Governance models for collaborations involving assessment

This paper is driven by a desire to improve assessment in higher education to yield better outcomes for communities, professions and individuals. The analysis unfolds within the field of medicine but is conceptualised to be of much broader relevance to other professional fields and academic disciplines. The focus is on assessment during the course as opposed to assessment for admissions or licensing purposes. The interest in assessment is not simply to produce practitioners, but to develop better practitioners. As well, the remarks are bounded by the context of universities in Australia and hence the complex but important assumption of academic autonomy. As the above remarks convey, we consider that while much current assessment practice is not broken, on quality and efficiency grounds it is certainly in need of somewhat radical improvement

The Australian Medical Assessment Collaboration: developing the foundations for a national assessment of medical student learning outcomes

In late December 2010 the Australian Learning and Teaching Council Ltd (ALTC) provided a grant to The University of Queensland along with the Australian Council for Educational Research (ACER) and Monash University to develop foundations for a national assessment that evaluates the learning outcomes of later‐year medical students in Australia. The project, titled ‘Developing the foundation for a national assessment of medical student learning outcomes’ responds to the growing need to prove and improve the standards of medical education by establishing an Australian Medical Assessment Collaboration (AMAC). This project includes scoping work, wide‐ranging sector engagement, development of an assessment framework, the compilation of assessment items, and the validation of items through pilot testing. The work provides a foundation for what will be the ongoing development and implementation of collaboration that will provide a sustainable and robust means of assuring the standards of medical education in Australia. The ALTC grant for this project has enabled the establishment of AMAC. This report outlines the achievements of the project and provides operational detail on the establishment of the collaboration

A non-linear structure-preserving matrix method for the computation of the coefficients of an approximate greatest common divisor of two Bernstein polynomials

This paper describes a non-linear structure-preserving ma trix method for the com- putation of the coefficients of an approximate greatest commo n divisor (AGCD) of degree t of two Bernstein polynomials f ( y ) and g ( y ). This method is applied to a modified form S t ( f, g ) Q t of the t th subresultant matrix S t ( f, g ) of the Sylvester resultant matrix S ( f, g ) of f ( y ) and g ( y ), where Q t is a diagonal matrix of com- binatorial terms. This modified subresultant matrix has sig nificant computational advantages with respect to the standard subresultant matri x S t ( f, g ), and it yields better results for AGCD computations. It is shown that f ( y ) and g ( y ) must be pro- cessed by three operations before S t ( f, g ) Q t is formed, and the consequence of these operations is the introduction of two parameters, α and θ , such that the entries of S t ( f, g ) Q t are non-linear functions of α, θ and the coefficients of f ( y ) and g ( y ). The values of α and θ are optimised, and it is shown that these optimal values allo w an AGCD that has a small error, and a structured low rank approxi mation of S ( f, g ), to be computed

A Novel Role for MAPKAPK2 in Morphogenesis during Zebrafish Development

One of the earliest morphogenetic processes in the development of many animals is epiboly. In the zebrafish, epiboly ensues when the animally localized blastoderm cells spread, thin over, and enclose the vegetally localized yolk. Only a few factors are known to function in this fundamental process. We identified a maternal-effect mutant, betty boop (bbp), which displays a novel defect in epiboly, wherein the blastoderm margin constricts dramatically, precisely when half of the yolk cell is covered by the blastoderm, causing the yolk cell to burst. Whole-blastoderm transplants and mRNA microinjection rescue demonstrate that Bbp functions in the yolk cell to regulate epiboly. We positionally cloned the maternal-effect bbp mutant gene and identified it as the zebrafish homolog of the serine-threonine kinase Mitogen Activated Protein Kinase Activated Protein Kinase 2, or MAPKAPK2, which was not previously known to function in embryonic development. We show that the regulation of MAPKAPK2 is conserved and p38 MAP kinase functions upstream of MAPKAPK2 in regulating epiboly in the zebrafish embryo. Dramatic alterations in calcium dynamics, together with the massive marginal constrictive force observed in bbp mutants, indicate precocious constriction of an F-actin network within the yolk cell, which first forms at 50% epiboly and regulates epiboly progression. We show that MAPKAPK2 activity and its regulator p38 MAPK function in the yolk cell to regulate the process of epiboly, identifying a new pathway regulating this cell movement process. We postulate that a p38 MAPKAPK2 kinase cascade modulates the activity of F-actin at the yolk cell margin circumference allowing the gradual closure of the blastopore as epiboly progresses

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Data Souvenirs and Reflection in the Home

Abstract. We present Data Souvenirs, book-like electronic objects that display various forms of information with the goal of supporting reflection and reminiscence. Data Souvenirs draw on the ability of electronic data streams to provide new perspectives on data in and around the home while taking on a less distracting, more reflective form than existing domestic technologies. Several authors highlight the importance of self reflection in technology design [6, 9]. Sengers et al. [9] define reflection as “bringing unconscious aspects of experience to conscious awareness,... making them available for conscious choice. ” They argue that “critical reflection is crucial to individual freedom and our quality of life in society as a whole, since without it, we unthinkingly adopt attitudes, practices, values, and identities we might not consciously espouse. ” We agree with this argument; we further argue that many technologies for the home offer poor support for contemplative activities like reflection, and in fact often serve as a distraction from such activities. Blurring work/home boundaries, the tendency of multi-purpose computers to be a distraction [2], and the ability of entertainment technologies like televisions to support passiv

The Australian Medical Schools Assessment Collaboration: benchmarking the preclinical performance of medical students

Objectives: To report the level of participation of medical schools in the Australian Medical Schools Assessment Collaboration (AMSAC); and to measure differences in student performance related to medical school characteristics and implementation methods. Design: Retrospective analysis of data using the Rasch statistical model to correct for missing data and variability in item difficulty. Linear model analysis of variance was used to assess differences in student performance. Setting and participants: 6401 preclinical students from 13 medical schools that participated in AMSAC from 2011 to 2013. Main outcome measures: Rasch estimates of preclinical basic and clinical science knowledge. Results: Representation of Australian medical schools and students in AMSAC more than doubled between 2009 and 2013. In 2013 it included 12 of 19 medical schools and 68% of medical students. Graduate-entry students scored higher than students entering straight from school. Students at large schools scored higher than students at small schools. Although the significance level was high (P \u3c 0.001), the main effect sizes were small (4.5% and 2.3%, respectively). The time allowed per multiple choice question was not significantly associated with student performance. The effect on performance of multiple assessments compared with the test items as part of a single end-of-year examination was negligible. The variables investigated explain only 12% of the total variation in student performance. Conclusions: An increasing number of medical schools are participating in AMSAC to monitor student performance in preclinical sciences against an external benchmark. Medical school characteristics account for only a small part of overall variation in student performance. Student performance was not affected by the different methods of administering test items