Missed opportunities in health care education evidence synthesis

We read with excitement the systematic review on how to teach evidence-based medicine (EBM) to medical trainees.1 The conclusions of the paper1 represent a concise and accurate reflection of this large synthesis of evidence. Unfortunately, we were left reflecting not on the evidence base illuminated by this review, but on the missed opportunities we will highlight herein. These examples are not in any way meant to represent a specific set of criticisms of this work,1 but, rather, are intended as exemplars of wider methodological issues that currently exist within much published material on the synthesis of evidence in health care educatio

AMEE guide 94: Systematic reviews in medical education: A practical approach

The twentieth century saw a paradigm shift in medical education, with acceptance that ‘knowledge’ and ‘truth’ are contextual, in flux and always evolving. The twenty-first century has seen a greater explosion in computer technology leading to a massive increase in information and an ease of availability, both offering great potential to future research. However, for many decades, there have been voices within the health care system raising an alarm at the lack of evidence to support widespread clinical practice; from these voices, the concept of and need for evidence-based health-care has grown. Parallel to this development has been the emergence of evidence-based medical education; if healthcare is evidence-based, then the training of practitioners who provide this healthcare must equally be evidence-based. Evidence-based medical education involves the systematic collection, synthesis and application of all available evidence, when available, and not just the opinion of experts. This represented a seismic shift from a position of expert based consensus guidance to evidence led guidance for evolving clinical knowledge. The aim of this guide is to provide a practical approach to the development and application of a systematic review in medical education; a valid method used in this guide to seek and substantiate the effects of interventions in medical education

Horizontal Well Placement Optimization in Gas Reservoirs Using Genetic Algorithms

Horizontal well placement determination within a reservoir is a significant and difficult step in the reservoir development process. Determining the optimal well location is a complex problem involving many factors including geological considerations, reservoir and fluid properties, economic costs, lateral direction, and technical ability. The most thorough approach to this problem is that of an exhaustive search, in which a simulation is run for every conceivable well position in the reservoir. Although thorough and accurate, this approach is typically not used in real world applications due to the time constraints from the excessive number of simulations. This project suggests the use of a genetic algorithm applied to the horizontal well placement problem in a gas reservoir to reduce the required number of simulations. This research aims to first determine if well placement optimization is even necessary in a gas reservoir, and if so, to determine the benefit of optimization. Performance of the genetic algorithm was analyzed through five different case scenarios, one involving a vertical well and four involving horizontal wells. The genetic algorithm approach is used to evaluate the effect of well placement in heterogeneous and anisotropic reservoirs on reservoir recovery. The wells are constrained by surface gas rate and bottom-hole pressure for each case. This project's main new contribution is its application of using genetic algorithms to study the effect of well placement optimization in gas reservoirs. Two fundamental questions have been answered in this research. First, does well placement in a gas reservoir affect the reservoir performance? If so, what is an efficient method to find the optimal well location based on reservoir performance? The research provides evidence that well placement optimization is an important criterion during the reservoir development phase of a horizontal-well project in gas reservoirs, but it is less significant to vertical wells in a homogeneous reservoir. It is also shown that genetic algorithms are an extremely efficient and robust tool to find the optimal location

How to review a paper on medical education

There has been a substantial increase in the number of medical and health professional education manuscripts being submitted to an increasing number of journals in this field.  More reviews and more reviewers are needed to facilitate discussion of both relevance and quality of those manuscripts.  MedEdPublish relies on readers and Review Panel members to contribute to this process, thereby helping to maintain standards in medical and health professional education publishing.  This article provides guidance that is most relevant to reviewers and potential authors for MedEdPublish, but may be relevant to publishing in other medical and health professional journals

Horizontal Well Placement Optimization in Gas Reservoirs Using Genetic Algorithms

Horizontal well placement determination within a reservoir is a significant and difficult step in the reservoir development process. Determining the optimal well location is a complex problem involving many factors including geological considerations, reservoir and fluid properties, economic costs, lateral direction, and technical ability. The most thorough approach to this problem is that of an exhaustive search, in which a simulation is run for every conceivable well position in the reservoir. Although thorough and accurate, this approach is typically not used in real world applications due to the time constraints from the excessive number of simulations. This project suggests the use of a genetic algorithm applied to the horizontal well placement problem in a gas reservoir to reduce the required number of simulations. This research aims to first determine if well placement optimization is even necessary in a gas reservoir, and if so, to determine the benefit of optimization. Performance of the genetic algorithm was analyzed through five different case scenarios, one involving a vertical well and four involving horizontal wells. The genetic algorithm approach is used to evaluate the effect of well placement in heterogeneous and anisotropic reservoirs on reservoir recovery. The wells are constrained by surface gas rate and bottom-hole pressure for each case. This project's main new contribution is its application of using genetic algorithms to study the effect of well placement optimization in gas reservoirs. Two fundamental questions have been answered in this research. First, does well placement in a gas reservoir affect the reservoir performance? If so, what is an efficient method to find the optimal well location based on reservoir performance? The research provides evidence that well placement optimization is an important criterion during the reservoir development phase of a horizontal-well project in gas reservoirs, but it is less significant to vertical wells in a homogeneous reservoir. It is also shown that genetic algorithms are an extremely efficient and robust tool to find the optimal location

Impact of the COVID-19 pandemic: The perceptions of health professions educators

What are health professions educators doing during the COVID-19 pandemic? A search of articles in MedEdPublish on the topics of COVID-19 revealed 39 articles published in the first 3 months of the pandemic. Topics included curriculum adaptation, guidelines for using technology, assessment adaptation, impact on students, faculty and career development, and conference adaptation. There was significant overlap among articles, particularly those discussing teaching, learning, and assessment practices. Common themes were adaptation, innovation, remote delivery, flexibility in the face of a pandemic, and how to continue to educate and graduate competent health professionals. All articles were descriptive, and none included data describing efficacy, likely due to the short timeline since the pandemic’s inception. Additional study is necessary to produce evidence for the teaching and assessment adaptations described. Some changes are likely to persist longer-term and may outlast the pandemic itself

Signaling in Secret: Pay-for-Performance and the Incentive and Sorting Effects of Pay Secrecy

Key Findings: Pay secrecy adversely impacts individual task performance because it weakens the perception that an increase in performance will be accompanied by increase in pay; Pay secrecy is associated with a decrease in employee performance and retention in pay-for-performance systems, which measure performance using relative (i.e., peer-ranked) criteria rather than an absolute scale (see Figure 2 on page 5); High performing employees tend to be most sensitive to negative pay-for- performance perceptions; There are many signals embedded within HR policies and practices, which can influence employees’ perception of workplace uncertainty/inequity and impact their performance and turnover intentions; and When pay transparency is impractical, organizations may benefit from introducing partial pay openness to mitigate these effects on employee performance and retention

What Matters Most? An Exploration of Quality of Life Through the Everyday Experiences of Autistic Young People and Adults

BACKGROUND: The quality of life (QoL) of Autistic people is consistently reported to be poor compared with the general population. Little is known, however, about how Autistic people experience QoL from their perspectives and the ways they would like it to be enhanced. This qualitative study, conducted in collaboration with Autistic people, sought to understand how Autistic young people and adults define a good life and what helps and hinders them from achieving a good QoL. METHODS: We conducted semi-structured in-depth interviews with 34 Autistic adults and 14 Autistic adolescents about their everyday life experiences of different aspects of QoL, including physical health, sensory needs, mental health, money, home, transport, leisure, social connections, acceptance, and inclusion, being in charge of one's life and perceptions of the future. We coded transcripts in NVivo and analyzed them using reflexive thematic analysis. RESULTS: We identified four themes: two themes that described what a good QoL meant for our participants along with aspects of their lives that facilitated a good QoL: “feeling good” and “being myself in the world”; and two themes that described barriers to achieving a good QoL: “exhaustion and overwhelm” and “negative experiences shape perceptions.” DISCUSSION: These findings highlight the need to consider Autistic people's QoL within the context of their everyday realities. Enhancing QoL will only be achieved through focusing on these realities and through the provision of adaptations and supports to create more inclusive environments