Training simulated patients: evaluation of a training approach using self-assessment and peer/tutor feedback to improve performance

<p>Abstract</p> <p>Background</p> <p>Most medical schools use simulated patients (SPs) for teaching. In this context the authenticity of role play and quality of feedback provided by SPs is of paramount importance. The available literature on SP training mostly addresses instructor led training where the SPs are given direction on their roles. This study focuses on the use of peer and self evaluation as a tool to train SPs.</p> <p>Methods</p> <p>SPs at the medical school participated in a staff development and training programme which included a) self-assessment of their performance while observing video-tapes of their role play using a structured guide and b) peer group assessment of their performance under tutor guidance. The pre and post training performance in relation to authenticity of role play and quality of feedback was blindly assessed by students and tutors using a validated instrument and the scores were compared. A focus group discussion and a questionnaire assessed acceptability of the training programme by the SPs.</p> <p>Results</p> <p>The post-training performance assessment scores were significantly higher (p < 0.05) than the pre-training scores. The degree of improvement in the quality of feedback provided to students was more when compared to the improvement of role play. The acceptability of the training by the SPs was very satisfactory scoring an average of 7.6 out of 10. The majority of the SPs requested the new method of training to be included in their current training programme as a regular feature.</p> <p>Conclusion</p> <p>Use of structured self-reflective and peer-interactive, practice based methods of SP training is recommended to improve SP performance. More studies on these methods of training may further refine SP training and lead to improvement of SP performance which in turn may positively impact medical education.</p

Random and Correlated Phases of Primordial Gravitaional Waves

The phases of primordial gravity waves is analysed in detail within a quantum mechanical context following the formalism developed by Grishchuk and Sidorov. It is found that for physically relevant wavelengths both the phase of each individual mode and the phase {\it difference} between modes are randomly distributed. The phase {\it sum} between modes with oppositely directed wave-vectors, however, is not random and takes on a definite value with no rms fluctuation. The conventional point of view that primordial gravity waves appear after inflation as a classical, random stochastic background is also addressed.Comment: 14 pages, written in REVTE

Ecological evaluation of proposed discharge of dredged material from Oakland Harbor into ocean waters (Phase 3 of 38-Foot Project). Volume 1, Background and appendixes A through H

At the request of the US Army Corps of Engineering (USACE), environmental studies were conducted by Battelle/Marine Sciences Laboratory (MSL) to evaluate the suitability of sediments from Oakland Inner Harbor for dredging and ocean disposal. During the Phase 3 38-Foot Project, sediment cores were collected from mudline to {minus}39 ft mean lower low water at various locations in Oakland Inner Harbor channel and allocated to six composite samples. These composites were evaluated through physical/chemical analyses, acute toxicity to sensitive marine organisms, and bioaccumulation potential. Sediment samples from individual locations were tested for physical/chemical parameters only. The results of toxicological and bioaccumulation testing may be used by USACE to determine the amount of potential dredged material from Oakland Inner Harbor channel acceptable for open-water disposal as defined by the Draft Implementation Manual (EPA/USACE 1990) and consistent with the Water Resources Development Act of 1986 (Public Law 99-662). This is Volume 1 of a two-volume data report that presents the data gathered during the Oakland Harbor Phase 3 38-Foot Project, conducted in the Fall of 1990. This data report does not include interpretation or statistical analysis of the 38-Foot data. Volume 1 includes the project background as well as a full presentation of data and results in Appendixes A through H. Volume 2 contains the remaining data in Appendixes I through L

Showing Israel the red card. Activists engaged in pro-Palestinian sport-related campaigns

© 2017 Informa UK Limited, trading as Taylor & Francis Group. This article explores the motivations of activists involved in pro-Palestinian sports-based campaigns. The activists’ intention is to bring pressure to bear upon Israel until it complies with international law and supports the rights of Palestinian people under the universal principles of human rights. In response to expressions of pro-Palestinian solidarity, the Israeli state and its supporters are interpreting such activity as a ‘new’ manifestation of ‘old’ antisemitism. In seeking to assess whether such activity is informed by antisemitism, 10 semi-structured interviews were conducted with activists to examine their motives. Their political biographies were explored as were their views on the use of sport as platform to express support for the Palestinian people and/or their displeasure at Israeli participation in international sport. One central theme was the activists’ responses to the suggestion that they were motivated by antisemitism. A qualitative content analysis of the interview transcripts revealed a shared observation that the accusation of antisemitism was a ‘shameless tactic’ employed by those seeking to cover up the ongoing injustices experienced by the Palestinian people. Sport was seen as a legitimate platform for political activity, to raise public awareness and to put pressure on the Israeli state. The findings contribute to a better understanding of activist motivations, the use of sport as a political platform and the challenges facing sport and its governing bodies

Nutritional Geometry Provides Food for Thought

Dietary Restriction extends lifespan in a diverse range of animals, but this often comes at a cost to reproduction. While a number of molecular pathways integral to these relationships have been characterised, we still do not fully understand whether restriction of specific nutrients or calories is responsible. Two recent studies on insects have offered novel insights into this longstanding issue via the application of Nutritional Geometry. This technique promises to significantly advance our understanding of how nutrition influences reproduction and longevity

Black Hole Mass Estimates Based on CIV are Consistent with Those Based on the Balmer Lines

Using a sample of high-redshift lensed quasars from the CASTLES project with observed-frame ultraviolet or optical and near-infrared spectra, we have searched for possible biases between supermassive black hole (BH) mass estimates based on the CIV, Halpha and Hbeta broad emission lines. Our sample is based upon that of Greene, Peng & Ludwig, expanded with new near-IR spectroscopic observations, consistently analyzed high S/N optical spectra, and consistent continuum luminosity estimates at 5100A. We find that BH mass estimates based on the FWHM of CIV show a systematic offset with respect to those obtained from the line dispersion, sigma_l, of the same emission line, but not with those obtained from the FWHM of Halpha and Hbeta. The magnitude of the offset depends on the treatment of the HeII and FeII emission blended with CIV, but there is little scatter for any fixed measurement prescription. While we otherwise find no systematic offsets between CIV and Balmer line mass estimates, we do find that the residuals between them are strongly correlated with the ratio of the UV and optical continuum luminosities. Removing this dependency reduces the scatter between the UV- and optical-based BH mass estimates by a factor of approximately 2, from roughly 0.35 to 0.18 dex. The dispersion is smallest when comparing the CIV sigma_l mass estimate, after removing the offset from the FWHM estimates, and either Balmer line mass estimate. The correlation with the continuum slope is likely due to a combination of reddening, host contamination and object-dependent SED shapes. When we add additional heterogeneous measurements from the literature, the results are unchanged.Comment: Accepted for publication in The Astrophysical Journal. 37 text pages + 8 tables + 23 figures. Updated with comments by the referee and with a expanded discussion on literature data including new observation

Diagnostic thinking and information used in clinical decision-making: a qualitative study of expert and student dental clinicians

<p>Abstract</p> <p>Background</p> <p>It is uncertain whether the range and frequency of Diagnostic Thinking Processes (DTP) and pieces of information (concepts) involved in dental restorative treatment planning are different between students and expert clinicians.</p> <p>Methods</p> <p>We video-recorded dental visits with one standardized patient. Clinicians were subsequently interviewed and their cognitive strategies explored using guide questions; interviews were also recorded. Both visit and interview were content-analyzed, following the Gale and Marsden model for clinical decision-making. Limited tests used to contrast data were t, χ², and Fisher's. Scott's π was used to determine inter-coder reliability.</p> <p>Results</p> <p>Fifteen dentists and 17 senior dental students participated in visits lasting 32.0 minutes (± 12.9) among experts, and 29.9 ± 7.1 among students; contact time with patient was 26.4 ± 13.9 minutes (experts), and 22.2 ± 7.5 (students). The time elapsed between the first and the last instances of the clinician looking in the mouth was similar between experts and students. Ninety eight types of pieces of information were used in combinations with 12 DTPs. The main differences found in DTP utilization had dentists conducting diagnostic interpretations of findings with sufficient certainty to be considered definitive twice as often as students. Students resorted more often to more general or clarifying enquiry in their search for information than dentists.</p> <p>Conclusions</p> <p>Differences in diagnostic strategies and concepts existed within clearly delimited types of cognitive processes; such processes were largely compatible with the analytic and (in particular) non-analytic approaches to clinical decision-making identified in the medical field. Because we were focused on a clinical presentation primarily made up of non-emergency treatment needs, use of other DTPs and concepts might occur when clinicians evaluate emergency treatment needs, complex rehabilitative cases, and/or medically compromised patients.</p

Anthropology and GIS: Temporal and Spatial Distribution of the Philippine Negrito Groups

The Philippine negrito groups comprise a diverse group of populations speaking over 30 different languages, who are spread all over the archipelago, mostly in marginal areas of Luzon Island in the north, the central Visayas islands, and Mindanao in the south. They exhibit physical characteristics that are different from more than 100 Philippine ethnolinguistic groups that are categorized as non-negritos. Given their numbers, it is not surprising that Philippine negritos make up a major category in a number of general ethnographic maps produced since the nineteenth century. Reports from various ethnological surveys during this period, however, have further enriched our understanding regarding the extent and distribution of negrito populations. Using the data contained in these reports, it is possible to plot and create a map showing the historical locations and distribution of negrito groups. Using geographic information systems (GIS), the location and distribution of negrito groups at any given time can be overlaid on historical or current maps. In the present study, a GIS layer was compiled and extracted from the 2000 Philippine Census of population at the village level and overlaid on existing maps of the Philippines. The maps that were generated from this project will complement ongoing anthropological and genetic studies of negrito groups that inhabit different locations within the Philippine archipelago

The influence of medical expertise, case typicality and illness script component on case processing and disease probability estimates

The present study investigated the influence of medical expertise, case typicality, and illness script component (enabling conditions vs. consequences) on the speed of case informati

Mobility patterns of Asian students: the case of tourism and hospitality management students in the UK

This study aims to investigate the driving forces of Asian students to study tourism and hospitality in the United Kingdom (UK) at three stages, including: (1) choice of a foreign country, (2) selecting the UK as the host country, and (3) undertaking tourism and hospitality courses. We collected data using questionnaires, distributing among tourism and management students attending a major higher education provider in the UK. The findings identified subgroups of push and pull factors that explain the movement patterns of Asian students toward studying tourism and hospitality in the UK. Using a mathematical equation, this study revealed that “seeking a better life,” “the nature of the program,” and “external influences” significantly impact students’ movements