clinicaltrials.gov Identifier: NCT02075450.

SUMMARY It has been assumed that force enhancement in single fibres of skeletal muscles only occurs on the descending, and not the ascending or plateau region, of the force–length relationship. This assumption has been based, however, on theoretical considerations or isolated experiments, in which neither stretch conditions nor fibre lengths were optimized for force enhancement. Therefore, the purpose of this study was to investigate the residual, steady-state force enhancement following active stretch in single muscle fibres of frog on the ascending limb of the force–length relationship. Twenty-nine stretch experiments on ten single fibres from the lumbrical muscle of the frog Rana pipiens were carried out on the ascending limb of the force–length relationship. Force enhancement was observed in 28 out of the 29 tests. Moreover, the force produced for stretch experiments finishing at optimal fibre length always exceeded the force obtained for an isometric contraction at optimal length. We conclude from these results that steady-state force enhancement occurs systematically on the ascending limb of the force–length relationship, and that the steady-state force in the enhanced state can easily exceed the maximal isometric force of the fibre.

Simulation faculty development has become a high priority for the past couple of years because simulation programs have rapidly expanded in health systems and universities worldwide. A formalized, structured model for developing quality facilitators of simulation is helpful to support and sustain this continued growth in the field of simulation. In this article, we present a tiered faculty development plan that has been implemented at a university in the United States and includes the essentials of faculty development. We discuss the rationale and benefits of a tiered faculty development program as well as describe our certification plan. The article concludes with lessons learned throughout the process of implementation.

Simulation is effective at improving healthcare students' knowledge and communication. Despite increasingly interprofessional approaches to medicine, most studies demonstrate these effects in isolation. We enhanced an existing internal medicine curriculum with immersive interprofessional simulations. For ten months, third‐year medical students and senior nursing students were recruited for four, 1‐hour simulations. Scenarios included myocardial infarction, pancreatitis/hyperkalemia, upper gastrointestinal bleed, and chronic obstructive pulmonary disease exacerbation. After each scenario, experts in medicine, nursing, simulation, and adult learning facilitated a debriefing. Study measures included pre‐ and post‐tests assessing self‐efficacy, communication skills, and understanding of each profession's role. Seventy‐two medical students and 30 nursing students participated. Self‐efficacy communication scores improved for both (medicine, 18.9 ± 3.3 pretest vs 23.7 ± 3.7 post‐test; nursing, 19.6 ± 2.7 pretest vs 24.5 ± 2.5 post‐test). Both groups showed improvement in “confidence to correct another healthcare provider in a collaborative manner” (Δ = .97 medicine, Δ = 1.2 nursing). Medical students showed the most improvement in “confidence to close the loop in patient care” (Δ = .93). Nursing students showed the most improvement in “confidence to figure out roles” (Δ = 1.1). This study supports the hypothesis that interdisciplinary simulation improves each discipline's self‐efficacy communication skills and understanding of each profession's role. Despite many barriers to interprofessional simulation, this model is being sustained. Journal of Hospital Medicine 2014;9:189–192. © 2014 Society of Hospital Medicine