Balancing responsibility-sharing in the simulated clinical skills setting: A strategy to remove barriers to feedback engagement as a new concept to promote a growth-enhancing process

Background. When feedback is provided in a formative context, it must be used effectively by learners. Many barriers prevent medical students from meaningfully engaging with feedback in the clinical learning environment.Objective. To explore how medical students engage with feedback in preclinical skills training.Methods. Using an exploratory qualitative methodology, data from five focus groups, including 25 purposively selected third-year medical students, were iteratively analysed and identified and key themes were clarified.Results. The data revealed barriers that inhibit the use of feedback, ranging from students’ difficulties with decoding feedback, to their unwillingness to expend effort. Thematic analysis revealed four major themes related to the barriers to feedback receptivity and utilisation.Conclusion. Without collaboration, neither clinical educators nor students are empowered to fully remove the abovementioned barriers. Promoting a student’s learning is often framed as predominantly the task of their clinical educators. With a move towards constructivism, competency-based medical education claims that effective learning requires students to complement and significantly share in their educator’s responsibilities for their academic growth. Developing a responsibility-sharing culture in the giving and receiving of feedback ensures that students benefit fully from the feedback received through proactive engagement, leading to effective and sustainable clinical educator’s feedback practices. With minimal discussion on the concept ofresponsibility-sharing in the context of assessment feedback in medical education, it is necessary to further analyse and discuss this critical issue by considering certain expectations that should reinforce such a culture, along with the practicalities of creating this cultural shift within the preclinical skills setting

An Improved Approximate Consensus Algorithm in the Presence of Mobile Faults

This paper explores the problem of reaching approximate consensus in synchronous point-to-point networks, where each pair of nodes is able to communicate with each other directly and reliably. We consider the mobile Byzantine fault model proposed by Garay '94 -- in the model, an omniscient adversary can corrupt up to $f$ nodes in each round, and at the beginning of each round, faults may "move" in the system (i.e., different sets of nodes may become faulty in different rounds). Recent work by Bonomi et al. '16 proposed a simple iterative approximate consensus algorithm which requires at least $4f+1$ nodes. This paper proposes a novel technique of using "confession" (a mechanism to allow others to ignore past behavior) and a variant of reliable broadcast to improve the fault-tolerance level. In particular, we present an approximate consensus algorithm that requires only $\lceil 7f/2\rceil + 1$ nodes, an $\lfloor f/2 \rfloor$ improvement over the state-of-the-art algorithms. Moreover, we also show that the proposed algorithm is optimal within a family of round-based algorithms

Popular matchings with two-sided preferences and one-sided ties

We are given a bipartite graph $G = (A \cup B, E)$ where each vertex has a preference list ranking its neighbors: in particular, every $a \in A$ ranks its neighbors in a strict order of preference, whereas the preference lists of $b \in B$ may contain ties. A matching $M$ is popular if there is no matching $M'$ such that the number of vertices that prefer $M'$ to $M$ exceeds the number of vertices that prefer $M$ to~$M'$. We show that the problem of deciding whether $G$ admits a popular matching or not is NP-hard. This is the case even when every $b \in B$ either has a strict preference list or puts all its neighbors into a single tie. In contrast, we show that the problem becomes polynomially solvable in the case when each $b \in B$ puts all its neighbors into a single tie. That is, all neighbors of $b$ are tied in $b$'s list and $b$ desires to be matched to any of them. Our main result is an $O(n^2)$ algorithm (where $n = |A \cup B|$) for the popular matching problem in this model. Note that this model is quite different from the model where vertices in $B$ have no preferences and do not care whether they are matched or not.Comment: A shortened version of this paper has appeared at ICALP 201

Travelling on Graphs with Small Highway Dimension

We study the Travelling Salesperson (TSP) and the Steiner Tree problem (STP) in graphs of low highway dimension. This graph parameter was introduced by Abraham et al. [SODA 2010] as a model for transportation networks, on which TSP and STP naturally occur for various applications in logistics. It was previously shown [Feldmann et al. ICALP 2015] that these problems admit a quasi-polynomial time approximation scheme (QPTAS) on graphs of constant highway dimension. We demonstrate that a significant improvement is possible in the special case when the highway dimension is 1, for which we present a fully-polynomial time approximation scheme (FPTAS). We also prove that STP is weakly NP-hard for these restricted graphs. For TSP we show NP-hardness for graphs of highway dimension 6, which answers an open problem posed in [Feldmann et al. ICALP 2015]

Effect of base–acid properties of the mixtures of water with methanol on the solution enthalpy of selected cyclic ethers in this mixture at 298.15 K

The enthalpies of solution of cyclic ethers: 1,4- dioxane, 12-crown-4 and 18-crown-6 in the mixture of water and methanol have been measured within the whole mole fraction range at T = 298.15 K. Based on the obtained data, the effect of base–acid properties of water– methanol mixtures on the solution enthalpy of cyclic ethers in these mixtures has been analyzed. The solution enthalpy of cyclic ethers depends on acid properties of water– methanol mixtures in the range of high and medium water contents in the mixture. Based on the analysis performed, it can be assumed that in the mixtures of high methanol contents, cyclic ethe

A framework for Operational Security Metrics Development for industrial control environment

Security metrics are very crucial towards providing insights when measuring security states and susceptibilities in industrial operational environments. Obtaining practical security metrics depend on effective security metrics development approaches. To be effective, a security metrics development framework should be scope-definitive, objective-oriented, reliable, simple, adaptable, and repeatable (SORSAR). A framework for Operational Security Metrics Development (OSMD) for industry control environments is presented, which combines concepts and characteristics from existing approaches. It also adds the new characteristic of adaptability. The OSMD framework is broken down into three phases of: target definition, objective definition, and metrics synthesis. A case study scenario is used to demonstrate an instance of how to implement and apply the proposed framework to demonstrate its usability and workability. Expert elicitation has also be used to consolidate the validity of the proposed framework. Both validation approaches have helped to show that the proposed framework can help create effective and efficient ICS-centric security metrics taxonomy that can be used to evaluate capabilities or vulnerabilities. The understanding from this can help enhance security assurance within industrial operational environments

The illusion of competency versus the desirability of expertise: Seeking a common standard for support professions in sport

In this paper we examine and challenge the competency-based models which currently dominate accreditation and development systems in sport support disciplines, largely the sciences and coaching. Through consideration of exemplar shortcomings, the limitations of competency-based systems are presented as failing to cater for the complexity of decision making and the need for proactive experimentation essential to effective practice. To provide a better fit with the challenges of the various disciplines in their work with performers, an alternative approach is presented which focuses on the promotion, evaluation and elaboration of expertise. Such an approach resonates with important characteristics of professions, whilst also providing for the essential ‘shades of grey’ inherent in work with human participants. Key differences between the approaches are considered through exemplars of evaluation processes. The expertise-focused method, although inherently more complex, is seen as offering a less ambiguous and more positive route, both through more accurate representation of essential professional competence and through facilitation of future growth in proficiency and evolution of expertise in practice. Examples from the literature are also presented, offering further support for the practicalities of this approach

Deletion of parasite immune modulatory sequences combined with immune activating signals enhances vaccine mediated protection against filarial nematodes

<p>Background: Filarial nematodes are tissue-dwelling parasites that can be killed by Th2-driven immune effectors, but that have evolved to withstand immune attack and establish chronic infections by suppressing host immunity. As a consequence, the efficacy of a vaccine against filariasis may depend on its capacity to counter parasite-driven immunomodulation.</p> <p>Methodology and Principal Findings: We immunised mice with DNA plasmids expressing functionally-inactivated forms of two immunomodulatory molecules expressed by the filarial parasite Litomosoides sigmodontis: the abundant larval transcript-1 (LsALT) and cysteine protease inhibitor-2 (LsCPI). The mutant proteins enhanced antibody and cytokine responses to live parasite challenge, and led to more leukocyte recruitment to the site of infection than their native forms. The immune response was further enhanced when the antigens were targeted to dendritic cells using a single chain Fv-αDEC205 antibody and co-administered with plasmids that enhance T helper 2 immunity (IL-4) and antigen-presenting cell recruitment (Flt3L, MIP-1α). Mice immunised simultaneously against the mutated forms of LsALT and LsCPI eliminated adult parasites faster and consistently reduced peripheral microfilaraemia. A multifactorial analysis of the immune response revealed that protection was strongly correlated with the production of parasite-specific IgG1 and with the numbers of leukocytes present at the site of infection.</p> <p>Conclusions: We have developed a successful strategy for DNA vaccination against a nematode infection that specifically targets parasite-driven immunosuppression while simultaneously enhancing Th2 immune responses and parasite antigen presentation by dendritic cells.</p&gt