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Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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1

Kumar, Arunaz, Sam Sturrock, Euan M. Wallace, Debra Nestel, Donna Lucey, Sally Stoyles, Jenny Morgan, Peter Neil, Michelle Schlipalius, and Philip Dekoninck. "Evaluation of learning from Practical Obstetric Multi-Professional Training and its impact on patient outcomes in Australia using Kirkpatrick’s framework: a mixed methods study." BMJ Open 8, no. 2 (February 2018): e017451. http://dx.doi.org/10.1136/bmjopen-2017-017451.

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ObjectivesThe aim of this study was to evaluate the implementation of the Practical Obstetric Multi-Professional Training (PROMPT) simulation using the Kirkpatrick’s framework. We explored participants’ acquisition of knowledge and skills, its impact on clinical outcomes and organisational change to integrate the PROMPT programme as a credentialing tool. We also aimed to assess participants’ perception of usefulness of PROMPT in their clinical practice.Study designMixed methods approach with a pre-test/post-test design.SettingHealthcare network providing obstetric care in Victoria, Australia.ParticipantsMedical and midwifery staff attending PROMPT between 2013 and 2015 (n=508); clinical outcomes were evaluated in two cohorts: 2011–2012 (n=15 361 births) and 2014–2015 (n=12 388 births).InterventionAttendance of the PROMPT programme, a simulation programme taught in multidisciplinary teams to facilitate teaching emergency obstetric skills.Main outcome measureClinical outcomes compared before and after embedding PROMPT in educational practice.Secondary outcome measureAssessment of knowledge gained by participants through a qualitative analysis and description of process of embedding PROMPT in educational practice.ResultsThere was a change in the management of postpartum haemorrhage by early recognition and intervention. The key learning themes described by participants were being prepared with a prior understanding of procedures and equipment, communication, leadership and learning in a safe, supportive environment. Participants reported a positive learning experience and increase in confidence in managing emergency obstetric situations through the PROMPT programme, which was perceived as a realistic demonstration of the emergencies.ConclusionParticipants reported an improvement of both clinical and non-technical skills highlighting principles of teamwork, communication, leadership and prioritisation in an emergency situation. An improvement was observed in management of postpartum haemorrhage, but no significant change was noted in clinical outcomes over a 2-year period after PROMPT. However, the skills acquired by medical and midwifery staff justify embedding PROMPT in educational programmes.
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Zhang, Wenxi, Inna Lozynska, Wei Li, Nana Cai, and Hongmin Yang. "Benefits and Barriers of Holistic Nursing Training by High-Fidelity Simulation in Obstetrics." Computational and Mathematical Methods in Medicine 2022 (June 28, 2022): 1–5. http://dx.doi.org/10.1155/2022/1848849.

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Background. With the technology of high-fidelity simulates developed, the clinical education route has changed. The nursing school pays attention on the use of high-fidelity simulations in nursing education. However, in China, only a few schools can afford the expensive teaching tools, including SimMom 3G and virtual reality (VR) devices, which also focus on “holistic nursing simulation.” Objective. To explore the evaluation and development of a holistic nursing simulation session for nursing students based on an integrated nursing approach in obstetrics. Methods. This study was based in a rich Chinese nursing school under the medical university that value nursing education. This study is founded on 147 third-year nursing students in obstetrics classes. After the simulation teaching, the teaching effect of the questionnaire was investigated, and the total number of questionnaires was 124 students. Results. Students agreed that the holistic nursing simulation cultivated humanistic care literacy, clinical practice ability, and clinical thinking ability; enhanced teamwork ability; and reinforced professional knowledge. Conclusion. This simulation teaching method helps to cultivate students’ enthusiasm and initiative and fosters their self-learning ability.
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Yaregal Melesse, Debas, and Henos Enyew Ashagrie. "Simulation-Based Neonatal Resuscitation Education for Undergraduate Anesthesia Students: A Pre- and Post-Evaluation of Knowledge and Clinical Skills." Anesthesiology Research and Practice 2022 (June 24, 2022): 1–8. http://dx.doi.org/10.1155/2022/7628220.

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Background. Nearly one in five hundred babies unexpectedly need resuscitation at birth, and the need for resuscitation is often unpredictable. A large majority of these deaths occur in low-resource settings and are preventable. Appropriate resuscitation techniques are crucial to the survival of newborn infants. Therefore, producing skilled health professionals in teaching institutions is mandatory to perform this activity. Objective. The study aimed a pre- and post-evaluation of knowledge and clinical skills performance of anesthesia students completing simulation-based neonatal resuscitation training at a Teaching Referral Hospital. Methods. A pre-post-intervention study was conducted on undergraduate final-year anesthesia students at Comprehensive and Specialized Teaching Referral Hospital, Ethiopia. We used a validated checklist to follow the students’ performance (American Heart Association, 2005, and Ogunlesi et al., 2012). The data were collected through this checklist. The collected data were analyzed with statistical package for social sciences (SPSS) version 20. Categorical variables were analyzed with chi-square test, and a p -value <0.05 was considered as statistically significant. Results. A total of 51 students participated in the study. Twenty of them were females. The pre-intervention knowledge of the respondents about aspects of evaluation for neonatal resuscitation was 90.2%, and post-intervention was 94.1%; the knowledge of the respondents about aspects of appropriate actions at pre- and post-interventions was 73.4% and 83.1%, respectively. Conclusions and recommendations: This study showed that there was improvement of post-interventions knowledge and clinical skills of undergraduate anesthesia students for both aspects of evaluation and appropriate actions for neonatal resuscitation. We recommend that students who attached clinical anesthesia practice should take at least simulation-based training at skill laboratories timely.
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Brown, Janie, Helen Myers, Derek Eng, Lucy Kilshaw, Jillian Abraham, Grace Buchanan, Liz Eggimann, and Michelle Kelly. "Evaluation of the ‘Talking Together’ simulation communication training for ‘goals of patient care’ conversations: a mixed-methods study in five metropolitan public hospitals in Western Australia." BMJ Open 12, no. 8 (August 2022): e060226. http://dx.doi.org/10.1136/bmjopen-2021-060226.

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IntroductionIn partnership with Cancer Council Western Australia (WA), the East Metropolitan Health Service in Perth, WA has developed a clinical simulation training programme ‘Talking Together’ using role play scenarios with trained actors as patients/carers. The aim of the training is to improve clinicians’ communication skills when having challenging conversations with patients, or their carers, in relation to goals of care in the event of clinical deterioration.Methods and analysisA multisite, longitudinal mixed-methods study will be conducted to evaluate the impact of the communication skills training programme on patient, family/carer and clinician outcomes. Methods include online surveys and interviews. The study will assess outcomes in three areas: evaluation of the ‘Talking Together’ workshops and their effect on satisfaction, confidence and integration of best practice communication skills; quality of goals of patient care conversations from the point of view of clinicians, carers and family/carers; and investigation of the nursing/allied role in goals of patient care.Ethics and disseminationThis study has received ethical approval from the Royal Perth Hospital, St John of God and Curtin University Human Research Ethics Committees. The outputs from this project will be a series of research papers and conference presentations.
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Hunchak, C., E. Fremes, S. Kebede, and N. Meshkat. "P063: Perceptions and reflections of Ethiopian emergency medicine graduates regarding the Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM) Curriculum: a qualitative evaluation study." CJEM 19, S1 (May 2017): S99. http://dx.doi.org/10.1017/cem.2017.265.

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Introduction: The first-ever EM postgraduate training program in Ethiopia was launched at Addis Ababa University in 2010. EM faculty from the University of Toronto were invited to design and implement an EM rotation-based curriculum with tri-annual teaching trips to support the overall AAU EM program. To date, three cohorts of EM specialists (n=15) have graduated from the three-year program. After six years of implementation, we undertook a qualitative evaluation of the TAAAC-EM curriculum. Methods: Data collection took place in 2016 in Ethiopia via in-person graduate interviews (n=12). Participants were interviewed by a trained research assistant who used a semi-structured interview guide. Standard interview, transcription and analysis protocols were utilized. Qualitative software (QSR-NVIVO 9) was used for thematic grouping and analysis. Results: Graduates of AAU’s EM residency training program reported very positive experiences with the TAAAC-EM curriculum overall. All graduates acknowledged the positive impact of TAAAC-EM’s emphasis on bedside teaching, a unique component of the TAAAC-EM model compared to traditional teaching methods at AAU. Graduates felt that TAAAC-EM teachers were effective in creating a novel culture of EM at AAU and in role-modeling ethical, evidence-based EM practice. When asked about specific areas for program improvement, the following themes emerged: 1) a desire to shift delivery of the didactic clinical epidemiology curriculum to the senior residency years (PGY2-3) to coincide with completion of a required residency research project; 2) a desire for increased simulation and procedural teaching sessions and 3) the need for more nuanced context specificity in the curriculum delivery to incorporate local guidelines and practice patterns. A lack of educational supports during non-TAAAC-EM visits was also identified as an area for further work. Conclusion: Interviewing graduates of AAU’s EM residency training program proved important for determining areas of curriculum improvement for future trainees. It also provided critical input to TAAAC-EM strategic planning discussions as the partnership considers expanding its scope beyond Addis Ababa.
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Hauschild, Jordan, Jessica C. Rivera, Anthony E. Johnson, Travis C. Burns, and Christopher J. Roach. "Shoulder Arthroscopy Simulator Training Improves Surgical Procedure Performance: A Controlled Laboratory Study." Orthopaedic Journal of Sports Medicine 9, no. 5 (May 1, 2021): 232596712110038. http://dx.doi.org/10.1177/23259671211003873.

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Background: Previous simulation studies evaluated either dry lab (DL) or virtual reality (VR) simulation, correlating simulator training with the performance of arthroscopic tasks. However, these studies did not compare simulation training with specific surgical procedures. Purpose/Hypothesis: To determine the effectiveness of a shoulder arthroscopy simulator program in improving performance during arthroscopic anterior labral repair. It was hypothesized that both DL and VR simulation methods would improve procedure performance; however, VR simulation would be more effective based on the validated Arthroscopic Surgery Skill Evaluation Tool (ASSET) Global Rating Scale. Study Design: Controlled laboratory study. Methods: Enrolled in the study were 38 orthopaedic residents at a single institution, postgraduate years (PGYs) 1 to 5. Each resident completed a pretest shoulder stabilization procedure on a cadaveric model and was then randomized into 1 of 2 groups: VR or DL simulation. Participants then underwent a 4-week arthroscopy simulation program and completed a posttest. Sports medicine–trained orthopaedic surgeons graded the participants on completeness of the surgical repair at the time of the procedure, and a single, blinded orthopaedic surgeon, using the ASSET Global Rating Scale, graded participants’ arthroscopy skills. The procedure step and ASSET grades were compared between simulator groups and between PGYs using paired t tests. Results: There was no significant difference between the groups in pretest performance in either the procedural steps or ASSET scores. Overall procedural step scores improved after combining both types of simulator training ( P = .0424) but not in the individual simulation groups. The ASSET scores improved across both DL ( P = .0045) and VR ( P = .0003), with no significant difference between the groups. Conclusion: A 4-week simulation program can improve arthroscopic skills and performance during a specific surgical procedure. This study provides additional evidence regarding the benefits of simulator training in orthopaedic surgery for both novice and experienced arthroscopic surgeons. There was no statistically significant difference between the VR and DL models, which disproved the authors’ hypothesis that the VR simulator would be the more effective simulation tool. Clinical Relevance: There may be a role for simulator training in the teaching of arthroscopic skills and learning of specific surgical procedures.
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Gelmini, And Yara Particelli, Márcio Luís Duarte, André Moreira de Assis, Josias Bueno Guimarães Junior, and Francisco César Carnevale. "Virtual reality in interventional radiology education: a systematic review." Radiologia Brasileira 54, no. 4 (August 2021): 254–60. http://dx.doi.org/10.1590/0100-3984.2020.0162.

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Abstract The aim of this study was to compare virtual reality simulation with other methods of teaching interventional radiology. We searched multiple databases-Cochrane Library; Medline (PubMed); Embase; Trip Medical; Education Resources Information Center; Cumulative Index to Nursing and Allied Health Literature; Scientific Electronic Library Online; and Latin-American and Caribbean Health Sciences Literature-for studies comparing virtual reality simulation and other methods of teaching interventional radiology. This systematic review was performed in accordance with the criteria established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Best Evidence Medical Education (BEME) Collaboration. Eligible studies were evaluated by using the quality indicators provided in the BEME Guide No. 11 and the Kirkpatrick model of training evaluation. After the eligibility and quality criteria had been applied, five randomized clinical trials were included in the review. The Kirkpatrick level of impact varied among the studies evaluated, three studies being classified as level 2B and two being classified as level 4B. Among the studies evaluated, there was a consensus that virtual reality aggregates concepts and is beneficial for the teaching of interventional radiology. Although the use of virtual reality has been shown to be effective for skill acquisition and learning in interventional radiology, there is still a lack of studies evaluating and standardizing the employment of this technology in relation to the numerous procedures that exist within the field of expertise.
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Moretza-Bagi, Hamid Reza, Amir Ghaffarzad, Peyman Fathipour, Reza Yazdani, Zhila Khamnian, and Sama Rahnemayan. "The effect of teacher-made simulation moulage on learning cricothyrotomy skills in emergency medicine physicians." Journal of Emergency Practice and Trauma 8, no. 1 (April 9, 2021): 3–7. http://dx.doi.org/10.34172/jept.2021.10.

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Objective: Nowadays, simulation of clinical environment in medical education system (simulation-based learning) has led to a huge revolution in the quality of education and has increased the safety of educators and patients. In this study, we investigated the effect of teacher-made neck and lung simulators in teaching cricothyrotomy skills for emergency medicine residents. Methods: In this pre-post test study, all faculty member of emergency medicine of Tabriz University of medical sciences specialty were invited to participate. After holding an educational and training session for assistants on a teacher-made moulage, all emergency medicine residents performed a tracheostomy on the commercial moulages of the skill lab unit for the second time and their scores were recorded. Results: In this study, 23 emergency medicine residents participated. The mean±standard deviation of age was 35.91±3.57 years. There was a significant difference between the mean duration of cricothyrotomy before and after the training (P value=0.006). There was also a significant difference between the mean scores obtained by residents in the pre-and post-training evaluation (P value<0.001). Conclusion: Findings showed that the moulages constructed by teachers not only can be effective in improving the cricothyrotomy skills in emergency medicine residents but also can reduce the likelihood of failure in performing cricothyrotomy.
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Klemenc-Ketis, Zalika, Antonija Poplas Susič, Nina Ružić Gorenjec, Špela Miroševič, Uroš Zafošnik, Polona Selič, and Špela Tevžič. "Effectiveness of the Use of Augmented Reality in Teaching the Management of Anaphylactic Shock at the Primary Care Level: Protocol for a Randomized Controlled Trial." JMIR Research Protocols 10, no. 1 (January 4, 2021): e22460. http://dx.doi.org/10.2196/22460.

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Background Augmented reality (AR) has benefits and feasibility in emergency medicine, especially in the clinical care of patients, in operating rooms and inpatient facilities, and in the education and training of emergency care providers, but current research on this topic is sparse. Objective The primary objective is to evaluate the short-term and long-term effectiveness of the use of AR in the treatment of patients with anaphylactic shock. The secondary objectives are to evaluate the safety in the treatment of patients with anaphylactic shock, evaluate the short-term and long-term effectiveness of stress management in this process, and determine the experiences and attitudes towards the use of AR in education. Methods The study will be conducted in 3 phases. In the first phase, we will develop and test the scenario for simulation of anaphylactic shock and the evaluation scale for assessing the effect of the intervention. In the second phase, a single-blinded, randomized controlled trial will be conducted. In the third phase, the use of AR in teaching the management of anaphylactic shock using focus groups will be evaluated qualitatively. All participants will participate in a 1-day training program consisting of a lecture on emergency care and anaphylactic shock as well as exercises in manual dexterity (aspiration, airway management, alternative airway management, artificial respiration, chest compressions, safe defibrillation, oxygen application, use of medication during emergency care). The test group will also focus on education about anaphylactic shock in AR (the intervention). The main outcome will be the evaluation of the participants' performance in coping with a simulated scenario of anaphylactic shock using a high-fidelity simulator (simulator with high levels of realism) and a standardized patient in an educational and clinical environment. The study will be conducted with primary care physicians. Results A scenario for the simulation with a high-fidelity simulator and standardized patient has already been developed. For the time being, we are developing an evaluation scale and starting to recruit participants. We plan to complete the recruitment of participants by the end of December 2020, start the randomized controlled trial in January 2021, and finish 1 year later. The first results are expected to be submitted for publication in 2021. Conclusions This will be the first study to evaluate the effectiveness of the use of AR in medical teaching. Specifically, it will be based on a clinical case of anaphylactic shock at the primary care level. With our study, we also want to evaluate the translation of these educational results into clinical practice and assess their long-term impact. Trial Registration ISRCTN Registry ISRCTN58047410; http://www.isrctn.com/ISRCTN58047410 International Registered Report Identifier (IRRID) PRR1-10.2196/22460
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Gabarin, Nadia, Martina Trinkaus, Rita Selby, Nicola Goldberg, Jessica Petrucci, Hina Chaudhry, and Michelle Sholzberg. "Can an Online Educational Module Improve Medical Trainee Confidence and Knowledge of Coagulation?" Blood 134, Supplement_1 (November 13, 2019): 4695. http://dx.doi.org/10.1182/blood-2019-129385.

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Background: Coagulation has notoriously been a topic that medical trainees find challenging to learn. A lack of understanding around coagulation has led to widespread inappropriate ordering of commonly used coagulation tests, including the prothrombin time (PT) and the activated partial thromboplastin time (aPTT). Despite these tests being validated for specific clinical indications, they are frequently ordered as screening tests in unselected patients, and often ordered together, suggesting a gap in physician understanding of coagulation and appropriate testing. To explore this further, we conducted a root-cause-analysis survey of 10 medical trainees. 70% of the surveyed trainees did not feel comfortable with their knowledge regarding coagulation and the appropriate use of coagulation tests. Trainees attributed their suboptimal knowledge to the manner in which coagulation is taught in training programs. Furthermore, they identified a scarcity of practical resources on coagulation and expressed interest in a web-accessible resource. Methods: We created an educational module on coagulation testing for trainees, available online at www.coagtesting.com. This module was created with the intent of simplifying the teaching of coagulation, with a focus on emphasizing clinically-relevant concepts. The module was evaluated at the University of Toronto with 50 participating medical trainees (11 medical students, 39 internal medicine residents [14 PGY1, 15 PGY2, 10 PGY3 residents]). Participation in our study included completing a validated knowledge pre-quiz on coagulation, completion of the educational module, and then the post-quiz following the module. To assess longer term knowledge retention, participants were asked to repeat the knowledge quiz three months following their initial participation. Our educational intervention was evaluated according to the Kirkpatrick Model, a framework for learning evaluation, with educational outcomes organized into four ranked levels (level 1, reaction; level 2, learning; level 3, behaviour; level 4, results). The primary objective of this study was to determine if the module improves trainee knowledge of coagulation, as indicated by their quiz results (level 2, learning). The secondary objective was to evaluate if the module has an influence on trainee ordering practices as assessed by a follow-up survey (level 3, behaviour). Results: The median pre-module quiz score was 67% (range 24% - 86%) with an increase of 24% to a median post-module quiz score of 91% (range 64% - 100%). Notably, in the pre-module quiz, 94% of trainees overestimated the sensitivity and specificity of the PT and aPTT in detecting a bleeding disorder, and 44% of trainees underestimated the cost of a PT test. 80% of trainees described increased confidence regarding their knowledge of coagulation and the use of coagulation tests following completion of the module. In addition, we have demonstrated sustained knowledge acquisition with a 3-month post-quiz median score of 89% (n=15, range 67%-100%). 100% of trainees who completed the 3-month follow-up survey (n=15) felt that the educational module had a positive influence on their practice and 87% of trainees were more likely to consider the sensitivity, specificity, and cost of a lab test prior to ordering it. In the seven months since the module was launched, it has been completed by over 2,000 unique visitors worldwide, with use in Canada, the United States, the United Kingdom, Australia, France, and Saudi Arabia according to data from our website host. Furthermore, several visitors to the website have re-visited the module multiple times. Conclusion: We have successfully demonstrated a significant increase in trainee knowledge and confidence regarding coagulation and appropriate use of coagulation tests with our educational intervention. Using the expertise of medical educators and incorporating feedback from trainees, we have employed a novel approach to the teaching of coagulation to maximize its approachability and clinical relevance. Our module also incorporates education on the cost of coagulation testing and appropriate use of these tests thus in line with the tenets of Choosing Wisely. The degree to which trainees have been utilizing and re-referring to our educational module worldwide emphasizes the need for this resource and its importance in bridging a large gap in medical training. Disclosures Sholzberg: Novartis: Honoraria; Amgen: Honoraria, Research Funding.
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Mughal, Arsalan Manzoor, and Muhammad Umar. "Evolution of Post Graduate Curricula in Pakistan." Journal of Rawalpindi Medical College 25, no. 4 (January 13, 2022): 439–40. http://dx.doi.org/10.37939/jrmc.v25i4.1884.

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Postgraduate medical training started with the apprenticeship model. This system heavily relied on tradition and subjectivity. In the middle of the 20th century, there was a gradual shift to an objective-based structure which had its roots in the works of Ralph Tyler and Benjamin Bloom. As a result, the curriculum became focused on predefined objectives in the cognitive, psychomotor, and affective domains. This drive was aimed to standardize the learning criteria across various centers and align the tools for assessment for postgraduate medical students.1In our country, the College of Physicians and Surgeons Pakistan (CPSP) has been the main center of postgraduate medical education since its inception in 1962. With both local and foreign-trained faculty members, it was one of the first centers to start training in Medical Education in collaboration with the World Health Organization in 1979.2 Various supervisor workshops and certifications by the Department of Medical Education helped equip the faculty with the tools required for curricular development.3 Thus new curricula in each discipline were developed and were called “structured training programs”. They were based on the objective approach and largely focused on summative assessments with very few formative assessments.4In the last two decades, new evidence and methods of postgraduate teaching and assessment have evolved in the west.5 Due to technological enhancements in patient care and vast development in the scientific pool of medical knowledge, there was a demand to define outcome-based competencies that strongly align with the demands of the workplace. As a result, competency-based curriculum models were developed which “de-emphasized time-based training and promised greater accountability, flexibility, and learner-centeredness”.1 CANMEDS (Canadian Medical Education Directives for Specialists) and ACGME (Accreditation Council for Graduate Medical Education) are two of the most popular systems having a competency-based framework which has been developed and successfully implemented in North America.Competency-based programs differ from objective-based ones in the fact that instead of prescribing how to teach or learn, they focus on the demonstration of various competencies required for practice. A competency-based curriculum must exhibit “teacher-learner relationship and responsibility, workplace-based assessment approach, alignment of competencies with criterion-referenced assessment, and flexible training duration”. 6 The system focuses on the attainment of competencies by the trainee to determine readiness for unsupervised practice rather than the length of their training.The structure of a competency-based curriculum is not based solely on objectives but rather uses defined Entrustable Professional Activities (EPAs) which align the teaching and assessment at the workplace with the competency frameworks. Another key aspect of this curricular structure is milestones which are based on the skill development framework of Dreyfus and Dreyfus.1 Both these key elements ensure that the trainee has attained the desired level of clinical skill to practice.The teaching of these competencies is often done in a workplace setting. Assessments employ Work Place Based Assessment (WPBA) tools such as Directly Observed Procedural Skills (DOPS) for procedural skills, Mini Clinical Evaluation Exercises (Mini-CEX), and Chart Based Recall (CBR) for clinical reasoning skills and 360-degree feedback for professionalism, interpersonal and communication skills. The system also caters to the extent of differential achievement of learners by offering targeted help to trainees in form of regular formative feedback which is an essential component of WPBAs.7As with other, in vogue ideas of medical education, the College of Surgeons and Physicians Pakistan was the first to develop a competency-based curricular framework nearly a decade ago. It was centered on patient care and involved professionalism, pedagogy, and advocacy as essential competencies to be acquired by the specialists.4,8 One key area where the CPSP fellowship program has developed since then is the development of portfolios 9 in the form of an electronic log (e-log) system for regular monitoring of training. The e-log system also includes reflections by supervisors and trainees which is a step in the right direction.10 Other technological solutions such as learning management systems, mobile applications, simulation, and social media if added could further enhance student learning and engagement.11,12 A close inspection of the current fellowship and membership structured training programs of CPSP reveals that despite the claim of running a competency-based framework, none of the key features of this system like defined EPAs, milestones, and WPBA strategies exist. Also, there is a lack of curricular alignment with the core competencies. So, it is difficult to consider it as a competency-based framework of postgraduate medical education in a true sense.Other medical universities in the country have relatively recently developed their Master of Surgery (MS) and Doctor of Medicine (MD) curricula. Wide variations exist in their induction, teaching & learning, assessment, and evaluation criteria. Also, limited literature is available to study their curricular structural design. Instead of adopting the new competency-based framework, most have chosen to retain the archaic objective-based curricular model. Unfortunately, with no guidelines from the nascent Pakistan Medical Commission, most programs tend to evolve in the light of the Higher Education Commission’s curriculum recommendations which are based on the older objective-based approach.13Rawalpindi Medical University right from its inception had the vision to develop a University Residency Program for post-graduate studies in Medicine, Surgery, and allied disciplines based on ACGME competency-based curriculum. Under this program, we train hundreds of trainees with regular monitoring via workplace-based assessment and 360-degree feedback forms. These are evaluated by the Quality Enhancement Cell in 6 monthly cycles with feedback provided to the trainees, supervisors, and administration. The trainee is also required to log cases and activities with reflections in their logbooks. Each clinical case is also added to their online portal for record and evaluation. These regular formative tools with monitoring and feedback help the trainee assess their weaknesses, supervisors plan their trainee's progress and administration take decisions for improvement. Formative assessments are done at the end of each year comprising of MCQ, SAQ, and OSCE formats. At the end of the program, a comprehensive summative assessment is also conducted to certify competence.Nine years ago, Wasim Jafri14 wrote that “The competency-based model provides an exceptional opportunity for Pakistani postgraduate medical institutes”. We believe that today Rawalpindi Medical University is a pioneer among the medical sector universities in providing this excellent opportunity to its trainees and supports other partnering universities in developing competency-based curricula.
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Huynh, C., E. Clement, D. DeGirolamo, A. Kleiman, R. Ralph-Edwards, L. Streith, J. Bogach, et al. "Canadian Surgery Forum 201901. The future of general surgery training: a Canadian resident nationwide Delphi consensus statement02. Traumatized: Can mindfulness lead to improved mental health outcomes after multisystem trauma?03. Operating room availability for general surgery in 2007 versus 2017 at a regional hospital in BC04. Perceptions and barriers to Gastrografin protocol implementation05. Resident opinions and educational experience of a mixed night-float system for general surgery resident call06. A scoping review of best management for hepato-pancreatobiliary trauma07. Simultaneous versus staged resection for synchronous colorectal liver metastases: a population-based cohort study08. Weight loss following hepatopancreatobiliary surgery. How much is too much?09. Uptake and patient outcomes of laparoscopic liver resection for colon cancer liver metastases: a population-based analysis10. Simultaneous resection of colorectal cancer with synchronous liver metastases: a survey-based analysis11. When is it safe to start VTE prophylaxis after blunt solid organ injury? A prospective study from a level I trauma centre12. Undertriaged trauma patients: Who are we missing?13. Trauma team activation at a level I trauma centre: time of day matters14. The diagnostic dilemma of shotgun injuries15. Evaluating the efficacy of self-study videos for the surgery clerkship rotation: an innovative project in undergraduate surgical education16. Systematic review and meta-analysis: preoperative anti-TNF therapy does not increase the risk of postoperative complications in patients with inflammatory bowel disease undergoing elective surgery17. Simulation platforms to assess laparoscopic suturing skills: a scoping review18. Cost analysis of simultaneous versus staged resection of colorectal cancer liver metastases: a population-based study19. Complementary and alternative medicine use among general surgery patients in Nova Scotia20. General surgery in Canada: current scope of practice and future needs21. Impact of dedicated operating time on access to surgical care in an acute care surgery model22. Adolescent appendicitis management and outcomes: comparison study between adult and pediatric institutions23. A systematic review of behavioural interventions to improve opioid prescribing after surgery24. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in trauma: a gap analysis of the Edmonton Zone Trauma Registry25. Learning by holographic anatomic models for surgical education26. The nature of learning from trauma team simulation27. Comparing reversing half-hitch alternating postsurgical knots and square knots for closure of enterotomy in a simulated deep body cavity: a randomized controlled trial28. Propagating the “SEAD”: exploring the value of an overnight call shift in the Surgical Exploration and Discovery Program29. Comparing 2 approaches to residency application file review30. A Canadian experience with posterior retroperitoneoscopic adrenalectomy31. A cost-efficient, realistic breast phantom for oncoplastic breast surgery training32. Impact of patient frailty on morbidity and mortality after common emergency general surgery operations33. Preventing opioid prescription after major surgery: a scoping review of the literature on opioid-free analgesia34. Correct usage of propensity score methodology in contemporary high-impact surgical literature35. Responsible blood compatibility testing for appendectomy: practice assessment at a single Canadian academic centre36. What patient factors are associated with participation in a provincial colorectal cancer screening program?37. Missed appendix tumours owing to nonoperative management for appendicitis38. Operative delay increases morbidity and mortality in emergency general surgery patients: a study of multiple EGS services within a single city39. Withdrawn40. Improved disease-free survival after prehabilitation for colorectal cancer surgery41. Development of a conceptual framework of recovery after abdominal surgery42. Comparison of Dor and Nissen fundoplication following laparoscopic paraesophageal hernia repair43. A systematic review and summary of clinical practice guidelines on the periprocedural management of patients on antithrombotic medications undergoing gastroenterological endoscopy44. Impact of socioeconomic status on postoperative complications following Whipple procedure for pancreatic ductal adenocarcinoma45. Clinical outcomes of high-risk breast lesions and breast cancer patients treated with total mastectomy and immediate reconstruction46. My On Call (MOC) Pager App: practising and assessing safe clinical decision-making47. Comprehensive complication index for major abdominal surgeries: an external validation using the American College of Surgeons’ National Surgical Quality Improvement Program (ACS NSQIP)48. The impact of surgeon experience on script concordance test scoring49. Decay of competence with extended research absences during postgraduate residency training: a scoping review50. Long-term outcomes of elderly patients managed nonoperatively for choledocholithiasis51. Predictors of mortality and cost among surgical patients admitted to hospital and requiring rapid response team activation52. Sex-based disparities in the hourly earnings of surgeons in Ontario’s fee-for-service system53. Outcomes of intestinal ischemia among patients undergoing cardiac surgery54. Factors influencing resident teaching evaluations: the relationship between resident interest in teaching, career plan, training level and their performance in teaching junior learners55. Validating a uniform system for measuring disease severity in acute colonic diverticulitis56. Active negative pressure peritoneal therapy and C-reactive protein (CRP) levels after abbreviated laparotomy for abdominal trauma or intraabdominal sepsis: the validity of serum and peritoneal CRP in measuring outcomes in critically ill patients57. Intraoperative use of indocyanine green fluorescence in emergency general surgery: a systematic review58. Is it safe? Nonoperaive management of blunt splenic injuries in geriatric trauma patients59. Bladder injury from laparoscopic appendicectomy: a multicentre experience over 5 years60. Perioperative cardiac investigations for chest pain after parathyroidectomy rarely yield a cardiac diagnosis61. Entero-hepatic axis injury following hemorrhagic shock: a role for uric acid62. Loss of functional independence after emergency abdominal surgery in older patients: a prospective cohort study63. Association between use of nonsteroidal antiinflammatory drugs, diuretics or angiotensin converting enzyme inhibitor/receptor blockers after major surgery and acute kidney injury: a nested, population-based case–control study64. Timing of CT for adhesive small bowel obstructions (SBO)65. The ABDO (Acute Biliary Disease Optimization) Study: improving the management of biliary diseases in emergency general surgery66. Rates and predictors of advanced biliary imaging and interventions in acute care surgery: a quality improvement study67. The use of early warning scores in patients undergoing emergency general surgery: a systematic review68. Does primary closure versus resection and anastomosis in patients with hollow viscus injury affect 30-day mortality?69. Impact of sarcopenia on morbidity and mortality after Whipple procedure for pancreatic ductal adenocarcinoma70. Mind the speaker gap: a cross-specialty analysis of the representation of women at surgical meetings in 5 different geographic regions71. Immediate breast reconstruction in locally advanced breast cancer: Is it safe?72. An administrative review of the incidence of adverse events involving electrocautery73. If you don’t document it, did it really happen? A review of the documentation of informed consent in laparoscopic cholecystectomy74. Can an online module help medical students gain confidence and proficiency in writing orders?75. The influence of undergraduate medical education anatomy exposure on choice of surgical specialty: a national survey76. Association between patient engagement and surgical outcomes: a pilot study77. Guidelines on the intraoperative transfusion of red blood cells: a systematic review78. Cancer is common in missed appendicitis: a retrospective cohort study79. Everyone is awesome: analyzing letters of reference in a general surgery residency selection process80. Evaluating the true additional costs of general surgery complications using a propensity score weighted model81. Deriving literature-based benchmarks for surgical complications from national databases in high-income countries: a systematic review on pancreatectomy outcomes82. The impact of distance on postoperative follow-up in pediatric general surgery patients: a retrospective review83. Water-soluble contrast in adhesive small bowel obstruction management: a Canadian centre’s experience84. Recognizing predatory journals in general surgery and their common violations85. Prophylactic negative pressure wound therapy for closed laparotomy incisions: a meta-analysis of randomized controlled trials86. Choosing Wisely Canada: 2019 general surgery recommendations87. Content-specific resident teaching can improve medical student learning outcomes on certifying examinations88. Transition to practice: preparedness for independent practice in general surgery graduates89. CAGS Exam 2.0: maximizing the potential for teaching and learning90. Resident attitudes toward the introduction of synoptic operative reporting for appendectomy and cholecystectomy91. Determining the individual, hospital and environmental cost of unnecessary laboratory investigations for patients admitted to general surgery services at an academic centre92. Gender-based compensation disparity among general surgeons in British Columbia93. Transgastric robotic resection for gastrointestinal stromal tumours of the stomach94. Recurrent gallstone ileus after laparoscopic-assisted enterolithotomy treated with totally laparoscopic enterolithotomy01. Predictors and outcomes among patients requiring salvage APR for the treatment of squamous cell carcinoma of the anus: a population-based study02. Short-course radiotherapy with perioperative systemic chemotherapy for patients with rectal cancer and synchronous resectable liver metastases: a single-centre Canadian experience03. Compliance with preoperative elements of the American Society of Colon and Rectal Surgeons rectal cancer surgery checklist improves pathologic and postoperative outcomes04. Clinical predictors of pathologic complete response following neoadjuvant chemoradiation therapy for rectal cancer: a systematic review and meta-analysis05. Rejected06. The impact of laparoscopic technique on the rate of perineal hernia after abdominoperineal resection of the rectum07. An assessment of the current perioperative practice, barriers and predictors for utilization of enhanced recovery after surgery protocols: a provincial survey08. Regional variation in the utilization of laparoscopy for the treatment of rectal cancer: the importance of fellowship training sites09. Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy: a systematic review and meta-analysis10. The relation between the gut microbiota and anastomotic leak in patients with colorectal cancer: a preliminary feasibility study11. Optimizing discharge decision-making in colorectal surgery: an audit of discharge practices in a newly implemented enhanced recovery pathway12. Trends in colectomy for colorectal neoplasms in ulcerative colitis (UC) patients over 2 decades: a National Inpatient Sample database analysis13. Spin in minimally invasive transanal total mesorectal excision articles (TaTME): an assessment of the current literature14. Venous thromboembolism (VTE) in colon cancer: a population-based cohort study of VTE rates following surgery and during adjuvant chemotherapy15. Robotic-assisted lateral lymph node dissection for rectal neuroendocrine tumor16. Loop ileostomy and colonic lavage as an alternative to colectomy for fulminant Clostridium difficile colitis17. Recurrent diverticulitis: Is it all in the family?18. Le traitement des fistules entérocutanées complexes : expérience du Centre hospitalier de l’Université de Montréal (CHUM)19. A North American single-blinded pilot randomized controlled trial for outpatient nonantibiotic management of acute uncomplicated diverticulitis (MUD TRIAL): feasibility and lessons learned20. Treatment failure after conservative management of acute diverticulitis: a nationwide readmission database analysis21. Impact of immunosuppression on mortality and major morbidity following sigmoid colectomy for diverticulitis: a propensity-score weighted analysis of the National Inpatient Sample22. Presentation and survival in colorectal cancer under 50 years of age: a systematic review and meta-analysis23. Genetics of postoperative recurrence of Crohn’s disease: a systematic review and meta-analysis24. Improving the identification and treatment of preoperative anemia in patients undergoing elective bowel resection25. Impact of postoperative complications on quality of life after colorectal surgery26. Colon cancer survival by subsite: a retrospective analysis of the National Cancer Database27. A second opinion for T1 colorectal cancer pathology reports results in frequent changes to clinical management28. Effects of the quadratus lumborum block regional anesthesia on postoperative pain after colorectal resection: a double-blind randomized clinical trial29. Safety of a short-stay postoperative unit for the early discharge of patients undergoing a laparosocpic right hemicolectomy30. What is the optimal bowel preparation to reduce surgical site infection in Crohn disease?31. TaTME surgery and the learning curve: our early experience32. Watch-and-wait experience in patients with rectal cancer: results in selected patients at a high-volume centre01. Automatic referral of suspicious findings detected on thoracic CT scan decreases delays in care without compromising referral quality02. Variation in receipt of therapy and survival with provider volume in noncurative esophagogastric cancer: a population-based analysis03. What makes patients high risk for lobectomy in the era of minimally invasive lobectomy?04. The value proposition of minimally invasive esophagectomy: a community hospital perspective05. Deviation from treatment plan in patients with potentially curable esophageal carcinoma06. Implementation of a standardized minimal opioid prescription for post-thoracic surgery patients is feasible and provides adequate pain control07. Sentinel node navigation surgery using indocyanine green in lung cancer: a systematic review and meta-analysis08. Surgical outcomes with trimodality neoadjuvant versus adjuvant therapy for esophageal cancer: results of the QUINTETT randomized trial09. Enhanced invasive mediastinal staging in an academic thoracic surgical unit by employing a shared accountability model for quality improvement10. Evaluation and harmonization of international database elements for adverse events monitoring following thoracic surgery: the pursuit of a common language11. Endobronchial ultrasound staging of operable non–small cell lung carcinoma: triple-negative lymph nodes may not require routine biopsy12. Wait times in the management of non-small cell lung cancer before, during and after regionalization of lung cancer care: a high-resolution analysis13. Wearable technology for preconditioning before thoracic surgery: a feasibility study14. Impact of carbohydrate-loading enhanced recovery after surgery protocol on adverse cardiopulmonary events in a thoracic surgery population15. Heat production during pulmonary artery sealing with energy vessel-sealing devices in a porcine model16. Who can afford to wait? The effect of wait times on survival in lung cancer patients: clinical predictors of poor outcomes17. Impact of the Integrated Comprehensive Care Program after thoracic surgery: a propensity score matched study18. Incidence, severity and risk of postoperative pulmonary complications in patients undergoing pulmonary resection for cancer19. Evaluation of the limits of use of a thoracoscopic lung palpation device to identify artificial tumour nodules in ex-vivo tissue20. Personalized surgical management of esophagogastric junction cancers21. Validity of a model to predict the risk of atrial fibrillation after thoracic surgery22. Severe symptoms persist for up to 1 year after diagnosis of stage I–III lung cancer: an analysis of province-wide patient-reported outcomes23. Do postoperative infectious adverse events influence cancer recurrence and survival after surgical resection of esophagogastric cancers? Experience from a Canadian university centre24. Utilization, safety and efficacy of hybrid esophagectomy on a population level25. Endoscopic submucosal dissection for upper gastrointestinal neoplasia: lessons learned from a high-volume North American centre26. Long-term quality of life after esophagectomy27. Early and late outcomes after surgery for pT4 NSCLC reclassified by AJCC 8th edition criteria28. Early results on the learning curve for subxiphoid video-assisted thoracoscopic lobectomy29. Should adjuvant therapy be offered for patients undergoing esophagectomy after neoadjuvant CROSS protocol for esophageal cancer? A multicentre cohort study30. Outcomes of patients discharged home with a chest tube following anatomic lung resection: a multicentre cohort study01. Management of cancer-associated intestinal obstruction in the final year of life02. Evaluating the prognostic significance of lymphovascular invasion in stage II and III colon cancer03. A matched case–control study on real-time electromagnetic navigation for breast-conserving surgery using NaviKnife04. Gaps in the management of depression symptom screening following cancer diagnosis: a population-based analysis of prospective symptom screening05. Patterns of symptom burden in neuroendocrine tumours: a population-based analysis of patient-reported outcomes06. Outcomes of salvage surgery for anal canal squamous cell carcinoma: a systematic review and meta-analysis07. Expression of the Plk4 inhibitor FAM46C predicts better survival following resection of gastric adenocarcinoma08. Current treatment strategies and patterns of recurrence in locally advanced colon cancer09. A 5-year retrospective review of outcomes after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in a provincial peritoneal malignancy program10. Withdrawn11. Geographic disparities in care and outcomes for noncurative pancreatic adenocarcinoma: a population-based study12. How often is implant-based breast reconstruction following postmastectomy radiation unsuccessful?13. Comparison of partial mastectomy specimen volume and tumour volume following neoadjuvant chemotherapy in breast cancer14. Two-year experience with hookwire localized clipped node and sentinel node as alternative to targeted axillary dissection in a regional centre15. Opioid use among cancer patients undergoing surgery and their associated risk of readmissions and emergency department visits in the 1-year postsurgical period16. Preliminary results of a pilot randomized controlled trial comparing axillary reverse mapping with standard axillary surgery in women with operable breast cancer17. Complementary and alternative medicine among general surgery patients in Nova Scotia18. Improving wait times and patient experience through implementation of a provincial expedited diagnostic pathway for BI-RADS 5 breast lesions19. Population-based regional recurrence patterns in Merkel cell carcinoma: a 15-year review20. Survival and health care cost benefits of high-volume care in the noncurative management of pancreatic adenocarcinoma: a population-based analysis21. Trends in the use of sentinel node biopsy after neoadjuvant chemotherapy in the United States22. Predictors of grossly incomplete resection in primary retroperitoneal sarcoma (RPS)23. Mastectomy versus breast conservation therapy: an examination of how individual, clinicopathologic and physician factors influence decision making24. Immunophenotyping postoperative myeloid-derived suppressor cells in cancer surgery patients25. Adherence to sentinel lymph node biopsy guidelines in the management of cutaneous melanoma in the province of British Columbia26. Breast cancer with supraclavicular and internal mammary node metastases: therapeutic options27. Textbook outcomes and survival in patients with gastric cancer: an analysis of the population registry of esophageal and stomach tumours of Ontario (PRESTO)28. Withdrawn29. Symptomatic bowel complications in patients with metastatic cancer: comparison of surgical versus medical outcomes and development of a prediction model for successful surgical palliation30. Rejected31. Gastric cancer biopsies show distinct biomarker profiles compared with normal gastric mucosa in Canadian patients32. Withdrawn01. Management of high patient-reported pain scores in noncurative pancreatic adenocarcinoma: a population-based analysis02. Outcomes of liver donors with a future liver remnant less than or equal to 30%: a matched-cohort study03. The applicability of intraoperative fluorescent imaging with indocyanine green in hepatic resection for malignancy: a systematic review and meta-analysis04. Impact of adjuvant chemotherapy completion on outcomes following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma05. Primary hepatic acinar cell carcinoma06. Laparoscopic distal pancreatectomy provides equivalent oncologic outcomes for pancreatic ductal adenocarcinoma07. Passive versus active intraabdominal drainage following pancreatic resection: Does a superior drainage system exist? A systematic review and meta-analysis08. Low yield of preoperative MRCP and ERCP in the management of low-intermediate suspicion choledocholithiasis09. Pancreatic cancer resection rates and survival in the United States and Canada10. Prognostic value of immune heterogeneity in colorectal cancer liver metastases11. Impact of intraoperative hypovolemic phlebotomy on blood loss and perioperative transfusion in patients undergoing hepatectomy for cancer12. Prediction of postoperative pancreatic fistula following pancreatectomy: a systematic review of clinical tools13. The impact of preoperative frailty in liver resection: an analysis of the American College of Surgeons’ National Surgical Quality Improvement Program (ACS NSQIP)14. Topical agents as adjuncts in pancreatic surgery for prevention of postoperative pancreatic fistula: a systematic review and meta-analysis15. Phlebotomy resulting in controlled hypovolemia to prevent blood loss in major hepatic resections (PRICE-1): a feasibility randomized controlled trial16. Pylorus-preserving versus classic pancreaticoduodenectomy: a single-centre retrospective review of total lymph node yield17. An audit and evaluation of appropriateness of intraoperative allogenic red blood cell transfusion in liver surgery: application of 3 decision rules18. A comparison of lymph node ratio with AJCC lymph node status for survival after Whipple resection for pancreatic adenocarcinoma19. Duodenopancréatectomie céphalique (intervention de Whipple) par voie laparoscopique pure20. Use of the Molecular Adsorbent Recirculating System (MARS) in acute liver failure: a multicentre experience21. Barriers to adjuvant chemotherapy after resection for pancreatic cancer22. Comparison of primary and metastatic pancreatic cancer by clinical and genomic features23. Factors associated with invasion and postoperative overall survival in resected IPMN01. Incisional hernia repair surgery improves patient-reported outcomes02. Prospective study of single-stage repair of contaminated hernias with the novel use of calcium sulfate antibiotic beads in conjunction with biologic porcine submucosa tissue matrix03. e-TEP transversus abdominus release04. Umbilical hernias05. Review of 1061 femoral hernias done at the Shouldice Hospital over a period of 6 years01. Metabolic outcomes after bariatric surgery for a provincial Indigenous population02. Outcomes of sleeve gastrectomy performed in a regional hospital03. A longitudinal analysis of wait times in a publicly funded, regionalized bariatric care system04. Concurrent laparoscopic ventral hernia repair with bariatric surgery: a propensity-matched analysis05. Outcomes from explantation of laparoscopic adjustable gastric band: experience from a Canadian bariatric centre of excellence06. Development of consensus-derived quality indicators for laparoscopic sleeve gastrectomy07. Conversion of sleeve gastrectomy to laparoscopic Roux-en-Y gastric bypass in intestinal nonrotation08. The utility of routine preoperative upper gastrointestinal series for laparoscopic sleeve gastrectomy09. Body image concerns, depression, suicidality and psychopharmacological changes in postoperative bariatric surgery patients: a mixed-methods study10. Technical factors associated with early sleeve stenosis after sleeve gastrectomy: an analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database11. Analysis of complication and readmission rates after laparoscopic sleeve gastrectomy at a single bariatric surgery centre: a retrospective NSQIP study12. Management of common bile duct stones in patients after Roux-en-Y gastric bypass: a systematic review13. Improvement and resolution of urinary incontinence after bariatric surgery: a systematic review and meta-analysis14. Bridging interventions for weight loss prior to bariatric surgery in patients with superobesity: a systematic review and meta-analysis15. Secondary and tertiary learning curves in bariatric surgery16. Achalasia following laparoscopic sleeve gastrectomy: a case report17. Multidisciplinary approach to halving length of stay after bariatric surgery18. Prospective analysis of staple line haemostatic materials in stapled bariatric surgery19. Barriers and facilitators to managing patients with class II and III obesity in primary care: a qualitative study20. The Edmonton Obesity Staging System predicts risk of postoperative complications and mortality following bariatric surgery21. The impact of attention-deficit/hyperactivity disorder on bariatric surgery outcomes: systematic review and meta-analysis22. The effect of bariatric surgery on migraines: a systematic review and meta-analysis23. A population-based matched cohort study of mortality after bariatric surgery24. Safety and outcomes of bariatric surgery performed at an ambulatory site associated with a tertiary care hospital in Canada25. Race and sex predict adverse outcomes following bariatric surgery: a propensity-matched MBSAQIP analysis26. A survey of primary care physician referral to bariatric surgery: access, perceptions and barriers." Canadian Journal of Surgery 62, no. 4 Suppl 2 (August 2019): S89—S169. http://dx.doi.org/10.1503/cjs.011719.

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Rajan, Meenakshi, Ravyn Middleton, Alyssa Field, Candace Pineda, Niqqui Kiffin, and Andrew Rosenthal. "Effectiveness of surgical residents compared to surgical faculty in teaching trauma evaluation and management." Trauma, April 24, 2021, 146040862110122. http://dx.doi.org/10.1177/14604086211012245.

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Introduction Senior medical students learn trauma principles in a 90-min interactive teaching session based on the trauma evaluation and management module designed by the American College of Surgeons. However, the number of surgical faculty available to conduct these interactive small group sessions is limited. The goal of this study is to compare the effectiveness of surgical residents to that of surgical faculty in teaching trauma principles. Methods 53 senior medical students received trauma teaching from trauma faculty ( n = 22), trauma residents ( n = 21), or no teaching ( n = 10). Students were tested on cognitive trauma knowledge (20 multiple choice questions) and clinical trauma simulation (using objective structured clinical performance score). All students completed a 5-point subjective questionnaire. Results Students receiving trauma teaching outperformed students receiving no teaching in the knowledge test (mean 13.0 ± 3.6 standard deviation (SD) vs. 8.4 ± 2.4 SD, p < 0.05), while faculty and resident teaching outcomes were similar (mean 12.6 ± 3.0 SD vs. 13.4 ± 4.1, p = 0.45). Similarly, in the clinical trauma simulation, students receiving trauma teaching scored better (objective score mean 78% vs. 56%, p < 0.05), while there was no difference between faculty and resident teaching outcomes (objective score mean 77% vs. 80%, p = 0.52). In the subjective questionnaire, students who received trauma teaching rated themselves higher on a scale of 10 in trauma knowledge and skills than those who did not have formal teaching (mean 5.2 vs. 2.1, p < 0.05) as resident and attending teaching group ratings were similar. Conclusions Although small group discussions and increased simulation enhance undergraduate surgical trauma education, the number of faculty surgeons needed to fully incorporate these activities is limited. Objective and perceived effectiveness of teaching trauma management by surgical residents compared to trauma attendings is equivalent. This highlights the opportunity to incorporate residents into teaching roles to bridge the gap in undergraduate trauma education.
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Kurz, Sandra, Jana Lohse, Holger Buggenhagen, Irene Schmidtmann, Rita Laufenberg-Feldmann, and Kristin Engelhard. "Improving competence and safety in pain medicine: a practical clinical teaching strategy for students combining simulation and bedside teaching." BMC Medical Education 21, no. 1 (February 25, 2021). http://dx.doi.org/10.1186/s12909-021-02554-6.

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Abstract Background Pain is a devastating sensation and has to be treated immediately. Therefore, we developed a training program to improve the knowledge of medical students in the field of pain medicine. In the present study, the applicability and efficacy of this training program was tested. Methods Half of the students attended first a training with simulated patients (SP) followed by bedside teaching (Group 1). Group 2 performed the training programs in reverse order. The evaluation based on standardized questionnaires completed by students (self-assessment) and all students took part in two practical examinations after the learning interventions. Results This study included 35 students. The quality of the simulation was evaluated by the students with average grade 1.1 (1 = very good, 6 = very bad). The practical work on the ward with patients was rated with grade 1.4 of 6, the whole course with 1.1. Students of Group A were significantly better in the final examination (grade 1.7 vs. grade 2.2, p < 0.05). To rate the improvement of skills (self-assessment) we used a Likert Scale (1 = very certain, 5 = very uncertain). The following skills were similar in both groups and significantly better after the course: taking responsibility, expert knowledge, empathy, relationship building and communication. Conclusions Training with simulated patients in combination with small-group teaching at the bedside with real patients achieves a dramatic increase in student competence. Students prefer learning from the simulation before bedside teaching and propose to include simulation into the curricular teaching of pain medicine.
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Muhumuza, Albert, Josephine Nambi Najjuma, Heather MacIntosh, Nishan Sharma, Nalini Singhal, Gwendolyn L. Hollaar, Ian Wishart, Francis Bajunirwe, and Data Santorino. "Understanding the barriers and enablers for postgraduate medical trainees becoming simulation educators: a qualitative study." BMC Medical Education 23, no. 1 (January 14, 2023). http://dx.doi.org/10.1186/s12909-022-03995-3.

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Abstract Introduction There is increasing evidence that Simulation-based learning (SBL) is an effective teaching method for healthcare professionals. However, SBL requires a large number of faculty to facilitate small group sessions. Like many other African contexts, Mbarara University of Science and Technology (MUST) in Uganda has large numbers of medical students, but limited resources, including limited simulation trained teaching faculty. Postgraduate medical trainees (PGs) are often involved in clinical teaching of undergraduates. To establish sustainable SBL in undergraduate medical education (UME), the support of PGs is crucial, making it critical to understand the enablers and barriers of PGs to become simulation educators. Methods We used purposive sampling and conducted in-depth interviews (IDIs) with the PGs, key informant interviews (KIIs) with university staff, and focus group discussions (FGDs) with the PGs in groups of 5–10 participants. Data collection tools were developed using the Consolidated framework for implementation research (CFIR) tool. Data were analyzed using the rigorous and accelerated data reduction (RADaR) technique. Results We conducted seven IDIs, seven KIIs and four focus group discussions. The barriers identified included: competing time demands, negative attitude towards transferability of simulation learning, inadequacy of medical simulation equipment, and that medical simulation facilitation is not integrated in the PGs curriculum. The enablers included: perceived benefits of medical simulation to medical students plus PGs and in-practice health personnel, favorable departmental attitude, enthusiasm of PGs to be simulation educators, and improved awareness of the duties of a simulation educator. Participants recommended sensitization of key stakeholders to simulation, training and motivation of PG educators, and evaluation of the impact of a medical simulation program that involves PGs as educators. Conclusion In the context of a low resource setting with large undergraduate classes and limited faculty members, SBL can assist in clinical skill acquisition. Training of PGs as simulation educators should address perceived barriers and integration of SBL into UME. Involvement of departmental leadership and obtaining their approval is critical in the involvement of PGs as simulation educators.
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Younes, Nadia, Anne Laure Delaunay, M. Roger, Pierre Serra, France Hirot, Frédéric Urbain, Nathalie Godart, Mario Speranza, Christine Passerieux, and Paul Roux. "Evaluating the effectiveness of a single-day simulation-based program in psychiatry for medical students: a controlled study." BMC Medical Education 21, no. 1 (June 16, 2021). http://dx.doi.org/10.1186/s12909-021-02708-6.

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Abstract Background Training in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, of which the use is only recent and still needs further development. Evidence is accumulating on its effectiveness but requires further validation for medical students. We aimed to evaluate the effectiveness of a single-day optional teaching program in psychiatry by simulation for medical students and validate a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ), as part of the assessment. Methods This was a controlled study in a French University that compared (using paired-sample Student t-tests) knowledge and attitudes (university grades and CPCQ scores) before, just after teaching with simulated patients, and 2 months later. Satisfaction with the program (including the quality of the debriefing) was also investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability. Finally, a comparison was run with a control group who received the usual psychiatric instruction using covariance analyses. Results Twenty-four medical students were included in the simulation group and 76 in the control group. Just after the simulation, knowledge and attitudes increased significantly in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α = 0.73 [0.65–0.85]), and good test-retest reliability (ICC = 0.71 [0.35–0.88]). Two months after the simulation, knowledge and attitudes were significantly higher in the simulation group than the control group, despite a lack of difference in knowledge before the simulation. Conclusions Adding a simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students. The CPCQ scale could be used for the evaluation of educational programs.
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Gaubert, Sinead, Alice Blet, Fadia Dib, Pierre-François Ceccaldi, Thomas Brock, Maude Calixte, Léa De Macédo, et al. "Positive effects of lumbar puncture simulation training for medical students in clinical practice." BMC Medical Education 21, no. 1 (January 6, 2021). http://dx.doi.org/10.1186/s12909-020-02452-3.

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Abstract Background Lumbar puncture (LP) is an invasive medical procedure that can be done by any doctor. Several simulation-based trainings have been built however the evaluations of the theoretical knowledge and the impact of the simulation-based training have never been performed in real life. The objective was to evaluate the impact of a LP training on the theoretical knowledge improvement and the performance of a LP in clinical practice. Methods Before and after medical students’ training, theoretical knowledge and confidence level were assessed. Over a 6 months period, the impact of simulation training was evaluated by the success rate of students’ first LP carried out in hospitalized patients and compared to the results of a no-training control. Results Students’ theoretical knowledge and confidence level showed significant improvement after simulation training on 115 students (p < 0.0001). The evaluation in real life based on 41 students showed that the success rate of the first LP in patients was higher in the LP simulation group compared to the control group (67% vs 14%, p = 0.0025). The technical assistance was also less frequently needed in the LP simulation group (19% vs 57%, respectively, p = 0.017). The rate of students who participated in this educational study was low. Discussion Simulation-based teaching was an effective way to improve students’ theoretical and practical knowledge. Whether this approach translates to other procedural skills in real clinical settings merits further study. The low participation rate in the study is due to the fact that students are not used to be included in educational studies and to the complexity of evaluation in routine clinical practice.
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Zhou, Xin-yi, Yan-feng Wang, Chun-xia Dou, Xiao-ying Tian, Jin Su, Yan-ya Chen, Feng-xia Yan, Qiao-hong Yang, and Wenru Wang. "Evaluating the effects of simulated interprofessional teaching on the development of clinical core competence in nursing students: a mixed methods study." BMC Nursing 21, no. 1 (December 19, 2022). http://dx.doi.org/10.1186/s12912-022-01108-5.

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Abstract Background While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design. Methods A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied “Clinical Critical Thinking Training” together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann–Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience. Results The students’ interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p < 0.05). Three themes emerged regarding simulated interprofessional teaching: clarifying team positioning, improving team efficiency, and optimizing the learning experience. Conclusion SIPE can build students' critical thinking, teamwork, and interprofessional core competencies, which makes it a useful teaching design.
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Singhania, Ashika, and Sweta Kale Pisulkar. "Implementation of Modified Peyton’s Method for Skill Training among Undergraduate Students in Prosthodontics." JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2022. http://dx.doi.org/10.7860/jcdr/2022/56295.16833.

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Introduction: Simulation training has been practiced in dental schools all throughout. The pertinent use of simulation in any professional education program allows the students to get clarity for their clinical skills without the danger of harming the patient during the learning process. The success of different teaching methods in skill laboratories is still debated in the literature. One of them is Peyton’s approach which is designed for student: teacher ratio of 1:1. To overcome this modified Peyton’s method was introduce which allows each of the trainees to perform respective skill at least once. Aim: To evaluate and compare Modified Peyton’s approach with conventional teaching for skill training among undergraduate students in Prosthodontics. Materials and Methods: This prospective interventional study will be conducted in Department of Prosthodontics at Sharad Pawar Dental College, Wardha, Maharshtra, India, from October 2022 to December 2023. The study will involve 70 third year BDS students randomly divided two groups equally. The study will be conducted in dental setting utilising the dental skill laboratory to make alginate impression. Group A will be taught using conventional method and group B will be divided into 10 groups and taught using modified Peyton method and evaluation will be done using Objective Structured Practical Examination and post-test. Expected Outcome: At the end of the study, student’s taught using modified Peyton’s method might show better result in OSPE and post-test. Conclusion: Modified Peyton’s method will prove beneficial to students learning new skill.
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Mallik, Ritwika, Mayank Patel, Ben Atkinson, and Partha Kar. "Exploring the Role of Virtual Reality to Support Clinical Diabetes Training—A Pilot Study." Journal of Diabetes Science and Technology, July 1, 2021, 193229682110278. http://dx.doi.org/10.1177/19322968211027847.

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Background: It is estimated that 16 to 25% of patients in hospital have diabetes and 1 in 25 inpatients with Type 1 Diabetes develop diabetic ketoacidosis (DKA). It is vital that non-specialist doctors recognize and appropriately manage diabetes emergencies. Simulation training is increasingly being used in healthcare and virtual reality (VR) based educational resources is transforming medical education. This study aimed to evaluate the use of virtual reality to help non-specialist clinicians manage clinical scenarios related to diabetes. Methods: This pilot project, titled ‘DEVICE’ (Diabetes Emergencies: Virtual Interactive Clinical Education) was developed in collaboration with Oxford Medical Simulation. Fully interactive immersive VR scenarios were created to stimulate real life diabetes emergencies. Users then received personalized feedback and performance metrics. Feedback surveys were provided before and after the participation in the VR scenario. Kirkpatrick’s training evaluation model was used. Results: Thirty-nine participants from 2 hospitals in UK provided feedback up to 3 months after attending the VR education sessions. Overall feedback was extremely positive, and participants found this immersive teaching experience very helpful. After use of virtual reality scenarios, the mean trainee confidence in managing DKA (on an 8-point Likert scale) increased from 3.92 (3.38-4.47) 95% CI to 5.41 (4.79-6.03) 95% CI (statistically significant). The VR study demonstrates Kirkpatrick level 3 in the follow up survey. Conclusion: VR based training scenarios in this pilot project increased confidence in managing diabetes emergencies and demonstrated positive changes in their behavior. VR education is a safe, useful and a well-liked training tool for diabetes emergencies.
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Nagy, Ede, Gloria Matondo Miguel Luta, Daniel Huhn, Anna Cranz, Jobst-Hendrik Schultz, Anne Herrmann-Werner, Till Johannes Bugaj, Hans-Christoph Friederich, and Christoph Nikendei. "Teaching patient-centred communication skills during clinical procedural skill training - a preliminary pre-post study comparing international and local medical students." BMC Medical Education 21, no. 1 (September 3, 2021). http://dx.doi.org/10.1186/s12909-021-02901-7.

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Abstract Background International medical students are frequently confronted with intercultural, psychosocial, and language barriers and often receive lower marks in written, oral, and clinical-practical examinations than fellow local students. Training communication competence in procedural skills, such as blood sampling, is further challenge in this particular group of medical students. This pre-post comparative intervention study aimed to investigate the effects of training communication skills during the performance of procedural skills (taking blood samples from a silicone model) in international and local students as part of their clinical practical medical training. Methods Study participants performed blood sampling on an arm prosthesis model (part-task trainer) before and after the communication skills training, focusing on accompanying communication with a simulation patient sitting next to the arm model. The pre- and post-evaluation video was assessed by two independent evaluators using a binary checklist, the Integrated Procedural Performance Instrument (IPPI) and global assessments of clinical professionalism in terms of procedural and communication performance. Linear models with mixed effects were used. Group differences regarding global competence levels were analysed with χ2-tests. Results International medical students did not perform as well as their local counterparts in the pre- and post-examinations. Both groups improved their performance significantly, whereby the international students improved more than their local counterparts in terms of their communication performance, assessed via binary checklist. Clinical professionalism evaluated via global assessments of procedural and communication performance highlights the intervention’s impact insofar as no international student was assessed as clinically not competent after the training. Conclusions Our results suggest that already a low-dose intervention can lead to improved communication skills in medical students performing procedural tasks and significantly increase their confidence in patient interaction.
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Shanahan, Madeleine, Tom Molyneux, and Dein Vindigni. "Chiropractic students’ experiences on the use of virtual radiography simulation: a pilot observational study." BMC Medical Education 21, no. 1 (July 28, 2021). http://dx.doi.org/10.1186/s12909-021-02827-0.

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Abstract Background Virtual radiography provides students with an opportunity to practise their clinical skills in patient positioning and evaluating radiographic images. The purpose of this pilot study was to introduce Projection VR™, a software radiography simulation program, into a student chiropractic program and evaluate its potential application as a teaching and learning tool. Methods Undergraduate chiropractic students, enrolled in a radiographic course (unit within the chiropractic program), were invited to attend a scheduled laboratory where they were introduced to, and undertook purposefully designed activities using the radiography simulation. At the end of this activity, students were asked to complete an online survey (see Virtual Radiography Survey) to describe their experiences of the educational value of the software program. Descriptive statistics were used to evaluate outcomes. Content analysis was performed for free-text comments provided by respondents with key themes provided by the predetermined quantitative categories of the questionnaire. Results Responses were received from 44 out of the 47 students who attended the scheduled laboratory (response rate 92%). Overall students were positive about this simulation identifying that it was easy to use (95%) and that they could control the equipment as needed (95%). The main reported benefits included students being enabled to repeat tasks until they were satisfied with the results (98%) and being able to quickly assess images and determine if changes needed to be made (98%). Participants reported improvement in their understanding of the effect of exposure factors on patient radiation dose (93%) as well as their technical image evaluation (84%) and problem-solving skills (80%). Conclusions The results of this study suggest that virtual radiography is a valuable complementary resource in providing chiropractic students with radiographic knowledge and skills.
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Chavdarov, Anatoliy V. "Special Issue No. – 10, June, 2020 Journal > Special Issue > Special Issue No. – 10, June, 2020 > Page 5 “Quantative Methods in Modern Science” organized by Academic Paper Ltd, Russia MORPHOLOGICAL AND ANATOMICAL FEATURES OF THE GENUS GAGEA SALISB., GROWING IN THE EAST KAZAKHSTAN REGION Authors: Zhamal T. Igissinova,Almash A. Kitapbayeva,Anargul S. Sharipkhanova,Alexander L. Vorobyev,Svetlana F. Kolosova,Zhanat K. Idrisheva, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00041 Abstract: Due to ecological preferences among species of the genus GageaSalisb, many plants are qualified as rare and/or endangered. Therefore, the problem of rational use of natural resources, in particular protection of early spring plant species is very important. However, literary sources analysis only reveals data on the biology of species of this genus. The present research,conducted in the spring of 2017-2019, focuses on anatomical and morphological features of two Altai species: Gagealutea and Gagea minima; these features were studied, clarified and confirmed by drawings and photographs. The anatomical structure of the stem and leaf blade was studied in detail. The obtained research results will prove useful for studies of medicinal raw materials and honey plants. The aforementioned species are similar in morphological features, yet G. minima issmaller in size, and its shoots appear earlier than those of other species Keywords: Flora,gageas,Altai species,vegetative organs., Refference: I. Atlas of areas and resources of medicinal plants of Kazakhstan.Almaty, 2008. II. Baitenov M.S. Flora of Kazakhstan.Almaty: Ġylym, 2001. III. DanilevichV. G. ThegenusGageaSalisb. of WesternTienShan. PhD Thesis, St. Petersburg,1996. IV. EgeubaevaR.A., GemedzhievaN.G. The current state of stocks of medicinal plants in some mountain ecosystems of Kazakhstan.Proceedings of the international scientific conference ‘”Results and prospects for the development of botanical science in Kazakhstan’, 2002. V. Kotukhov Yu.A. New species of the genus Gagea (Liliaceae) from Southern Altai. Bot. Journal.1989;74(11). VI. KotukhovYu.A. ListofvascularplantsofKazakhstanAltai. Botan. Researches ofSiberiaandKazakhstan.2005;11. VII. KotukhovYu. The current state of populations of rare and endangered plants in Eastern Kazakhstan. Almaty: AST, 2009. VIII. Kotukhov Yu.A., DanilovaA.N., AnufrievaO.A. Synopsisoftheonions (AlliumL.) oftheKazakhstanAltai, Sauro-ManrakandtheZaisandepression. BotanicalstudiesofSiberiaandKazakhstan. 2011;17: 3-33. IX. Kotukhov, Yu.A., Baytulin, I.O. Rareandendangered, endemicandrelictelementsofthefloraofKazakhstanAltai. MaterialsoftheIntern. scientific-practical. conf. ‘Sustainablemanagementofprotectedareas’.Almaty: Ridder, 2010. X. Krasnoborov I.M. et al. The determinant of plants of the Republic of Altai. Novosibirsk: SB RAS, 2012. XI. Levichev I.G. On the species status of Gagea Rubicunda. Botanical Journal.1997;6:71-76. XII. Levichev I.G. A new species of the genus Gagea (Liliaceae). Botanical Journal. 2000;7: 186-189. XIII. Levichev I.G., Jangb Chang-gee, Seung Hwan Ohc, Lazkovd G.A.A new species of genus GageaSalisb.(Liliaceae) from Kyrgyz Republic (Western Tian Shan, Chatkal Range, Sary-Chelek Nature Reserve). Journal of Asia-Pacific Biodiversity.2019; 12: 341-343. XIV. Peterson A., Levichev I.G., Peterson J. Systematics of Gagea and Lloydia (Liliaceae) and infrageneric classification of Gagea based on molecular and morphological data. Molecular Phylogenetics and Evolution.2008; 46. XV. Peruzzi L., Peterson A., Tison J.-M., Peterson J. Phylogenetic relationships of GageaSalisb.(Liliaceae) in Italy, inferred from molecular and morphological data matrices. Plant Systematics and Evolution; 2008: 276. XVI. Rib R.D. Honey plants of Kazakhstan. Advertising Digest, 2013. XVII. Scherbakova L.I., Shirshikova N.A. Flora of medicinal plants in the vicinity of Ust-Kamenogorsk. Collection of materials of the scientific-practical conference ‘Unity of Education, Science and Innovation’. Ust-Kamenogorsk: EKSU, 2011. XVIII. syganovA.P. PrimrosesofEastKazakhstan. Ust-Kamenogorsk: EKSU, 2001. XIX. Tsyganov A.P. Flora and vegetation of the South Altai Tarbagatay. Berlin: LAP LAMBERT,2014. XX. Utyasheva, T.R., Berezovikov, N.N., Zinchenko, Yu.K. ProceedingsoftheMarkakolskStateNatureReserve. Ust-Kamenogorsk, 2009. XXI. Xinqi C, Turland NJ. Gagea. Flora of China.2000;24: 117-121. XXII. Zarrei M., Zarre S., Wilkin P., Rix E.M. Systematic revision of the genus GageaSalisb. (Liliaceae) in Iran.BotJourn Linn Soc.2007;154. XXIII. Zarrei M., Wilkin P., Ingroille M.J., Chase M.W. A revised infrageneric classification for GageaSalisb. (Tulipeae; Liliaceae): insights from DNA sequence and morphological data.Phytotaxa.2011:5. View | Download INFLUENCE OF SUCCESSION CROPPING ON ECONOMIC EFFICIENCY OF NO-TILL CROP ROTATIONS Authors: Victor K. Dridiger,Roman S. Stukalov,Rasul G. Gadzhiumarov,Anastasiya A. Voropaeva,Viktoriay A. Kolomytseva, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00042 Abstract: This study was aimed at examining the influence of succession cropping on the economic efficiency of no-till field crop rotations on the black earth in the zone of unstable moistening of the Stavropol krai. A long-term stationary experiment was conducted to examine for the purpose nine field crop rotation patterns different in the number of fields (four to six), set of crops, and their succession in crop rotation. The respective shares of legumes, oilseeds, and cereals in the cropping pattern were 17 to 33, 17 to 40, and 50 to 67 %. It has been established that in case of no-till field crop cultivation the economic efficiency of plant production depends on the set of crops and their succession in rotation. The most economically efficient type of crop rotation is the soya-winter wheat-peas-winter wheat-sunflower-corn six-field rotation with two fields of legumes: in this rotation 1 ha of crop rotation area yields 3 850 grain units per ha at a grain unit prime cost of 5.46 roubles; the plant production output return and profitability were 20,888 roubles per ha and 113 %, respectively. The high production profitabilities provided by the soya-winter wheat-sunflower four-field and the soya-winter-wheat-sunflower-corn-winter wheat five-field crop rotation are 108.7 and 106.2 %, respectively. The inclusion of winter wheat in crop rotation for two years in a row reduces the second winter wheat crop yield by 80 to 100 %, which means a certain reduction in the grain unit harvesting rate to 3.48-3.57 thousands per ha of rotation area and cuts the production profitability down to 84.4-92.3 %. This is why, no-till cropping should not include winter wheat for a second time Keywords: No-till technology,crop rotation,predecessor,yield,return,profitability, Refference: I Badakhova G. Kh. and Knutas A. V., Stavropol Krai: Modern Climate Conditions [Stavropol’skiykray: sovremennyyeklimaticheskiyeusloviya]. Stavropol: SUE Krai Communication Networks, 2007. II Cherkasov G. N. and Akimenko A. S. Scientific Basis of Modernization of Crop Rotations and Formation of Their Systems according to the Specializations of Farms in the Central Chernozem Region [Osnovy moderniz atsiisevooborotoviformirovaniyaikh sistem v sootvetstvii so spetsi-alizatsiyeykhozyaystvTsentral’nogoChernozem’ya]. Zemledelie. 2017; 4: 3-5. III Decree 330 of July 6, 2017 the Ministry of Agriculture of Russia “On Approving Coefficients of Converting to Agricultural Crops to Grain Units [Ob utverzhdeniikoeffitsiyentovperevoda v zernovyyee dinitsysel’s kokhozyaystvennykhkul’tur]. IV Dridiger V. K., About Methods of Research of No-Till Technology [O metodikeissledovaniytekhnologii No-till]//Achievements of Science and Technology of AIC (Dostizheniyanaukiitekhniki APK). 2016; 30 (4): 30-32. V Dridiger V. K. and Gadzhiumarov R. G. Growth, Development, and Productivity of Soya Beans Cultivated On No-Till Technology in the Zone of Unstable Moistening of Stavropol Region [Rost, razvitiyeiproduktivnost’ soiprivozdelyvaniipotekhnologii No-till v zone ne-ustoychivog ouvlazhneniyaStavropol’skogokraya]//Oil Crops RTBVNIIMK (Maslichnyyekul’turyNTBVNIIMK). 2018; 3 (175): 52–57. VI Dridiger V. K., Godunova E. I., Eroshenko F. V., Stukalov R. S., Gadzhiumarov, R. G., Effekt of No-till Technology on erosion resistance, the population of earthworms and humus content in soil (Vliyaniyetekhnologii No-till naprotivoerozionnuyuustoychivost’, populyatsiyudozhdevykhcherveyisoderzhaniyegumusa v pochve)//Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2018; 9 (2): 766-770. VII Karabutov A. P., Solovichenko V. D., Nikitin V. V. et al., Reproduction of Soil Fertility, Productivity and Energy Efficiency of Crop Rotations [Vosproizvodstvoplodorodiyapochv, produktivnost’ ienergeticheskayaeffektivnost’ sevooborotov]. Zemledelie. 2019; 2: 3-7. VIII Kulintsev V. V., Dridiger V. K., Godunova E. I., Kovtun V. I., Zhukova M. P., Effekt of No-till Technology on The Available Moisture Content and Soil Density in The Crop Rotation [Vliyaniyetekhnologii No-till nasoderzhaniyedostupnoyvlagiiplotnost’ pochvy v sevoob-orote]// Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2017; 8 (6): 795-99. IX Kulintsev V. V., Godunova E. I., Zhelnakova L. I. et al., Next-Gen Agriculture System for Stavropol Krai: Monograph [SistemazemledeliyanovogopokoleniyaStavropol’skogokraya: Monogtafiya]. Stavropol: AGRUS Publishers, Stavropol State Agrarian University, 2013. X Lessiter Frank, 29 reasons why many growers are harvesting higher no-till yields in their fields than some university scientists find in research plots//No-till Farmer. 2015; 44 (2): 8. XI Rodionova O. A. Reproduction and Exchange-Distributive Relations in Farming Entities [Vosproizvodstvoiobmenno-raspredelitel’nyyeotnosheniya v sel’skokhozyaystvennykhorganizatsiyakh]//Economy, Labour, and Control in Agriculture (Ekonomika, trud, upravleniye v sel’skomkhozyaystve). 2010; 1 (2): 24-27. XII Sandu I. S., Svobodin V. A., Nechaev V. I., Kosolapova M. V., and Fedorenko V. F., Agricultural Production Efficiency: Recommended Practices [Effektivnost’ sel’skokhozyaystvennogoproizvodstva (metodicheskiyerekomendatsii)]. Moscow: Rosinforagrotech, 2013. XIII Sotchenko V. S. Modern Corn Cultivation Technologies [Sovremennayatekhnologiyavozdelyvaniya]. Moscow: Rosagrokhim, 2009. View | Download DEVELOPMENT AND TESTING OF AUTONOMOUS PORTABLE SEISMOMETER DESIGNED FOR USE AT ULTRALOW TEMPERATURES IN ARCTIC ENVIRONMENT Authors: Mikhail A. Abaturov,Yuriy V. Sirotinskiy, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00043 Abstract: This paper is concerned with solving one of the issues of the general problem of designing geophysical equipment for the natural climatic environment of the Arctic. The relevance of the topic has to do with an increased global interest in this region. The paper is aimed at considering the basic principles of developing and the procedure of testing seismic instruments for use at ultralow climatic temperatures. In this paper the indicated issue is considered through the example of a seismic module designed for petroleum and gas exploration by passive seismoacoustic methods. The seismic module is a direct-burial portable unit of around 5 kg in weight, designed to continuously measure and record microseismic triaxial orthogonal (ZNE) noise in a range from 0.1 to 45 Hz during several days in autonomous mode. The functional chart of designing the seismic module was considered, and concrete conclusions were made for choosing the necessary components to meet the ultralow-temperature operational requirements. The conclusions made served for developing appropriate seismic module. In this case, the components and tools used included a SAFT MP 176065 xc low-temperature lithium cell, industrial-spec electronic component parts, a Zhaofeng Geophysical ZF-4.5 Chinese primary electrodynamic seismic sensor, housing seal parts made of frost-resistant silicone materials, and finely dispersed silica gel used as water-retaining sorbent to avoid condensation in the housing. The paper also describes a procedure of low-temperature collation tests at the lab using a New Brunswick Scientific freezing plant. The test results proved the operability of the developed equipment at ultralow temperatures down to -55°C. In addition, tests were conducted at low microseismic noises in the actual Arctic environment. The possibility to detect signals in a range from 1 to 10 Hz at the level close to the NLNM limit (the Peterson model) has been confirmed, which allows monitoring and exploring petroleum and gas deposits by passive methods. As revealed by this study, the suggested approaches are efficient in developing high-precision mobile seismic instruments for use at ultralow climatic temperatures. The solution of the considered instrumentation and methodical issues is of great practical significance as a constituent of the generic problem of Arctic exploration. Keywords: Seismic instrumentation,microseismic monitoring,Peterson model,geological exploration,temperature ratings,cooling test, Refference: I. AD797: Ultralow Distortion, Ultralow Noise Op Amp, Analog Devices, Inc., Data Sheet (Rev. K). Analog Devices, Inc. URL: https://www.analog.com/media/en/technical-documentation/data-sheets/AD797.pdf(Date of access September 2, 2019). II. Agafonov, V. M., Egorov, I. V., and Shabalina, A. S. Operating Principles and Technical Characteristics of a Small-Sized Molecular–Electronic Seismic Sensor with Negative Feedback [Printsipyraboty I tekhnicheskiyekharakteristikimalogabaritnogomolekulyarno-elektronnogoseysmodatchika s otritsatel’noyobratnoysvyaz’yu]. SeysmicheskiyePribory (Seismic Instruments). 2014; 50 (1): 1–8. DOI: 10.3103/S0747923914010022. III. Antonovskaya, G., Konechnaya, Ya.,Kremenetskaya, E., Asming, V., Kvaema, T., Schweitzer, J., Ringdal, F. Enhanced Earthquake Monitoring in the European Arctic. Polar Science. 2015; 1 (9): 158-167. IV. Anthony, R. E., Aster, R. C., Wiens, D., Nyblade, Andr., Anandakrishnan, Sr., Huerta, Audr., Winberry, J. P., Wilson, T., and Rowe, Ch. The Seismic Noise Environment of Antarctica. Seismological Research Letters. 2015; 86(1): 89-100. DOI: 10.1785/0220150005 V. Brincker, R., Lago, T. L., Andersen, P., and Ventura, C. Improving the Classical Geophone Sensor Element by Digital Correction. In Conference Proceedings: IMAC-XXIII: A Conference & Exposition on Structural Dynamics Society for Experimental Mechanics, 2005. URL: https://www.researchgate.net/publication/242452637_Improving_the_Classical_Geophone_Sensor_Element_by_Digital_Correction(Date of access September 2, 2019). VI. Bylaw 164 of the State Committee for Construction of the Russian Federation “On adopting amendments to SNiP 31-01-99 “Construction climatology”. URL: https://base.garant.ru/2322381/(Date of access September 2, 2019). VII. Chao Xu, Junbo Wang, Deyong Chen, Jian Chen, Bowen Liu, Wenjie Qi, XichenZheng, Hua Wei, Guoqing Zhang. The Electrochemical Seismometer Based on a Novel Designed.Sensing Electrode for Undersea Exploration. 20th International Conference on Solid-State Sensors, Actuators and Microsystems &Eurosensors XXXIII (TRANSDUCERS &EUROSENSORS XXXIII). IEEE, 2019. DOI: 10.1109/TRANSDUCERS.2019.8808450. VIII. Chebotareva, I. Ya. New algorithms of emission tomography for passive seismic monitoring of a producing hydrocarbon deposit: Part I. Algorithms of processing and numerical simulation [Novyye algoritmyemissionnoyto mografiidlyapassivnogoseysmicheskogomonitoringarazrabatyvayemykhmestorozhdeniyuglevodorodov. Chast’ I: Algoritmyobrabotki I chislennoyemodelirovaniye]. FizikaZemli. 2010; 46(3):187-98. DOI: 10.1134/S106935131003002X IX. Danilov, A. V. and Konechnaya, Ya. V. Analytical comparison of seismic instruments for stationary surveys in the Arctic [Sravnitel’nyyanalizseysmicheskoyapparaturydlyastatsionarnykhnablyudeniy v Arktike]. DSYS. URL: https://dsys.ru/upload/id254_docPDF_FranzJosefLand.pdf(Date of access September 2, 2019). X. Dew point temperature calculator. Maple Tech. International LLC. URL: https://www.calculator.net/dew-point-calculator.html?airtemperature=20&airtemperatureunit=celsius&humidity=0.34&dewpoint=&dewpointunit=celsius&x=51&y=14(Date of access September 2, 2019). XI. Frolov, A. S. Matching of wave fields recorded by different geophysical receivers [Soglasovaniyevolnovykhpoley, poluchennykh s primeneniyemrazlichnoyregistriruyushcheyapparatury]. Abstracts IX International scientific and technical conference competition of young specialists “Geophysics-2013”. Saint-Petersburg: Gubkin University, 2013. URL: https://www.gubkin.ru/faculty/geology_and_geophysics/chairs_and_departments/exploration_geophysics_and_computers_systems/files/2013_SPb_Frolov.pdf. (Date of access September 2, 2019). XII. Gibbons, S. J., Asming, V., Fedorov, A., Fyen, J., Kero, J., Kozlovskaya, E., Kværna, T., Liszka, L., Näsholm, S.P., Raita, T., Roth, M., Tiira, T., Vinogradov, Yu. The European Arctic: A laboratory for seismoacoustic studies. Seism. Res. Letters. 2015; 86 (3): 917–928. XIII. GOST 8.395-80. State system for ensuring the uniformity of measurements. Reference conditions of measurements while calibrating. General requirements [Gosudarstvennayasistemaobespecheniyaedinstvaizmereniy. Normal’nyyeusloviyaizmereniypripoverke. Obshchiyetrebovaniya]. Moscow: Standartinform, 2008. URL: http://gostrf.com/normadata/1/4294821/4294821960.pdf (Date of access September 2, 2019). XIV. Guralp 6TD. Operators’ Guide. Document Number: MAN-T60-0002, Issue J: April, 2017. Guralp Systems Limited. URL: https://www.guralp.com/documents/MAN-T60-0002.pdf (Date of access September 2, 2019). XV. Inshakova, A. S., Barykina, E. S., and Kozlov, V. V. Role of silica gel in adsorption air drying [Rol’ silikagelya v adsorbtsionnoyosushkevozdukha]. AlleyaNauki (Alley of Science). 2017; 15. URL: https://www.alley- science.ru/domains_data/files/November2017/ROL%20SILIKAGELYa%20V%20ADSORBCIONNOY%20OSUShKE%20VOZDUHA.pdf(Date of access September 2, 2019). XVI. Ioffe, D. and Pozdnyakov, P. Searching for Hidden Reserves of Modern Microchip Circuits. Part I [Poiskskrytykhrezervovsovremennykhmikroskhem. Chast’ I].Komponenty I tekhnologii (Components and Technologies). 2015; 4: 144-46. XVII. Jiang Xu, Xi Wang, Ningyi Yuan, Jianning Ding, Si Qin, Joselito M. Razal, Xuehang Wang, ShanhaiGe, Gogotsi, Yu. Extending the low temperature operational limit of Li-ion battery to −80 °C. Energy Storage Materials (IF0). Published 2019-04-27. DOI: 10.1016/j.ensm.2019.04.033. XVIII. Kouznetsov, O. L., Lyasch, Y. F., Chirkin, I. A., Rizanov, E. G., LeRoy, S. D., Koligaev, S. O. Long-term monitoring of microseismic emissions: Earth tides, fracture distribution, and fluid content. SEG, APPG Interpretation. 2016: 4 (2): T191–T204. XIX. Laverov, N. P., Bogoyavlenskiy, V. I., Bogoyavlenskiy, I. V. Fundamental Aspects of Rational Management of the Petroleum and Gas Resources of the Arctic and the Russian Continental Shelf: Strategy, Prospects, and Problems [Fundamental’nyyeaspektyratsional’nogoosvoyeniyaresursovneftiigazaArktiki I shel’faRossii: strategiya, perspektivyi problem].Arktika: ekologiya I ekonomika [Arctic: Ecology and Economy]. 2016; 2 (22): 4-13. XX. Lee, P. Low Noise Amplifier Selection Guide for Optimal Noise Performance, Analog Devices, Inc., AN-940 Application Note. Analog Devices, Inc. URL: https://www.analog.com/media/en/technical-documentation/application-notes/AN-940.pdf(Date of access September 2, 2019). XXI. Markatis, N., Polychronopoulou, K., Tselentis, Ak. Passive seismic tomography: A passive concept actively evolving. First Break. 2012; 30 (7): 83-90. XXII. Matveev, I. V. and Matveeva, N. V. Portable seismic recorder “SEISAR-5” with very low energy consumption for autonomous work in harsh climatic conditions [Portativnyyseysmicheskiyregistrator «Seysar-5» s ochen’ nizkimenergopotrebleniyemdlyaavtonomnoyraboty v slozhnykhklimatic heskikhusloviyakh]. Nauka I tekhnologicheskierazrabotki (Science and Technological Developments). 2017; 96 (3): 33-40. [Special Issue “Applied Geophysics: New Developments and Results. Part 1. Seismology and Seismic Exploration]. DOI: 10.21455/std2017.3-3. XXIII. Mishra, R. The Temperature Ratings of Electronic Parts.Electronics Cooling magazine. URL: http://www.electronics-cooling.com/2004/02/the-temperature-ratings-of-electronic-parts(Date of access September 2, 2019). XXIV. Moore, Sue E.; Stabeno, Phyllis J.; Van Pelt, Thomas I. The Synthesis of Arctic Research (SOAR) project. 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View | Download COMPARATIVE ANALYSIS OF RESULTS OF TREATMENT OF PATIENTS WITH FOOT PATHOLOGY WHO UNDERWENT WEIL OPEN OSTEOTOMY BY CLASSICAL METHOD AND WITHOUT STEOSYNTHESIS Authors: Yuriy V. Lartsev,Dmitrii A. Rasputin,Sergey D. Zuev-Ratnikov,Pavel V.Ryzhov,Dmitry S. Kudashev,Anton A. Bogdanov, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00044 Abstract: The article considers the problem of surgical correction of the second metatarsal bone length. The article analyzes the results of treatment of patients with excess length of the second metatarsal bones that underwent osteotomy with and without osteosynthesis. The results of treatment of patients who underwent metatarsal shortening due to classical Weil-osteotomy with and without osteosynthesis were analyzed. The first group consisted of 34 patients. They underwent classical Weil osteotomy. The second group included 44 patients in whomosteotomy of the second metatarsal bone were not by the screw. When studying the results of the treatment in the immediate postoperative period, weeks 6, 12, slightly better results were observed in patients of the first group, while one year after surgical treatment the results in both groups were comparable. One year after surgical treatment, there were 2.9% (1 patient) of unsatisfactory results in the first group and 4.5% (2 patients) in the second group. Considering the comparability of the results of treatment in remote postoperative period, the choice of concrete method remains with the operating surgeon. Keywords: Flat feet,hallux valgus,corrective osteotomy,metatarsal bones, Refference: I. A novel modification of the Stainsby procedure: surgical technique and clinical outcome [Text] / E. Concannon, R. MacNiocaill, R. Flavin [et al.] // Foot Ankle Surg. – 2014. – Dec., Vol. 20(4). – P. 262–267. II. Accurate determination of relative metatarsal protrusion with a small intermetatarsal angle: a novel simplified method [Text] / L. Osher, M.M. Blazer, S. Buck [et al.] // J. Foot Ankle Surg. – 2014. – Sep.-Oct., Vol. 53(5). – P. 548–556. III. Argerakis, N.G. The radiographic effects of the scarf bunionectomy on rearfoot alignment [Text] / N.G. Argerakis, L.Jr. Weil, L.S. Sr. Weil // Foot Ankle Spec. – 2015. – Apr., Vol. 8(2). – P. 89–94. IV. Bauer, T. Percutaneous forefoot surgery [Text] / T. Bauer // Orthop. Traumatol. Surg. Res. – 2014. – Feb., Vol. 100(1 Suppl.). – P. S191–S204. V. Biomechanical Evaluation of Custom Foot Orthoses for Hallux Valgus Deformity [Text] // J. Foot Ankle Surg. – 2015. – Sep.-Oct., Vol.54(5). – P. 852–855. VI. Chopra, S. Characterization of gait in female patients with moderate to severe hallux valgus deformity [Text] / S. Chopra, K. Moerenhout, X. Crevoisier // Clin. Biomech. (Bristol, Avon). – 2015. – Jul., Vol. 30(6). – P. 629–635. VII. Computer assisted planning and custom-made surgical guide for malunited pronation deformity after first metatarsophalangeal joint arthrodesis in rheumatoid arthritis: a case report [Text] / M. Hirao, S. Ikemoto, H. Tsuboi [et al.] // Comput. Aided Surg. – 2014. – Vol. 19(1-3). – P. 13–19. VIII. Correlation between static radiographic measurements and intersegmental angular measurements during gait using a multisegment foot model [Text] / D.Y. Lee, S.G. Seo, E.J. Kim [et al.] // Foot Ankle Int. – 2015. – Jan., Vol.36(1). – P. 1–10. IX. Correlative study between length of first metatarsal and transfer metatarsalgia after osteotomy of first metatarsal [Text]: [Article in Chinese] / F.Q. Zhang, B.Y. Pei, S.T. Wei [et al.] // Zhonghua Yi XueZaZhi. – 2013. – Nov. 19, Vol. 93(43). – P. 3441–3444. X. Dave, M.H. Forefoot Deformity in Rheumatoid Arthritis: A Comparison of Shod and Unshod Populations [Text] / M.H. Dave, L.W. Mason, K. Hariharan // Foot Ankle Spec. – 2015. – Oct., Vol. 8(5). – P. 378–383. XI. Does arthrodesis of the first metatarsophalangeal joint correct the intermetatarsal M1M2 angle? Analysis of a continuous series of 208 arthrodeses fixed with plates [Text] / F. Dalat, F. Cottalorda, M.H. Fessy [et al.] // Orthop. Traumatol. Surg. Res. – 2015. – Oct., Vol. 101(6). – P. 709–714. XII. Dynamic plantar pressure distribution after percutaneous hallux valgus correction using the Reverdin-Isham osteotomy [Text]: [Article in Spanish] / G. Rodríguez-Reyes, E. López-Gavito, A.I. Pérez-Sanpablo [et al.] // Rev. Invest. Clin. – 2014. – Jul., Vol. 66, Suppl. 1. – P. S79-S84. XIII. Efficacy of Bilateral Simultaneous Hallux Valgus Correction Compared to Unilateral [Text] / A.V. Boychenko, L.N. Solomin, S.G. Parfeyev [et al.] // Foot Ankle Int. – 2015. – Nov., Vol. 36(11). – P. 1339–1343. XIV. Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up [Text] / C. Biz, M. Corradin, I. Petretta [et al.] // J. OrthopSurg Res. – 2015. – Jul. 2, № 10. – P. 102. XV. First metatarsal proximal opening wedge osteotomy for correction of hallux valgus deformity: comparison of straight versus oblique osteotomy [Text] / S.H. Han, E.H. Park, J. Jo [et al.] // Yonsei Med. J. – 2015. – May, Vol. 56(3). – P. 744–752. XVI. Long-term outcome of joint-preserving surgery by combination metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis [Text] / H. Niki, T. Hirano, Y. Akiyama [et al.] // Mod. Rheumatol. – 2015. – Sep., Vol. 25(5). – P. 683–638. XVII. Maceira, E. Transfer metatarsalgia post hallux valgus surgery [Text] / E. Maceira, M. Monteagudo // Foot Ankle Clin. – 2014. – Jun., Vol. 19(2). – P.285–307. XVIII. Nielson, D.L. Absorbable fixation in forefoot surgery: a viable alternative to metallic hardware [Text] / D.L. Nielson, N.J. Young, C.M. Zelen // Clin. Podiatr. Med. Surg. – 2013. – Jul., Vol. 30(3). – P. 283–293 XIX. Patient’s satisfaction after outpatient forefoot surgery: Study of 619 cases [Text] / A. Mouton, V. Le Strat, D. Medevielle [et al.] // Orthop. Traumatol. Surg. Res. – 2015. – Oct., Vol. 101(6 Suppl.). – P. S217–S220. XX. Preference of surgical procedure for the forefoot deformity in the rheumatoid arthritis patients–A prospective, randomized, internal controlled study [Text] / M. Tada, T. Koike, T. Okano [et al.] // Mod. Rheumatol. – 2015. – May., Vol. 25(3). – P.362–366. XXI. Redfern, D. Percutaneous Surgery of the Forefoot [Text] / D. Redfern, J. Vernois, B.P. Legré // Clin. Podiatr. Med. Surg. – 2015. – Jul., Vol. 32(3). – P. 291–332. XXII. Singh, D. Bullous pemphigoid after bilateral forefoot surgery [Text] / D. Singh, A. Swann // Foot Ankle Spec. – 2015. – Feb., Vol. 8(1). – P. 68–72. XXIII. Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy [Text] / J. Lucas y Hernandez, P. Golanó, S. Roshan-Zamir [et al.] // Bone Joint J. – 2016. – Mar., Vol. 98-B(3). – P. 365–373. XXIV. Weil, L.Jr. Scarf osteotomy for correction of hallux abducto valgus deformity [Text] / L.Jr. Weil, M. Bowen // Clin. Podiatr. Med. Surg. – 2014. – Apr., Vol.31(2). – P. 233–246. View | Download QUANTITATIVE ULTRASONOGRAPHY OF THE STOMACH AND SMALL INTESTINE IN HEALTHYDOGS Authors: Roman A. Tcygansky,Irina I. Nekrasova,Angelina N. Shulunova,Alexander I.Sidelnikov, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00045 Abstract: Purpose.To determine the quantitative echogenicity indicators (and their ratio) of the layers of stomach and small intestine wall in healthy dogs. Methods. A prospective 3-year study of 86 healthy dogs (aged 1-7 yrs) of different breeds and of both sexes. Echo homogeneity and echogenicity of the stomach and intestines wall were determined by the method of Silina, T.L., et al. (2010) in absolute values ​​of average brightness levels of ultrasound image pixels using the 8-bit scale with 256 shades of gray. Results. Quantitative echogenicity indicators of the stomach and the small intestine wall in dogs were determined. Based on the numerical values ​​characterizing echogenicity distribution in each layer of a separate structure of the digestive system, the coefficient of gastric echogenicity is determined as 1:2.4:1.1 (mucosa/submucosa/muscle layers, respectively), the coefficient of duodenum and jejunum echogenicity is determined as 1:3.5:2 and that of ileum is 1:1.8:1. Clinical significance. The echogenicity coefficient of the wall of the digestive system allows an objective assessment of the stomach and intestines wall and can serve as the basis for a quantitative assessment of echogenicity changes for various pathologies of the digestive system Keywords: Ultrasound (US),echogenicity,echogenicity coefficient,digestive system,dogs,stomach,intestines, Refference: I. Agut, A. Ultrasound examination of the small intestine in small animals // Veterinary focus. 2009.Vol. 19. No. 1. P. 20-29. II. Bull. 4.RF patent 2398513, IPC51A61B8 / 00 A61B8 / 14 (2006.01) A method for determining the homoechogeneity and the degree of echogenicity of an ultrasound image / T. Silina, S. S. Golubkov. – No. 2008149311/14; declared 12/16/2008; publ. 09/10/2010 III. Choi, M., Seo, M., Jung, J., Lee, K., Yoon, J., Chang, D., Park, RD. Evaluation of canine gastric motility with ultrasonography // J. of Veterinary Medical Science. – 2002. Vol. 64. – № 1. – P. 17-21. IV. Delaney, F., O’Brien, R.T., Waller, K.Ultrasound evaluation of small bowel thickness compared to weight in normal dogs // Veterinary Radiology and Ultrasound. 2003 Vol. 44, № 5. Р 577-580. V. Diana, A., Specchi, S., Toaldo, M.B., Chiocchetti, R., Laghi, A., Cipone, M. Contrast-enhanced ultrasonography of the small bowel in healthy cats // Veterinary Radiology and Ultrasound. – 2011. – Vol. 52, № 5. – Р. 555-559. VI. Garcia, D.A.A., Froes, T.R. Errors in abdominal ultrasonography in dogs and cats // J. of Small Animal Practice. – 2012. Vol. 53. – № 9. – P. 514-519. VII. Garcia, D.A.A., Froes, T.R. Importance of fasting in preparing dogs for abdominal ultrasound examination of specific organs // J. of Small Animal Practice. – 2014. Vol. 55. – № 12. – P. 630-634. VIII. Gaschen, L., Granger, L.A., Oubre, O., Shannon, D., Kearney, M., Gaschen, F. The effects of food intake and its fat composition on intestinal echogenicity in healthy dogs // Veterinary Radiology and Ultrasound. 2016. Vol. 57. № 5. P. 546-550 IX. Gaschen, L., Kircher, P., Stussi, A., Allenspach, K., Gaschen, F., Doherr, M., Grone, A. Comparison of ultrasonographic findings with clinical activity index (CIBDAI) and diagnosis in dogs with chronic enteropathies // Veterinary radiology and ultrasound. – 2008. – Vol. 49. – № 1. – Р. 56-64. X. Gil, E.M.U. Garcia, D.A.A. Froes, T.R. In utero development of the fetal intestine: Sonographic evaluation and correlation with gestational age and fetal maturity in dogs // Theriogenology. 2015. Vol. 84, №5. Р. 681-686. XI. Gladwin, N.E. Penninck, D.G., Webster, C.R.L. Ultrasonographic evaluation of the thickness of the wall layers in the intestinal tract of dogs // American Journal of Veterinary Research. 2014. Vol. 75, №4. Р. 349-353. XII. Gory, G., Rault, D.N., Gatel, L, Dally, C., Belli, P., Couturier, L., Cauvin, E. Ultrasonographic characteristics of the abdominal esophagus and cardia in dogs // Veterinary Radiology and Ultrasound. 2014. Vol. 55, № 5. P. 552-560. XIII. Günther, C.S. Lautenschläger, I.E., Scholz, V.B. Assessment of the inter- and intraobserver variability for sonographical measurement of intestinal wall thickness in dogs without gastrointestinal diseases | [Inter-und Intraobserver-Variabilitätbei der sonographischenBestimmung der Darmwanddicke von HundenohnegastrointestinaleErkrankungen] // Tierarztliche Praxis Ausgabe K: Kleintiere – Heimtiere. 2014. Vol. 42 №2. Р. 71-78. XIV. Hanazono, K., Fukumoto, S., Hirayama, K., Takashima, K., Yamane, Y., Natsuhori, M., Kadosawa, T., Uchide, T. Predicting Metastatic Potential of gastrointestinal stromal tumors in dog by ultrasonography // J. of Veterinary Medical Science. – 2012. Vol. 74. – № 11. – P. 1477-1482. XV. Heng, H.G., Lim, Ch.K., Miller, M.A., Broman, M.M.Prevalence and significance of an ultrasonographic colonic muscularishyperechoic band paralleling the serosal layer in dogs // Veterinary Radiology and Ultrasound. 2015. Vol. 56 № 6. P. 666-669. XVI. Ivančić, M., Mai, W. Qualitative and quantitative comparison of renal vs. hepatic ultrasonographic intensity in healthy dogs // Veterinary Radiology and Ultrasound. 2008. Vol. 49. № 4. Р. 368-373. XVII. Lamb, C.R., Mantis, P. Ultrasonographic features of intestinal intussusception in 10 dogs // J. of Small Animal Practice. – 2008. Vol. 39. – № 9. – P. 437-441. XVIII. Le Roux, A. B., Granger, L.A., Wakamatsu, N, Kearney, M.T., Gaschen, L.Ex vivo correlation of ultrasonographic small intestinal wall layering with histology in dogs // Veterinary Radiology and Ultrasound.2016. Vol. 57. № 5. P. 534-545. XIX. Nielsen, T. High-frequency ultrasound of Peyer’s patches in the small intestine of young cats / T. Nielsen [et al.] // Journal of Feline Medicine and Surgery. – 2015. – Vol. 18, № 4. – Р. 303-309. XX. PenninckD.G. Gastrointestinal tract. In Nyland T.G., Mattoon J.S. (eds): Small Animal Diagnostic Ultrasound. Philadelphia: WB Saunders. 2002, 2nd ed. Р. 207-230. XXI. PenninckD.G. Gastrointestinal tract. In: PenninckD.G.,d´Anjou M.A. Atlas of Small Animal Ultrasonography. Blackwell Publishing, Iowa. 2008. Р. 281-318. XXII. Penninck, D.G., Nyland, T.G., Kerr, L.Y., Fisher, P.E. Ultrasonographic evaluation of gastrointestinal diseases in small animals // Veterinary Radiology. 1990. Vol. 31. №3. P. 134-141. XXIII. Penninck, D.G.,Webster, C.R.L.,Keating, J.H. The sonographic appearance of intestinal mucosal fibrosis in cats // Veterinary Radiology and Ultrasound. – 2010. – Vol. 51, № 4. – Р. 458-461. XXIV. Pollard, R.E.,Johnson, E.G., Pesavento, P.A., Baker, T.W., Cannon, A.B., Kass, P.H., Marks, S.L. Effects of corn oil administered orally on conspicuity of ultrasonographic small intestinal lesions in dogs with lymphangiectasia // Veterinary Radiology and Ultrasound. 2013. Vol. 54. № 4. P. 390-397. XXV. Rault, D.N., Besso, J.G., Boulouha, L., Begon, D., Ruel, Y. Significance of a common extended mucosal interface observed in transverse small intestine sonograms // Veterinary Radiology and Ultrasound. 2004. Vol. 45. №2. Р. 177-179. XXVI. Sutherland-Smith, J., Penninck, D.G., Keating, J.H., Webster, C.R.L. Ultrasonographic intestinal hyperechoic mucosal striations in dogs are associated with lacteal dilation // Veterinary Radiology and Ultrasound. – 2007. Vol. 48. – № 1. – P. 51-57. View | Download EVALUATION OF ADAPTIVE POTENTIAL IN MEDICAL STUDENTS IN THE CONTEXT OF SEASONAL DYNAMICS Authors: Larisa A. Merdenova,Elena A. Takoeva,Marina I. Nartikoeva,Victoria A. Belyayeva,Fatima S. Datieva,Larisa R. Datieva, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00046 Abstract: The aim of this work was to assess the functional reserves of the body to quantify individual health; adaptation, psychophysiological characteristics of the health quality of medical students in different seasons of the year. When studying the temporal organization of physiological functions, the rhythm parameters of physiological functions were determined, followed by processing the results using the Cosinor Analysis program, which reveals rhythms with an unknown period for unequal observations, evaluates 5 parameters of sinusoidal rhythms (mesor, amplitude, acrophase, period, reliability). The essence of desynchronization is the mismatch of circadian rhythms among themselves or destruction of the rhythms architectonics (instability of acrophases or their disappearance). Desynchronization with respect to the rhythmic structure of the body is of a disregulatory nature, most pronounced in pathological desynchronization. High neurotism, increased anxiety reinforces the tendency to internal desynchronization, which increases with stress. During examination stress, students experience a decrease in the stability of the temporary organization of the biosystem and the tension of adaptive mechanisms develops, which affects attention, mental performance and the quality of adaptation to the educational process. Time is shortened and the amplitude of the “initial minute” decreases, personal and situational anxiety develops, and the level of psychophysiological adaptation decreases. The results of the work are priority because they can be used in assessing quality and level of health. Keywords: Desynchronosis,biorhythms,psycho-emotional stress,mesor,acrophase,amplitude,individual minute, Refference: I. Arendt, J., Middleton, B. Human seasonal and circadian studies in Antarctica (Halley, 75_S) – General and Comparative Endocrinology. 2017: 250-259. (http://dx.doi.org/10.1016/j.ygcen.2017.05.010). II. BalandinYu.P. A brief methodological guide on the use of the agro-industrial complex “Health Sources” / Yu.P. Balandin, V.S. Generalov, V.F. Shishlov. Ryazan, 2007. III. Buslovskaya L.K. Adaptation reactions in students at exam stress/ L.K. Buslovskaya, Yu.P. Ryzhkova. Scientific bulletin of Belgorod State University. Series: Natural Sciences. 2011;17(21):46-52. IV. Chutko L. S. Sindromjemocionalnogovygoranija – Klinicheskie I psihologicheskieaspekty./ L.S Chutko. Moscow: MEDpress-inform, 2013. V. Eroshina K., Paul Wilkinson, Martin Mackey. The role of environmental and social factors in the occurrence of diseases of the respiratory tract in children of primary school age in Moscow. Medicine. 2013:57-71. VI. Fagrell B. “Microcirculation of the Skin”. The physiology and pharmacology of the microcirculation. 2013:423. VII. Gurova O.A. Change in blood microcirculation in students throughout the day. New research. 2013; 2 (35):66-71. VIII. Khetagurova L.G. – Stress/Ed. L.G. Khetagurov. Vladikavkaz: Project-Press Publishing House, 2010. IX. Khetagurova L.G., Urumova L.T. et al. Stress (chronomedical aspects). International Journal of Experimental Education 2010; 12: 30-31. X. Khetagurova L.G., Salbiev K.D., Belyaev S.D., Datieva F.S., Kataeva M.R., Tagaeva I.R. Chronopathology (experimental and clinical aspects/ Ed. L.G. Khetagurov, K.D. Salbiev, S.D.Belyaev, F.S. Datiev, M.R. Kataev, I.R. Tagaev. Moscow: Science, 2004. XI. KlassinaS.Ya. Self-regulatory reactions in the microvasculature of the nail bed of fingers in person with psycho-emotional stress. Bulletin of new medical technologies, 2013; 2 (XX):408-412. XII. Kovtun O.P., Anufrieva E.V., Polushina L.G. Gender-age characteristics of the component composition of the body in overweight and obese schoolchildren. Medical Science and Education of the Urals. 2019; 3:139-145. XIII. Kuchieva M.B., Chaplygina E.V., Vartanova O.T., Aksenova O.A., Evtushenko A.V., Nor-Arevyan K.A., Elizarova E.S., Efremova E.N. A comparative analysis of the constitutional features of various generations of healthy young men and women in the Rostov Region. Modern problems of science and education. 2017; 5:50-59. XIV. Mathias Adamsson1, ThorbjörnLaike, Takeshi Morita – Annual variation in daily light expo-sure and circadian change of melatonin and cortisol consent rations at a northern latitude with large seasonal differences in photoperiod length – Journal of Physiological Anthropology. 2017; 36: 6 – 15. XV. Merdenova L.A., Tagaeva I.R., Takoeva E.A. Features of the study of biological rhythms in children. The results of fundamental and applied research in the field of natural and technical sciences. Materials of the International Scientific and Practical Conference. Belgorod, 2017, pp. 119-123. XVI. Ogarysheva N.V. The dynamics of mental performance as a criterion for adapting to the teaching load. Bulletin of the Samara Scientific Center of the Russian Academy of Sciences. 2014;16:5 (1): S.636-638. XVII. Pekmezovi T. Gene-environment interaction: A genetic-epidemiological approach. Journal of Medical Biochemistry. 2010;29:131-134. XVIII. Rapoport S.I., Chibisov S.M. Chronobiology and chronomedicine: history and prospects/Ed. S.M. Chibisov, S.I. Rapoport ,, M.L. Blagonravova. Chronobiology and Chronomedicine: Peoples’ Friendship University of Russia (RUDN) Press. Moscow, 2018. XIX. Roustit M., Cracowski J.L. “Non-invasive assessment of skin microvascular function in humans: an insight into methods” – Microcirculation 2012; 19 (1): 47-64. XX. Rud V.O., FisunYu.O. – References of the circadian desinchronosis in students. Ukrainian Bulletin of Psychoneurology. 2010; 18(2) (63): 74-77. XXI. Takoeva Z. A., Medoeva N. O., Berezova D. T., Merdenova L. A. et al. Long-term analysis of the results of chronomonitoring of the health of the population of North Ossetia; Vladikavkaz Medical and Biological Bulletin. 2011; 12(12,19): 32-38. XXII. Urumova L.T., Tagaeva I.R., Takoeva E.A., Datieva L.R. – The study of some health indicators of medical students in different periods of the year. Health and education in the XXI century. 2016; 18(4): 94-97. XXIII. Westman J. – Complex diseases. In: Medical genetics for the modern clinician. USA: Lippincott Williams & Wilkins, 2006. XXIV. Yadrischenskaya T.V. Circadian biorhythms of students and their importance in educational activities. Problems of higher education. Pacific State University Press. 2016; 2:176-178. View | Download TRIADIC COMPARATIVE ANALYSIS Authors: Stanislav A.Kudzh,Victor Ya. Tsvetkov, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00047 Abstract: The present study of comparison methods based on the triadic model introduces the following concepts: the relation of comparability and the relation of comparison, and object comparison and attributive comparison. The difference between active and passive qualitative comparison is shown, two triadic models of passive and active comparison and models for comparing two and three objects are described. Triadic comparison models are proposed as an alternative to dyadic comparison models. Comparison allows finding the common and the different; this approach is proposed for the analysis of the nomothetic and ideographic method of obtaining knowledge. The nomothetic method identifies and evaluates the general, while the ideographic method searches for unique in parameters and in combinations of parameters. Triadic comparison is used in systems and methods of argumentation, as well as in the analysis of consistency/inconsistency. Keywords: Comparative analysis,dyad,triad,triadic model,comparability relation,object comparison,attributive comparison,nomothetic method,ideographic method, Refference: I. AltafS., Aslam.M.Paired comparison analysis of the van Baarenmodel using Bayesian approach with noninformativeprior.Pakistan Journal of Statistics and Operation Research 8(2) (2012) 259{270. II. AmooreJ. 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PührerJ.Realizability of three-valued semantics for abstract dialectical frameworks.Artificial Intelligence 278 (2020) 103{198. XVII. SwansonG.Frameworks for comparative research: structural anthropology and the theory of action. In: Vallier, Ivan (Ed.). Comparative methods in sociology: essays on trends and applications.Berkeley: University of California Press, 1971 141{202. XVIII. TsvetkovV.Ya.Worldview model as the result of education.World Applied Sciences Journal 31(2) (2014) 211{215. XIX. TsvetkovV. Ya. Logical analysis and variable scales. Slavic Forum 4(22) (2018) 103{109. XX. Wang S. et al. Transit traffic analysis zone delineating method based on Thiessen polygon. Sustainability 6(4) (2014) 1821{1832. View | Download DEVELOPING TECHNOLOGY OF CREATING WEAR-RESISTANT CERAMIC COATING FOR ICE CYLINDER." JOURNAL OF MECHANICS OF CONTINUA AND MATHEMATICAL SCIENCES spl10, no. 1 (June 28, 2020). http://dx.doi.org/10.26782/jmcms.spl.10/2020.06.00048.

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