No abstract

This study contributes to the current body of research in this area by examining the most current data, a more robust sample, and a methodology that allows analysis of actual rather than extrapolated last-year-of-life expenses. The analysis has shown current trends in decedent/survivor costs, their relationship to each other, and the changes in this relationship over time. In addition, the finding that the relationship has changed to varying degrees by age groups provides the impetus for including age, gender, and decedent/survivor refinements into the current Medicare projection methodology.

Objective: We built 2 versions of an asynchronous pediatric orthopedic educational intervention for emergency medicine residents and sought to compare the two. We hypothesized that the version incorporating more instructional scaffolding in the form of a cognitive aid (CA) would optimize germane cognitive load for our target novice learners and result in higher test scores.Methods: Learners were block randomized to either a "CA" or "non-CA" arm, each containing a random set of 18 modules. The CA arm incorporated an orthopedic fracture classification chart embedded within the diagnostic questions to guide the learner in forming a diagnosis. The non-CA arm was designed with more active learning as the classification chart was provided only after each diagnostic answer submission. For both arms, the final 6 modules completed per learner were scored. Learners also completed a perceived cognitive load assessment tool measured on a 10-point Likert scale.Results: Learners in the non-CA arm had a mean total score on the testing modules of 33% correct compared with a mean total score of 44% correct for learners in the CA arm (mean difference, 11; 95% confidence interval, 4%-19%, P = 0.005). There was a trend for the CA arm to have lower perceived overall cognitive load scores; however, this did not reach statistical significance.Conclusions: Emergency medicine residents performed better after completing the CA version of our educational intervention. Applying cognitive load theory to an educational intervention may increase its success among target learners.

statistics were conducted using STATA 13. Performance standards were set for beginning and mastery levels by summing the critical items that a trainee at each level must perform to pass.Results: Experts were recruited and brought together for the standard setting meeting on November 8, 2016. Experts indicated that for a well-prepared beginning resident, 25/51 items (49%) were considered critical for patient safety. Experts focused on the need for beginning residents to be skilled enough to assure safe task performance. Concerning mastery learners, experts noted that 49/51 (96%) of the items identified in the scenario were critical for mastery level comprehensive airway management.Conclusions: The modified Angoff standard setting procedure developed proficiency standards for comprehensive airway management for beginning and mastery level trainees. Future work will focus on evaluation of resident performance using these procedural proficiency standards to predict patient outcomes.