Predicting student outcomes using digital logs of learning behaviors: Review, current standards, and suggestions for future work.

Using traces of behaviors to predict outcomes is useful in varied contexts ranging from buyer behaviors to behaviors collected from smart-home devices. Increasingly, higher education systems have been using Learning Management System (LMS) digital data to capture and understand students' learning and well-being. Researchers in the social sciences are increasingly interested in the potential of using digital log data to predict outcomes and design interventions. Using LMS data for predicting the likelihood of students' success in for-credit college courses provides a useful example of how social scientists can use these techniques on a variety of data types. Here, we provide a primer on how LMS data can be feature-mapped and analyzed to accomplish these goals. We begin with a literature review summarizing current approaches to analyzing LMS data, then discuss ethical issues of privacy when using demographic data and equitable model building. In the second part of the paper, we provide an overview of popular machine learning algorithms and review analytic considerations such as feature generation, assessment of model performance, and sampling techniques. Finally, we conclude with an empirical example demonstrating the ability of LMS data to predict student success, summarizing important features and assessing model performance across different model specifications.

The impact of trauma-informed design on psychological well-being in homeless shelters.

Trauma-informed design is an emerging concept that combines elements of interior design, environmental psychology, and clinical psychology. Previous reports describe the potential impact of the physical space and design of homeless shelters on positive psychological outcomes (Pable, 2012). However, there is little known research on these outcomes. This article provides preliminary support for positive outcomes through a program evaluation of a trauma-informed design of resident bedrooms at two homeless shelters in North Carolina. Residents (n = 61) were asked to take a presurvey (before room design) and postsurvey (after design) that assessed their experiences of preparedness, hopefulness, and safety. Among those who completed both pre and postsurveys (n = 43), there was a statistically significant improvement in all three factors following the design, with the largest effect sizes for safety and total score average. Additionally, qualitative findings indicate participants felt the design updates increased their experiences of dignity (n = 17) and safety (n = 13), with some indicating increased feelings of hope (n = 4). We discuss implications for other homeless shelters, as well as similar institutions that support people in transitional housing. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

What Are They Thinking? Exploring College Students' Mental Processing and Decision-Making About COVID-19 (Mis)Information on Social Media.

More and more, people are abandoning the active pursuit of news, assuming instead that important information will be pushed to them via their social media networks. This approach to news makes people susceptible to the vast amounts of misinformation online, yet research on the effects of this kind of engagement is mixed. More research is needed on technology incidental learning effects, defined as changes in knowledge, attitudes, beliefs, and behaviors as a result of being exposed to information while pursuing goals other than learning (e.g., entertainment). In this study, we examined how 51 college students responded to incidental exposure to accurate and inaccurate COVID-19 information delivered via a simulated social media environment. Participants' verbalizations during think-aloud protocols indicated numerous mental processes including cognition, metacognition, epistemic cognition, motivation, and emotions. Positively valenced mental processing was more often expressed with accurate COVID-19 information and negatively valenced mental processing was more often verbalized with misinformation. Negatively valenced evaluations of knowledge claims and sources predicted less engagement with COVID-19 misinformation posts. However, in many cases the relations among verbalized mental processing and behavioral responses were complex or non-obvious. For example, participants' positive metacognition and epistemic cognition verbalizations decreased their likelihood of engaging with accurate COVID-19 information, whereas positive interest was associated with an increased likelihood of engaging with misinformation. Our findings have implications for how to accurately infer people's beliefs and intentions from their social media behaviors and how to design interventions to help people be more active and thoughtful consumers of online information.

Can Life Experiences Predict Readiness for Residency? A Family Medicine Residency's Analysis.

BACKGROUND: Program directors for Family Medicine residencies must navigate an increasingly complex recruitment landscape. With increasing United States allopathic and osteopathic graduates and continued high volumes of international graduates, the ability to identify application characteristics that predict quality residents both for filtering applications for interview offers and ranking is vital. Our study concentrates on the predictive value of reported life experiences including volunteerism, work experiences, prior career, research experience, and participation in medical student organizations including student leadership. METHODS: Through a retrospective cohort study, we extracted the described life experiences from resident application materials. We then obtained initial clinical performance data on the Family Medicine inpatient service during the first six months of residency to determine readiness for residency. This analysis occurred in 2020 and included all matriculants in the graduating classes of 2013 through 2020 for a single residency. Of 110 matriculating residents, data were available for 97(88%). RESULTS: Applicants with a history of a prior career demonstrated improved overall readiness for residency with competency domain-specific advantages in Interpersonal and Communication Skills and Systems-Based Practice. In contrast, applicants reporting participation in research performed below peers in all competency domains. Applicant reports on volunteerism, work experience, academic productivity and student involvement did not correlate with initial clinical performance. CONCLUSIONS: Residency directors should recognize applicants with prior careers as likely having strong communications and systems-based practice skills. All other examined experiences should be evaluated within the context of broader applicant assessments including research experience which overall has a potential negative correlation to clinical readiness.

Disseminated Herpes Simplex Virus-2 (HSV-2) as a Cause of Viral Hepatitis in an Immunocompetent Host.

BACKGROUND Herpes simplex virus-2 (HSV-2) affects nearly 1 in 5 adults in the United States. Complications such as viral hepatitis and dissemination are rare in immunocompetent hosts. In this report, we describe a case of viral hepatitis secondary to disseminated HSV-2 in an immunocompetent patient with recurrent fevers and elevated aminotransferases. CASE REPORT A 57-year-old man with a history of type 2 diabetes and hypertension was admitted with a right index finger lesion concerning for an abscess. He underwent successful incision and drainage and was started on ampicillin-sulbactam. On Day 2 of hospitalization, he developed recurrent fevers and elevated aminotransferases and inflammatory markers. An extensive infectious, rheumatologic, and malignancy workup were pursued without immediate findings. Imaging demonstrated cirrhotic morphology of the liver and splenomegaly, but lab markers were intact for liver synthetic function. On Day 7 of hospitalization, fever frequency decreased, and HSV-2 titers resulted, with positive IgM and negative IgG. He subsequently developed erythematous, raised lesions in multiple dermatomes. Nucleic acid amplification testing of biopsied lesions was positive for HSV-2, confirming viral hepatitis secondary to disseminated HSV-2. He was started on intravenous acyclovir and discharged on valacyclovir following improvement in symptoms. CONCLUSIONS We report a case of viral hepatitis secondary to disseminated HSV-2 in an immunocompetent host. Up to 25% of cases occur in immunocompetent hosts and many patients do not develop characteristic skin lesions. Early diagnosis and treatment of viral hepatitis secondary to disseminated HSV remains vital to minimize morbidity and mortality.

COVID-19 and the Consequences of Anchoring Bias.

Suspicion of coronavirus disease in febrile patients might lead to anchoring bias, causing misdiagnosis of other infections for which epidemiologic risks are present. This bias has potentially severe consequences, illustrated by cases of human granulocytic anaplasmosis and Lyme disease in a pregnant woman and human granulocytic anaplasmosis in another person.

Virtual Emergency Medicine Clerkship Curriculum during the COVID-19 Pandemic: Development, Application, and Outcomes.

The COVID-19 pandemic has been a significant catalyst for change in medical education and clinical care. The traditional model of bedside clinical teaching in required advanced clerkships was upended on March 17, 2020, when the Association of American Medical Colleges recommended removing medical students from direct patient care to prevent further spread of the disease and also to help conserve scarce personal protective equipment (PPE). This created unique challenges for delivering a robust, advanced emergency medicine (EM) clerkship since the emergency department is ground zero for the undifferentiated and potentially infected patient and has high demand for PPE. Here, we describe the development, application, and program evaluation of an online-based, virtual advanced EM curriculum developed rapidly in response to the COVID-19 pandemic.Starting March 23, 2020, we began rotating fourth-year medical students through a four-week rotation. We completed a total of four virtual clerkship experiences comprised of 56 students through July 27, 2020. Through analysis of the students' performance on a national standardized EM shelf exam, students participating in this virtual clerkship demonstrated a fund of knowledge that was not significantly different from that of their peers who completed a traditional clerkship in the specialty prior to the pandemic interruptions. Additionally, the critical review of the traditional course created the opportunity to make improvements and enrich the medical student educational experience in a virtual environment and upon resumption of the traditional course when students returned to the in-person environment. The resources provided for those interested in adopting our pedagogical approach include a course syllabus, calendar, and learner summative assessment.

One Institution's evaluation of family medicine residency applicant data for academic predictors of success.

BACKGROUND: Family Medicine residencies are navigating recruitment in a changing environment. The consolidation of accreditation for allopathic and osteopathic programs, the high volume of applicants, and the forthcoming transition of the United States Medical Licensing Exam (USMLE) Step 1 to pass/fail reporting all contribute. This retrospective cohort study evaluated which components of a student's academic history best predict readiness for residency. METHODS: In 2020, we analyzed applicant data and initial residency data for program graduates at a single residency program between 2013 and 2020. This included undergraduate education characteristics, medical school academic performance, medical school academic problems (including professionalism), STEP exams, location of medical school, and assessments during the first 6 months of residency. Of 110 matriculating residents, assessment data was available for 97 (88%). RESULTS: Pre-matriculation USMLE data had a positive correlation with initial American Board of Family Medicine (ABFM) in-training exams. Pre-matriculation exam data did not have a positive correlation with resident assessment across any of the six Accreditation Council for Graduate Medical Education (ACGME) competency domains. A defined cohort of residents with a history of academic struggles during medical school or failure on a USMLE exam performed statistically similarly to residents with no such history on assessments across the six ACGME competency domains. CONCLUSIONS: Applicants with a history of academic problems perform similarly in the clinical environment to those without. While a positive correlation between pre-matriculation exams and the ABFM in-training exam was found, this did not extend to clinical assessments across the ACGME competency domains.

Correction to: "It is this very knowledge that makes us doctors": an applied thematic analysis of how medical students perceive the relevance of biomedical science knowledge to clinical medicine.

An amendment to this paper has been published and can be accessed via the original article.

"It is this very knowledge that makes us doctors": an applied thematic analysis of how medical students perceive the relevance of biomedical science knowledge to clinical medicine.

BACKGROUND: Intensive study of the biomedical sciences remains a core component of undergraduate medical education with medical students often completing up to 2 years of biomedical science training prior to entering clerkships. While it is generally accepted that biomedical science knowledge is essential for clinical practice because it forms the basis of clinical reasoning and decision-making, whether medical students perceive an expanded role for their biomedical science knowledge remains to be examined. METHODS: We conducted a qualitative research study to explore how medical students in the first clerkship year perceived the relevance of biomedical science knowledge to clinical medicine during this pivotal time as they begin their transition from students to physicians. To identify previously unidentified perspectives and insights, we asked students to write brief essays in response to the prompt: How is biomedical science knowledge relevant to clinical medicine? Ten codes and four themes were interpreted through an applied thematic analysis of students' essays. RESULTS: Analysis of students' essays revealed novel perspectives previously unidentified by survey studies and focus groups. Specifically, students perceived their biomedical science knowledge as contributory to the development of adaptive expertise and professional identity formation, both viewed as essential developmental milestones for medical students. CONCLUSIONS: The results of this study have important implications for ongoing curricular reform efforts to improve the structure, content, delivery, and assessment of the undergraduate medical curriculum. Identifying the explicit and tacit elements of the formal, informal, and hidden curriculum that enable biomedical science knowledge to contribute to the development of adaptive expertise and professional identity formation will enable the purposeful design of innovations to support the acquisition of these critical educational outcomes.

Psychological foundations of emerging technologies for teaching and learning in higher education.

As the research on the use of educational technologies increases, greater focus is being placed on the psychological processes underlying teaching and learning with these tools. In this research review, we examine six contemporary technologies identified in the 2020 edition of the Horizon Report through the lens of educational psychology theory. Specifically, we highlight the educational, cognitive, and social psychological processes that unfold during teaching and learning with each technology and illustrate how considering these processes can inform study and use of educational technologies and subsequent learning outcomes.

Reduced Hospitalizations, Emergency Room Visits, and Costs Associated with a Web-Based Health Literacy, Aligned-Incentive Intervention: Mixed Methods Study.

BACKGROUND: The association between health literacy and health care costs, particularly for hospitalizations and emergency room services, has been previously observed. Health information interventions aimed at addressing the negative impacts of inadequate health literacy are needed. The MedEncentive Mutual Accountability and Information Therapy (MAIT) Program is a Web-based system designed to improve health and lower costs by aligning patient-doctor incentives. OBJECTIVE: In this mixed methods study of a Web-based patient-doctor aligned-incentive, information therapy program conducted in an 1800-member employee health plan, we aimed to (1) determine the program's quantitative impact on hospitalization and emergency room utilization and costs, and (2) assess survey responses about the program's perceived value. METHODS: We used a mixed methods, single within-group, pre-post, descriptive study design. We analyzed quantitative data using pre-post mean utilization and cost differences and summarized the data using descriptive statistics. We used open-ended electronic survey items to collect descriptive data and analyzed them using thematic content analysis. RESULTS: Hospitalizations and emergency room visits per 1000 decreased 32% (26.5/82.4) and 14% (31.3/219.9), respectively, after we implemented the program in 2015-2017, relative to 2013-2014. Correspondingly, the plan's annual per capita expenditures declined US $675 (95% CI US $470-865), or 10.8% ($675/$6260), after program implementation in 2015-2017 (US $5585 in 2013-2014 dollars), relative to the baseline years of 2013-2014 (US $6260; P<.05). Qualitative findings suggested that respondents valued the program, benefiting from its educational and motivational aspects to better self-manage their health. CONCLUSIONS: Analyses suggested that the reported reductions in hospitalizations, emergency room visits, and costs were associated with the program. Qualitative findings indicated that targeted users perceived value in participating in the MAIT Program. Further research with controls is needed to confirm these outcomes and more completely understand the health improvement and cost-containment capabilities of this Web-based health information, patient-doctor, aligned-incentive program.

Call for ACTion: Transforming Dental Education at the University of North Carolina at Chapel Hill.

The University of North Carolina at Chapel Hill Adams School of Dentistry is developing a transformative curriculum that prepares students to enter contemporary practice. The Advocate, Clinician, and Thinker (ACT) framework will provide the basis for developing a resilient workforce capable of meeting emerging health care needs over the next 40 years.

Monitoring and depth of strategy use in computer-based learning environments for science and history.

BACKGROUND: Self-regulated learning (SRL) models position metacognitive monitoring as central to SRL processing and predictive of student learning outcomes (Winne & Hadwin, 2008; Zimmerman, 2000). A body of research evidence also indicates that depth of strategy use, ranging from surface to deep processing, is predictive of learning performance. AIMS: In this study, we investigated the relationships among the frequency of metacognitive monitoring and the utilization of deep and surface-level strategies, and the connections between these SRL processes and learning outcomes across two academic domains, science and history. SAMPLE: This was a secondary data analysis of two studies. The first study sample was 170 undergraduate students from a University in the south-eastern United States. The second study sample consisted of 40 US high school students in the same area. METHODS: We collected think-aloud protocol SRL and knowledge measure data and conducted both structural equation modelling and path analysis to investigate our research questions. RESULTS: Findings showed across both studies and two distinct academic domains, students who enacted more frequent monitoring also enacted more frequent deep strategies resulting in better performance on academic evaluations. CONCLUSIONS: These findings suggest the importance of measuring not only what depth of strategies learners use, but also the degree to which they monitor their learning. Attention to both is needed in research and practice.

Are There Linguistic Markers of Suicidal Writing That Can Predict the Course of Treatment? A Repeated Measures Longitudinal Analysis.

The purpose of this pilot study was to predict resolution of suicidal ideation and risk over the course of therapy among suicidal outpatients (N = 144) using a novel method for analyzing Self- verses Relationally oriented qualitative written responses to the Suicide Status Form (SSF). A content analysis software program was used to extract word counts and a repeated measures longitudinal design was implemented to assess improvement over time. Patients with primarily Relationally focused word counts were more likely to have a quicker suicide risk resolution than those with more Self-focused word counts (6-7 sessions versus 17-18 sessions). Implications of these data are discussed, including the potential for enhancing treatment outcomes using this method with individuals entering treatment.

The wisdom development scale: further validity investigations.

Researchers are gaining an interest in the concept of wisdom, a more holistic yet often ineffable educational outcome. Models of wisdom abound, but few have rigorously tested measures. This study looks at Brown's (2004a, 2004b) Model of Wisdom Development and its associated measure, the Wisdom Development Scale (WDS; Brown & Greene, 2006). The construct validity, measurement invariance, criterion validity, and reliability of scores from the WDS were assessed with over 3000 participants from two separate groups: one a sample of professionals and the other a sample of college students. Support for construct validity and reliability with these samples was found, along with measurement invariance. Latent means analyses showed predicted discrimination between the groups, and criterion validity evidence, with another measure of collegiate educational outcomes, was found.

Clinical improvements of suicidal outpatients: Examining suicide status form responses as predictors and moderators.

This investigation used hierarchical linear modeling (HLM) to examine whether index responses on the Suicide Status Form (SSF) moderated the predicted session-to-session change over course of care in overall symptoms and suicidal ideation. Ninety-two suicidal patients at a university counseling center were studied. Overall, suicidal patients improved symptomatically and decreased their suicidal ideation over the course of care. SSF index ratings of overall risk of suicide significantly moderated the predicted session-to-session change in suicidal ideation over the course of care; patient ratings of frequency of suicidal thoughts were also moderated by index SSF ratings of hopelessness and self-hate. These findings partially replicated earlier data of differential treatment response outcomes and provide valuable assessment and treatment information that is relevant to future research and successful clinical care of suicidal outpatients.

Temporary vascular shunts as initial treatment of proximal extremity vascular injuries during combat operations: the new standard of care at Echelon II facilities?

BACKGROUND: Historically, penetrating injuries to the extremities account for up to 75% of wounds sustained during combat and 10% of deaths. Rapid vascular control and perfusion of injured extremities at forward deployed Echelon II surgical facilities is essential to limit loss of life and maximize limb preservation. We review our experience with the management of extremity vascular trauma and report the largest single Echelon II experience to date on temporary vascular shunting (TVS) for proximal extremity vascular injuries. METHODS: Data on combat trauma patients presenting to a US Navy Echelon II forward surgical facility in Iraq were prospectively recorded during a 7-month period. Patients with suspected vascular injuries underwent exploration in the operating room. After vessel control, thrombectomy and instillation of heparinized saline, vascular injuries in the proximal extremity were temporarily shunted in a standardized fashion. Vascular injuries in the distal extremity were routinely ligated. After shunting, patients were transported to an Echelon III facility in the Iraqi Theater and underwent vascular reconstruction. They were followed through transfer to the Continental United States or discharge into the civilian Iraqi medical system. Shunt patency, limb salvage, and survival data were obtained by retrospective review of electronic medical records. RESULTS: Six hundred ten combat trauma patients were treated from August 16, 2006 to February 25, 2007. Thirty-seven patients (6.1%) sustained 73 injuries to major extremity vascular structures. Twenty-three proximal vascular shunts were placed in 16 patients with mean Injury Severity Score of 25 (range, 17-43) and mean mangled extremity severity score (MESS) of 8 (range, 5-10). Twenty-two of 23 shunts (95.6%) were patent upon arrival to the Echelon III facility and underwent successful autologous vein reconstruction. All shunt patients survived their injuries with 100% early limb preservation as followed through their first 30 days of medical care or discharge into the local medical community. CONCLUSIONS: Complex combat injuries to proximal extremity vessels should be routinely shunted at forward-deployed Echelon II facilities as part of the resuscitative, damage control process.

Characterization of volatile compounds contributing to naturally occurring fruity fermented flavor in peanuts.

Published research has indicated that ethyl 2-methylpropanoate, ethyl 2-methybutanaote, ethyl 3-methylbutanoate, hexanoic acid, butanoic acid, and 3-methylbutanoic acid are responsible for fruity fermented (FF) off-flavor; however, these compounds were identified in samples that were artificially created by curing immature peanuts at a constant high temperature. The objective of this study was to characterize the volatile compounds contributing to naturally occurring FF off-flavor. Volatile compounds of naturally occurring FF and no-FF samples were characterized using solvent-assisted flavor evaporation (SAFE), solid phase microextraction (SPME), gas chromatography-olfactometry (GC-O), and gas chromatography-mass spectrometry (GC-MS). Aroma extract dilution analysis (AEDA) identified 12 potent aroma active compounds, none of which were the previously identified esters, with no consistent differences among the aroma active compounds in no-FF and FF samples. Hexanoic acid alone was identified in the naturally occurring FF sample using the SAFE GC-MS methodology, whereas two of the three previously identified esters were identified in natural and artificially created samples. The same two esters were confirmed by SPME GC-MS in natural and artificially created samples. This study demonstrated the need for caution in the direct application of data from artificially created samples until those compounds are verified in natural samples. However, these results suggest that a laboratory method using SPME-GC techniques could be developed and correlated on an ester concentration versus FF intensity basis to provide an alternative to sensory analysis for detection of FF off-flavor in peanut lots.