Enteral glutamine supplementation in adult burn patients reduces blood infection by a factor of three, prevents bacteremia with P. aeruginosa, and may decrease mortality rate. It has no effect on level of consciousness and does not appear to influence phagocytosis by circulating polymorphonuclear cells.

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Imaging specialties require both perceptual and interpretation skills. Except in very simple cases, data perception and interpretation vary among clinicians. This variability makes for difficulty in measuring these skills with traditional assessment tools. The script concordance approach is conceived to allow standardized assessment in contexts of uncertainty. In this exploratory study, the authors tested the usefulness of the approach for assessment of perceptual and interpretation skills in radiology. A perception test (PT) and an interpretation test (IT) were designed according to the approach. Both tests used plain chest X-rays. Three groups were tested: clerkship students (20), junior residents (R1-R3; 20), senior residents (R4-R5; 20). Eleven certified radiologists, all currently appointed to chest reading, provided the answers by aggregate scoring method. Statistics included descriptive, ANOVA, regression analysis, Pearson and Spearman correlation coefficients. Cronbach alpha values were 0.79 and 0.81 for the PT and IT respectively. Score progression was statistically significant in both tests. Perception scores progressed more rapidly than interpretation scores during training. Effect size was large in discriminating low versus higher level of expertise, 2.2 (PT) and 1.6 (IT). The Pearson correlation coefficient between both tests was 0.58. Cronbach alpha coefficient values indicate reasonable reliability for both tests. The linear progression of scores, each at its own pace, and the positive and moderate magnitude of the Pearson correlation coefficient are arguments suggesting measurement of two different skills. More studies are necessary to document the approach usefulness for assessment in radiology training.

Références Le portfolio en éducation des sciences de la santé : un outil d'apprentissage, de développement professionnel et d'évaluation

Background: The CanMEDS physician competency framework will be updated in 2025. The revision occurs during a time of disruption and transformation to society, healthcare, and medical education caused by the COVID-19 pandemic and growing acknowledgement of the impacts of colonialism, systemic discrimination, climate change, and emerging technologies on healthcare and training. To inform this revision, we sought to identify emerging concepts in the literature related to physician competencies. Methods: Emerging concepts were defined as ideas discussed in the literature related to the roles and competencies of physicians that are absent or underrepresented in the 2015 CanMEDS framework. We conducted a literature scan, title and abstract review, and thematic analysis to identify emerging concepts. Metadata for all articles published in five medical education journals between October 1, 2018 and October 1, 2021 were extracted. Fifteen authors performed a title and abstract review to identify and label underrepresented concepts. Two authors thematically analyzed the results to identify emerging concepts. A member check was conducted. Results: 1017 of 4973 (20.5%) of the included articles discussed an emerging concept. The thematic analysis identified ten themes: Equity, Diversity, Inclusion, and Social Justice; Anti-racism; Physician Humanity; Data-Informed Medicine; Complex Adaptive Systems; Clinical Learning Environment; Virtual Care; Clinical Reasoning; Adaptive Expertise; and Planetary Health. All themes were endorsed by the authorship team as emerging concepts. Conclusion: This literature scan identified ten emerging concepts to inform the 2025 revision of the CanMEDS physician competency framework. Open publication of this work will promote greater transparency in the revision process and support an ongoing dialogue on physician competence. Writing groups have been recruited to elaborate on each of the emerging concepts and how they could be further incorporated into CanMEDS 2025.

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Background: Collaboration between physicians in different specialties is often taken for granted. However, poor interactions between family physicians and specialists contribute significantly to the observed discontinuity between primary and specialty care. The objective of this study was to explore how collaboration between family physicians and specialists was conceptualised as a competency and experienced in residency training curricula of four faculties of medicine in Canada.

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