Introduction: We conducted a national survey to characterize current Canadian procedural skills training in Undergraduate Medical Education (UGME). The goals were to identify the most important procedures students should know upon graduation and assess clinician-educator perceptions regarding implementation of a pre-clerkship procedural program. Methods: We distributed the survey to physician-educators across Canada’s 17 medical schools. Respondents were directed to an individualized survey that collected demographic data, physician-educator responses on essential procedural skills, as well as physician-educator opinions on the value of a pre-clerkship procedural training program. Results: The response rate for this survey was 21% (42 out of 201 distributed surveys were completed). The top 10 most important procedures identified by physician-educators included IV Access, Airway Management, Local anesthesia/field block, Casting, Spontaneous Vaginal Delivery, Testing for STIs, Phlebotomy, Suturing of Lacerations, Nasogastric Tube Insertion, and Venipuncture. Physician-educators supported a pre-clerkship procedural program. Conclusions: Identifying the most crucial procedural skills is the first step in implementing a competency-based procedural skills training program for Canadian medical students. With the list of essential skills, and the support for physician-educators in developing a pre-clerkship procedural skills curriculum, hopefully there can be future development of formalized curricula.

Introduction: Pre-clerkship procedural skills training is not yet a standard across Canadian medical school curricula, resulting in limited exposure to procedures upon entering clerkship. While simulated skills training has been documented in the literature to improve performance in technical ability, anxiety and confidence have yet to be investigated despite their documented impact on performance and learning. This study therefore aims to evaluate the effect of pre-clerkship procedural skills training on medical student anxiety and confidence. Methods: A procedural skills training program was designed based on an evidence-based near-peer, flipped classroom model of education. Ninety-two second-year medical students volunteered for the study. Fifty-six were randomized to the training group, and 36 were randomized to the control group. Students in the training group attended seven procedural skills tutorials over seven months. The control group represented the average medical school student without standardized procedural training. Student anxiety and confidence were assessed at the beginning and end of the program using the State Trait Anxiety Inventory and Confidence Questionnaires. Results: Students who participated in the procedural skills program demonstrated greater reductions in their state anxiety and greater improvements in confidence compared to the control group. Conclusion: Longitudinal procedural skills training in the simulation setting has demonstrated improvements in anxiety and confidence among pre-clerkship medical students. These added benefits to training have the potential to ease medical students’ transition into clerkship, while also contributing to a safer and more effective clinical experience. Therefore, future integration of standardized pre-clerkship procedural skills training within medical school curricula should be considered.

Box spread is a trading strategy in which one simultaneously buys and sells options having the same underlying asset and time to expiration, but different exercise prices. This study examined the efficiency of European style S&P CNX Nifty Index options of National Stock Exchange, (NSE) India by making use of high-frequency data on put and call options written on Nifty (Time-stamped transactions data) for the time period between 1 st January 2002 and 31 st December 2005 using box-spread arbitrage strategy. The advantages of box-spreads include reduced joint hypothesis problem since there is no consideration of pricing model or market equilibrium, no consideration of inter-market non-synchronicity since trading box spreads involve only one market, computational simplicity with less chances of misspecification error, estimation error and the fact that buying and selling box spreads more or less replicates risk-free lending and borrowing. One thousand three hundreds and fifty eight exercisable boxspreads were found for the time period considered of which 78 Box spreads were found to be profitable after incorporating transaction costs (32 profitable box spreads were identified for the year 2002, 19 in 2003, 14 in 2004 and 13 in 2005) The results of our study suggest that internal option market efficiency has improved over the years for S&P CNX Nifty Index options of NSE India. Abstrak:Box spread adalah strategi trading dimana seseorang dapat secara simultan membeli dan menjual option yang memiliki dasar aset dan waktu berakhir yang sama, namun dengan harga latihan yang berbeda. Penelitian ini menguji efisiensi gaya Eropa S&P CNX Nifty Index Option pada Bursa Efek Nasional di India dengan memanfaatkan data frekuensi tinggi pada put dan call option yang tertulis di Nifty (data transaksi cap waktu) untuk periode antara 1 Januari sampai 1 Desember 2005 dengan menggunakan strategi arbritase box spread. Keuntungan dari box spread adalah berkurangnya masalah hipotesis gabungan karena tidak ada pertimbangan atas model harga atau ekuilibrium pasar modal, tidak ada pertimbangan atas non-sinkronitas antarpasar modal karena box spread perdagangan hanya meliputi satu pasar modal, kemudahan komputasional dengan berkurangnya kesalahan spesifikasi, kesalahan estimasi, dan fakta bahwa pembelian dan penjualan box spread kurang lebih menggandakan pinjam-meminjam yang bebas resiko. Sebanyak 1358 box spread ditemukan dan sebanyak 78 box spread dianggap menguntungkan setelah Acknowledgement

Purpose -The purpose of this paper is to study the empirical relationship between order imbalance and returns in the backdrop of structural changes in the Indian market. Design/methodology/approach -The study makes use of hypothesis testing and dummy variable regression to investigate the relationship between order imbalance and returns during the period 1999-2005, which saw definitive change in the structure of the Indian markets. Findings -Order imbalance (buying or selling pressure) has significantly reduced post the structural reforms at the daily as well as intra-day intervals across trade, as well as value measures of order imbalance. After controlling for the number of transactions, order imbalance and return correlations have fallen in the post-2002 period as compared to the pre-2002 period, at daily as well as intra-day intervals. Further, after controlling for past high and low returns, order imbalance exhibits day of the week effect in the pre-2002 period while no such effect is seen in the post-2002 period. Originality/value -The work brings out order imbalance and returns relationship for the Indian market, which has different structure from that of many developed, as well as developing, markets in the backdrop of changes in its own structure. This would provide a richer literature in the area of market structure and design.

Introduction: Procedural skills training varies significantly across Canadian medical schools, and there is currently no standardized assessment tool to evaluate its benefits. This project aims to develop a curriculum that teaches 2nd-year medical students to perform and evaluate procedural skills. The goals of this program include decreasing anxiety, increasing confidence, and achieving competence for students and also allowing staff to judge the appropriate level of supervision when delegating learners to perform basic procedures in the team setting. Our curriculum incorporates, near-peer teaching as well as near peer formative assessment. Methods: Each of the twelve 2nd year participants completed a State Trait Anxiety Inventory and self-reported confidence questionnaire related to procedural skills. Students participated in four sessions taught by expert physicians over a five month period. A new skill was taught at each monthly workshop and an opportunity to practice previously taught skills was provided. Skills were assessed in a skills integration simulation OSCE, and the anxiety and confidence questionnaire was repeated. Results: Students who completed this pilot program showed a significant decrease in mean anxiety state (2.48 vs 1.74, p-value <0.001), while the control group did not (p-value = 0.408). When assessing confidence, students who completed this program showed increased self-assessed knowledge and confidence in each of the program's assessed skills. An increased level of competency was achieved in each skill by each student as assessed by the expert physicians. Conclusion: There is evidence to suggest that implementation of this procedural skills training model within the Canadian medical school curriculum may improve student anxiety, confidence, and competency for success in clerkship and could be the foundation for developing milestones for EPAs.