What makes a good clinical student and teacher? An exploratory study

<b>Background</b> What makes a good clinical student is an area that has received little coverage in the literature and much of the available literature is based on essays and surveys. It is particularly relevant as recent curricular innovations have resulted in greater student autonomy. We also wished to look in depth at what makes a good clinical teacher. <p></p> <b>Methods</b> A qualitative approach using individual interviews with educational supervisors and focus groups with senior clinical students was used. Data was analysed using a “framework” technique. <p></p> <b>Results</b> Good clinical students were viewed as enthusiastic and motivated. They were considered to be proactive and were noted to be visible in the wards. They are confident, knowledgeable, able to prioritise information, flexible and competent in basic clinical skills by the time of graduation. They are fluent in medical terminology while retaining the ability to communicate effectively and are genuine when interacting with patients. They do not let exam pressure interfere with their performance during their attachments. <p></p> Good clinical teachers are effective role models. The importance of teachers’ non-cognitive characteristics such as inter-personal skills and relationship building was particularly emphasised. To be effective, teachers need to take into account individual differences among students, and the communicative nature of the learning process through which students learn and develop. Good teachers were noted to promote student participation in ward communities of practice. Other members of clinical communities of practice can be effective teachers, mentors and role models. <p></p> <b>Conclusions</b> Good clinical students are proactive in their learning; an important quality where students are expected to be active in managing their own learning. Good clinical students share similar characteristics with good clinical teachers. A teacher’s enthusiasm and non-cognitive abilities are as important as their cognitive abilities. Student learning in clinical settings is a collective responsibility. Our findings could be used in tutor training and for formative assessment of both clinical students and teachers. This may promote early recognition and intervention when problems arise

Building Connections: An Interpretative Phenomenological Analysis of Qualitative Research Students’ Learning Experiences

This paper describes a phenomenological study in which the authors explored students’ experiences learning qualitative research in a variety of academic fields. Semi-structured in-depth interviews were conducted with six participants from various academic fields who had completed at least one post-secondary-school-level qualitative research course and who were not students of the researchers. Using Interpretative Phenomenological Analysis (IPA), the researchers identified five primary themes representing the lived experience and meaning found in the participants’ experience of learning qualitative research: (a) a variety of feelings are experienced, (b) a pivotal experience serves as a catalyst in the learning process, (c) the central role of story, (d) active learning, and (e) relating learning to prior knowledge. The findings both support and contribute new aspects to the knowledge of this experience. The results also point to “building connections” as the essence of the phenomenon of learning qualitative research

Chercheur-communicant ou communicant-chercheur : un médiateur de communautés

Comment composer avec les difficiles relations entre chercheurs et praticiens lorsqu’on réunit ces deux identités professionnelles en une seule et même personne ? Vise-t-on à élaborer des savoirs considérés comme scientifiques par la communauté des chercheurs ou comme exploitables par des praticiens pour décider de leur action (Déry, 1997) ? A qui adresser ses recherches pour acquérir soit la crédibilité (Arber, 2005), soit un certain prestige (Déry et Toulouse, 1994) ? Comment vivre la distanciation par rapport au travail quotidien et aux injonctions du temps court de l’action professionnelle versus le temps long de la réflexion académique ? Une meilleure mise en perspective des productions, une réelle transformation des théories et des analyses en connaissances opérationnelles permettent-elles de mettre les théories et les concepts à l’épreuve de leurs savoirs pratiques et inversément ces savoirs pratiques nourrissent-ils le travail épistémique (Avenier, 2004) ? Le vécu de quatorze chercheurs-communicants de 7 nationalités différentes illustre l’apport de la pratique à la recherche en SIC mais aussi les défis auxquels ils sont confrontés

Effets de facteurs naturels et de la coupe de récupération sur la défoliation de la régénération préétablie pendant une épidémie de la tordeuse des bourgeons de l'épinette

L’épidémie de la tordeuse des bourgeons de l’épinette (TBE) ayant débuté en 2006 au Québec a désormais affecté plus de 7 million d’hectares. Bien que l’abondance et la vigueur de la régénération préétablie soient des facteurs de haute importance concernant la composition et la productivité futures des forêts, très peu d’études ont ciblé la façon dont celles-ci sont affectées par la TBE. La coupe de récupération post-TBE deviendra un enjeu économique majeur en zone boréale et la réduction de son impact passe par une compréhension des processus écologiques affectés par l’épidémie en cours. La présente étude vise à approfondir les connaissances de l’impact d’une épidémie de la TBE et de la coupe de récupération post-TBE sur la défoliation subie par la régénération préétablie de peuplements mixtes de sapin baumier et d’épinette noire. Les objectifs spécifiques sont d’abord d’évaluer l’effet de la hauteur et de l’espèce des tiges de régénération, ainsi que de la composition du peuplement, sur la défoliation subie par la régénération préétablie. Ensuite, d’évaluer l’effet de la coupe de récupération sur cette défoliation. Les résultats démontrent que la hauteur, l’espèce, la composition du peuplement et la coupe de récupération affectent toutes significativement la défoliation subie par la régénération. Les individus plus grands, les tiges de sapin baumier et toutes les tiges se trouvant dans des sapinières subissent davantage de défoliation. La défoliation des tiges d’épinette noire dans les pessières était radicalement plus élevée dans les sites récupérés comparativement aux sites naturels, ce qui pourrait influencer la composition future de ces peuplements. Davantage d’études long-terme sont nécessaires afin de mieux comprendre la dynamique sous la canopée durant une épidémie de la TBE, en particulier dans des peuplements dominés par l’épinette noire, ce qui permettrait une meilleure gestion écosystémique de nos forêts et une diminution leur susceptibilité à la TBE.Since 2006, the area defoliated by the spruce budworm (SBW) in Quebec has doubled almost every year, and it has now affected more than 7 million hectares. Although advance regeneration abundance and vigor are critical factors determining future forest composition and productivity, very few studies have focused on how they are affected by a SBW outbreak. In the years to come, post-SBW salvage logging will become a major economic issue in boreal forests and reducing its impact involves an understanding of the ecological processes affected by the outbreak in progress. This study aims to determine the impact of SBW outbreaks and of post-outbreak salvage logging on the defoliation sustained by advance regeneration in mixed stands of balsam fir and black spruce. The specific objectives were, first, to assess the effect of regeneration height and species (balsam fir or black spruce), as well as canopy composition, on the defoliation of advance regeneration. Second, to evaluate whether the defoliation sustained by advance regeneration is greater in salvage logged sites or in natural stands of different compositions. Results showed that height and species of regeneration, canopy composition and salvage logging all significantly affected defoliation. Taller advance regeneration, balsam fir advance regeneration, and all regenerating stems in fir-dominated stands sustained more defoliation. Defoliation sustained by black spruce regeneration was much greater in post-outbreak harvested stands than in the understory of natural sites. Harvesting stands with an important component of black spruce regeneration could potentially reduce the future abundance of black spruce, the preferred species for harvesting. Long-term studies are needed to better understand the dynamics in the regeneration layer during a SBW outbreak, particularly in spruce-dominated stands, to conduct better ecosystem-based management and to help reduce the overall susceptibility of our forests

Relative importance of informational items in Participant Information Leaflets for trials : a Q-Methodology approach

Acknowledgements: The authors would like to thank the stakeholders who participated in the study for their time. Funding: This work was supported by personal fellowship award (to KG) from the Medical Research Council Strategic Skills Methodology Fellowship (MRC MR/ L01193X/1). KI and SC were supported by awards from the National Institute for Health Research Health Technology Assessment Programme (HTA ref 14/192/71, HTA ref 11/58/15). The Health Services Research Unit is supported by a core grant from the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.Peer reviewedPublisher PD

Enjeux identitaires et sociétaires : à la recherche d’une adéquation entre discours et attentes dans la construction des représentations sociales du sénior

L'étude de cas d'un système de téléalarme permet d'aborder l'adéquation entre les attentes du sénior actif et les discours du communicant jouant un rôle dans la construction des représentations sociales autour du sénior. Dans une société axée sur la productivité, où l’injonction d’autonomie est centrale, le sénior se voit soumis à une norme du « bien vieillir ». En resituant le sénior dans son histoire personnelle et collective, nous étudions le discours du communicant de la start-up belge Zembro à son égard et les constructions symboliques engendrées ou mobilisées. Tantôt représenté positivement dans une "horizontalité des pairs", retraité aux multiples activités, tantôt négativement dans une "verticalité des pères", vieillard dépendant, comment s’adresser à la fois au sénior et à ses proches qui participent à son autonomie conçue comme solidaire ou relationnelle ? Comment intégrer les proches souvent prescripteurs sans faire du sénior un « individu collectif ») sans réelle prise sur ce qui est important pour lui ?  Une approche thématique reposant sur l'adéquation « discours-cible » a permis de définir la place qu’un système de téléalarme prend ou pourrait prendre dans la vie d’un sénior et sa position par rapport au discours d'une entreprise.   The case study of a remote alarm system addresses the adequacy between the expectations of the active senior and the communication director’s discourse having a role in the construction of social representations around the senior. In a productivity-driven society focusing on autonomy, the senior is strongly invited to adopt the “age well” standards. Contextualising the senior in his personal and collective history, we study this discourse of the Belgian start-up Zembro and the symbolic constructions it engenders or mobilizes. Sometimes represented positively in a "peer horizontality", the retired with multiple activities, sometimes negatively in a "verticality of the fathers", the dependent old man, how to address both the senior and his relatives who participate in its autonomy conceived as solidary or relational? How to integrate the close relatives often prescribers without making the senior a "collective individual" that would no longer have real hold on what is important for him? A thematic approach of this case study based on the “discourse-public” adequacy, allowed us to define the place a remote alarm system takes or could take in the senior’s life and his position toward the discourse emanating from a profit organisation

Enjeux identitaires et sociétaires : à la recherche d’une adéquation entre discours et attentes dans la construction des représentations sociales du sénior

L'étude de cas d'un système de téléalarme permet d'aborder l'adéquation entre les attentes du sénior actif et les discours du communicant jouant un rôle dans la construction des représentations sociales autour du sénior. Dans une société axée sur la productivité, où l’injonction d’autonomie est centrale, le sénior se voit soumis à une norme du « bien vieillir ». En resituant le sénior dans son histoire personnelle et collective, nous étudions le discours du communicant de la start-up belge Zembro à son égard et les constructions symboliques engendrées ou mobilisées. Tantôt représenté positivement dans une "horizontalité des pairs", retraité aux multiples activités, tantôt négativement dans une "verticalité des pères", vieillard dépendant, comment s’adresser à la fois au sénior et à ses proches qui participent à son autonomie conçue comme solidaire ou relationnelle ? Comment intégrer les proches souvent prescripteurs sans faire du sénior un « individu collectif ») sans réelle prise sur ce qui est important pour lui ?  Une approche thématique reposant sur l'adéquation « discours-cible » a permis de définir la place qu’un système de téléalarme prend ou pourrait prendre dans la vie d’un sénior et sa position par rapport au discours d'une entreprise.   The case study of a remote alarm system addresses the adequacy between the expectations of the active senior and the communication director’s discourse having a role in the construction of social representations around the senior. In a productivity-driven society focusing on autonomy, the senior is strongly invited to adopt the “age well” standards. Contextualising the senior in his personal and collective history, we study this discourse of the Belgian start-up Zembro and the symbolic constructions it engenders or mobilizes. Sometimes represented positively in a "peer horizontality", the retired with multiple activities, sometimes negatively in a "verticality of the fathers", the dependent old man, how to address both the senior and his relatives who participate in its autonomy conceived as solidary or relational? How to integrate the close relatives often prescribers without making the senior a "collective individual" that would no longer have real hold on what is important for him? A thematic approach of this case study based on the “discourse-public” adequacy, allowed us to define the place a remote alarm system takes or could take in the senior’s life and his position toward the discourse emanating from a profit organisation

Testing the applicability of correlations between topographic slope and VS30 for Europe

In the past few years a series of articles have been published concerning the use of topographic slope from digital elevation models (DEMs) constructed through remote sensing (satellite imaging) to give first-order estimates of National Earthquake Hazards Reduction Program (NEHRP) site classes based on the average shear-wave velocity in the top 30 m, VS30 (Wald and Allen, 2007). We evaluate the potential applicability of these methods taking advantage of a large (706 sites) new database of measured and estimated VS30 values and their topographic slopes for locations in Europe and the Middle East. Novel statistical tests are performed to evaluate the predictive power of the procedure in this region. We evaluate the percentage of sites correctly classified/misclassified for each site class for active and stable regimes. We also analyze the marginal distributions of the input VS30 and slope values and their impact on the VS30-slope correlations and we evaluate whether the method performs better than does chance. We also consider the surface geology of sites and investigate whether differences in geology can help explain why certain sites are poorly classified by the method. Finally, we use the city of Thessaloniki, Greece, as a test case for comparison between the results of a recent microzonation and the site classes predicted by VS30-slope correlations. Our results show that the method does a better job than blind chance for all site classes in active regions, but only for class B (rock) and to a lesser extent class C (stiff soil) sites located in stable areas, although the conclusions for stable areas are based on limited data. We recommend that site classifications based on the VS30-slope correlations proposed by Wald and Allen (2007) be used only for regional or national (and not local or site-specific) first-order studies in active parts of Europe and only in the absence of other more detailed information, excluding sites inside small basins or those with special geological conditions that may affect results (e.g., flat-lying volcanic plateaus, carbonate rocks, continental glaciated terrain, or a coastal location if slope is not calculated using bathymetric data)

Verifying participant-reported clinical outcomes : challenges and implications

The parent trials KAT, REFLUX and CATHETER were all funded by the UK NIHR Health Technology Assessment Programme. RECORD was funded by the UK Medical Research Council. Suzanne Breeman and Lynda Constable are joint first authors.Peer reviewedPublisher PD

Metabolic processes and carbon nutrient exchanges between host and pathogen sustain the disease development during sunflower infection by Sclerotinia sclerotiorum.

International audienceInteractions between the necrotrophic fungus Sclerotinia sclerotiorum and one of its hosts, Helianthus annuus L., were analyzed during fungal colonization of plant tissues. Metabolomic analysis, based on (13)C- and (31)P-NMR spectroscopy, was used to draw up the profiles of soluble metabolites of the two partners before interaction, and to trace the fate of metabolites specific of each partner during colonization. In sunflower cotyledons, the main soluble carbohydrates were glucose, fructose, sucrose and glutamate. In S. sclerotiorum extracts, glucose, trehalose and mannitol were the predominant soluble carbon stores. During infection, a decline in sugars and amino acids was observed in the plant and fungus total content. Sucrose and fructose, initially present almost exclusively in plant, were reduced by 85%. We used a biochemical approach to correlate the disappearance of sucrose with the expression and the activity of fungal invertase. The expression of two hexose transporters, Sshxt1 and Sshxt2, was enhanced during infection. A database search for hexose transporters homologues in the S. sclerotiorum genome revealed a multigenic sugar transport system. Furthermore, the composition of the pool of reserve sugars and polyols during infection was investigated. Whereas mannitol was produced in vitro and accumulated in planta, glycerol was exclusively produced in infected tissues and increased during colonization. The hypothesis that the induction of glycerol synthesis in S. sclerotiorum exerts a positive effect on osmotic protection of fungal cells and favors fungal growth in plant tissues is discussed. Taken together, our data revealed the importance of carbon-nutrient exchanges during the necrotrophic pathogenesis of S. sclerotiorum