The Question of Competence: Reconsidering Medical Education in the Twenty-First Century

[Excerpt] The real challenge for those involved in designing competency-based educational programs is to recognize the complexity of competence as a concept. Only then can they effectively delineate the knowledge, skills, and attitudes that learners must acquire to be able to perform within each domain at a predetermined level and to recognize that the expected level of performance within each domain will vary depending on the learner\u27s stage of education and the specialty he or she is learning. The authors of this book help us do just that. They examine the challenges facing medical education and introduce the concept of discourse as a mechanism both for examining the idea of competence and considering how to implement competency-based education. In so doing, they provide us with a new way to ask the questions that are at the heart of every report advocating change, every criticism of medical education, and every conversation that questions why health care is the way it is today

Into the depths of C: Elaborating the de facto standards

C remains central to our computing infrastructure. It is notionally defined by ISO standards, but in reality the properties of C assumed by systems code and those implemented by compilers have diverged, both from the ISO standards and from each other, and none of these are clearly understood. We make two contributions to help improve this error-prone situation. First, we describe an in-depth analysis of the design space for the semantics of pointers and memory in C as it is used in practice. We articulate many specific questions, build a suite of semantic test cases, gather experimental data from multiple implementations, and survey what C experts believe about the de facto standards. We identify questions where there is a consensus (either following ISO or differing) and where there are conflicts. We apply all this to an experimental C implemented above capability hardware. Second, we describe a formal model, Cerberus, for large parts of C. Cerberus is parameterised on its memory model; it is linkable either with a candidate de facto memory object model, under construction, or with an operational C11 concurrency model; it is defined by elaboration to a much simpler Core language for accessibility, and it is executable as a test oracle on small examples. This should provide a solid basis for discussion of what mainstream C is now: what programmers and analysis tools can assume and what compilers aim to implement. Ultimately we hope it will be a step towards clear, consistent, and accepted semantics for the various use-cases of C.We acknowledge funding from EPSRC grants EP/H005633 (Leadership Fellowship, Sewell) and EP/K008528 (REMS Programme Grant), and a Gates Cambridge Scholarship (Nienhuis). This work is also part of the CTSRD projects sponsored by the Defense Advanced Research Projects Agency (DARPA) and the Air Force Research Laboratory (AFRL), under contract FA8750-10-C-0237.This is the author accepted manuscript. The final version is available from the Association for Computing Machinery via http://dx.doi.org/10.1145/2908080.290808

Argumentation in Educational Policy Disputes: Competing Visions of Quality and Equity

© 2016, Copyright © The College of Education and Human Ecology, The Ohio State University. Current debates about test-based accountability policies revolve around questions of how to ensure that all students have access to high-quality schools and teachers. Whether and how one can meet this goal depend, in part, on the nature of the arguments that policy proponents and opponents mobilize in these debates. This article examines these arguments, focusing specifically on how policymakers and educators justify and critique prominent test-based accountability policies, the OECD's PISA, and enhanced teacher evaluation. Drawing on pragmatic sociology and our research on these policies, we show how policy proponents mobilize industrial, market, and civic arguments to define both quality and equity as the efficient production of standardized test scores. In contrast, educators more often employ civic and domestic arguments that expand the definition of educational quality, but do not engage issues of educational equity. We explore how educators can mobilize arguments and the news media to expand the definition of educational quality and equity to enrich both our vision of education and our debates about it

The quest for effective interdisciplinary graduate supervision: A critical narrative analysis

Interdisciplinarity is a pervasive trend in 21st-century knowledge building and innovation. It is predicated on the recognition that creative solutions to the world’s increasingly complex problems require the intersection of diverse expertise. Little scholarly attention has been directed towards how the new interdisciplinary (ID) model is in uencing the processes and outcomes of graduate research training. In a qualitative study informed by critical narra- tive analysis and conducted at one institution, we investigate the epistemo- logical, structural, and relational factors that shape ID doctoral research supervision, explore how di ering knowledge cultures and values are negoti- ated in supervisory practices, and consider how established structures and discourses in uence the processes and outcomes of these supervisory rela- tionships

An immunotherapy survivor population: health-related quality of life and toxicity in patients with metastatic melanoma treated with immune checkpoint inhibitors

© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Purpose The immune checkpoint inhibitors (ICIs) have resulted in subgroups of patients with metastatic melanoma achievinghigh-quality durable responses. Metastatic melanoma survivors are a new population in the era of cancer survivorship. The aimofthis study was to evaluate metastatic melanoma survivors in terms of health-related quality of life (HRQoL), immune-relatedadverse events (irAEs) and exposure to immunosuppressive agents in a large single centre in the UK.Methods We defined the survivor population as patients with a diagnosis of metastatic melanoma who achieved a durableresponse to an ICI and had been followed-up for a minimum of 12 months from initiation of ICI without disease progression.HRQoL was assessed using SF-36. Electronic health records were accessed to collect data on demographics, treatments, irAEsand survival. HRQoL data was compared with two norm-based datasets.Results Eighty-four metastatic melanoma survivors were eligible and 87% (N = 73) completed the SF-36. ICI-related toxicity ofany grade occurred in 92%of patients and 43%had experienced a grade 3 or 4 toxicity. Almost half (49%) of the patients requiredsteroids for the treatment of ICI-related toxicity, whilst 14% required treatment with an immunosuppressive agent beyondsteroids.Melanoma survivors had statistically significant lower HRQoL scores with regard to physical, social and physical rolefunctioning and general health compared with the normative population. There was a trend towards inferior scores in patientswith previous exposure to ipilimumab compared with those never exposed to ipilimumab.Conclusions Our results show that metastatic melanoma survivors have potentially experienced significant ICI-related toxicityand experience significant impairments in specific HRQoL domains. Future service planning is required to meet this population’sunique survivorship needs.Peer reviewe

Interprofessional communication with hospitalist and consultant physicians in general internal medicine : a qualitative study

This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes

Comprehension as social and intellectual practice: Rebuilding curriculum in low socioeconomic and cultural minority schools

This article reframes the concept of comprehension as a social and intellectual practice. It reviews current approaches to reading instruction for linguistically and culturally diverse and low socioeconomic students, noting an emphasis on comprehension as autonomous skills. The Four Resources model (Freebody & Luke, 1990) is used to make the case for the integration of comprehension instruction with an emphasis on student cultural and community knowledge, and substantive intellectual and sociocultural content in elementary school curricula. Illustrations are drawn from research underway on the teaching of literacy in primary schools in low SES communities

My School? Critiquing the abstraction and quantification of education

This paper draws upon and critiques the Australian federal government's website My School as an archetypal example of the current tendency to abstract and quantify educational practice. Arguing in favour of a moral philosophical account of educational practice, the paper reveals how the My School website reduces complex educational practices to simple, supposedly objective, measures of student attainment, reflecting the broader 'audit' society/culture within which it is located. By revealing just how extensively the My School website reduces educational practices to numbers, the paper argues that we are in danger of losing sight of the 'internal' goods of Education which cannot be readily and simply codified, and that the teacher learning encouraged by the site marginalises more active and collective approaches. While having the potential to serve some beneficial diagnostic purposes, the My School website reinforces a view of teachers as passive consumers of information generated beyond their everyday practice

Australian Education Joins the OECD : Federalism, Regionalization, and the Role of Education in a Time of Transition

This chapter argues that Australian interactions with the Organisation for Economic Co-operation and Development (OECD) in the field of education in the mid- to late-1970s pointed in two separate but not yet incompatible directions—one equity-oriented and the other more in line with the standardization and accountability regime typically identified with the OECD’s current policies—both of which favored a shift of authority toward the national level in educational policy-making. In the process, the chapter highlights the importance of considering movements between different spatial levels of analysis when tracing the ability of international organizations to get their ideas and visions “out of house.” The chapter first outlines the international and domestic contexts for Australia’s early involvement in the OECD, followed by a discussion of the negotiations of state and federal interests on the Australian Commonwealth Department of Education’s advisory committee on OECD matters. This discussion, in turn, frames the last three analytical sections of the chapter, on interactions between the OECD and the Australian education authorities at different levels on initiatives negotiating both the location of authority between these levels and the role of education at a time when the relation between its social and economic potential was up for revision.Non peer reviewe