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We conducted a randomized trial to assess the educational effectiveness of VPs and SPs in teaching clinical skills.OBJECTIVE: To determine the effectiveness of VP cases when compared with live SP cases in improving clinical skills and knowledge.DESIGN: Randomized trial.PARTICIPANTS: Fifty-five health care providers (registered nurses 45%, physicians 15%, other provider types 40%) who attended a CME program.INTERVENTIONS: Participants were randomized to receive either 4 live cases (n=32) or 2 live and 2 virtual cases (n=23). Other aspects of the course were identical for both groups.RESULTS: Participants in both groups were equivalent with respect to pre-post workshop improvement in comfort level (P=.66) and preparedness to respond (P=.61), to screen (P=.79), and to care (P=.055) for patients using the skills taught. There was no difference in subjective ratings of effectiveness of the VPs and SPs by participants who experienced both (P=.79). A key aspect of the system is timely and comprehensive information, which is based on agent visits and is managed by trained nurses. Since the health agents system was launched, there has been a rapid decline in infant mortality, a rapid rise in immunization, identification of bottlenecks limiting the utilization of other medical resources, and timely interventions in Ray Ban Canada Aviators times of crisis. The health Ray Ban Toronto Canada agents system has combined administrative decentralization with financial centralization during a period of electoral democratization. A new method is presented, different from usual methods, for the discussion of the results of computer ECG measurement programs, based on a new graphical evaluation method. The proposed "scatter-graphs" both highlight the main program results and facilitate the comparison between various wave-recognition algorithms. They allow the distinction between the reliability of an algorithm, which is its capacity to provide a maximum of measurements with a minimum amount of errors, and its precision, i.e., the standard deviation of the differences between its point estimates and the reference. Motor unit discharges occurred more frequently when the body swayed faster and forward (Pearson R = 0.63; P < 0.0001). This higher likelihood of observing motor unit potentials was explained chiefly by the recruitment of additional units. During forward body shifts, the median number of units detected increased from 3 to 11 (P < 0.0001), whereas the discharge rate changed from 8 ± 1.1 (mean ± SD) to 10 ± 0.9 pulses/s (P = 0.001).  

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