Guidelines: The do's, don'ts and don't knows of direct observation of clinical skills in medical education.

IntroductionDirect observation of clinical skills is a key assessment strategy in competency-based medical education. The guidelines presented in this paper synthesize the literature on direct observation of clinical skills. The goal is to provide a practical list of Do's, Don'ts and Don't Knows about direct observation for supervisors who teach learners in the clinical setting and for educational leaders who are responsible for clinical training programs.MethodsWe built consensus through an iterative approach in which each author, based on their medical education and research knowledge and expertise, independently developed a list of Do's, Don'ts, and Don't Knows about direct observation of clinical skills. Lists were compiled, discussed and revised. We then sought and compiled evidence to support each guideline and determine the strength of each guideline.ResultsA final set of 33 Do's, Don'ts and Don't Knows is presented along with a summary of evidence for each guideline. Guidelines focus on two groups: individual supervisors and the educational leaders responsible for clinical training programs. Guidelines address recommendations for how to focus direct observation, select an assessment tool, promote high quality assessments, conduct rater training, and create a learning culture conducive to direct observation.ConclusionsHigh frequency, high quality direct observation of clinical skills can be challenging. These guidelines offer important evidence-based Do's and Don'ts that can help improve the frequency and quality of direct observation. Improving direct observation requires focus not just on individual supervisors and their learners, but also on the organizations and cultures in which they work and train. Additional research to address the Don't Knows can help educators realize the full potential of direct observation in competency-based education

Tutoring as an Elementary Reading Intervention to Benefit Bilingual Learners in Mexico

The research question addressed in this capstone project is, can peer tutoring be used as an effective elementary reading intervention to benefit bilingual learners in Mexico? Key influence for this capstone was the author’s observation of a lack of effective reading interventions in bilingual environments. The study is a qualitative study in which the author implemented a seven-week peer tutoring training with nineteen fifth grade tutors. These peer tutors each worked one on one with a fourth grade student to apply specific reading strategies. The goal of the capstone was to determine whether peer tutors could positively affect student outcomes in reading fluency, reading comprehension and reading disposition. The study results indicate that peer tutoring does have a positive effect on student fluency, reading comprehension and disposition, however in the case of struggling students, additional structure and strategies are needed for the peer tutors to foster student growth

Survey of teachers 2010 : support to improve teaching practice

In 2010 the annual survey of teachers, conducted on behalf of the General Teaching Council for England (GTC), explored teachers’ experiences of the different forms of support they receive to help them maintain and develop their teaching practice. Teachers were asked for their views on the following: • their participation in Continuing Professional Development (CPD) • their involvement in activities to improve teaching practice • use of observation and feedback • use of research • performance management, and • the professional standards

Contours of Inclusion: Frameworks and Tools for Evaluating Arts in Education

This collection of essays explores various arts education-specific evaluation tools, as well as considers Universal Design for Learning (UDL) and the inclusion of people with disabilities in the design of evaluation instruments and strategies. Prominent evaluators Donna M. Mertens, Robert Horowitz, Dennie Palmer Wolf, and Gail Burnaford are contributors to this volume. The appendix includes the AEA Standards for Evaluation. (Contains 10 tables, 2 figures, 30 footnotes, and resources for additional reading.) This is a proceedings document from the 2007 VSA arts Research Symposium that preceded the American Evaluation Association's (AEA) annual meeting in Baltimore, MD

Safer clinical systems : interim report, August 2010

Safer Clinical Systems is the Health Foundation’s new five year programme of work to test and demonstrate ways to improve healthcare systems and processes, to develop safer systems that improve patient safety. It builds on learning from the Safer Patients Initiative (SPI) and models of system improvement from both healthcare and other industries. Learning from the SPI highlighted the need to take a clinical systems approach to improving safety. SPI highlighted that many hospitals struggle to implement improvement in clinical areas due to inherent problems with support mechanisms. Clinical processes and systems, rather than individuals, are often the contributors to breakdown in patient safety. The Safer Clinical Systems programme aimed to measure the reliability of clinical processes, identify defects within those processes, and identify the systems that result in those defects. Methods to improve system reliability were then to be tested and re-developed in order to reduce the risk of harm being caused to patients. Such system-level awareness should lead to improvements in other patient care pathways. The relationship between system reliability and actual harm is challenging to identify and measure. Specific, well-defined, small-scale processes have been used in other programmes, and system reliability has been shown to have a direct causal relationship with harm (e.g. care bundle compliance in an intensive care unit can reduce the incidence of ventilator-associated pneumonia). However, it has become evident that harm can be caused by a variety of factors over time; when working in broader, more complex and dynamic systems, change in outcome can be difficult to attribute to specific improvements and difficulties are also associated with relating evidence to resulting harm. The overall aim of Phase 1 of the Safer Clinical Systems programme was to demonstrate proof-of-concept that using a systems-based approach could contribute to improved patient safety. In Phase 1, experienced NHS teams from four locations worked together with expert advisers to co-design the Safer Clinical Systems programme

Choreographic and Somatic Approaches for the Development of Expressive Robotic Systems

As robotic systems are moved out of factory work cells into human-facing environments questions of choreography become central to their design, placement, and application. With a human viewer or counterpart present, a system will automatically be interpreted within context, style of movement, and form factor by human beings as animate elements of their environment. The interpretation by this human counterpart is critical to the success of the system's integration: knobs on the system need to make sense to a human counterpart; an artificial agent should have a way of notifying a human counterpart of a change in system state, possibly through motion profiles; and the motion of a human counterpart may have important contextual clues for task completion. Thus, professional choreographers, dance practitioners, and movement analysts are critical to research in robotics. They have design methods for movement that align with human audience perception, can identify simplified features of movement for human-robot interaction goals, and have detailed knowledge of the capacity of human movement. This article provides approaches employed by one research lab, specific impacts on technical and artistic projects within, and principles that may guide future such work. The background section reports on choreography, somatic perspectives, improvisation, the Laban/Bartenieff Movement System, and robotics. From this context methods including embodied exercises, writing prompts, and community building activities have been developed to facilitate interdisciplinary research. The results of this work is presented as an overview of a smattering of projects in areas like high-level motion planning, software development for rapid prototyping of movement, artistic output, and user studies that help understand how people interpret movement. Finally, guiding principles for other groups to adopt are posited.Comment: Under review at MDPI Arts Special Issue "The Machine as Artist (for the 21st Century)" http://www.mdpi.com/journal/arts/special_issues/Machine_Artis