The one minute mentor : a pilot study assessing medical students’ and residents’ professional behaviours through recordings of clinical preceptors’ immediate feedback

Introduction: The assessment of professional development and behaviour is an important issue in the training of medical students and physicians. Several methods have been developed for doing so. What is still needed is a method that combines assessment of actual behaviour in the workplace with timely feedback to learners. Goal: We describe the development, piloting and evaluation of a method for assessing professional behaviour using digital audio recordings of clinical supervisors’ brief feedback. We evaluate the inter-rater reliability, acceptability and feasibility of this approach. Methods: Six medical students in Year 5 and three GP registrars (residents) took part in this pilot project. Each had a personal digital assistant (PDA) and approached their clinical supervisors to give approximately one minute of verbal feedback on professionalism-related behaviours they had observed in the registrar’s clinical encounters. The comments, both in transcribed text format and audio, were scored by five evaluators for competence (the learner’s performance) and confidence (how confident the evaluator was that the comment clearly described an observed behaviour or attribute that was relevant). Students and evaluators were surveyed for feedback on the process. Results: Study evaluators rated 29 comments from supervisors in text and audio format. There was good inter-rater reliability (Cronbach α around 0.8) on competence scores. There was good agreement (paired t-test) between scores across supervisors for assessments of comments in both written and audio formats. Students found the method helpful in providing feedback on professionalism. Evaluators liked having a relatively objective approach for judging behaviours and attributes but found scoring audio comments to be time-consuming. Discussion: This method of assessing learners’ professional behaviour shows potential for providing both formative and summative assessment in a way that is feasible and acceptable to students and evaluators. Initial data shows good reliability but to be valid, training of clinical supervisors is necessary to help them provide useful comments based on defined behaviours and attributes of students. In addition, the validity of the scoring method remains to be confirmed

Communicating disaster risk? An evaluation of the availability and quality of flood maps

One of the key priorities for disaster risk reduction is to ensure decision makers, stakeholders, and the public understand their exposure to disaster risk, so that they can take protective action. Flood maps are a potentially valuable tool for facilitating this understanding of flood risk, but previous research has found that they vary considerably in availability and quality. Using an evaluation framework comprising nine criteria grounded in existing scholarship, this study assessed the quality of flood maps available to the public in Canadian communities located in designated flood risk areas. It found that flood maps in most municipalities (62&thinsp;%) are low quality (meeting less than 50&thinsp;% of the criteria) and the highest score was 78&thinsp;% (seven of nine criteria met). The findings suggest that a more concerted effort to produce high-quality, publicly accessible flood maps is required to support Canada's international commitment to disaster risk reduction. Further questions surround possible weighting of quality assessment criteria, whether and how individuals seek out flood maps, and how flood risk information could be better communicated using modern technology.</p

Estimating the Lactate Threshold Using Wireless Near-Infrared Spectroscopy and Threshold Detection Analyses

International Journal of Exercise Science 14(4): 284-294, 2021. The present investigation examined the ability of two threshold detection analyses (maximum distance, Dmax; modified maximum distance, mDmax) in identifying the near-infrared spectroscopy (NIRS) threshold, a lactate threshold (LT) estimate, from exercising tissue oxygen saturation (StO2) responses. Additionally, the test-retest reliability of exercising StO2 and total hemoglobin concentration (THC) responses were examined at moderate and peak cycling intensities. Fourteen healthy, recreationally active participants performed maximal incremental step cycling tests (+25 W / 3 minutes) to volitional fatigue on two separate occasions while StO2 and THC of the vastus lateralis were monitored. Exercising blood [lactate] was collected during Session One. LT and NIRS thresholds (NIRS1, NIRS2) were then determined using Dmax and mDmax threshold analyses. Significant (p \u3c 0.05), moderate correlations were detected between LT and NIRS1 when using Dmax (LT = 130 ± 49 W, NIRS1 = 136 ± 34 W, r = 0.690), but not for mDmax (r = 0.487). No significant test-retest reliability for the NIRS thresholds were observed for Dmax (ICC = 0.351) or mDmax (ICC = 0.385). Exercising StO2 responses demonstrated good reliability (ICC = 0.841-0.873) while exercising THC responses demonstrated moderate-good reliability (ICC = 0.720-0.873) at moderate and peak exercise intensities. The results of this study suggest that neither the Dmax nor mDmax threshold analyses should be used to estimate the LT due to the unreliable detection of the NIRS threshold from session to session

Interprofessional training for final year healthcare students: a mixed methods evaluation of the impact on ward staff and students of a two-week placement and of factors affecting sustainability

BACKGROUND: Multiple care failings in hospitals have led to calls for increased interprofessional training in medical education to improve multi-disciplinary teamwork. Providing practical interprofessional training has many challenges and remains uncommon in medical schools in the UK. Unlike most previous research, this evaluation of an interprofessional training placement takes a multi-faceted approach focusing not only on the impact on students, but also on clinical staff delivering the training and on outcomes for patients. METHODS: We used mixed methods to examine the impact of a two-week interprofessional training placement undertaken on a medical rehabilitation ward by three cohorts of final year medical, nursing and therapy students. We determined the effects on staff, ward functioning and participating students. Impact on staff was evaluated using the Questionnaire for Psychological and Social factors at work (QPSNordic) and focus groups. Ward functioning was inferred from standard measures of care including length of stay, complaints, and adverse events. Impact on students was evaluated using the Readiness for Interprofessional Learning Survey (RIPLS) among all students plus a placement survey among medical students. RESULTS: Between 2007 and 2010, 362 medical students and 26 nursing and therapy students completed placements working alongside the ward staff to deliver patient care. Staff identified benefits including skills recognition and expertise sharing. Ward functioning was stable. Students showed significant improvements in the RIPLS measures of Teamwork, Professional Identity and Patient-Centred Care. Despite small numbers of students from other professions, medical students’ rated the placement highly. Increasing student numbers and budgetary constraints led to the cessation of the placement after three years. CONCLUSIONS: Interprofessional training placements can be delivered in a clinical setting without detriment to care and with benefits for all participants. While financial support is a necessity, it appears that having students from multiple professions is not critical for a valuable training experience; staff from different professions and students from a single profession can work successfully together. Difficulty in aligning the schedules of different student professions is commonly cited as a barrier to interprofessional training. Our experience challenges this and should encourage provision of authentic interprofessional training experience

UK informative inventory report (1990 to 2013)

This is the 10th Informative Inventory Report (IIR) from the UK National Atmospheric Emissions Inventory (NAEI) Programme. The report is compiled to accompany the UK’s 2015 data submission under the United Nations Economic Commission for Europe (UNECE) Convention on Long-Range Transboundary Air Pollution (CLRTAP) and contains detailed information on annual emission estimates of air quality pollutants by source in the UK from 1990 onwards