Timing and dynamics of Late Wolstonian Substage 'Moreton Stadial' (MIS 6) glaciation in the English West Midlands, UK

Glaciation during the late Middle Pleistocene is widely recognized across continental northwest Europe, but its extent and palaeoenvironmental significance in the British Isles are disputed. Although glaciogenic sediments at Wolston, Warwickshire, in the English West Midlands, have been used to define the stratotype of the Wolstonian Stage, their age has been variably assigned between marine isotope stages (MIS) 12 and 6. Here we present sedimentological and stratigraphical observations from five sites across the English West Midlands whose chronology is constrained by new luminescence ages from glaciofluvial sediments, supplemented by cosmogenic 36 Cl exposure dating of erratic boulders. The ages suggest that between 199 ± 5 and 147 ± 2.5 ka the British Ice Sheet advanced into the English West Midlands as far south as Moreton-in-Marsh, Gloucestershire. This advance is assigned to the Moreton Stadial of the Late Wolstonian Substage. Dating of the glaciation to this substage allows correlation of the Moreton Stadial glacial deposits in the English West Midlands with those of the Drenthe Stadial during the Late Saalian Substage across continental northwest Europe

Key challenges in simulated patient programs: An international comparative case study

<p>Abstract</p> <p>Background</p> <p>The literature on simulated or standardized patient (SP) methodology is expanding. However, at the level of the program, there are several gaps in the literature. We seek to fill this gap through documenting experiences from four programs in Australia, Canada, Switzerland and the United Kingdom. We focused on challenges in SP methodology, faculty, organisational structure and quality assurance.</p> <p>Methods</p> <p>We used a multiple case study method with cross-case synthesis. Over eighteen months during a series of informal and formal interactions (focused meetings and conference presentations) we documented key characteristics of programs and drew on secondary document sources.</p> <p>Results</p> <p>Although programs shared challenges in SP methodology they also experienced differences. Key challenges common to programs included systematic quality assurance and the opportunity for research. There were differences in the terminology used to describe SPs, in their recruitment and training. Other differences reflected local conditions and demands in organisational structure, funding relationships with the host institution and national trends, especially in assessments.</p> <p>Conclusion</p> <p>This international case study reveals similarities and differences in SP methodology. Programs were highly contextualised and have emerged in response to local, institutional, profession/discipline and national conditions. Broader trends in healthcare education have also influenced development. Each of the programs experienced challenges in the same themes but the nature of the challenges often varied widely.</p