Wednesday, September 28, 2011

Two More Interesting Articles

1. Janamian T, Myers SP, O’Rourke P, Eastwood H. Responding to GPs' information resource needs: implementation and evaluation of a complementary medicines information resource in Queensland general practice. BMC Compl Alternative Med 2011;11:77 doi:10.1186/1472-6882-11-77

Background: Australian General Practitioners (GPs) are in the forefront of primary health care and in an excellent position to communicate with their patients and educate them about Complementary Medicines (CMs) use. However previous studies have demonstrated that GPs lack the knowledge required about CMs to effectively communicate with patients about their CMs use and they perceive a need for information resources on CMs to use in their clinical practice. This study aimed to develop, implement, and evaluate a CMs information resource in Queensland (Qld) general practice.
Methods: The results of the needs assessment survey of Qld general practitioners (GPs) informed the development of a CMs information resource which was then put through an implementation and evaluation cycle in Qld general practice. The CMs information resource was a set of evidence-based herbal medicine fact sheets. This resource was utilised by 100 Qld GPs in their clinical practice for four weeks and was then evaluated. The evaluation assessed GPs' (1) utilisation of the resource (2) perceived quality, usefulness and satisfaction with the resource and (3) perceived impact of the resource on their knowledge, attitudes, and practice of CMs.
Results: Ninety two out of the 100 GPs completed the four week evaluation of the fact sheets and returned the post-intervention survey. The herbal medicine fact sheets produced by this study were well accepted and utilised by Qld GPs. The majority of GPs perceived that the fact sheets were a useful resource for their clinical practice. The fact sheets improved GPs' attitudes towards CMs, increased their knowledge of those herbal medicines and improved their communication with their patients about those specific herbs. Eighty-six percent of GPs agreed that if they had adequate resources on CMs, like the herbal medicine fact sheets, then they would communicate more to their patients about their use of CMs.
Conclusion: Further educational interventions on CMs need to be provided to GPs to increase their knowledge of CMs and to improve their communication with patients about their CMs use.

2. Kitzman R. How local IRBs view central IRBs in the US. BMC Med Ethics 2011; 12:13doi:10.1186/1472-6939-12-13

Background: Centralization of IRB reviews have been increasing in the US and elsewhere, but many questions about it remain. In the US, a few centralized IRBs (CIRBs) have been established, but how they do and could operate remain unclear.
Methods: I contacted 60 IRBs (every fourth one in the list of the top 240 institutions by NIH funding), and interviewed leaders from 34 (response rate = 55%) and an additional 12 members and administrators.
Results: These interviewees had often interacted with CIRBs, but supported local reviews, and offered advantages and disadvantages of each. Interviewees argued that local IRBs can provide "local knowledge" of subjects and PIs, and "curbside consults" with PIs, facilitating mutual trust. PIs may interact more fully and informally, and hence effectively with local IRBs. IRBs also felt additional responsibility to protect "their own" subjects. Respondents mentioned a few advantages of CIRBs (e.g., CIRBs may streamline reviews), though far more rarely and cursorily. Overall, interviewees were wary of CIRBs, which they saw as varying widely in quality, depending on who happened to be members. Both local and centralized IRBs appear to have unintended consequences. For instance, discrepancies arose between IRBs that appeared to reflect differences in institutional culture and history, and personalities of chairs and/or vocal members, more than in local community values per se, and thus do not seem to be the intent of the regulations. While some critics see CIRBs as solutions to many IRB problems, critical tradeoffs and uncertainties emerge.
Conclusions: These data have critical implications for future policy and research. Debates need to evolve beyond simply a binary discussion of whether CIRBs should replace local IRBs, to examine how and to what degree different models might operate, and what the relative advantages and disadvantages of each are. While some critics see CIRBs as panaceas, certain problems appear likely to continue. Careful consideration needs to be given to whether the advantages of local IRBs outweigh the problems that result, and whether a system can be developed that provides these benefits, while avoiding the disadvantages of local IRBs.

Monday, September 19, 2011

Themes for PowerPoint

In an excellent article entitled “12 tips for creating better PowerPoint presentations,” Stephanie Krieger offers these thoughts on making your slide presentation work better (1). She focuses here on the idea that your slides should grab viewers' attention. Her thought is that to create slides that grab attention you should learn how to use slides effectively and try not to pack your slides with dense text-based information. You should get in the habit of including only elements that contribute to the point you are trying to make. Consider the difference between a text-based slide presenting, say, information documenting the growth of an investment, compared to a slide demonstrating the same information in graphic format. The graphic format makes a much stronger point. This information is from Krieger's post on the MicroSoft website.
One way to help grab and keep your students’ attention is to select or create your own theme. Quoting directly from Krieger’s article on the MicroSoft website: “Themes are the evolution of design templates in PowerPoint, but they're also much more than that. Themes were introduced in Microsoft Office 2007 to help you easily create the right look for your presentations and to coordinate all of your Microsoft Office documents almost instantly.

A theme is a coordinated set of fonts, colors, and graphic effects that you can apply to your entire document with just a click. The same themes are available for your Microsoft PowerPoint presentations, Microsoft Word documents, Microsoft Excel workbooks, and even your Microsoft Outlook email messages (and, in Office 2010, your Microsoft Access database forms and reports), so it's easy to create your own personal or business branding throughout all of your documents.

In PowerPoint, the theme also includes the slide master, slide layouts (and slide background options). When you apply a theme in your presentation, you automatically get slide layouts, colors, fonts, and graphic effects that go together, and you can format content with just a few clicks. In the PowerPoint Ribbon (at the top of your screen), find many built-in themes on the Design tab. To preview a theme, in the Themes gallery, simply hover your pointer over it. In Office 2010, you also see a selection of themes in this gallery that are automatically updated periodically from

Using the galleries on the Design tab, you can also mix and match a slide design with different theme colors, fonts, and effects to quickly create your own look. You can even easily create a completely custom theme. Note: If you change the theme in your presentation but the formatting doesn't change, you may not have used theme-ready formatting when you created your presentation. When you start with a new PowerPoint 2010 or PowerPoint 2007 presentation, theme-ready formatting is automatic for fonts and colors on slide layouts and for Microsoft Office graphics, such as SmartArt graphics, charts, and shapes.”

1. Krieger S. 12 tips for creating better PowerPoint presentations., accessed September 12, 2011

Monday, September 12, 2011

Three New Article of Interest

1. Tiffin PA, Finn GM, Mclachlan JC. Evaluating professionalism in medical undergraduates using selected response questions: findings from an item response modelling study. BMC Medical Education 2011, 11:43doi:10.1186/1472-6920-11-43

Background: Professionalism is a difficult construct to define in medical students but aspects of this concept may be important in predicting the risk of postgraduate misconduct. For this reason attempts are being made to evaluate medical students' professionalism. This study investigated the psychometric properties of Selected Response Questions (SRQs) relating to the theme of professional conduct and ethics comparing them with two sets of control items: those testing pure knowledge of anatomy, and; items evaluating the ability to integrate and apply knowledge ("skills"). The performance of students on the SRQs was also compared with two external measures estimating aspects of professionalism in students; peer ratings of professionalism and their Conscientiousness Index, an objective measure of behaviours at medical school.
Methods: Item Response Theory (IRT) was used to analyse both question and student performance for SRQs relating to knowledge of professionalism, pure anatomy and skills. The relative difficulties, discrimination and 'guessabilities' of each theme of question were compared with each other using Analysis of Variance (ANOVA). Student performance on each topic was compared with the measures of conscientiousness and professionalism using parametric and non-parametric tests as appropriate. A post-hoc analysis of power for the IRT modelling was conducted using a Monte Carlo simulation.
Results: Professionalism items were less difficult compared to the anatomy and skills SRQs, poorer at discriminating between candidates and more erratically answered when compared to anatomy questions. Moreover professionalism item performance was uncorrelated with the standardised Conscientiousness Index scores (rho = 0.009, p = 0.90). In contrast there were modest but significant correlations between standardised Conscientiousness Index scores and performance at anatomy items (rho = 0.20, p = 0.006) though not skills (rho = .11, p = .1). Likewise, students with high peer ratings for professionalism had superior performance on anatomy SRQs but not professionalism themed questions. A trend of borderline significance (p = .07) was observed for performance on skills SRQs and professionalism nomination status.
Conclusions: SRQs related to professionalism are likely to have relatively poor psychometric properties and lack associations with other constructs associated with undergraduate professional behaviour. The findings suggest that such questions should not be included in undergraduate examinations and may raise issues with the introduction of Situational Judgement Tests into Foundation Years selection.

2. Klemenc-Ketis Z, Kersnick J. Using movies to teach professionalism to medical students. BMC Medical Education 2011, 11:60doi:10.1186/1472-6920-11-60

ABSTRACT (provisional)
Background: Professionalism topics are usually not covered as a separate lesson within formal curriculum, but in subtler and less officially recognized educational activities, which makes them difficult to teach and assess. Interactive methods (e.g. movies) could be efficient teaching methods but are rarely studied. The aims of this study were: 1) to test the relevance and usefulness of movies in teaching professionalism to fourth year medical students and, 2) to assess the impact of this teaching method on students' attitudes towards some professionalism topics.
Method: This was an education study with qualitative data analysis in a group of eleven fourth year medical students from the Medical School of University Maribor who attended an elective four month course on professionalism. There were 8 (66.7%) female students in the group. The mean age of the students was 21.9 +/- 0.9 years. The authors used students' written reports and oral presentations as the basis for qualitative analysis using thematic codes.
Results: Students recognised the following dimensions in the movie: communication, empathy, doctors' personal interests and palliative care. It also made them think about their attitudes towards their own life, death and dying.
Conclusions: The controlled environment of movies successfully enables students to explore their values, beliefs, and attitudes towards features of professionalism without feeling that their personal integrity had been threatened. Interactive teaching methods could become an indispensible aid in teaching professionalism to new generations.

3. White MR, Jacobson IG, Smith B, Wells TS, Gackstetter GD, Boyko EJ, Smith TC for the Millenium Cohort Study Team. Health care utilization among complementary and alternative medicine users in a large military cohort. BMC Complementary and Alternative Medicine 2011, 11:27doi:10.1186/1472-6882-11-27

Background: Complementary and Alternative Medicine use and how it impacts health care utilization in the United States Military is not well documented. Using data from the Millennium Cohort Study we describe the characteristics of CAM users in a large military population and document their health care needs over a 12-month period. The aim of this study was to determine if CAM users are requiring more physician-based medical services than users of conventional medicine.
Methods: Inpatient and outpatient medical services were documented over a 12-month period for 44,287 participants from the Millennium Cohort Study. Equal access to medical services was available to anyone needing medical care during this study period. The number and types of medical visits were compared between CAM and non-CAM users. Chi square test and multivariable logistic regression was applied for the analysis.
Results: Of the 44,287 participants, 39% reported using at least one CAM therapy, and 61% reported not using any CAM therapies. Those individuals reporting CAM use accounted for 45.1% of outpatient care and 44.8% of inpatient care. Individuals reporting one or more health conditions were 15% more likely to report CAM use than non-CAM users and 19% more likely to report CAM use if reporting one or more health symptoms compared to non-CAM users. The unadjusted odds ratio for hospitalizations in CAM users compared to non-CAM users was 1.29 (95% CI: 1.16-1.43). The mean number of days receiving outpatient care for CAM users was 7.0 days and 5.9 days for non-CAM users (p < 0.001).
Conclusions: Our study found those who report CAM use were requiring more physician-based medical services than users of conventional medicine. This appears to be primarily the result of an increase in the number of health conditions and symptoms reported by CAM users.

Tuesday, September 6, 2011

Starting Prezi

In order to use Prezi, you must first sign up and select a plan. Do not worry; one of the plans is completely free and will be more than sufficient for you to begin working in this platform. From the prezi welcome screen (, simply click on “Sign up” and provide the necessary information to the system. You will be urged to select a screen name and a password when you do so. You have options regarding pricing, so simply check the one that is free; this will allow you to store your work on the Prezi server but not work offline.

Once you begin working in Prezi, you will see what is known as the “Prezi Bubble Menu.” This does not look like your typical Windows menu system, because each menu choice appears as a circle, or, like a bubble, if you will. There is one main center bubble and 5 smaller bubbles around it. This is where all the action takes place. You will have these bubbles to choose from:

Write Bubble: this is how you can add text to the presentation and then format the text.

Transformation Bubble: This bubble is actually located inside the Write Bubble, and it allows you to move, resize or rotate any object you upload into the canvas (the canvas being the “whiteboard “ space you place all items into).

Insert Bubble: This is a submenu that includes commands Load Files as well as the command Shapes.

Frame Bubble: this has submenus offering you Bracket, Circle, Rectangle, and Hidden Frame bubbles.

Path Bubble: here you find 1-2-3 ADD, Capture View and Delete All bubbles.

Colors and Fonts Bubble: here you get to select the style for your presentation.

There is also the Show Bubble, which is the one from which you will present. In Show mode, the Bubble menu disappears and planning lines on screen are removed. You can set Autoplay options here and set timing if you wish, and you can also manually zoom in and out.

To use Prezi, you need to have Adobe Flash 9.0 or higher, 1gb memory, and a mouse, with an operating system of Windows XP, Vista or 7 and Mac OS X. When you log onto Prezi, there are 3 tabs on the screen. One is “Your Prezis.” This is where you can access all the Prezis you create, and as you create a number fo these, you can also organize them so that you an easily locate the one you need. There is the “Learn” tab. Clicking on this will allow you locate training sessions in Prezi, at the beginner, intermediate and expert level- there are text documents as well as video clips. There are links to tips and ideas from other creators, and there is also a link to the Prezi manual. Finally, the last tab is “Explore.” This is a page that can link you to other people’s Prezis as well as to message board and community resources.

Please note that one of the links- at least as I write- is to a Prezi presentation about how to convert your PowerPoint presentations into a Prezi. I recommend looking at this and playing around with the system.

To see a Prezi in action, click on, and use the arrow button at the bottom of the screen to take you through a Prezi about creating great Prezis. Enjoy and play around with this.