination (OSCE), and clerkship performance. Common and unique variables were identified through an extensive consensus-building process. Hierarchical linear regression and a manual stepwise variable selection approach were used for analysis. Analyses were performed on data set encompassing graduates of all six medical schools as well as on individual data sets from each school. For the combined data set the final model estimated 32% of the variance in performance on licensing exams, highlighting variables such as Age at Admission, Sex, Biomedical Knowledge, the first post-clerkship OSCE, and a clerkship theta score. Individual school analysis explained 41-60% of the variance in MCCQE1 outcomes, with comparable variables to the analysis from of the combined data set identified as significant independent variables. Therefore, strongly emphasising the need for variety of high-quality assessment on the educational continuum. This study underscores the importance of sharing data to enable educational insights. This study also had its challenges when it came to the access and aggregation of data. As such we advocate for the establishment of a common framework for multi-institutional educational research, facilitating studies and evaluations across diverse institutions. This study demonstrates the scientific potential of collaborative data analysis in enhancing educational outcomes. It offers a deeper understanding of the factors influencing performance on licensure exams and emphasizes the need for addressing data gaps to advance multi-institutional research for educational improvements.

A Win-Win for Sport and Exercise Medicine and Primary Care: A Qualitative Case Study of the Added Competence Model in Canada.

OBJECTIVE: To understand the unique impacts of the College of Family Physicians of Canada's (CFPC) Certificate of Added Competence (CAC) in Sport and Exercise Medicine (SEM) on the delivery of comprehensive care in Canada. DESIGN: Secondary analysis of qualitative interview data collected during a multiple case study of the impacts of the CAC program in Canada. SETTING: Six cases purposively sampled from across Canada. Each case was bound by a collective of healthcare providers who work with a defined group of patients. PARTICIPANTS: Across the cases, 48 individuals participated, including SEM and other enhanced skill family physicians, generalist family physicians, residents, specialists, and administrative staff. MAIN OUTCOME MEASURES: Qualitative descriptions of the impacts of the SEM certificate on comprehensive care provision in Canada. RESULTS: SEM certificate holders experience enhanced well-being and professional satisfaction while also benefitting comprehensive care in communities in numerous ways. That SEM certificate holders may prioritize professional interests over community healthcare needs was identified as a potential drawback. Athletes and physically active individuals have specific healthcare needs, and may constitute a significant critical mass to be considered a community unto themselves. CONCLUSIONS: The SEM certificates impact healthcare positively when holders work in collaborative models that are well aligned with local community needs. Expanding the awareness of the scope of SEM and advocacy for adequate remuneration for these services have the potential to enhance SEM contributions to comprehensive family medicine in Canada.

Intramolecular transformation reaction of the glutathione thiyl radical into a non-sulphur-centred radical: a pulse-radiolysis and EPR study.

The thiyl radical derived from glutathione (GSH) is shown to decay rapidly in aqueous solution by intramolecular rearrangement reactions into the non-sulphur-centred radical 1. The reaction is induced by OH- with a rate constant of 5 x 10(9) dm3 mol-1 and is also observable at near-neutral conditions (at physiological pH values around 7.5 the rate of formation of 1 amounts to approximately 1 x 10(3) s-1). The activation enthalpy and entropy at pH 8.4 and 20 degrees C were found to be 26.7 kJ mol-1 and -77 J mol-1 K-1, respectively. Radical 1 was unequivocally identified by EPR as the alpha-amino radical at the glutamyl residue of GSH. It is relatively long-lived with typical bimolecular decay rate constants of the order of (2-20) x 10(6) dm3 mol-1 s-1. At higher GSH concentrations the formation of 1 is retarded but not inhibited. All radicals, sulphur- as well as non-sulphur-centred ones are connected via equilibria, partly under the action of 'repair' processes of GSH. These repair processes, however, are slow (k much less than 1.4 x 10(5) dm3 mol-1 s-1). The equilibria are established quite rapidly and were found to be far on the side of the non-sulphur-centred radical under all conditions employed. Radical 1 possesses reducing properties as evidenced by its fast reaction with 4-nitro-acetophenone (PNAP) to yield PNAP.- (k = 7 x 10(8) dm3 mol-1 s-1).

Interhemispheric transmission time in persons with Down syndrome.

BACKGROUND: The study of cerebral specialization in persons with Down syndrome (DS) has revealed an anomalous pattern of organization. Specifically, persons with DS elicit a right cerebral hemisphere lateralization for receptive language and a left cerebral hemisphere lateralization for the production of simple and complex movements: a pattern quite different from the left hemisphere lateralization typically characterizing the aforementioned processes in the non-DS population. It is thought that the putative separation between speech perception and movement planning systems as well as the cost of interhemispheric integration impedes verbal-motor behaviours in persons with DS. Moreover, morphological anomalies of callosal structure may further amplify between-hemisphere communication difficulties in the DS population. In the present investigation, we employed a behavioural technique (i.e. the Poffenberger paradigm; Poffenberger) to determine whether global anomalies of callosal structure further amplify deficits in interhemispheric communication. METHODS: Fourteen individuals with DS and 25 chronological age-matched and gender-equated participants without intellectual disability performed a visuomotor reaction time (RT) test with their left or right hand to visual stimuli appearing left or right of visual fixation. Typically it is reported that responses to visual stimuli appearing ipsilateral to the responding hand (i.e. the uncrossed condition) are faster than responses wherein visual stimuli and responding hand are contralaterally mapped (i.e. the crossed condition). The increased RT associated with the crossed condition is reported on the order of 4 ms and has been interpreted to reflect the physiological result of interhemispheric transmission. RESULTS: Not surprisingly persons with DS exhibited slower and more variable RTs relative to control counterparts. In addition, a reliable RT advantage favouring the uncrossed conditions was observed among control participants but not persons with DS. CONCLUSIONS: In keeping with the extant literature, RT performance of the DS group was slower and more variable than control counterparts. This finding has been interpreted to reflect an 'adaptive reaction' wherein the perceptual-motor abilities of persons with DS are not optimized to respond to externally paced stimuli. In terms of evaluating interhemispheric transmission via the Poffenberger paradigm, our results show the finite measures of explicit brain-behaviour relations characterizing so-called healthy controls are not always tenable in the DS population. Indeed, we believe such a finding underpins the aforementioned 'adaptive reaction' exemplifying preferred movement control in persons with DS.