57 results on '"Sarah Blissett"'
Search Results
52. Should learners reason one step at a time? A randomised trial of two diagnostic scheme designs
- Author
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David McCarty, Deric Morrison, Sarah Blissett, and Matthew Sibbald
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Scheme (programming language) ,020205 medical informatics ,Decision Making ,Heart Valve Diseases ,Context (language use) ,02 engineering and technology ,Education ,Task (project management) ,03 medical and health sciences ,0302 clinical medicine ,Chart ,0202 electrical engineering, electronic engineering, information engineering ,Internal Medicine ,Humans ,Computer Simulation ,030212 general & internal medicine ,Medical diagnosis ,Arithmetic ,Set (psychology) ,Mathematics ,computer.programming_language ,Cross-Over Studies ,Heart Murmurs ,Repeated measures design ,Internship and Residency ,General Medicine ,Aortic Valve Stenosis ,Educational Measurement ,computer ,Algorithm ,Cognitive load ,Heart Auscultation - Abstract
Context Making a diagnosis can be difficult for learners as they must integrate multiple clinical variables. Diagnostic schemes can help learners with this complex task. A diagnostic scheme is an algorithm that organises possible diagnoses by assigning signs or symptoms (e.g. systolic murmur) to groups of similar diagnoses (e.g. aortic stenosis and aortic sclerosis) and provides distinguishing features to help discriminate between similar diagnoses (e.g. carotid pulse). The current literature does not identify whether scheme layouts should guide learners to reason one step at a time in a terminally branching scheme or weigh multiple variables simultaneously in a hybrid scheme. We compared diagnostic accuracy, perceptual errors and cognitive load using two scheme layouts for cardiac auscultation. Methods Focused on the task of identifying murmurs on Harvey, a cardiopulmonary simulator, 86 internal medicine residents used two scheme layouts. The terminally branching scheme organised the information into single variable decisions. The hybrid scheme combined single variable decisions with a chart integrating multiple distinguishing features. Using a crossover design, participants completed one set of murmurs (diastolic or systolic) with either the terminally branching or the hybrid scheme. The second set of murmurs was completed with the other scheme. A repeated measures manova was performed to compare diagnostic accuracy, perceptual errors and cognitive load between the scheme layouts. Results There was a main effect of the scheme layout (Wilks’ λ = 0.841, F3,80 = 5.1, p = 0.003). Use of a terminally branching scheme was associated with increased diagnostic accuracy (65 versus 53%, p = 0.02), fewer perceptual errors (0.61 versus 0.98 errors, p = 0.001) and lower cognitive load (3.1 versus 3.5/7, p = 0.023). Conclusions The terminally branching scheme was associated with improved diagnostic accuracy, fewer perceptual errors and lower cognitive load, suggesting that terminally branching schemes are effective for improving diagnostic accuracy. These findings can inform the design of schemes and other clinical decision aids.
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- 2016
53. Food and Theatre on the World Stage ed. by Dorothy Chansky and Ann Folino White
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Sarah Blissett
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White (horse) ,History ,Literature and Literary Theory ,Visual Arts and Performing Arts ,Stage (stratigraphy) ,Media studies ,Art history - Published
- 2016
54. ECG rhythm analysis with expert and learner-generated schemas in novice learners
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Rodrigo B. Cavalcanti, Sarah Blissett, and Matthew Sibbald
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Adult ,Male ,medicine.medical_specialty ,Models, Educational ,Rhythm analysis ,Computer science ,Cardiology ,Audiology ,Education ,Correlation ,Heart disorder ,Electrocardiography ,Rhythm ,Cognition ,Schema (psychology) ,medicine ,Humans ,Ontario ,business.industry ,General Medicine ,Knowledge acquisition ,Female ,Artificial intelligence ,Clinical Competence ,Educational Measurement ,business ,Cognitive load ,Education, Medical, Undergraduate - Abstract
Although instruction using expert-generated schemas is associated with higher diagnostic performance, implementation is resource intensive. Learner-generated schemas are an alternative, but may be limited by increases in cognitive load. We compared expert- and learner-generated schemas for learning ECG rhythm interpretation on diagnostic accuracy, cognitive load and knowledge acquisition. Fifty-seven medical students were randomized to two experiments. Experiment 1 (n = 29) compared use of traditional teaching frameworks to expert generated schemas. Participants randomly received either a traditional framework or an expert-generated schema to practice each of two content areas in a crossed design. Learning accuracy and cognitive load were measured during the training phase. Discriminating knowledge and diagnostic accuracy were tested immediately after the training phase and 1–2 weeks after. Using the same methodology, experiment 2 (n = 28) compared use of learner-generated versus expert-generated schemas. In experiment 1, learning from expert-generated schemas was associated with lower cognitive load (13 vs 16, p < 0.001), higher diagnostic accuracy on immediate testing (40 vs 29 %, p = 0.018), and higher discriminating knowledge (81 vs 71 %, p < 0.001). Both groups performed similarly on delayed testing (14 vs 8 %, p = 0.6). In experiment 2, use of learner-generated schemas reduced diagnostic accuracy during the training phase (55 vs 77 %, p < 0.001), with similar performance on the immediate (30 vs 33 %, p = 0.89) and delayed (7 vs 5 %, p = 0.79) testing phases.. Learner-generated schema generation was associated with increased cognitive load (17.1 vs 13.5, p < 0.001). When compared to traditional frameworks, use of an expert-generated schema improved learning of ECG rhythm interpretation. Participants generating their own schemas perform similarly to those using expert-generated schemas despite reporting higher cognitive load.
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- 2014
55. Should we teach using schemas? Evidence from a randomised trial
- Author
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Sarah, Blissett, Rodrigo B, Cavalcanti, and Matthew, Sibbald
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Analysis of Variance ,Canada ,Students, Medical ,Education, Medical ,Teaching ,Humans ,Educational Measurement ,Algorithms - Abstract
Schema-based instruction may alter knowledge organisation and diagnostic reasoning strategies through the provision of structured knowledge to novice trainees. The effects of schema-based instruction on diagnostic accuracy and knowledge organisation have not been rigorously tested.Year 2 medical students were randomised to learn four cardiac diagnoses using schema-based instruction (n = 26) or traditional instruction (n = 27) on a high-fidelity cardiopulmonary simulator (CPS). Students completed case-based learning in groups of two to five and underwent individual written and practical tests. The written test consisted of questions testing features that linked or distinguished diagnoses (structured knowledge) and questions testing features of individual diagnoses (factual knowledge). A practical test of diagnostic accuracy on the CPS was performed for two diagnoses present in the learning phase (taught lesions) and two untaught lesions. A majority of students (n = 37, 70%) voluntarily returned for follow-up written testing 2-4 weeks later.Learning time and accuracy did not differ between students on schema-based and those on traditional instruction. Students receiving schema-based instruction performed better on structured knowledge questions (p0.001) and no differently on factual knowledge questions (p = 0.7). Relative differences between groups remained unchanged on follow-up testing. Diagnostic success was higher in the schema-based instruction group for taught lesions (mean difference = 38%, 95% confidence interval [CI] 20-56; p0.001) and untaught lesions (mean difference = 31%, 95% CI 15-48; p0.001).Schema-based instruction was associated with improved retention of structured knowledge and diagnostic performance among novices. This study provides important proof-of-concept for a schema-based approach and suggests there is substantial benefit to using this approach with novice trainees.
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- 2012
56. The relative influence of available resources during the residency match: a national survey of canadian medical students
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Shiphra Ginsburg, Christine Law, Sarah Blissett, and Dante Morra
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Response rate (survey) ,Medical education ,medicine.medical_specialty ,Matching (statistics) ,Descriptive statistics ,Process (engineering) ,business.industry ,media_common.quotation_subject ,MEDLINE ,Context (language use) ,General Medicine ,Service (economics) ,Family medicine ,Medicine ,business ,Training program ,media_common ,Original Research - Abstract
Background Many medical students find choosing a residency challenging. There are several steps involved, including determining one's own priorities, arranging electives, choosing a training program and site, and preparing an in-depth application and a rank order list. Many resources are available to assist students, including the Canadian Resident Matching Service website, program websites, career counselors, career information sessions, mentors, peers, family/friends, and the Canadian Medical Residency Guide. Our study explored the relative impact of these resources on the career decision-making process. Method We invited medical students in their final year at 12 Canadian medical schools to complete an online survey. Questions included identifying the relative utility of resources in the context of each component of the decision-making process. Responses were analyzed using descriptive statistics. Results The response rate was 71% (1076 of 1518). Overall, mentors, family/friends, and peers had the most impact on students' decision making. Career counselors, websites, and the Canadian Medical Residency Guide had much less impact. Family/friends were most frequently cited as essential to the process; however, family/friends and peers were equal in having some impact. Conclusions Our findings suggest that students are most influenced by family, friends, and peers, who are not involved in the formal residency selection effort. Appreciating the impact of these influences on students' decision making is important to understanding how they decide on their future careers. The study supports continuation of mentorship programs. Future work could focus on qualitative research to further characterize resource use.
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- 2011
57. DIRECT VESSEL VISUALIZATION WITH ARTERIAL CUT-DOWN REDUCES VASCULAR COMPLICATION RATES IN TRANSCATHETER AORTIC VALVE IMPLANTATION: BACK TO THE FUTURE
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Michael W.A. Chu, Sarah Blissett, Patrick Teefy, Pantelis Diamantouros, Anthony C. Camuglia, and Bob Kiaii
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medicine.medical_specialty ,Transcatheter aortic ,business.industry ,medicine ,Vascular complication ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Surgery - Published
- 2014
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