Walking in a patient’s shoes: an evaluation study of immersive learning using a digital training intervention

Objectives: Evidence suggests that immersive learning increases empathy and understanding of the patient experience of illness. This study evaluated a digital training intervention ‘In Their Shoes’ which immerses participants in the experience of living with inflammatory bowel disease (IBD), highlighting the biopsychosocial impact. The simulation program uses a mobile application to deliver time-based tasks and challenges over 36 h, supplemented with telephone role-play and ‘kit’ items to open and use. This study investigated changes in IBD understanding and connection to patients, empathy and perception of job value in a group of pharmaceutical employees. Additionally, it explored experiences and impact of taking part in the intervention. Methods: A mixed methods pre–post design was utilized, with an opportunity sample of employees taking part in the training. 104 participants from sites in 12 countries completed measures at baseline and 97 post-intervention. Measures included the Toronto Empathy Questionnaire, Prosocial Job Characteristics Scale, and structured questions around IBD understanding and connection to patients. Two focus groups (N = 14) were conducted regarding participants experiences of the intervention to complement an open-response question in the questionnaire (N = 75). Qualitative data was analyzed using thematic analysis. Results: Following the intervention, there were statistically significant increases in IBD understanding and connection to patients (p < 0.00025), evaluation of organizational innovation (p < 0.00025), empathy (d = 0.45) and prosocial job perceptions (d = 0.28). Qualitative analysis revealed more fully the transformative personal journey undertaken by participants which provided ‘eye opening’ insight into the psychosocial impact of living and working with IBD. This insight encouraged patient perspective-taking and a strong desire to promote patient advocacy and reduce stigma around chronic illness. Finally, greater organizational pride and connectivity was evident for some participants. Conclusions: An immersive training program, focussing on the lived experience of illness, led to significant increases in disease understanding and empathy. These findings align with other literature evaluating immersive learning and the potential for increasing knowledge, empathy and motivation. The present study offers opportunities to extend this outside of the body of work focussing on healthcare practitioners and explores the benefits of using this type of learning experience within an organizational setting

Causas de variação de características de crescimento do nascimento a desmama de bezerros da raça Charolesa.

Causas da variação não genética dos pesos ao nascer (PN) aos 205 dias e aos 270 dias de idade e das taxas absolutas e relativas de crescimento do nascimento a desmama

Aperiodic invariant continua for surface homeomorphisms

We prove that if a homeomorphism of a closed orientable surface S has no wandering points and leaves invariant a compact, connected set K which contains no periodic points, then either K=S and S is a torus, or $K$ is the intersection of a decreasing sequence of annuli. A version for non-orientable surfaces is given.Comment: 8 pages, to appear in Mathematische Zeitschrif

Modeling livestock systems. I. A descriptive formalism

We attempted to categorize synthetic models of livestock production and assemble a set of descriptors for structural elements, level of resolution, operational objectives and algorithm for these models. These descriptors are suggested to be necessary and sufficient elements of the published documentation of operational model objective(s), the model algorithm and model domain of models of livestock systems. We suggest that the publication of models of livestock production require documentation of this information. Using the proposed set of descriptors, published models of livestock systems can be described systematically, allowing the evaluation of suitability to task to become more transparent and stringent. Nutrient supply level driven simulation models seem to be the model design archetype with least methodological restrictions. Their suitability to task is defined by the extent of qualitative and quantitative understanding of the relevant biology upon which they are based

Modeling livestock systems. II. Understanding the relevant biology

Essential components of bio-mathematical simulation models of livestock systems were examined for degree of understanding, qualitative and quantitative, of the relevant underlying biology. Key knowledge gaps in modeling of growth, lactation, and energy metabolism were shown to exist. Suggestions for discipline-oriented research, directed to close these gaps, are given

Global Diffusion in a Realistic Three-Dimensional Time-Dependent Nonturbulent Fluid Flow

We introduce and study the first model of an experimentally realizable three-dimensional time-dependent nonturbulent fluid flow to display the phenomenon of global diffusion of passive-scalar particles at arbitrarily small values of the nonintegrable perturbation. This type of chaotic advection, termed {\it resonance-induced diffusion\/}, is generic for a large class of flows.Comment: 4 pages, uuencoded compressed postscript file, to appear in Phys. Rev. Lett. Also available on the WWW from http://formentor.uib.es/~julyan/, or on paper by reques

An experimental methodology to characterise post-necking behaviour and quantify ductile damage accumulation in isotropic materials

The development of ductile damage, that occurs beyond the point of necking in a tensile test, can be difficult to quantify. An experimental methodology has been developed to accurately characterise the post-necking deformation response of a material through continuous monitoring of the specimens shape up until rupture. By studying the evolution of the neck geometry, the correct values of the local stress and strain have been determined in samples of grade 304L stainless steel and C110 copper. Notched bar specimens of various notch acuities were examined enabling the effects of stress triaxiality on ductile fracture to be determined. The methodology developed has provided a robust framework for macroscopic measurements of ductile damage during the necking process. To characterise the material degradation process, the elastic modulus reduction method was employed on hourglass-shaped specimens of the same materials. Stiffness degradation was measured using a small gauge extensometer during uninterrupted tensile tests with partial elastic unloadings. A metallographic study was conducted on progressively damaged specimens in order to validate the macroscopic damage measurements. A new non-linear ductile damage accumulation law has been developed and calibrated, which provides an advanced representation of the experimental results, and a significant improvement compared to linear accumulation models frequently employed. This realistic modelling approach considers the degradation of the material when it has undergone severe plastic deformation, and provides a more accurate representation of the near failure behaviour by considering the effects of stress triaxiality. The methodology provides accurate data for damage model development and calibration, to improve the predictions of remnant life from ductile damage in engineering components