Training standardized patients to provide effective feedback: development, implementation, and its effect on the efficacy of medical students’ education.

Introduction: Standardized patient (SP) encounters are a pivotal part of medical student training and provide essential feedback on student performance. Optimizing the quality of SP feedback allows educators to provide students with focused comments on performance, leading to personal development and better patient care. This project hypothesis states SPs receiving feedback training have greater confidence and offer more effective feedback during student encounters. Methods: SPs were taught to give quality feedback through a training workshop following a feedback model. Surveys were administered immediately prior to and after training for evaluation. Data gathered included demographics and questions relating to confidence in providing feedback and knowledge of communication skills. Performance was evaluated by observing SPs during encounters using a standardized checklist. Results: Attitude assessment between pre- and post-training surveys demonstrated statistical significance for the following items: I have strong knowledge base regarding giving feedback. (p=0.0006), I can easily identify learners’ areas that need improvement. (p=0.0007), I am comfortable reading and interpreting learners’ nonverbal messages. (p=0.0152). Multiple choice question knowledge assessment between pre- and post-training surveys showed statistical significance (p\u3c0.0001). Performance assessment showed the lowest mean completion for the following required feedback tasks: Gave at least one constructive comment (70.19%), tied constructive comment to feeling (57.17%), gave recommendation for next time regarding constructive comment (55.99%). Conclusion: SPs gained knowledge from the training course implemented. Attitudes and self-confidence when providing feedback improved after training. Feedback performance improved over subsequent days and the most difficult feedback to give was related to constructive criticism

In situ accretion of gaseous envelopes on to planetary cores embedded in evolving protoplanetary discs

The core accretion hypothesis posits that planets with significant gaseous envelopes accreted them from their protoplanetary discs after the formation of rocky/icy cores. Observations indicate that such exoplanets exist at a broad range of orbital radii, but it is not known whether they accreted their envelopes in situ, or originated elsewhere and migrated to their current locations. We consider the evolution of solid cores embedded in evolving viscous discs that undergo gaseous envelope accretion in situ with orbital radii in the range 0.1–10 au. Additionally, we determine the long-term evolution of the planets that had no runaway gas accretion phase after disc dispersal. We find the following. (i) Planets with 5 M⊕ cores never undergo runaway accretion. The most massive envelope contained 2.8 M⊕ with the planet orbiting at 10 au. (ii) Accretion is more efficient on to 10 M⊕ and 15 M⊕ cores. For orbital radii ap ≥ 0.5 au, 15 M⊕ cores always experienced runaway gas accretion. For ap ≥ 5 au, all but one of the 10 M⊕ cores experienced runaway gas accretion. No planets experienced runaway growth at ap = 0.1 au. (iii) We find that, after disc dispersal, planets with significant gaseous envelopes cool and contract on Gyr time-scales, the contraction time being sensitive to the opacity assumed. Our results indicate that Hot Jupiters with core masses ≲15 M⊕ at ≲0.1 au likely accreted their gaseous envelopes at larger distances and migrated inwards. Consistently with the known exoplanet population, super-Earths and mini-Neptunes at small radii during the disc lifetime, accrete only modest gaseous envelopes.The simulations presented in this paper utilized Queen Mary's MidPlus computational facilities, supported by QMUL Research-IT and funded by EPSRC grant EP/K000128/1. This research was supported in part by the National Science Foundation under Grant No. NSF PHY-1125915. We acknowledge the referee, Kaitlin Kratter, whose comments helped to improve this paper

Psychosocial factors related to children’s active school travel : A comparison of two European regions

Peer reviewedPublisher PD

Global N-body simulations of circumbinary planet formation around Kepler-16 and -34 analogues I: Exploring the pebble accretion scenario

Numerous circumbinary planets have been discovered in surveys of transiting planets. Often, these planets are found to orbit near to the zone of dynamical instability, close to the central binary. The existence of these planets has been explained by hydrodynamical simulations that show that migrating circumbinary planets, embedded in circumbinary discs, halt at the central cavity that is formed by the central binary. Transit surveys are naturally most sensitive to finding circumbinary planets with the shortest orbital periods. The future promise of detecting longer period systems using radial-velocity searches, combined with the anticipated detection of numerous circumbinary planets by ESA's PLATO mission, points to the need to model and understand the formation and evolution of circumbinary planets in a more general sense than has been considered before. With this goal in mind, we present a newly developed global model of circumbinary planet formation that is based on the mercury6 symplectic N-body integrator, combined with a model for the circumbinary disc and prescriptions for a range of processes involved in planet formation such as pebble accretion, gas envelope accretion and migration. Our results show that under reasonable assumptions, the pebble accretion scenario can produce circumbinary systems that are similar to those observed, and in particular is able to produce planets akin to Kepler-16b and Kepler-34b. Comparing our results to other systems, we find that our models also adequately reproduce such systems, including multi-planet systems. Resonances between neighbouring planets are frequently obtained, whilst ejections of planets by the central binary acts as an effective source of free floating planets.Comment: Accepted for publication in MNRAS, 23 pages, 16 figure

Dusty circumbinary discs: inner cavity structures and stopping locations of migrating planets

We present the results of two-fluid hydrodynamical simulations of circumbinary discs consisting of gas and dust, with and without embedded planets, to examine the influence of the dust on the structure of the tidally truncated inner cavity and on the parking locations of migrating planets. In this proof-of-concept study, we consider Kepler-16 and -34 analogues, and examine dust fluids with Stokes numbers in the range $10^{-4} \le St \le 10^{-1}$ and dust-to-gas ratios of 0.01 and 1. For the canonical dust-to-gas ratio of 0.01, we find the inclusion of the dust has only a minor effect on the cavity and stopping locations of embedded planets compared to dust-free simulations. However, for the enhanced dust-to-gas ratio of unity, assumed to arise because of significant dust drift and accumulation, we find that the dust can have a dramatic effect by shrinking and circularising the inner cavity, which brings the parking locations of planets closer to the central binary. This work demonstrates the importance of considering both gas and dust in studies of circumbinary discs and planets, and provides a potential means of explaining the orbital properties of circumbinary planets such as Kepler-34b, which have hitherto been difficult to explain using gas-only hydrodynamical simulations.Comment: Accepted for publication in MNRAS, 20 pages, 17 figure

Constraining the formation history of the TOI-1338/BEBOP-1 circumbinary planetary system

The recent discovery of multiple planets in the circumbinary system TOI-1338/BEBOP-1 raises questions about how such a system formed. The formation of the system was briefly explored in the discovery paper, but only to answer the question do current pebble accretion models have the potential to explain the origin of the system? We use a global model of circumbinary planet formation that utilises N-body simulations, including prescriptions for planet migration, gas and pebble accretion, and interactions with a circumbinary disc, to explore the disc parameters that could have led to the formation of the TOI-1338/BEBOP-1 system. With the disc lifetime being the main factor in determining how planets form, we limit our parameter space to those that determine the disc lifetime. These are: the strength of turbulence in the disc, the initial disc mass, and the strength of the external radiation field that launches photoevaporative winds. When comparing the simulated systems to TOI-1338/BEBOP-1, we find that only discs with low levels of turbulence are able to produce similar systems. The radiation environment has a large effect on the types of planetary systems that form, whilst the initial disc mass only has limited impact since the majority of planetary growth occurs early in the disc lifetime. With the most TOI-1338/BEBOP-1 like systems all occupying similar regions of parameter space, our study shows that observed circumbinary planetary systems can potentially constrain the properties of planet forming discs.Comment: Accepted for publication in MNRAS, 15 pages, 10 figure