{"title":"The Impact of Infographics on Surgical Education: Enhancing Learning and Performance","authors":"Amin Habibi, Babak Sabet, Masomeh Kalantarion","doi":"10.5812/jme-140953","DOIUrl":"https://doi.org/10.5812/jme-140953","url":null,"abstract":"<jats:p />","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135539370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Clinical education is a vital component of physician education, where medical students learn by attending to patients and applying their knowledge and reasoning to solve their problems. However, many medical students struggle to acquire procedural skills, the ultimate goal of clinical education. Procedural skills are expected to be learned by the residents according to their academic year and are essential for providing better health services to children and families. Objectives: This study evaluates the status of the training provided and the level of learning the necessary procedural skills in pediatric residents based on standards. Methods: This research was a descriptive cross-sectional method from 1998 to 99. In the first part of the researcher-made questionnaire, the implementation of the educational program on all pediatric residents (115) of Mofid Children's Hospital was evaluated. In the second part, the residents' views on the current state of their learning of essential procedural skills were determined. Results: All residents from years one to four participated in the study. After assessing the status of skills acquired by residents with a questionnaire and comparing the average of each skill acquisition procedure with the desired standards, the average of all skills in all three methods was under the standards approved by the Ministry of Health, except for independent subcutaneous, intramuscular and intravenous injection skills and the skill of working with a ventilator. Also, according to the Friedman test, the lowest score for gaining skills in performing procedures was related to NG tube placement skills and subcutaneous, intramuscular, and intravenous injection skills. According to the statistical results obtained from the Spearman coefficient in all procedures, the level of subcutaneous, intramuscular, and intravenous injection skills had a significant correlation with independent skills. Conclusions: According to the specialized assistants of children participating in this study, the current training program of essential procedural skills implemented at Shahid Beheshti University of Medical Sciences was generally useful and effective. But there were also obstacles and limitations. Therefore, it is recommended to review the implementation of the training programs and implement effective measures, including providing more exposure conditions for independent procedures.
{"title":"Factors Affecting Learning Essential Procedural Skills in Pediatric Residents: A Cross-Sectional Study","authors":"Soleiman Ahmady, Bahareh Abshari, Amin Habibi, Masomeh Kalantarion","doi":"10.5812/jme-123083","DOIUrl":"https://doi.org/10.5812/jme-123083","url":null,"abstract":"Background: Clinical education is a vital component of physician education, where medical students learn by attending to patients and applying their knowledge and reasoning to solve their problems. However, many medical students struggle to acquire procedural skills, the ultimate goal of clinical education. Procedural skills are expected to be learned by the residents according to their academic year and are essential for providing better health services to children and families. Objectives: This study evaluates the status of the training provided and the level of learning the necessary procedural skills in pediatric residents based on standards. Methods: This research was a descriptive cross-sectional method from 1998 to 99. In the first part of the researcher-made questionnaire, the implementation of the educational program on all pediatric residents (115) of Mofid Children's Hospital was evaluated. In the second part, the residents' views on the current state of their learning of essential procedural skills were determined. Results: All residents from years one to four participated in the study. After assessing the status of skills acquired by residents with a questionnaire and comparing the average of each skill acquisition procedure with the desired standards, the average of all skills in all three methods was under the standards approved by the Ministry of Health, except for independent subcutaneous, intramuscular and intravenous injection skills and the skill of working with a ventilator. Also, according to the Friedman test, the lowest score for gaining skills in performing procedures was related to NG tube placement skills and subcutaneous, intramuscular, and intravenous injection skills. According to the statistical results obtained from the Spearman coefficient in all procedures, the level of subcutaneous, intramuscular, and intravenous injection skills had a significant correlation with independent skills. Conclusions: According to the specialized assistants of children participating in this study, the current training program of essential procedural skills implemented at Shahid Beheshti University of Medical Sciences was generally useful and effective. But there were also obstacles and limitations. Therefore, it is recommended to review the implementation of the training programs and implement effective measures, including providing more exposure conditions for independent procedures.","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135884296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adrian Hang Yue Siu, Damien Gibson, Xin Mu, Ishith Seth, Alexander Chi Wang Siu, Dilshad Dooreemeah, Angus Lee
Background: The growing interest in artificial intelligence (AI) has spurred an increase in the availability of Large Language Models (LLMs) in surgical education. These LLMs hold the potential to augment medical curricula for future healthcare professionals, facilitating engagement in remote learning experiences, and assisting in personalised student feedback. Objectives: To evaluate the ability of LLMs to assist junior doctors in providing advice for common ward-based surgical scenarios with increasing complexity. Methods: Utilising an instrumental case study approach, this study explored the potential of LLMs by comparing the responses of the ChatGPT-4, BingAI and BARD. LLMs were prompted by 3 common ward-based surgical scenarios and tasked with assisting junior doctors in clinical decision-making. The outputs were assessed by a panel of two senior surgeons with extensive experience in AI and education, qualitatively utilising a Likert scale on their accuracy, safety, and effectiveness to determine their viability as a synergistic tool in surgical education. A quantitative assessment of their reliability and readability was conducted using the DISCERN score and a set of reading scores, including the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Coleman-Liau index. Results: BARD proved superior in readability, with Flesch Reading Ease Score 50.13 (± 5.00), Flesch-Kincaid Grade Level 9.33 (± 0.76), and Coleman-Liau index 11.67 (± 0.58). ChatGPT-4 outperformed BARD and BingAI, with the highest DISCERN score of 71.7 (± 2.52). Using a Likert scale-based framework, the surgical expert panel further affirmed that the advice provided by the ChatGPT-4 was suitable and safe for first-year interns and residents. A t-test showed statistical significance in reliability among all three AIs (P < 0.05) and readability only between the ChatGPT-4 and BARD. This study underscores the potential for LLM integration in surgical education, particularly ChatGPT, in the provision of reliable and accurate information. Conclusions: This study highlighted the potential of LLM, specifically ChatGPT-4, as a valuable educational resource for junior doctors. The findings are limited by the potential of non-generalizability of the use of junior doctors' simulated scenarios. Future work should aim to optimise learning experiences and better support surgical trainees. Particular attention should be paid to addressing the longitudinal impact of LLMs, refining AI models, validating AI content, and exploring technological amalgamations for improved outcomes.
{"title":"Emplying Large Language Models for Surgical Education: An In-depth Analysis of ChatGPT-4","authors":"Adrian Hang Yue Siu, Damien Gibson, Xin Mu, Ishith Seth, Alexander Chi Wang Siu, Dilshad Dooreemeah, Angus Lee","doi":"10.5812/jme-137753","DOIUrl":"https://doi.org/10.5812/jme-137753","url":null,"abstract":"Background: The growing interest in artificial intelligence (AI) has spurred an increase in the availability of Large Language Models (LLMs) in surgical education. These LLMs hold the potential to augment medical curricula for future healthcare professionals, facilitating engagement in remote learning experiences, and assisting in personalised student feedback. Objectives: To evaluate the ability of LLMs to assist junior doctors in providing advice for common ward-based surgical scenarios with increasing complexity. Methods: Utilising an instrumental case study approach, this study explored the potential of LLMs by comparing the responses of the ChatGPT-4, BingAI and BARD. LLMs were prompted by 3 common ward-based surgical scenarios and tasked with assisting junior doctors in clinical decision-making. The outputs were assessed by a panel of two senior surgeons with extensive experience in AI and education, qualitatively utilising a Likert scale on their accuracy, safety, and effectiveness to determine their viability as a synergistic tool in surgical education. A quantitative assessment of their reliability and readability was conducted using the DISCERN score and a set of reading scores, including the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Coleman-Liau index. Results: BARD proved superior in readability, with Flesch Reading Ease Score 50.13 (± 5.00), Flesch-Kincaid Grade Level 9.33 (± 0.76), and Coleman-Liau index 11.67 (± 0.58). ChatGPT-4 outperformed BARD and BingAI, with the highest DISCERN score of 71.7 (± 2.52). Using a Likert scale-based framework, the surgical expert panel further affirmed that the advice provided by the ChatGPT-4 was suitable and safe for first-year interns and residents. A t-test showed statistical significance in reliability among all three AIs (P < 0.05) and readability only between the ChatGPT-4 and BARD. This study underscores the potential for LLM integration in surgical education, particularly ChatGPT, in the provision of reliable and accurate information. Conclusions: This study highlighted the potential of LLM, specifically ChatGPT-4, as a valuable educational resource for junior doctors. The findings are limited by the potential of non-generalizability of the use of junior doctors' simulated scenarios. Future work should aim to optimise learning experiences and better support surgical trainees. Particular attention should be paid to addressing the longitudinal impact of LLMs, refining AI models, validating AI content, and exploring technological amalgamations for improved outcomes.","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136033482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1988-12-01DOI: 10.1097/00001888-198812000-00007
M M Aung, A M Han, L R Berger, A Kochi, N N Yi
Introducing problem-oriented medical education in Burma with 4 modules on child survival development (CSD) to replace the traditional lecture and rote learning method was met with preliminary success. Burma has 3 medical schools graduating 500 physicians yearly with all preclinical training based on lectures and all clinical training in hospitals. Yet community health is implemented by township medical officers with less training in child health than village health workers. 4 modules were created by groups of 12 medical faculty on acute respiratory infections high-risk pregnancy protein-energy malnutrition and dengue hemorrhagic fever in 1987. Modules concentrated on physicians roles: identify children at risk for malnutrition assess severity provide acute and long-term clinical management and coordinate growth monitoring and promotion of community programs. Students face obstacles such as life-time career of rote learning by lecture scarcity of text- books closed shelves for journals daytime-only library hours no copying machines and limited audiovisual equipment. Despite these limitations students learning scores increased from 36-86% their attitudes on a Likert scale improved and they volunteered approval of many specific aspects of the student-centered approach.
{"title":"Introducing child survival and development topics into the medical curriculum of a developing country.","authors":"M M Aung, A M Han, L R Berger, A Kochi, N N Yi","doi":"10.1097/00001888-198812000-00007","DOIUrl":"https://doi.org/10.1097/00001888-198812000-00007","url":null,"abstract":"Introducing problem-oriented medical education in Burma with 4 modules on child survival development (CSD) to replace the traditional lecture and rote learning method was met with preliminary success. Burma has 3 medical schools graduating 500 physicians yearly with all preclinical training based on lectures and all clinical training in hospitals. Yet community health is implemented by township medical officers with less training in child health than village health workers. 4 modules were created by groups of 12 medical faculty on acute respiratory infections high-risk pregnancy protein-energy malnutrition and dengue hemorrhagic fever in 1987. Modules concentrated on physicians roles: identify children at risk for malnutrition assess severity provide acute and long-term clinical management and coordinate growth monitoring and promotion of community programs. Students face obstacles such as life-time career of rote learning by lecture scarcity of text- books closed shelves for journals daytime-only library hours no copying machines and limited audiovisual equipment. Despite these limitations students learning scores increased from 36-86% their attitudes on a Likert scale improved and they volunteered approval of many specific aspects of the student-centered approach.","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-198812000-00007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14108157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1988-12-01DOI: 10.1097/00001888-198812000-00005
C J Lancaster, G R Ross, I K Smith
{"title":"Survey of practices in evaluating teaching in U.S. medical schools, 1978 and 1986.","authors":"C J Lancaster, G R Ross, I K Smith","doi":"10.1097/00001888-198812000-00005","DOIUrl":"https://doi.org/10.1097/00001888-198812000-00005","url":null,"abstract":"","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-198812000-00005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14329240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1988-12-01DOI: 10.1097/00001888-198812000-00009
M T Wayland, D Culik, W Bonzelaar, J Lukas, R Dunchok, T Coombs
{"title":"Differences in the use of consultations by family medicine and internal medicine physicians.","authors":"M T Wayland, D Culik, W Bonzelaar, J Lukas, R Dunchok, T Coombs","doi":"10.1097/00001888-198812000-00009","DOIUrl":"https://doi.org/10.1097/00001888-198812000-00009","url":null,"abstract":"","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-198812000-00009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14274772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1988-12-01DOI: 10.1097/00001888-198812000-00001
C Zeleznik, M Hojat, C E Goepp, P Amadio, O D Kowlessar, B Borenstein
Psychometric aspects of multiple-choice tests were investigated using a confidence-weighted scoring technique. The contributions of two indices, overconfidence and underconfidence, in the prediction of subsequent academic performance of examinees were studied. A total of 444 sophomore students (entering classes of 1982 and 1983) in one medical school were asked to indicate their confidence, on a 5-point scale (100, 75, 50, 25, and 0), in the correctness of their responses to each multiple-choice item on an Introduction to Clinical Medicine examination. Examinations were scored in two ways: in the conventional way, using the total number of correct responses, and by a confidence-weighted technique based on the level of certainty indicated for each response by the examinee. Only the conventional score determined the grade; the confidence-weighted score was calculated for the purely experimental purposes of this study. Overconfidence and underconfidence indices were also calculated by using the indicated levels of certainty. Improvements in the psychometrics of the examinations were observed when confidence-weighted scoring was used. In multiple-regression models, the confidence-weighted scores and indices of over- and underconfidence contributed significantly to predicting scores of the students studied on Parts I and II of the National Board of Medical Examiners examinations, whereas the conventional score did not contribute to the prediction of Part II scores. Significant differences on junior clerkship examinations and ratings were observed between those who were highly overconfident and those who were slightly overconfident. The highly overconfident students also estimated higher future incomes than did those who were slightly overconfident.
{"title":"Students' certainty during course test-taking and performance on clerkships and board exams.","authors":"C Zeleznik, M Hojat, C E Goepp, P Amadio, O D Kowlessar, B Borenstein","doi":"10.1097/00001888-198812000-00001","DOIUrl":"https://doi.org/10.1097/00001888-198812000-00001","url":null,"abstract":"<p><p>Psychometric aspects of multiple-choice tests were investigated using a confidence-weighted scoring technique. The contributions of two indices, overconfidence and underconfidence, in the prediction of subsequent academic performance of examinees were studied. A total of 444 sophomore students (entering classes of 1982 and 1983) in one medical school were asked to indicate their confidence, on a 5-point scale (100, 75, 50, 25, and 0), in the correctness of their responses to each multiple-choice item on an Introduction to Clinical Medicine examination. Examinations were scored in two ways: in the conventional way, using the total number of correct responses, and by a confidence-weighted technique based on the level of certainty indicated for each response by the examinee. Only the conventional score determined the grade; the confidence-weighted score was calculated for the purely experimental purposes of this study. Overconfidence and underconfidence indices were also calculated by using the indicated levels of certainty. Improvements in the psychometrics of the examinations were observed when confidence-weighted scoring was used. In multiple-regression models, the confidence-weighted scores and indices of over- and underconfidence contributed significantly to predicting scores of the students studied on Parts I and II of the National Board of Medical Examiners examinations, whereas the conventional score did not contribute to the prediction of Part II scores. Significant differences on junior clerkship examinations and ratings were observed between those who were highly overconfident and those who were slightly overconfident. The highly overconfident students also estimated higher future incomes than did those who were slightly overconfident.</p>","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-198812000-00001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14329236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1988-12-01DOI: 10.1097/00001888-198812000-00004
C Kaplan, M Marshall
When senior house officers were observed to be resistant to an intern support group, they were surveyed in order to identify the sources of their resistance. Sixty-nine percent of house officers in postgraduate year two (PGY-2) and PGY-3 responded to an anonymous seven-item survey. Although their attitudes toward supportive programs were generally favorable, a minority of the house officers felt that residents expressing the need for support were less competent than other residents or needed to change to a less rigorous specialty. A majority felt that it was unfair to require senior house officers to provide coverage for interns attending a support group. They felt that support should be made available to all house officers rather than interns only and that stress would be reduced by eliminating the sources of stress as well as by providing supportive programs. Training program directors need to be aware of and anticipate these attitudes before designing supportive programs.
{"title":"Sources of resistance to an intern support group.","authors":"C Kaplan, M Marshall","doi":"10.1097/00001888-198812000-00004","DOIUrl":"https://doi.org/10.1097/00001888-198812000-00004","url":null,"abstract":"<p><p>When senior house officers were observed to be resistant to an intern support group, they were surveyed in order to identify the sources of their resistance. Sixty-nine percent of house officers in postgraduate year two (PGY-2) and PGY-3 responded to an anonymous seven-item survey. Although their attitudes toward supportive programs were generally favorable, a minority of the house officers felt that residents expressing the need for support were less competent than other residents or needed to change to a less rigorous specialty. A majority felt that it was unfair to require senior house officers to provide coverage for interns attending a support group. They felt that support should be made available to all house officers rather than interns only and that stress would be reduced by eliminating the sources of stress as well as by providing supportive programs. Training program directors need to be aware of and anticipate these attitudes before designing supportive programs.</p>","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-198812000-00004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14329239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1988-12-01DOI: 10.1097/00001888-198812000-00010
A J Kovel, J K Davis
{"title":"Use of interviews in the selection of pediatric house officers.","authors":"A J Kovel, J K Davis","doi":"10.1097/00001888-198812000-00010","DOIUrl":"https://doi.org/10.1097/00001888-198812000-00010","url":null,"abstract":"","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-198812000-00010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14329243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1988-12-01DOI: 10.1097/00001888-198812000-00011
J A Shrader
{"title":"Computerized medical records.","authors":"J A Shrader","doi":"10.1097/00001888-198812000-00011","DOIUrl":"https://doi.org/10.1097/00001888-198812000-00011","url":null,"abstract":"","PeriodicalId":31052,"journal":{"name":"Journal of Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1988-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/00001888-198812000-00011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14329244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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