How was the intern year?: self and clinical assessment of four cohorts, from two medical curricula

BACKGROUND Problem-based curricula have provoked controversy amongst educators and students regarding outcome in medical graduates, supporting the need for longitudinal evaluation of curriculum change. As part of a longitudinal evaluation program at the University of Adelaide, a mixed method approach was used to compare the graduate outcomes of two curriculum cohorts: traditional lecture-based ‘old’ and problem-based ‘new’ learning. METHODS Graduates were asked to self-assess preparedness for hospital practice and consent to a comparative analysis of their work-place based assessments from their intern year. Comparative data were extracted from 692 work-place based assessments for 124 doctors who graduated from the University of Adelaide Medical School between 2003 and 2006. RESULTS Self-assessment: Overall, graduates of the lecture-based curriculum rated the medical program significantly higher than graduates of the problem-based curriculum. However, there was no significant difference between the two curriculum cohorts with respect to their preparedness in 13 clinical skills. There were however, two areas where the cohorts rated their preparedness in the 13 broad practitioner competencies as significantly different: problem-based graduates rated themselves as better prepared in their ‘awareness of legal and ethical issues’ and the lecture-based graduates rated themselves better prepared in their ‘understanding of disease processes’. Work-place based assessment: There were no significant differences between the two curriculum cohorts for ‘Appropriate Level of Competence’ and ‘Overall Appraisal’. Of the 14 work-place based assessment skills assessed for competence, no significant difference was found between the cohorts. CONCLUSIONS The differences in the perceived preparedness for hospital practice of two curriculum cohorts do not reflect the work-place based assessments of their competence as interns. No significant difference was found between the two cohorts in relation to their knowledge and clinical skills. However results suggest a trend in ‘communication with peers and colleagues in other disciplines’ (χ2 (3, N = 596) =13.10, p = 0.056) that requires further exploration. In addition we have learned that student confidence in a new curriculum may impact on their self-perception of preparedness, while not affecting their actual competence.Gillian Laven, Dorothy Keefe, Paul Duggan, and Anne Tonki

Patient-maintained sedation for oral surgery using a target-controlled infusion of propofol - a pilot study

OBJECTIVE: To assess the safety and efficacy of a new patient-maintained propofol system for conscious sedation in dentistry. DESIGN: Prospective clinical trial SETTING: Department of Sedation, Glasgow Dental Hospital and School, 2001 SUBJECTS AND METHODS: Patients scheduled for oral surgery with conscious sedation. Exclusions included ASA IV -V, inability to use the handset, opioid use and severe respiratory disease. INTERVENTIONS: Patients were given intravenous propofol to a level of 1.0 microg/ml (reducing from 1.5 microg/ml) using a target controlled infusion system, they then controlled their sedation level by double-clicking a handset which on each activation increased the propofol concentration by 0.2 microg/ml. MAIN OUTCOME MEASURES: Oxygen saturation, patient satisfaction, and surgeon satisfaction. RESULTS: Twenty patients were recruited, 16 female and four male. Nineteen patients completed sedation and treatment successfully. Mean lowest oxygen saturation was 94%. No patients were over-sedated. All patients successfully used the system to maintain a level of sedation adequate for their comfort. Patient and surgeon satisfaction were consistently high. CONCLUSIONS: Initial experience with this novel system has confirmed safety, patient satisfaction and surgeon satisfaction

Effects of classification context on categorization in natural categories

The patterns of classification of borderline instances of eight common taxonomic categories were examined under three different instructional conditions to test two predictions: first, that lack of a specified context contributes to vagueness in categorization, and second, that altering the purpose of classification can lead to greater or lesser dependence on similarity in classification. The instructional conditions contrasted purely pragmatic with more technical/quasi-legal contexts as purposes for classification, and these were compared with a no-context control. The measures of category vagueness were between-subjects disagreement and within-subjects consistency, and the measures of similarity based categorization were category breadth and the correlation of instance categorization probability with mean rated typicality, independently measured in a neutral context. Contrary to predictions, none of the measures of vagueness, reliability, category breadth, or correlation with typicality were generally affected by the instructional setting as a function of pragmatic versus technical purposes. Only one subcondition, in which a situational context was implied in addition to a purposive context, produced a significant change in categorization. Further experiments demonstrated that the effect of context was not increased when participants talked their way through the task, and that a technical context did not elicit more all-or-none categorization than did a pragmatic context. These findings place an important boundary condition on the effects of instructional context on conceptual categorization

Denial at the top table: status attributions and implications for marketing

Senior marketing management is seldom represented on the Board of Directors nowadays, reflecting a deteriorating status of the marketing profession. We examine some of the key reasons for marketing’s demise, and discuss how the status of marketing may be restored by demonstrating the value of marketing to the business community. We attribute marketing’s demise to several related key factors: narrow typecasting, marginalisation and limited involvement in product development, questionable marketing curricula, insensitivity toward environmental change, questionable professional standards and roles, and marketing’s apparent lack of accountability to CEOs. Each of these leads to failure to communicate, create, or deliver value within marketing. We argue that a continued inability to deal with marketing’s crisis of representation will further erode the status of the discipline both academically and professionally

Pattern formation of reaction-diffusion system having self-determined flow in the amoeboid organism of Physarum plasmodium

The amoeboid organism, the plasmodium of Physarum polycephalum, behaves on the basis of spatio-temporal pattern formation by local contraction-oscillators. This biological system can be regarded as a reaction-diffusion system which has spatial interaction by active flow of protoplasmic sol in the cell. Paying attention to the physiological evidence that the flow is determined by contraction pattern in the plasmodium, a reaction-diffusion system having self-determined flow arises. Such a coupling of reaction-diffusion-advection is a characteristic of the biological system, and is expected to relate with control mechanism of amoeboid behaviours. Hence, we have studied effects of the self-determined flow on pattern formation of simple reaction-diffusion systems. By weakly nonlinear analysis near a trivial solution, the envelope dynamics follows the complex Ginzburg-Landau type equation just after bifurcation occurs at finite wave number. The flow term affects the nonlinear term of the equation through the critical wave number squared. Contrary to this, wave number isn't explicitly effective with lack of flow or constant flow. Thus, spatial size of pattern is especially important for regulating pattern formation in the plasmodium. On the other hand, the flow term is negligible in the vicinity of bifurcation at infinitely small wave number, and therefore the pattern formation by simple reaction-diffusion will also hold. A physiological role of pattern formation as above is discussed.Comment: REVTeX, one column, 7 pages, no figur

A novel algorithm for dynamic student profile adaptation based on learning styles

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.E-learning recommendation systems are used to enhance student performance and knowledge by providing tailor- made services based on the students’ preferences and learning styles, which are typically stored in student profiles. For such systems to remain effective, the profiles need to be able to adapt and reflect the students’ changing behaviour. In this paper, we introduce new algorithms that are designed to track student learning behaviour patterns, capture their learning styles, and maintain dynamic student profiles within a recommendation system (RS). This paper also proposes a new method to extract features that characterise student behaviour to identify students’ learning styles with respect to the Felder-Silverman learning style model (FSLSM). In order to test the efficiency of the proposed algorithm, we present a series of experiments that use a dataset of real students to demonstrate how our proposed algorithm can effectively model a dynamic student profile and adapt to different student learning behaviour. The results revealed that the students could effectively increase their learning efficiency and quality for the courses when the learning styles are identified, and proper recommendations are made by using our method

Evaluational adjectives

This paper demarcates a theoretically interesting class of "evaluational adjectives." This class includes predicates expressing various kinds of normative and epistemic evaluation, such as predicates of personal taste, aesthetic adjectives, moral adjectives, and epistemic adjectives, among others. Evaluational adjectives are distinguished, empirically, in exhibiting phenomena such as discourse-oriented use, felicitous embedding under the attitude verb `find', and sorites-susceptibility in the comparative form. A unified degree-based semantics is developed: What distinguishes evaluational adjectives, semantically, is that they denote context-dependent measure functions ("evaluational perspectives")—context-dependent mappings to degrees of taste, beauty, probability, etc., depending on the adjective. This perspective-sensitivity characterizing the class of evaluational adjectives cannot be assimilated to vagueness, sensitivity to an experiencer argument, or multidimensionality; and it cannot be demarcated in terms of pretheoretic notions of subjectivity, common in the literature. I propose that certain diagnostics for "subjective" expressions be analyzed instead in terms of a precisely specified kind of discourse-oriented use of context-sensitive language. I close by applying the account to `find x PRED' ascriptions

The characteristics of cognitive neuroscience tests in a schizophrenia cognition clinical trial: Psychometric properties and correlations with standard measures.

In comparison to batteries of standard neuropsychological tests, cognitive neuroscience tests may offer a more specific assessment of discrete neurobiological processes that may be aberrant in schizophrenia. However, more information regarding psychometric properties and correlations with standard neuropsychological tests and functional measures is warranted to establish their validity as treatment outcome measures. The N-back and AX-Continuous Performance Task (AX-CPT) are two promising cognitive neuroscience tests designed to measure specific components of working memory and contextual processing respectively. In the current study, we report the psychometric properties of multiple outcome measures from these two tests as well as their correlations with standard neuropsychological measures and functional capacity measures. The results suggest that while the AX-CPT and N-back display favorable psychometric properties, they do not exhibit greater sensitivity or specificity with functional measures than standard neurocognitive tests