The Quality of Operative Performance Narrative Feedback: A Retrospective Data Comparison Between End of Rotation Evaluations and Workplace-based Assessments.

OBJECTIVE: To describe the quality of operative performance feedback using evaluation tools commonly used by general surgery residency training programs. SUMMARY OF BACKGROUND DATA: The majority of surgical training programs administer an evaluation through which faculty members may rate and comment on trainee operative performance at the end of the rotation (EOR). Many programs have also implemented the system for improving and measuring procedural learning (SIMPL), a workplace-based assessment tool with which faculty can rate and comment on a trainee's operative performance immediately after a case. It is unknown how the quality of narrative operative performance feedback delivered with these tools compares. METHODS: The authors collected EOR evaluations and SIMPL narrative comments on trainees' operative performance from 3 university-based surgery training programs during the 2016-2017 academic year. Two surgeon raters categorized comments relating to operative skills as being specific or general and as encouraging and/or corrective. Comments were then classified as effective, mediocre, ineffective, or irrelevant. The frequencies with which comments were rated as effective were compared using Chi-square analysis. RESULTS: The authors analyzed a total of 600 comments. 10.7% of EOR and 58.3% of SIMPL operative performance evaluation comments were deemed effective (P < 0.0001). CONCLUSIONS: Evaluators give significantly higher quality operative performance feedback when using workplace-based assessment tools rather than EOR evaluations.

Functional Difficulties of Patients Seeking Low Vision Services in South India.

PURPOSE: The aim of the study was to determine the functional concerns of patients with different clinical and demographic characteristics seeking low vision care in South India. DESIGN: Cross-sectional clinic-based survey. METHODS: Consecutive new patients evaluated by the low vision service at Aravind Eye Care System (AECS), Madurai, India, India from September 2016 to March 2017 were recruited. Clinical and sociodemographic data were collected and participants underwent a semistructured survey to determine vision-related functional concerns. Analyses were conducted to determine associations with functional concerns. This study was approved by the AECS Institutional Review Board and all participants provided informed consent. RESULTS: The study included 419 participants (mean age 42.0 years, 65.2% male). Retinal dystrophy (35.8%) and acquired retinal disease (22.0%) were the most common diagnoses. The most frequently cited functional concerns were reading (37.7%), mobility (19.9%), and facial identification (13.8%). The number of functional concerns did not vary by diagnosis, age, sex, education, occupation, or presenting visual acuity (P > 0.05). Participants with retinal dystrophy were more likely to cite problems with night vision (P < .001). Age was significantly associated with greater difficulty recognizing faces [odds ratio (OR) = 1.20, 95% confidence interval (CI) = 1.01-1.43] and less night vision difficulty (OR = 0.75, 95% CI = 0.60-1.00). Worse presenting visual acuity was significantly associated with reporting a mobility problem (OR = 2.87, 95% CI = 2.09-3.93). CONCLUSIONS: This study supports the expansion of low vision services in India targeted to common functional concerns including reading, mobility, and facial identification. However, results do not support the use of ocular diagnosis for this purpose.

Linear Self-Motion Cues Support the Spatial Distribution and Stability of Hippocampal Place Cells.

The vestibular system provides a crucial component of place-cell and head-direction cell activity [1-7]. Otolith signals are necessary for head-direction signal stability and associated behavior [8, 9], and the head-direction signal's contribution to parahippocampal spatial representations [10-14] suggests that place cells may also require otolithic information. Here, we demonstrate that self-movement information from the otolith organs is necessary for the development of stable place fields within and across sessions. Place cells in otoconia-deficient tilted mice showed reduced spatial coherence and formed place fields that were located closer to environmental boundaries, relative to those of control mice. These differences reveal an important otolithic contribution to place-cell functioning and provide insight into the cognitive deficits associated with otolith dysfunction.