Development and evaluation of an interactive multimedia clinical skills teaching program designed for the pediatric clerkship.

Background and Purpose: The physical examination section of a multimedia program developed to teach infant history and physical examination skills was evaluated. Methods: 71 students participated: one group viewed only the physical examination section (PX), one the history section (HX), one none of the program (CX). Physical examination skills were assessed by direct observation of medical students performing an abdominal exam and scored using a checklist at baseline, immediately after intervention and at the end of the pediatric clerkship. Results were analyzed using ANOVA with repeated measures. Results: Baseline scores were: PX 2.5; HX 2.8. The PX group scored significantly higher immediately post intervention at 6.8 compared to the HX group 3.1. At the end of the clerkship significant differences between the groups remained. Final group mean scores were: PX 5.5, HX 4.4 and CX 2.7. Conclusion: The program improved examination skills with attenuation over 6 weeks

The effect of amblyopia treatment on stereoacuity

Purpose: To explore how stereoacuity changes in patients while they are being treated for amblyopia. Methods: The Monitored Occlusion Treatment for Amblyopia Study (MOTAS) comprised 3 distinct phases. In the first phase, baseline, assessments of visual function were made to confirm the initial visual and binocular visual deficit. The second phase, refractive adaptation, now commonly termed “optical treatment,” was an 18-week period of spectacle wear with measurements of logMAR visual acuity and stereoacuity with the Frisby test at weeks 0, 6, 12, and 18. In the third phase, occlusion, participants were prescribed 6 hours of patching per day. Results: A total of 85 children were enrolled (mean age, 5.1 ± 1.5 years). In 21 children amblyopia was associated with anisometropia; in 29, with strabismus; and in 35, with both. At study entry, poor stereoacuity was associated with poor visual acuity (P < 0.001) in the amblyopic eye and greater angle of strabismus (P < 0.001). Of 66 participants, 25 (38%) who received refractive adaptation and 19 (29%) who received occlusion improved by at least one octave in stereoacuity, exceeding test–retest variability. Overall, 38 (45%) improved one or more octaves across both treatment phases. Unmeasureable stereoacuity was observed in 56 participants (66%) at study entry and in 37 (43%) at study exit. Conclusions: Stereoacuity improved for almost one half of the study participants. Improvement was observed in both treatment phases. Factors associated with poor or nil stereoacuity at study entry and exit were poor visual acuity of the amblyopic eye and large-angle strabismus

Instructional multimedia: An investigation of student and instructor attitudes and student study behavior

<p>Abstract</p> <p>Background</p> <p>Educators in allied health and medical education programs utilize instructional multimedia to facilitate psychomotor skill acquisition in students. This study examines the effects of instructional multimedia on student and instructor attitudes and student study behavior.</p> <p>Methods</p> <p>Subjects consisted of 45 student physical therapists from two universities. Two skill sets were taught during the course of the study. Skill set one consisted of knee examination techniques and skill set two consisted of ankle/foot examination techniques. For each skill set, subjects were randomly assigned to either a control group or an experimental group. The control group was taught with live demonstration of the examination skills, while the experimental group was taught using multimedia. A cross-over design was utilized so that subjects in the control group for skill set one served as the experimental group for skill set two, and vice versa. During the last week of the study, students and instructors completed written questionnaires to assess attitude toward teaching methods, and students answered questions regarding study behavior.</p> <p>Results</p> <p>There were no differences between the two instructional groups in attitudes, but students in the experimental group for skill set two reported greater study time alone compared to other groups.</p> <p>Conclusions</p> <p>Multimedia provides an efficient method to teach psychomotor skills to students entering the health professions. Both students and instructors identified advantages and disadvantages for both instructional techniques. Reponses relative to instructional multimedia emphasized efficiency, processing level, autonomy, and detail of instruction compared to live presentation. Students and instructors identified conflicting views of instructional detail and control of the content.</p

Becoming invisible: The ethics and politics of imperceptibility

This speculative essay examines ‘invisible’ social identities and the processes by which they are manifested and occasionally sought. Using various literary and academic sources, and loosely informed by an unlikely combination of Stoic philosophy and post-structuralist politics, we argue that invisibility is conventionally viewed as undesirable or ‘suffered’ by individuals or groups that are disadvantaged or marginalised within society. Whilst appreciating this possibility, we argue that social invisibility can also be the result of strategies carefully conceived and consciously pursued. We suggest that forms of social invisibility can be acquired by ethically informed personal action as well as by politically informed collective action. In this context, invisibility can be seen as a strategy of escaping from institutionalised and organisational judgements and which presents a challenge to common notions of voice and identity

Exploring the “impact” in Impact sourcing ventures: a sociology of space perspective

Using qualitative methods this paper explores the lived experience of individuals employed in impact sourcing ventures. In doing so, the paper attempts to understand “impact” from the point of view of beneficiaries. The paper, drawing on Georg Simmel’s work on the sociology of space, explores how space influences the lived experience of beneficiaries in ImS ventures. The findings highlight the various strategies adopted by beneficiaries to navigate the dialectical tensions experienced as a result of living and working in the new (ImS workplace) and the old (community) space. The paper also draws attention to the multifaceted nature of impact

The impacts of foot and mouth disease on a peripheral tourism area: the role and effect of crisis management.

This study reports on the consequences of endemic cattle and sheep disease (2001) on two separate areas on the tourist industry; (a) the Grampian Region of Scotland (indirectly affected) and (b) Cumbria in England (directly affected), and secondly on the effects of various crisis management strategies to alleviate the ensuing problems in both areas. Data were collected by a survey of a sample of 200 tourism orientated SME operators in Grampian and 170 businesses in Cumbria. The results show two forms of impact caused by the disease, direct and those less obvious or tangible. Direct impact was the dramatic loss of trade, most dramatically experienced by the lack of tourists visiting the areas. Indirect effects included loss of supply, change to the product offered and cuts in future investment. In the combination of these impacts, it was clear that the effects would have longevity far beyond the period of the actual crisis. Although the actual presence of the disease was geographically limited in Grampian, the consequences rippled out to affect areas that had no direct connection. In Cumbria, the effects were only slightly more severe but the response more direct and initially effective. Significantly the data also demonstrated a perception of minimal effort by the government to limit the consequences to the farming industry especially in Grampian. We conclude that the tourist industry in peripheral regions is fragile and highly vulnerable to any external shocks. However, we also note the ability of small rural firms to respond to such catastrophes and to avert the worst impacts of crisis

The discovery of endogenous retroviruses

When endogenous retroviruses (ERV) were discovered in the late 1960s, the Mendelian inheritance of retroviral genomes by their hosts was an entirely new concept. Indeed Howard M Temin's DNA provirus hypothesis enunciated in 1964 was not generally accepted, and reverse transcriptase was yet to be discovered. Nonetheless, the evidence that we accrued in the pre-molecular era has stood the test of time, and our hypothesis on ERV, which one reviewer described as 'impossible', proved to be correct. Here I recount some of the key observations in birds and mammals that led to the discovery of ERV, and comment on their evolution, cross-species dispersion, and what remains to be elucidated