Month: December 2013
Holiday Gifts for Teaching
I’m sending you these, from the UG Educational Team, with a wish for peace-filled and joyful holidays with family and friends .
Did you know we subscribe to Poll Everywhere for our year 1 and 2 students?
And that you can use it with up to 40 other learners otherwise? It’s clickers without clickers—students can use their phones or laptops to answer questions anonymously in the classroom. Teachers can use word document, or PowerPoint, or ask a question orally to solicit the answers. Questions can be multiple choice, or they can be open-ended!
To get Poll Everywhere to work, you can visit their site for a demo video: http://www.polleverywhere.com/
Or you can look at their explanation: http://www.polleverywhere.com/how-it-works
Or you can contact Theresa Suart in the Ed Team at email@example.com, or Lynel Jackson at MEdTech at firstname.lastname@example.org
Second Gift: Diagnostic process (and winning points):
Dr. Tony Sanfilippo isn’t only our UGME Associate Dean extraordinaire, he’s also an intuitive teacher. One of his cases, Megan, is one I use for explanations all the time with faculty. Here is a slide from his Megan case that gives the diagnostic process in a nutshell.
And while I’m at it, another gift he gives us is the idea of getting students to rank their ordering of investigations, winning or losing “points” (often in chocolate) depending on how rational their choices were. 2 ideas from Megan
Have you ever wondered if you could synthesize a concept or unit so that students could grasp it visually? Dr. David Lee from Hematology has done a great job of this with my favourite slide of all time: the algorithm for Hematapoiesis. Here it is: hematapoiesis slide Dr David Lee Why not see what you can do with your ideas? And if you need help with graphic organizers, Theresa or I can give you a hand—they’re one of our best tools.
Dr. Lindsay Davidson has won so many teaching awards, I can’t keep track. Here she offers 2 ways you can take your students’ pulses.
In our professional lives, many of us are used to “taking the patient’s pulse”. This, and other clinical observations, inform our assessment and management plans. Similarly, as teachers, we can “take the pulse” of the students – finding out what knowledge they bring into a session or checking in to determine if important concepts have been grasped.
One of the best ways to do the first of these is a readiness assessment test. Readiness assessment tests – or RATs – are used at the beginning of a curricular theme (normally spanning about a week of the curriculum). These 10-15 question tests are designed to assess foundational concepts needed to progress to problem solving – they are quite different from the questions given on midterm and final exams. A RAT should be linked to one pre-defined preparatory resource (such as a section from a textbook, an online module or a review article). Students complete them individually and then re-take them as a team. The whole process is complete in 30 minutes, leaving the teacher time to speak to any questions or topics identified as difficult or confusing.
Another way of checking the class’ vital signs is a “muddy point” exercise. Popularized by former Queen’s Chair of Teaching and Learning Tom Russell as the “ticket out of class”, this exercises asks students to submit a note to the teacher (either on paper or could be electronically using polleverywhere’s open ended question function) outlining the “one thing” they do not understand. A review of the submissions allows teachers to begin the next class clarifying any items multiple students identify as confusing.
Interested in trying a RAT or Muddiest Point? Check in with Sheila or Theresa.
There are several tasteful and (ahem) not quite so tasteful music videos out there where people have created peons to everything from medical careers to organ systems. Perhaps you could use one as a memory tool or a way to introduce a concept. Theresa recently found this takeoff on What the Fox Say, in Harvard Medical School’s What the Spleen Do http://www.youtube.com/watch?v=aEi_4Cyx4Uw. I’ve always loved Pinky and the Brain on the Brainstem: http://www.youtube.com/watch?v=snO68aJTOpM More lyrically, Dr. Jackie Duffin sent this lovely excerpt about the muscles in the gluteous maximus: http://www.spiraldynamik.com/newsarchiv/huefte_1.mp3.
I just found Lullabye for a recovering addict by Jake Silver: http://www.youtube.com/watch?v=PFJ3DMdiEMU&feature=youtu.be (Thanks to U Sask’s Deidre Bonnycastle’s scoop on music videos!) and Dr. Heather Murray and I crossed paths sending each other Viva la Evidence by James McCormack: a parody of Coldplay’s Viva La Vida – a song all about evidence based: http://www.youtube.com/watch?v=QUW0Q8tXVUc
And finally, here’s the song Clouds written by 17 year old Zach Sobiech after being told he has months to live: http://www.youtube.com/watch?v=sDC97j6lfyc and http://www.youtube.com/watch?v=bLhUS_QjcZY
This was really a gift that was given to me, and I’d like to share it with you as a way to close out 2013, and look forward to 2014.
I’m going to have to tell you a little story…Once, long ago…
Some of you will recall the days when we worked hard to infuse small group learning into our curriculum. Going back about 5 years, our students were resentful and confused, and I was concerned our teachers were just confused. Sitting in those classes, week after week, I worried that small group learning would never work—that lectures were too much the pattern of learning and that all the reasons that had bubbled up—too long, too complicated, inefficient, students don’t like it…all these reasons for not teaching this way would overcome our efforts.
Flash forward to a C1 class in September 2013. I was wandering the back of a class given by Dr. David Taylor. He put up a clinical case on the screen. There was a pause—a discernable beat– while 100 students looked at and read from the screen. Then, as one, all of them turned to their group members and began to talk. Books were hauled out, computers fired up, tasks divided, and the usual wrangle about who’s the note-keeper soared overhead. It was a symphony of sound of minds at work. Even more beautiful: it was commonplace and accepted. The students knew exactly what to do. The teacher did what he was supposed to do—stand back and let the students wrestle that learning to the ground before taking to the stairs and moving around the room.
I can’t tell you how wonderful it felt! I saw this again even more recently as Dr. Michelle Gibson had her C2 class working on a graded team assignment, reconciling medications for a patient. Again the class gave their attention to the screen and then again the busy hum. And the results were wonderful—groups passionately prepared to defend their new prescriptions, and scathingly and brilliantly able to articulate why they had taken several prescriptions away.
I guess the gift for me is that after 5 years, small group learning is now part of the status quo. Teachers feel comfortable. Students know how to make this kind of learning work for them and are used to using it. They haven’t abandoned learning from lectures, nor have they stopped reading. But they look at the screen…beat…and they turn to their peers. I tell you, it almost brings tears to my eyes.
So this is my last holiday gift for 2013: our faculty have made innovations in teaching work and our students are making innovations in teaching work. Thank you for that gift!
Do you have any gifts to share? Musical, textual or other? Write back and let us know.
The Challenge of Career Selection
When are Medical Students ready to decide?
Medical students begin their studies believing they have decided upon and achieved their career path, and can now devote their energies and attention to advancing that goal. They soon learn that even greater and more complex decisions lay ahead. The process of career selection has become a major cause of concern and stress for both medical students and curricular leaders at our Canadian medical schools. Students must, by the end of medical school, select from among over 30 postgraduate training program options, which will further differentiate into over 70 approved medical specialty certifications. Are students ready? A recent, informal survey was carried out among the first and second year classes at our medical school. Students were asked to state their agreement with one of three statements:
- I have a single, clear career interest.
- I have narrowed my focus to between 2 and 5 options
- I have no idea
So it would appear only a minority of our students have established a choice by these early years, although it’s unclear how durable these choices will prove to be. It also seems that some further clarity emerges even by second year, but the majority of students remain uncertain. Studies from the British medical educational system would suggest that about a quarter of doctors change their career choice after qualification (Goldacre MJ, Lambert TW, Medical Education 2000:34:700-707). A review of Canadian graduates reports that 83% of graduates felt somewhat or very well prepared to make career decisions, but that leaves a full 17% who described themselves as “not at all sure” by graduation (Columbia B. Can Med Assoc J 1997;156:1248)
To illustrate how much the medical landscape has evolved, it might be useful to consider a “Tale of Three Classes”.
This photograph provided by Queen’s Archives illustrates one of our earliest graduating classes, circa 1870. Students of that era received a common 3-4 years of instruction and clinical training, after which they were fully qualified practitioners. Their scope of practice throughout their careers was virtually identical, determined only by the needs of the communities they served.
Let’s move forward about a hundred years. The second photo was taken at the 25th reunion of my class, Meds ‘81. My classmates and I also undertook a common four year curriculum. With one further year of training, in virtually any “internship”, we were all deemed fully qualified as “General Practitioners”. About half the class remained in General Practice, eventually becoming qualified by the College of Family Physicians when that body and its qualifying examinations came into being. The remainder went on to additional training in one of the limited number of specialty programs and certification examinations offered by the Royal College of Physicians and Surgeons. Importantly, I doubt any of my contemporaries regretted their general training, and even those eventually engaging very specialized disciplines would say that their clinical proficiency and effectiveness was enhanced by that background.
Contrast all this to the graduates of Meds 2009. About a quarter of these students undertook training in Family Medicine. Many will, by now, have completed the minimum two year training program and will have begun practice, having passed qualifying examinations and achieved full certification through the College of Family Physicians. The remainder are still in training, having undertaken further training through the CFP or entered a variety of Royal College programs, all with their own entry requirements, training program and qualification examinations. Although their undergraduate experience would have differed in many ways from that of their predecessors, it was based on a structurally similar four year model, common to all students regardless of career direction.
The routes to practice are, in fact, becoming increasingly tortuous, complex and longer. In order to better understand this, I’ve consulted with my colleagues in our postrgraduate education office. Jordan Sinnett, PG Program Manager, provided me with the accompanying table that outlines the various paths to the current available postgraduate programs. The reasoning by which some programs are direct entry from undergrad whereas others diverge after core training, and the length of time of various programs is all rather opaque, but appears to reside with the individual program committees.
It’s important, in considering all this change, to recognize that the major driver is the increase in medical knowledge, available technologies and vast expansion of valuable service the profession is able to provide to our patients. Our society requires (and demands) physicians who have the highly specialized knowledge and training that’s required to diagnose and manage our ever-expanding array of conditions and provide technologically complex treatments. This is obviously all good. However, as training needs have increased, we have simply added more time and qualifications to those previously available rather than to consider new educational paradigms. At this point, a few questions must be posed:
- Is this a problem? Stated another way, are there unintended consequences of this evolutionary change that should be addressed?
- What, if anything, is being done?
- How will all this affect our learners, and can they be expected to engage career selection in a different way?
1. Increasing focus of attention and stress for medical students. The expansion of career options and requirement to choose from so many postgraduate training tracks is becoming an increasing focus (some would say obsession) of our students during medical school. Observerships, interest groups, electives and even summer voluntary placements are all seen, and used, as opportunities to explore career options and advance one’s suitability for the increasingly competitive application process. Although all of value, these pursuits compete with ever increasing educational demands expected of our students.
2. Unhealthy competition among students. Many postgraduate programs are over- subscribed relative to available training positions. This results in a competitive environment at the very time medical schools are working hard to “undo” the pre-medical focus on superficial academic success and advance principles of patient-centred learning, collaboration and cooperation among colleagues.
3. Subversion of medical education. Medical school curricula are increasingly directed toward career exploration, to the extent that both core content and Electives (18 to 20 weeks at most schools) are essentially devoted to this purpose. Career exploration is, in essence, subverting the educational priority.
4. Increased time required to achieve practice readiness. With the expansion of postgraduate programs and numerous emerging competency tracks, the duration of training is getting progressively longer. Becoming a qualified interventional cardiologist, for example, requires 15 years from university entry (4 year undergraduate degree + 4 years of medical school + 3 years General Internal Medicine + 3 years Cardiology + at least 1 year Interventional fellowship). Given that much of that time is spent in educational pursuits not directly relevant to the eventual practice requirements, the need for such a long training period is, at the very least, debatable, and given the increasing resource limitations of our health care system, will come under increasing scrutiny.
What’s happening that will affect all this?
The Future of Medical Education Postgraduate recommendations included the following:
To implement this recommendation, the Association of Faculties of Medicine of Canada has established three committees with mandates to explore methods to refine processes within undergraduate programs, the transition from undergraduate to postgraduate education, and the transition to practice. Those groups have been encouraged to think beyond current models. Those revisions may involve more “streaming” or specialty-specific teaching during medical school, a more gradual transition from foundational to specialty-specific learning, and effective career counseling processes.
However (and this is a big “however”), any such change in the three or four-year common curriculum paradigm will necessarily require our students to make even earlier career choice decisions. Is this a reasonable expectation? The information I provided above would suggest they certainly are far from optimally prepared at this time. So, what would be required to allow our students to make valid, durable career decisions earlier in their training?
The following would seem at least a reasonable place to start:
Clear and easily accessible information about the various career choices available to them. Students need to understand the scope of specialty options and the essential differences, not only in clinical content, but also credible information about the “life” that goes with each. They’re particularly interested in issues such as call expectations, mobility, and the availability of opportunities to integrate academic interests with their clinical obligations.
An understanding of their own preferences and aptitudes. Students require direction and help in thoughtfully and honestly considering a number of personal issues relevant to career selection, such as:
- Their willingness to engage patients with undifferentiated presentations
- Their comfort with critically ill patients
- Their comfort with continuing care versus issue-specific consultancy
- Their comfort with surgery and procedural work
- Their comfort with certain patient populations, such as children, the elderly, the terminally ill
- Their comfort with various practice settings, such as hospital wards, emergency rooms, ICUs, clinics, and offices
- The degree of flexibility with respect to practice settings and mobility they wish to have
Although it can be very difficult for students, a full and candid consideration of issues such as these will allow them to reduce their reasonable options to a more manageable number.
Knowledge about availability of training and career opportunities. Students have expressed very clearly their desire to know about long-term career availability. Both shared experiences and recent studies (Frechette D et al, http://www.para-ab.ca/upload/files/docs/employment/RoyalCollege_EmploymentSummary_2013.pdf) have suggested that many highly-qualified graduates of postgraduate programs have difficulty finding practice opportunities in certain specialties. Students wish to have such information. In this regard, they are allied with our provincial governments who seek to ensure our production of various medical specialists matches societal needs. Unfortunately, accurate information is very hard to come by, particularly for students whose entry into the workforce is several years in the future.
An understanding of the application process. Students need to understand the process by which they will apply and compete for postgraduate positions. This requires clarity and transparency about both the matching and selection processes. The former is carried out by the Canadian Residency Matching Service (CARMS), and is open, transparent and effectively provided. The latter, which is in the hands of each specific postgraduate program, is considerably less transparent and subject to considerable rumour and “urban myth” among students.
Is there hope on the horizon?
All this requires a fresh, early and much more comprehensive approach to career exploration and counseling than medical schools have provided to date. This week, those directing career counseling curricula and services at the six Ontario medical schools are assembling at the request of the Council of Ontario Faculty of Medicine Undergraduate committee to compare approaches, discuss challenges, and begin to develop more cooperative and effective approaches for our students.
The AFMC and ministry are jointly interested in providing more reliable definition of societal needs for all our specialties. Such information will certainly be informative for our students.
The FMEC sub-committees mentioned above have, as a component of their collective mandate, consideration of improved student counseling and application processes.
These initiatives provide some optimism that students will be better prepared for their career decisions, and for the systematic changes likely to develop within our medical education programs in the coming years. All these discussions and initiatives will be more effective if informed by those involved in (and effected by) the processes under discussion. It’s in that spirit that this article is provided and your feedback is welcome.
Many thanks to Jordan Sinett (Postgraduate Program Manager), Sarah Wickett (Health Informatics Librarian, Bracken Library), Jonathan Cluett (Meds 17 Class President), Sean Henderson (Meds 16 Class President), Jennifer Siu (Meds 16) and, as always, Lynel Jackson, for their assistance in the compilation of information for this article.
UGME (and PG) go to the AAMC: Here’s what we learned
On Nov. 6, a band of intrepid medical educators from Queen’s travelled to Philadelphia to attend the Association of American Medical Colleges’ annual meeting.
Attending sessions from Nov. 6 to 10, Dr. Renee Fitzpatrick, Dr. John Drover, Dr. Laura McEwen, (Assessment Specialist in Post Grad), Ulemu Luhanga (a doctoral candidate working as a research assistant with Laura), Eleni Katsoulas (our UG Assessment and Evaluation Consultant) and I learned a great deal from our American counterparts.
But I would venture to say that they learned some from us too. For example Laura and Ulemu presented their poster Queen’s Multisource Feedback Rubrics: Operationalizing Frames of Reference for Raters and Residents, and judging from the crowd around them during the whole session, their ideas were well-received.
I attended a great morning with the Directors of Clinical Skills group, where milestones were the topic of discussion and I’ve been invited to share our work on the clinical skills milestones we’re developing. I’ll write more about milestones and the work from the AAMC in a later blog.
And Eleni went to hear the speakers of a great article, Jim Crossley and Brian Jolly, who wrote Making sense of work‐based assessment: Ask the right questions, in the right way, about the right things, of the right people.
Here she writes about their presentation and their article. Please feel free to share your thoughts
Multiple Perspectives: finding relevance in idiosyncrasies
What do you see in the picture above?
Do you see an owl? Or coffee beans and two cups of coffee? Some of you might say you see both things! Each piece is only part of the whole. This illustrates how different people can look at the same thing and see different things. Any one of these perspectives might be useful depending on the context!
How are subjectivity and reliability related?
Does every context provide equally valid and reliable data for every domain? Crossley & Jolly (2012) argue that not every context provides good data for accessing every domain! So when might standing back and considering the whole performance give you a better picture than the sum of its parts? Or when are other perspectives just as useful?
The literature demonstrates that those who “have the competence to judge an aspect of performance, and have had the opportunity to observe it, appear to provide more reliable ratings” (Crossley & Jolly,p.35). Since clinical competence is so broad, isn’t it rational to say that multiple perspectives might be equally valid in certain contexts?
What does this mean for those of us teaching and assessing in medical education?
The authors argue that while historically, assessments have often
measured the measurable now we are concerned with measuring the important. Workplace based assessments are often based on subjective judgements. Sometimes the assessors develop an ” instrumental impressionism” whereby he or she makes a judgement that is global but, nevertheless, is vitally dependent on an overall, somewhat merged,
perception of the details (Crossley & Jolly, p. 33) and this is an equally valid if not more valid perspective.
For us, a few things emerge: Some of our finely grained assessments are asking too much of assessors to provide meaningful assessment, especially in cases of concepts that are hard if not impossible to observe in the assessment setting. Our assessors should be those with experience and knowledge in the specific areas of assessment, and their judgements as opposed to objective observations can and should play a large role in assessment. And finally, we should ask the right questions, in the right way, about the right things, of the right people.
Crossley, J. & Jolly, B. (2012). Making sense of work-based assessment: ask the right questions, in the right way, about the right things, of the right people. Medical Education, 46, p-28-37.
Medical Students as Researchers, Part 2–a complete list
Last week, Dr. Sanfilippo wrote about our medical students who have been part of research projects and studies. He promised a list of all of our students who have been first authors of studies published or in progress.
Before we bring you to the list, we’d like to correct an error in the last blog–two of the articles by students got blended into one in our Excel spreadsheet.
Here are the two separate articles, with apologies to the authors and thanks to Yan Sim for helping us correct this:
Ross GA, Mihok ML, Murrant CL. Extracellular adenosine initiates rapid arteriolar vasodilation induced by a single skeletal muscle contraction in hamster cremaster muscle. Acta Physiol (Oxf) (2013).
Sim AY, Hopman W, Engen D, Silva M, James, P. Predicting operative bleeding in elective pediatric surguries using the pediatric bleeding questionnaire. Journal of Pediatric Hematology and Oncology (2013).
And here’s the full list as far as we could ascertain from students’ MSPRs, (Brace yourselves! It’s a great and long list!) in alphabetical order by first author all 123 publications:
Badowski, M., Boyd, G., Day, A., Ilan, R. Factors Associated with Failure to Diagnose Delirium in the ICU: An Observational Study. Intensive Care Medicine (Publication Pending)
Baylis, J.B., Fernando, S.M., Szulewski, A., and Howes, D.W. Data Gathering in Resuscitation Scenarios: Novice Versus Expert Physicians. Canadian Journal of Emergency Medicine (2013)
Cameron P, Ellis PM, Pond GR, Goffin. Do beta-blockers alter dyspnea and fatigue in advanced lung cancer? A retrospective analysis. JR. Palliat Med (2012)
Cameron, P. et al. A comparison of patient knowledge of clinical trials and trialist priorities. Current Oncology (2013)
Campbell AB, McIntyre WF, Baranchuk A. Ventricular Tachycardia in a Patient with Repaired Tetralogy of Fallot. J Gen Pract (2013)
Chang, J., Sohaib M., Shafeequr, S., Baranchuk, A., Morris, C.,Reilly, M., Raveen S. Pal. Atrial Thrombi Detection Prior to Pulmonary Vein Isolation: Cardiac Computer Tomography Versus Transesophageal Echocardiography. Journal of American College of Cardiology (2013)
Cho C.K., Drabovich A.P., Batruch I., Diamandis E.P. Verification of a biomarker discovery approach for detection of Down syndrome in amniotic fluid via multiplex selected reaction monitoring (SRM) assay. Journal of Proteomics. (2011)
Cho C.K., Diamandis E.P. Application of proteomics to prenatal screening and diagnosis for aneuploidies. Clinical Chemistry and Laboratory Medicine (2011)
Cho C.K., Smith C.R., Diamandis E.P. Amniotic fluid proteome analysis from Down Syndrome pregnancies for biomarker discovery. Journal of Proteome Research (2010)
Cho C.K., Shan S.J., Winsor E.J., Diamandis E.P. Proteomics analysis of human amniotic fluid. Molecular & Cellular Proteomics (2007)
Climans, S.A., Melanson M., Desai J.A. To the Editor: A Case of Collet-Sicard Syndrome Caused by Necrotizing Otitis Externa. The Canadian Journal of Neurological Sciences (2013)
Climans, S.A., Murphy J.A., Evans G.A., Shamseddin M.K. Renal Failure, Hepatitis, and Myocarditis in a Previously Healthy Man. The Canadian Journal of Infectious Diseases & Medical Microbiology (2013) (publication pending)
Cusimano, M., Pudwell, J., Roddy, M., Cho, C.K., Smith, G.N. The Maternal Health Clinic: An Initiative for Cardiovascular Risk Identification in Women with Pregnancy-Related Complications. American Journal of Obstetrics and Gynecology (publication pending)
Di Pierdomenico A., et al. Brucellosis in a returned traveller. CMAJ (2011 )
Dossa F., Gao F.Q., Scott C.J.M., Black S.E. Relationship between white matter hyperintensities and hippocampal atrophy in Alzheimer Disease. Canadian Journal of Geriatrics (2009)
Dossa F., Tator C.H. Concussions in Rugby: A review of risk factors, awareness, and prevention strategies. British Journal of Sports Medicine (submitted)
Eid L., Heim K., Doucette S., McCloskey S., Duffy, A., Grof, P. Bipolar disorder and socioeconomic status: What is the nature of this relationship? International Journal of Bipolar Disorders (2013)
Fage B.A., Seitz D.P., Gill S.S., Herrmann N., Smailagic N., Chan C.C.H., Nikolaou V. Mini‑Cog for the diagnosis of Alzheimers disease dementia and other dementias within a community setting Cochrane Database of Systematic Reviews (In Press)
Farrell, R., Rogers, E., Jumma, K. Women in Medicine Evening Inaugural Meeting. Queen’s Medicine Review (2011)
Farrell, R. Renee’s Run. Current Spina Bifda and Hydrocephalus Association of Ontario Quarterly Magazine (2008)
Fernando S.M., Rao, P., Niel, L., Chatterjee, D., Stagljar, M., Monks, D.A. Myocyte androgen receptors increase metabolic rate and improve body composition by reducing fat mass. Endocrinology (2010)
Ferrara, S., Bradi, A., Pokrupa, R. Decreasing neurologic consequences in patients with spinal infection: the testing of a novel diagnostic guide-line. Canadian Journal of Surgery (2012)
Ferrara, S., Leveridge, M. Content Analysis and Predictive Factors in 3288 Patients’ Online Ratings of Urologists. Canadian Urological Association Journal (2013)
Fitzpatrick, A.M., Gao, L.L., Smith B.L., Cetrulo, C.L., Cowell, A.S., Winograd, J.M., Yaremchuk, M.J., Austen, W.G., Liao, E.C. Cost and Outcome Analysis of Breast Reconstruction Paradigm Shift. Annals of Plastic Surgery (2013)
Fitzpatrick, A.M. Cost and Outcome Analysis of Breast Reconstruction Paradigm Shift. Canadian Society of Plastic Surgeons. Podium presentation (May, 2013)
Fitzpatrick, A. M. Cost and Outcome Analysis of Breast Reconstruction Paradigm Shift. American Society of Plastic Surgeons. Podium presentation. (October, 2012)
Fitzpatrick, A. M. Cost and Outcome Analysis of Breast Reconstruction Paradigm Shift with Increased Incidence of Prophylactic Mastectomy. New England Society of Plastic and Reconstructive Surgeons. Podium presentation (June ,2012)
Fitzpatrick, A.M., McKay, D.R., Levine, R. Abdominoplasty: Do Multiple Versus Single Drains Impact Seroma Incidence. Journal of Plastic, Reconstruction and Aesthetic Surgery (2013)
Fitzpatrick, A.M., Jokic, R., Depression and Sleep Apnea: Investigating the Links. Synergy (2009)
Garg, V., Tsrigotis, D., Dickson, J., Dalamagas, C., Bonneau, D., Latter, D.A., Verma, S., Peterson, M.D. Direct Innominate Artery Cannulation for Selective Antegrade Cerebral Perfusion during Deep Hypothermic Circulatory Arrest in Aortic Surgery. Journal of Thoracic Cardiovascular Surgery (2013)
Ginsberg, D., Dagnone, D., Hall, A., Sivilotti, M. Validation of a Novel Method for Determining the Effects of Fatigue on Emergency Medicine Clinical Decision Making in Trainees. Can Med Education Journal (2013)
Ginsberg, D., Pang, R. Duty Hours and Fatigue in Canadian Medical Clerks. Academic Medicine (2013)
Ginbserg, D., Sivilotti, M., Hall, A., Dagnone, J. The Sleep Habits of Junior Residents and Medical Students Working in the Emergency Department. Can J Emerg Med 2013. Canadian Association of Emergency Physicians Annual Scientific Assembly (2013)
Ginsberg, D., Lavie, P., Lavie, L. A Novel Method for Detecting Nuclear Localization of Transcription Factors in Blood Leukocytes. Master’s Thesis. Technion University Press (2010)
Ginsberg, D. An Unidentified Monster in the Bed. Assessing Nocturnal Asthma in Children. McGill Journal of Medicine (2009)
Gray, Alia, et al. An Anatomically Shaped Coronoid Prosthesis Restores Stability of the Coronoid Deficient Elbow: An In-Vitro Biomechanical Study. Journal of Bone & Joint Surgery, British (2012)
Gray, A.B., et al. The Effect of a Coronoid Prosthesis on Restoring Stability to the Coronoid-Deficient Elbow: A Biomechanical Study. The Journal of Hand Surgery (2013).
Joundi, R. A., et al. Driving Oscillatory Activity in the Human Cortex Enhances Motor Performance. Current Biology (2012)
Joundi, R. A., et al. Oscillatory Activity in the Subthalamic Nucleus during Arm Reaching in Parkinson’s Disease. Experimental Neurology (2012)
Joundi, R. A., et al. Persistent Suppression of Subthalamic Beta-Band Activity during Rhythmic Finger Tapping in Parkinson’s Disease. Clinical Neurophysiology (2013)
Joundi, R. A., et al. High-Frequency Stimulation of the Subthalamic Nucleus Selectively Decreases Central Variance of Rhythmic Finger Tapping in Parkinson’s Disease. Neuropsychologia (2012)
Joundi, R. A., et al. Rapid Tremor Frequency Assessment with the iPhone Accelerometer. Parkinsonism and Related Disorders (2011)
Joundi, R.A. Enhancing Motor Performance in the Healthy and Parkinsonian Brain: Adaptation, Oscillations, and Electrical Stimulation. PhD Thesis. Oxford University, UK.
The thesis explored the neurophysiological underpinnings of motor activity in humans, with a focus on Parkinson’s disease. Experiments involved recording of electrical activity from the basal ganglia of Parkinson’s patients with implanted deep brain electrodes, as well as using invasive and non-invasive electrical stimulation to improve motor output. The main thrust of the work is demonstrating the importance of neuronal oscillations in the generation of movement.
Khan, M., Saheb, H., Fellman, R., Harasymowycz, P., Vest, Z., Neelakantan, A., Ahmed, I. Comparison of Combined Cataract Surgery with iStent versus Trabectome. Manuscript submitted to Ophthalmology; Journal of the American Academy of Ophthalmology. (2013)
Khan, M., Ahmed, I. A.. Multi-Centre Study Evaluating the Visual Outcomes and Reduction of Astigmatism in Patients Following Bilateral Implantation of the Tecnis Toric 1-piece IOL. (Study trial in progress)
Khan, M., and Campochiaro, P. Effects of Vascular Endothelial Growth Factor on Central Retinal Vein Occlusion. (Manuscript in preparation)
Khan, M., O’Reilly, M., Sanfilippo, T., Johri, A., Kafka, H., Londry, C., Pal, R. Development of a novel evaluation tool for assessment of competence in Level 1 echocardiography following focused training. Scholarship of Health Sciences Education Symposium, Queen’s School of Medicine. (2012)
Khan M. Health Care Transformation – A Nationwide Discussion. Canadian Federation of Medical Students Position Paper. (2012)
Khan M. and Sen. Segal, H. Health Access in Rural Canada. Senate of Canada Research Paper (2006)
Khan, M., Lalani, N., Plamadeala, C., Sun, E., Gardner, B. Highlights: on Health Care for the Uninsured and Undocumented. The Wellesley Institute (2010).
Khan M et al. Wading Through Wait Times; What Do Meaningful Reductions and Guarantees Mean? Health Council of Canada Annual Report (2007)
Kokorovic, A., Cheung, G.W., Breen, D.M., Chari, M., Lam, C.K., Lam, T.K. Duodenal mucosal protein kinase regulates glucose production in rats. Gastroenterology (2011)
Kokorovic, A., Cheung, G.W., Lam, T.K. Upper intestinal lipids regulate glucose production. Cellular and Molecular Life Science (2008) [Co-first authors]
Kokorovic, A., Cheung, G.W., Lam T.K. Hypothalamic sensing of circulating lactate regulates glucose production. Journal of Cellular and Molecular Medicine (2009)
Koppikar, S., Baranchuk, A., Guzman, J.C., and Morillo, C. Stroke and Ventricular Arrhythmias. International Journal of Cardiology (2013)
Koppikar, S., Shaw, C., and Baranchuk, A. Electrocardiogram quiz: A tale of an abnormal ECG,.Journal of Electrocardiology (2013)
Koumpan, Y., VanDenKerkhof, E., Van Vlymen, J., An observational cohort study to assess glycosylated hemoglobin screening for elective surgical patients (in preparation)
Kroll, R.R., Collie, M.R., Lacroix, J., Doumit, J., Mamelak, A. Non-Melanoma Skin Cancer in Ontario Part 1: Total Claims from 2003- 2009. Proc. of 87th Annual Canadian Dermatology Association Conference, Ottawa. Canadian Dermatology Association (2012)
Kroll, R. R., Grossman, R. F Pulmonary Blastomycosis in a Professional Diver: An Occupational Risk. Canadian Respiratory Journal (2013)
Kroll, R., Flood, D., Srigley, J., Desquamative Interstitial Pneumonitis in a Non-Smoker: A Rare Diagnosis Canadian Respiratory Journal (2013)
Kurji, A., Faazil, K., Sourabh, A., Kiage, D., Giorgis A.T., Mulugeta, A., Damji K.J. Preventing and Treating Avoidable Blindness from Glaucoma in Sub-Saharan Africa with Telemedicine (in preparation)
Kurji, A.K., Koppikar, S., Khalid-Khan, S. A Case of QTc Prolongation in a 13-year-old Boy on Escitalopram for Obsessive Compulsive Disorder (In progress)
Lacombe, S. P., Goodman, J.M., Spragg, C.M., Liu, S., Thomas, S.G. Interval and Continuous Exercise Elicit Equivalent Postexercise Hypotension in Prehypertensive Men, Despite Differences in Regulation. Applied Physiology, Nutrition, and Metabolism (2011)
Lacombe, S., LaHaye, S., Hopkins-Rosseel, D., Ball, D., Lau, W. Identifying Patients at Low Risk for Activity Related Events: The RARE Score. Journal of Cardiopulmonary Rehabilitation and Prevention (2013)
Leitch, J., Figley, C., Stroman, P. Applying fMRI to the brainstem and spinal cord. Magnetic Resonance Imaging (2010)
Leitch, J., Cahill, C., and Stroman, P. Functional magnetic resonance imaging of peripheral neuropathic pain in the human spinal cord and brainstem. Journal of Magnetic Resonance Imaging (2013)
Lo, C.C., Schwartz, J.A., Johnson, D.J., Yu, M., Aidarus, N., Mujib, S., Benko, E., Hyrcza, M., Kovacs, C., Ostrowski, M.A. HIV delays IFN-alpha production from human plasmacytoid dendritic cells and is associated with SYK phosphorylation. PLoS One (2012)
Lopez, A.S. Taking a second: reflection on social pediatrics. Scrub-In (2013)
Lopez, A.S. Exploring the Suitability of a Specific Glucocorticoid Receptor Antagonist as a Tool in the Study of the Regulation of Rat Lung Alveolarization by Glucocorticoids. MSc Thesis. Toronto: University of Toronto. Library and Archives Canada Catalogue, Electronic Resource (2010)
Luckett-Gatopoulos, S. Investigating the impact of teacher variables in a reading intervention program. Undergraduate thesis Electronic (2007)
Luckett-Gatopoulos, S., Conative Factors in the Context of Adolescent Reading Remediation. Master of Science thesis Electronic (2010)
Luckett-Gatopoulos, S., Dinsdale, H. Treatment of migraine using ergot compounds: An historical perspective (Pending publication)
Luckett-Gatopoulos, S., Taylor, S. Should dabigatran-anticoagulated acute stroke patients receive tPA? A review of the evidence (Pending publication)
Lun, G., Atenafu, E.G., Knox, J.J., Sridhar, S.S., Tannock, I.F., Joshua, A.M. Use of a Clinical Assistant to Screen Patients with Genitourinary Cancer to Encourage Entry into Clinical Trials and use of Supportive Medication: A Pilot Project at a Canadian Cancer Center. Clinical Genitourinary Cancer (2013)
Mazzetti, A., Borici-Mazi R. Childhood chronic urticaria and type 1 diabetes. Allergy Asthma & Clin Immunol (2011)
Mohajer, K., Fregeau, B., Garg, V., et. al. Management of Atrial Fibrillation by Canadian Electrophysiologists After Early Termination of the PALLAS Study. Can J Cardiol (2013)
Mohajer, K., and Sydor, D. Ultrasound Guided Central Venous Catheter Placement. Online Module, Published online at Queen’s Department of Anesthesia Website. Link: https://qshare.queensu.ca/Groups/School%20of%20Medicine/Assets/Public/Storyline/central-line/ (2013)
Mohajer, K., Cheng, J., Siu, J., et al. Signal Averaged versus 12-Lead Electrocardiography in Measuring QRS Duration for Cardiac Resynchronization Therapy, the Role of Ventricular Late Potentials. (in preparation)
Mohajer, K., Haley, C., Simpson, C., et al. Efficacy Of Periprocedural Dabigatran For Patients Undergoing Pulmonary Vein Isolation For Atrial Fibrillation (in preparation)
Mok, D., Wilson, R., Petsikas, D., Saha, T. Prevalence and patient impact of chronic post-sternotomy pain after coronary artery bypass graft. Canadian Journal of Anesthesia (Pending publication)
Mok, D. Of Helium and Happiness. Queen’s Medical Review (2012)
Munir, S., Patil, K., Miller, E., Uleryk, E., Twilt, M., Spiegel, L., Doria, A.S. Juvenile Idiopathic Arthritis of Axial Joints: A Systematic Review on the Diagnostic Accuracy and Predictive Value of Conventional MRI. American Journal of Roentgenology (In Press)
Munir, S., Patil, K., Miller, E., Uleryk, E., Twilt, M., Spiegel, L., Doria, A.S. Evidence-Based Outcomes of Studies Addressing Diagnostic Accuracy of MRI of Juvenile Idiopathic Arthritis in the Axial Skeleton – A Systematic Review. Pediatric Radiology (2013)
Munir, S., Koppikar, S., Hopman, W.M., Boag, A., Flood, J., Salahudeen, S., Nolan, R. Efficacy of CT Guided Core Needle Biopsy of Subsolid Pulmonary Nodules. Journal of Thoracic Imaging (Submitted)
Munir, S., Chang, J.H., Salahudeen, S., Baranchuk, A., Morris, C., O’Reilly, M., Pal, R.S. Atrial Thrombi Detection prior to Pulmonary Vein Isolation Diagnostic Accuracy of Cardiac Computer Tomography Versus Transesophageal Echocardiography. Journal of American College of Cardiology Cardiovascular Imaging. (Submitted)
Narducci, L., Horgan, S., Khalid-Khan, S. Exploring how Facebook may contribute to anxiety in adolescents with anxiety disorders (in preparation)
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O’Loghlen, S., Pickett, W., Janssen, I. Active transportation environments surrounding Canadian schools. Can J Public Health (2011)
Osumek, J.E., Revesz, A., Morton, J.S., Davidge, S.T., Hardy, D.B. Enhanced Trimethylation of Histone H3 Mediates Impaired Expression of Hepatic Glucose 6-Phosphatase Expression in Offspring From Rat Dams Exposed to Hypoxia During Pregnancy. Reproductive Sciences (2013)
Ramsey, J.B., Ramer, L.M., Inskip, J.A., Alan, N., Ramer, M.S., Krassioukov, A.V. Care of Rats with Complete High-Thoracic Spinal Cord Injury. J Neurotrauma (2010)
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Rogers, E., Casadiego-Cubides, G., Lacy, J., Gerstle, J.T., Kives, S., Allen, L. Preoperative Risk Stratification of Adnexal Masses: Can We Predict the Optimal Surgical Management? Journal of Pediatric and Adolescent Gynecology (2013)
Rogers, E., Allen, L., Kives, S. The Recurrence Rate of Ovarian Dermoid Cysts in Pediatric and Adolescent Girls. Journal of Pediatric and Adolescent Gynecology (2013)
Ross, G.A., Mihok, M.L., Murrant, C.L. Extracellular adenosine initiates rapid arteriolar vasodilation induced by a single skeletal muscle contraction in hamster cremaster muscle. Acta Physiologica (Oxford) (2013)
Ross, G.A., Hoffman, W., MacGillivray, T.E., Sundt, T.M. Evaluation of a post-operative fluid resuscitation protocol in adult cardiac surgery patients at an academic medical centre. (Publication pending)
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Rumman, A., Gee, K., White, C.A., Wobeser, W.L. Estimation of glomerular filtration rate using serum cystatin C and beta-trace protein in HIV patients. Antiviral Therapy (2012)
Rumman, A., O’Loghlen, S., Rutherford, K., Priesman, M., Raboud, J., Wobeser, W. Predictors of Antiretroviral Treatment Initiation among Foreign-born HIV patients in Ontario. Can J Infect Dis Med Microbiol (2010)
Rumman, A., Mueses, H., Galindo, J., Agudelo, J.F. Martinez-Cajas, J.L. How would the Oligonucleotide Ligation Assay (OLA) perform if used in Colombia for detection of HIV drug resistance? Can J Infect Dis Med Microbiol (2012)
Rumman, A., Sadeghi, A., Zagdyn, Z., Hopman, W., Cox, D., Pankovich, J., Rosenes, R., Cooper, C., Frolova, O., Balasanyants, G., Wobeser, W.L. Delayed Screening and Advanced Presentation of Tuberculosis in HIV-infected Prisoners and Homeless Persons in a Multi-Centre Russian Cohort Study. Can J Infect Dis Med Microbiol (2013)
Sim, AY., Bowman, M., Hopman, W., Engen, D., Silva, M., James, P. Predicting in Elective Pediatric Surgeries using the Pediatric Bleeding Questionnaire (PBQ). Journal of Pediatric Hematology and Oncology. (2013)
Squissato, V., Brown, G.D. Five Things You Should Know About Carpal Tunnel Syndrome. Canadian Medical Association Journal. (publication pending)
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Tohidi, M., Robinson, L., Graham, T., Smith, G. Effect of Caffeine Ingestion on Fetal Heart Rate Activity. J Obstet Gynaecol Can (2013)
Tohidi, M. The Effects of Exogenous Estrogens on Estrogen Receptors in Male Reproductive Organs. Interdisciplinary Journal of Health Sciences (2010)
Tryphonopoulos, T., Lim, R., Poonai, N. Serum Bicarbonate as a Predictor of adverse Outcomes in the Pediatric Emergency Department (in preparation)
Urbanellis, P., Wang, J., Shalev, I., He, W., Adeyi, O., Phillips, M.J., Bartczak, A., Grant, D.R., Levy, G.A. Rapamycin promotes tolerance through increased expression of CD4+CD25+Foxp3+ regulatory T cells and impaired development of CD8+CD44+CD62L+ memory T cells. The Journal of Immunology (2010)
Wang, J.G., McIntyre, W.F., Kong, W., Baranchuk, A. Electrocution-induced Brugada phenocopy. Int J Cardiol (2012)
Wang, J.G., Abreu, C.C., Milne, B., Rooney, R., Saha, T. The role of modified electroconvulsive therapy in improving quality of life in a patient with metastatic gastric adenocarcinoma. Journal of Electroconvulsive Therapy (2013)
Wang, M., Reid, D. Using virtual reality to improve contextual processing in children with autism. Come to Your Senses: Creating Supportive Environments to Nurture the Sensory Capital Within. Ed. Nehama Baum. Toronto: Muki Baum Association (2009)
Wang, M., Reid, D. The Virtual Reality-Cognitive Rehabilitation (VR-CR) Approach for Children with Autism; Journal of CyberTherapy and Rehabilitation (2009)
Wang, M., Reid, D. Virtual Reality in Pediatric Neurorehabilitation: Attention-Deficit Hyperactivity Disorder, Autism and Cerebral Palsy. Neuroepidemiology (2010)
Wang, M., Gladman, D., Ibanez, D., Urowitz, M. Long-term outcome of early neuropsychiatric events due to active disease in systemic lupus erythematosus. Arthritis Care & Research (2012)
Wang, M., Anagnostou, E. Using Virtual Reality as a Treatment Tool for Children with Autism. The Comprehensive Guide to Autism Springer Reference (2013)
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Worley, B., Sack, J., Gibson, M. Recognition, Prevention and Management of Ulcers, Educational Module. (2011)
Worley, B., Alhusayen, R., Miranda, V. H1-Histamine Antagonists for the Treatment of Chronic Idiopathic Urticaria: A Systematic Review and Meta-Analysis. (in preparation)
Worley, B., Pratt, M. Patch Testing in Contact Dermatitis: From Theory to Therapy. Monograph.23rd World Congress in Dermatology (in preparation)
Worley, B., Glassman, S.J. Unusual morphing keratodermatosis following hydroxyurea therapy for essential thrombocythemia (in preparation)