Citations

Objective Measurement of motivation and cognitive load has potential value in health professions education. Our objective was to evaluate the validity of scores from Dweck's Implicit Theories of Intelligence Scale ( ITIS ), Elliot's Achievement Goal Questionnaire‐Revised ( AGQ ‐R) and Leppink's cognitive load index ( CLI ). Methods This was a validity study evaluating internal structure using reliability and factor analysis, and relationships with other variables using the multitrait‐multimethod matrix. Two hundred and thirty‐two secondary school students participated in a medical simulation‐based training activity at an academic medical center. Pre‐activity ITIS (implicit theory [mindset] domains: incremental, entity) and AGQ ‐R (achievement goal domains: mastery‐approach, mastery‐avoidance, performance‐approach, performance‐avoidance), post‐activity CLI (cognitive load domains: intrinsic, extrinsic, germane) and task persistence (self‐directed repetitions on a laparoscopic surgery task) were measured. Results Internal consistency reliability (Cronbach's alpha) was > 0.70 for all domain scores except AGQ ‐R performance‐avoidance (alpha 0.68) and CLI extrinsic load (alpha 0.64). Confirmatory factor analysis of ITIS and CLI scores demonstrated acceptable model fit. Confirmatory factor analysis of AGQ ‐R scores demonstrated borderline fit, and exploratory factor analysis suggested a three‐domain model for achievement goals (mastery‐approach, performance and avoidance). Correlations among scores from conceptually‐related domains generally aligned with expectations, as follows: ITIS incremental and entity, r = −0.52; AGQ ‐R mastery‐avoidance and performance‐avoidance, r = 0.71; mastery‐approach and performance‐approach, r = 0.55; performance‐approach and performance‐avoidance, r = 0.43; mastery‐approach and mastery‐avoidance, r = 0.36; CLI germane and extrinsic, r = −0.35; ITIS incremental and AGQ ‐R mastery‐approach, r = 0.34; ITIS incremental and CLI germane, r = 0.44; AGQ ‐R mastery‐approach and CLI germane, r = 0.48 (all p < 0.001). We found no correlation between the number of task repetitions (i.e. persistence) and mastery‐approach scores, r = −0.01. Conclusions ITIS and CLI scores had appropriate internal structures and relationships with other variables. AGQ ‐R scores fit a three‐factor (not four‐factor) model that collapsed avoidance into one domain, although relationships of other variables with the original four domain scores generally aligned with expectations. Mastery goals are positively correlated with germane cognitive load.

Objective: The goal of the present study was to assess the sound quality of a cochlear implant for single-sided deaf (SSD) patients fit with a cochlear implant (CI). Background: One of the fundamental, unanswered questions in CI research is “what does an implant sound like?” Conventional CI patients must use the memory of a clean signal, often decades old, to judge the sound quality of their CIs. In contrast, SSD-CI patients can rate the similarity of a clean signal presented to the CI ear and candidate, CI-like signals presented to the ear with normal hearing. Methods: For Experiment 1 four types of stimuli were created for presentation to the normal hearing ear: noise vocoded signals, sine vocoded signals, frequency shifted, sine vocoded signals and band-pass filtered, natural speech signals. Listeners rated the similarity of these signals to unmodified signals sent to the CI on a scale of 0 to 10 with 10 being a complete match to the CI signal. For Experiment 2 multitrack signal mixing was used to create natural speech signals that varied along multiple dimensions. Results: In Experiment 1 for eight adult SSD-CI listeners, the best median similarity rating to the sound of the CI for noise vocoded signals was 1.9; for sine vocoded signals 2.9; for frequency upshifted signals, 1.9; and for band pass filtered signals, 5.5. In Experiment 2 for three young listeners, combinations of band pass filtering and spectral smearing lead to ratings of 10. Conclusion: The sound quality of noise and sine vocoders does not generally correspond to the sound quality of cochlear implants fit to SSD patients. Our preliminary conclusion is that natural speech signals that have been muffled to one degree or another by band pass filtering and/or spectral smearing provide a close, but incomplete, match to CI sound quality for some patients.

Objective Microlobectomy is a novel form of videoscopic-assisted thoracic surgery lobectomy. Strict inclusion criteria consist of the following: no intercostal incisions greater than 5 mm, 12 mm subxiphoid port, subxiphoid removal of the specimen, total endoscopic technique with CO 2 insufflation, vision through a 5-mm camera, stapling via the subxiphoid port, or with 5-mm stapling devices. Methods The combined early experiences of six hospitals from three countries were combined from September 2014 to May 2016. During that time, the study represents a consecutive cohort study of this technique. Results Seventy-two patients underwent microlobectomy. The median (range) age was 66 (27–82). Half of the patients were female. There were 48 right-sided resections and 24 on the left. There were four segmental resections and there was one right pneumonectomy. Four operations were performed robotically (with 8-mm intercostal incisions). The median (range) operative time was 180 (94–285) minutes and the blood loss was 118 (5–800) mL. There were three conversions to thoracotomy and two conversions to videoscopic-assisted thoracic surgery by means of an intercostal utility incision to complete the operation. The median (range)length of stay was 3(1–44) days and 30 patients (42%) when home by day 2 and 16 patients (22%) were discharged on day 1. There were no deaths. Five patients (7%) had a prolonged airleak. There were no wound infections and there was one incisional hernia. Conclusions We believe that microlobectomy is an interesting novel form of videoscopic-assisted thoracic surgery lobectomy and has several theoretical advantages. We have presented our early results and hope that this will stimulate others to investigate this type of videoscopic-assisted thoracic surgery lobectomy further.

Studies have found variability in self-care behaviors in patients with type 1 diabetes, particularly when incorporating exercise and alcohol consumption. The objective of this study was to provide results from a survey to understand (1) insulin pump behaviors, (2) reported self-management behaviors for exercise and alcohol, and (3) perceptions of the effects of exercise and alcohol on blood glucose (BG) control. Fourteen participants from an outpatient endocrinology practice were recruited and administered an electronic survey. Compensation techniques for exercise and alcohol, along with reasons for employing the techniques were identified. Also identified were factors that participants said affected BG control with regard to exercise and alcohol. These results confirm the considerable inconsistency patients have about incorporating exercise and alcohol into decisions about self-management behaviors.