Developing an integrated national simulation-based educational programme for Scottish junior doctors through structured, multi-step action research cycles

OBJECTIVES: Simulation is widely employed to teach a range of skills, across healthcare professions and is most effective when embedded within a standarised curriculum. Although recommended by many governing bodies, establishing a national programme of simulation presents many challenges. Successful implementation requires a clear understanding of the priorities and needs of those it seeks to serve yet there are limited examples of how best to do this. This study aimed to develop an integrated national simulation-based educational programme for junior doctors in Scotland through a structed, multistep prioritisation process. DESIGN: A series of action research cycles were undertaken to develop and evaluate a national simulation programme. This paper describes cycle 1, which employed a six-step structured approach to understand and prioritise learner needs. SETTING: The study considered the educational needs of Scottish junior doctors in the UK Foundation Programme (UKFP). PARTICIPANTS: Multiple stakeholder groups were involved in each stage of the process including recent Scottish UKFP graduates, clinical educators, UKFP programme directors and postgraduate deans. RESULTS: Key stakeholders reviewed the 370 competencies in the UKFP curriculum and identified 18 initial competency areas. These 18 areas were subsequently prioritised through the analytical hierarchy process, resulting in a carefully ordered list of 12 competencies from which a targeted simulation-based educational programme could be developed. CONCLUSIONS: To our knowledge, this is the first study to outline the methods of competency prioritisation to create a simulation curriculum that is integrated within a national curriculum in the medical education context. As well as demonstrating the practical steps of such a process, key implications for practice are identified. This robust approach to educational design also resulted in unexpected benefits, including educator and clinician acceptance and programme funding sustainability

Preventing Ventilator Associated Pneumonia

The most common nosocomial (hospital acquired) infection is Ventilator Associated Pneumonia (VAP). VAP increases morbidity and mortality rates. 8-28% of critical care patients develop VAP. VAP also increases the length of a hospital stay and adds $20,000-40,000 to the cost. Insurance companies will not cover this cost. The purpose of this study is to determine the best method to reduce the occurrence of VAP

Developing a national dental education research strategy:priorities, barriers and enablers

Objectives: This study aimed to identify national dental education research (DER) priorities for the next 3-5 years and to identify barriers and enablers to DER. Setting: Scotland Participants: In this two-stage online questionnaire study we collected data with multiple dental professions (e.g. dentistry, dental nursing, dental hygiene) and stakeholder groups (e.g. learners, clinicians, educators, managers, researchers, academics). Eighty-five participants completed the Stage 1 qualitative questionnaire and 649 participants the Stage 2 quantitative questionnaire. Results: Eight themes were identified at Stage 1. Of the 24 DER priorities identified, the top three were: role of assessments in identifying competence; undergraduate curriculum prepares for practice; and promoting teamwork. Following exploratory factor analysis, the 24 items loaded onto four factors: teamwork and professionalism, measuring and enhancing performance, dental workforce issues, and curriculum integration and innovation. Barriers and enablers existed at multiple levels: individual, interpersonal, institutional structures and cultures, and technology. Conclusion: This priority setting exercise provides a necessary first step to developing a national DER strategy capturing multiple perspectives. Promoting DER requires improved resourcing alongside efforts to overcome peer stigma and lack of valuing and motivation

The importance of wavelength for tight temperature control during µ-laser assisted machining

The area of single point diamond turning of brittle materials like semiconductors and ceramics is significantly benefitted by incorporation of laser assistance. In a new developmental technology that is now recognized as micro-laser-assisted machining (μ-LAM), a laser is shone through a diamond tool to soften the high-pressure phase transformed ductile machining phases that in turn allows thermal softening and thereby enables a higher material removal rate during ductile mode machining. One of the lasers currently used in μ-LAM is the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser operating at 100 W (continuous wave) at the wavelength of 1064 nm. Although this configuration has worked to the benefit of the technology, here we report futuristic developments that will significantly enhance temperature control by selecting a laser wavelength according to the material being machined, allowing tunable machining properties. The concept is illustrated with sample calculations for μ-LAM of silicon, and it appears to offer better target temperatures, thus enhancing the performance of the μ-LAM process

Selected area hot machining with a multi-tipped diamond tooling system.

An investigation of a novel ultra-precision tool is presented, the hot-milling multi-turret diamond tool. The tool implements micro-Laser Assisted Machining (μ-LAM) upon a multiple diamond fly cutter. Details of its design, both mechanical and optical, are presented- along with proposed modifications to Cranfield University’s Tetraform C machine to allow for its implementation. Relevant experimentation is presented- the modal analysis of the Tetraform C machine and the testing of laser heating on a silicon substrate. FE analyses are carried out and calculations presented to justify design choices. Analytical investigations predicted increased depths of cut by using laser, and indicated that at lower wavelengths of laser light and with lower feed rates that the depth of cut may be significantly increased. A novel method of selecting laser wavelength based upon change in material absorptivity with temperature is investigated which may offer substantial increases in μ-LAM performanceMRes in Manufacturin

An Evaluation of a Scottish Higher Education ‘Student Transitions’ Enhancement Theme:Stakeholders’ Perceptions and Recommendations for Future Activities

We would like to acknowledge that this work was funded by QAA Scotland.The Quality Assurance Agency Enhancement Themes identify specific development themes to enhance the student learning experience in Scottish higher education (HE). This evaluation explored the second year of the ‘Student Transitions’ theme through the questions: How do stakeholders perceive the impact of the ‘Student Transitions’ work and, what are the facilitators and barriers to the successful development of projects? Data were collected during two overlapping phases. In Phase 1, 30 individuals, with national or institutional leadership roles associated with the current Enhancement Theme participated in semi-structured telephone interviews. In Phase 2, 43 online questionnaires were completed by institutionally nominated individuals. Professional, support and academic staff, and student representatives from all 19 Scottish Universities participated. Data were analysed using a thematic framework approach and descriptive statistics. Themes developed were: perceived impact; facilitators and barriers, such as support, engagement and sustainability. These themes were explored across institutions and sector wide. Participants felt ‘Student Transitions’ work was fundamental for Universities. Participants considered that Theme work had enhanced reflection on, and engagement with transition issues. Capturing direct impact was challenging for participants and it was proposed that it may take several years to evidence the outcomes of the work at the level of student experience. Broadly, participants reported that the sector was supportive and collaborative where ideas and resources for the ‘Student Transitions’ work had been openly shared. Challenges to advancing Enhancement Theme activities include limited time and other agendas competing for limited resources e.g. the Teaching Excellence Framework (TEF). The findings highlight the complexity of integrating the Theme within institutions and broadly across the sector. Key recommendations and lessons learned surround 1) defining and measuring impact; 2) enhancing engagement; 3) and Theme integration.Publisher PDFPeer reviewe

Antimicrobial Interventions and Application Time Effects on Ground Beef Quality

Small business meat processors can use organic acid antimicrobial interventions to control Shiga toxin-producing E. coli (STEC) when producing ground beef; however, many small producers are concerned about the impact on ground beef quality. The effects of two commonly used organic acids, lactic acid and peroxyacetic acid, were evaluated at short (15 seconds) or extended (3 minutes) raw material dip times on ground beef quality parameters. Beef trim dipped in lactic acid for 3 minutes had a reduction in total aerobic bacteria plate count, but also increased ground beef discoloration and lipid oxidation during retail display. Use of a shorter dip time showed minimal differences in ground beef quality compared to untreated controls. In addition, dipping lean trim in peroxyacetic acid for 3 minutes slowed ground beef discoloration during display. Therefore, processors should consider either type of organic acid, and the length of lean trim exposure to organic acid during dipping, to optimize shelf life quality attributes

Antimicrobial Interventions and Application Time Effects on Ground Beef Quality

Small business meat processors can use organic acid antimicrobial interventions to control Shiga toxin-producing E. coli (STEC) when producing ground beef; however, many small producers are concerned about the impact on ground beef quality. The effects of two commonly used organic acids, lactic acid and peroxyacetic acid, were evaluated at short (15 seconds) or extended (3 minutes) raw material dip times on ground beef quality parameters. Beef trim dipped in lactic acid for 3 minutes had a reduction in total aerobic bacteria plate count, but also increased ground beef discoloration and lipid oxidation during retail display. Use of a shorter dip time showed minimal differences in ground beef quality compared to untreated controls. In addition, dipping lean trim in peroxyacetic acid for 3 minutes slowed ground beef discoloration during display. Therefore, processors should consider either type of organic acid, and the length of lean trim exposure to organic acid during dipping, to optimize shelf life quality attributes

Analysis of World War One Diaries using Natural Language Processing

World War I was a significant event in Australian history and as such it has been extensively researched. The analysis of relevant primary sources has included the close reading of war diaries. Close reading involves reading the diaries to understand what the soldiers went through. With the advancement of computational techniques, we now have the ability to analyse large volumes of text, and this concept is known as distant reading. This project focuses on 557 Australian World War I diaries collected and transcribed by the State Library of New South Wales, and aims to use distant reading methods to determine what the soldiers wrote about and how they felt over the course of the war. In order to perform our analysis over time, we first needed to extract dates from the diaries. This was done using regular expressions. However, some problems were found in the extracted dates, including missing data such as the month or year, dates which were written incorrectly, and dates that were actually within the text referring to events that happened rather than the date the diaries were written. Hence, an optimisation program was formed to fix these problems and give more accurate information about when the diaries were written. We then considered several types of analysis to understand what the soldiers wrote about, including word frequencies, tf-idf (term frequency - inverse document frequency), and topic modelling. It was found that whilst all three of these techniques gave results that would be expected when considering World War I diaries, they also showed different aspects of the war. In particular, through considering the tf-idf results for 1916 we see many words regarding places and battles in the Middle East. However, when considering topic modelling for this time period we see more words regarding Europe. Sentiment analysis, more specifically dictionary-based methods, was then used to understand the emotions of the soldiers over time. Using our dictionaries, each month was given an overall sentiment score from -1 (very negative) to +1 (very positive). It was found that the average sentiment of the diaries ranged between 0 and 0.2. We were also able to compare this to our topic modelling results to determine which topics corresponded to peaks and dips in our sentiment.Thesis (MPhil) -- University of Adelaide, School of Mathematical Sciences, 202