Students in health care professional programs face many stressful tests that determine successful completion of their program. Test anxiety during these high stakes examinations can affect working memory and lead to poor outcomes. Methods of decreasing test anxiety include lengthening the time available to complete examinations or evaluating students using untimed examinations. There is currently no consensus in the literature regarding whether untimed examinations provide a benefit to test performance in clinical anatomy. This study aimed to determine the impact of timed versus untimed practical tests on Master of Physical Therapy student anatomy performance and test anxiety. Test anxiety was measured using the State-Trait Anxiety Inventory (STAI). Differences in performance, anxiety scores, and time taken were compared using paired sample Student's t-tests. Eighty-one of the 84 students completed the study and provided feedback. Students performed significantly higher on the untimed test (P = 0.005), with a significant reduction in test anxiety (P < 0.001). Students who were unsuccessful on the timed test showed the greatest improvement on the untimed test ( x¯ = 20.4 ±10%). Eighty-three percent (n = 69) of students preferred the untimed test, 8.4% (n = 7) the timed test, and 8.4% (n = 7) had no preference. Students took on average eight minutes longer on the untimed test. This study found that physical therapy students perform better on untimed tests, which may be related to a reduction in test anxiety. If the intended goal of evaluating health care professional students is to determine fundamental competencies, these factors should be considered when designing future curricula.
Introduction: While wideband segmented, breath-hold late gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) has been shown to suppress image artifacts associated with cardiac-implanted electronic devices (CIEDs), it may produce image artifacts in patients with arrhythmia and/or dyspnea. Single-shot LGE is capable of suppressing said artifacts. We sought to compare the performance of wideband single-shot free-breathing LGE against the standard and wideband-segmented LGEs in CIED patients.
Methods and Results:We retrospectively identified all 54 consecutive patients (mean age: 61 ± 15 years; 31% females) with CIED who had undergone CMR with standard segmented, wideband segmented, and/or wideband single-shot LGE sequences as part of quality assurance for determining best clinical practice at 1.5 T.Two raters independently graded the conspicuity of myocardial scar or normal myocardium and the presence of device artifact level on a 5-point Likert scale (1: worst; 3: acceptable; 5: best). Summed visual score (SVS) was calculated as the sum of conspicuity and artifact scores (SVS ≥ 6 defined as diagnostically interpretable). Median conspicuity and artifact scores were significantly better for wideband single-shot LGE (F = 24.2, p < .001) and wideband-segmented LGE (F = 20.6, p < .001) compared to standard-segmented LGE. Among evaluated myocardial segments, 72% were deemed diagnostically interpretable-defined as SVS ≥ 6-for standard-segmented LGE, 89% were deemed diagnostically interpretable for wideband-segmented LGE, and 94% segments were deemed diagnostically interpretable for wideband single-shot LGE.Conclusions: Wideband single-shot LGE and wideband-segmented LGE produced similarly improved image quality compared to standard LGE.
Introduction:
Wideband late gadolinium enhancement (LGE) CMR is capable of suppressing image artifacts induced by cardiac implanted electronic devices (CIEDs). We implemented our own wideband segmented (seg) breath-hold and wideband single-shot (SS) free-breathing LGE pulse sequences and used them clinically since 2016. The purpose of this study was to evaluate image quality and CMR safety of wideband LGE compared to standard LGE.
Methods:
We retrospectively identified 54 consecutive patients (mean age: 61±15 years; 31% females) with CIED (33 t-ICD, 4 s-ICD, 15 pacemaker, 1 CRT-D, 1 CRT-P) who underwent CMR at 1.5T (Avanto, Siemens). Standard seg, wideband seg, and wideband SS LGE used standard imaging parameters. 16 myocardial segments were scored for scar/myocardial conspicuity and presence of any visual artifact on a 5-point Likert scale (1:worst; 3:acceptable; 5:best). Distance between center of the heart and CIED (CXR D) was measured on chest X-ray. Whole-body specific absorption rate (SAR) was read from DICOM metadata. Device changes were calculated from pre- and post- device interrogation measurements.
Results:
Both wideband seg and SS LGE consistently produced better image quality than standard LGE (Figure 1A). Median conspicuity and artifact scores were significantly better for wideband seg (F=20.6, p<0.001) and wideband SS (F=24.2, p<0.001) LGE compared to standard LGE. There was a trend in conspicuity and artifact scores with CIED distance for standard LGE (rho=0.476, p=0.02), but not wideband LGE scans (Figure 1B, 1C). Whole-body SAR averaged for both wideband scans (0.15±0.04 W/kg) was one order of magnitude below the 2.0 W/kg FDA limit. Device parameters (sensing, impedance, threshold, battery level) did not differ before and after CMR including wideband LGE.
Conclusions:
Both wideband seg and SS LGE scans produced improved image quality compared to standard LGE while maintaining CMR safety. *The first two authors (SS and AP) contributed equally
Language sample analysis (LSA) is an important practice for providing a culturally sensitive and accurate assessment of a child's language abilities. A child's usage of literate language devices in narrative samples has been shown to be a critical target for evaluation. While automated scoring systems have begun to appear in the field, no such system exists for conducting progress-monitoring on literate language usage within narratives. The current study aimed to develop a hard-coded scoring system called the Literate Language Use in Narrative Assessment (LLUNA), to automatically evaluate six aspects of literate language in non-coded narrative transcripts. LLUNA was designed to individually score six literate language elements (e.g., coordinating and subordinating conjunctions, meta-linguistic and meta-cognitive verbs, adverbs, and elaborated noun phrases). The interrater reliability of LLUNA with an expert scorer, as well as its' reliability compared to certified undergraduate scorers was calculated using a quadratic weighted kappa (Kqw). Results indicated that LLUNA met strong levels of interrater reliability with an expert scorer on all six elements. LLUNA also surpassed the reliability levels of certified, but non-expert scorers on four of the six elements and came close to matching reliability levels on the remaining two. LLUNA shows promise as means for automating the scoring of literate language in LSA and narrative samples for the purpose of assessment and progress-monitoring.
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