Constructing Quality Feedback to the Students in Distance Learning: Review of the Current Evidence with Reference to the Online Master Degree in Transplantation

Introduction: It was a challenge to design a feedback pathway for distance learning course that deals with complexand ambiguous clinical subject like organ transplantation. This course attracts mature clinicians (n=117 spread overthree modules) from 27 countries where in addition to the time and zone barriers; there are cultural, institutionalbackground and also ethnic barriers. In addition to the challenges faced in designing the curriculum and assessmentthat match this diverse group of students, we have to deliver a quality feedback to achieve our leaning objective. Howwould we construct and deliver this feedback to students you have not seen (in a virtual classroom) and may be on adifferent continent of this busy planet?Methods: We analysed the published data on feedback with reflection on the nature of this course and the pedagogyused while considering the diversity of the students joined this courseConclusion: In this distance-learning course constructing a quality feedback to the students is more technicallydemanding compared to a traditional course. Students in distance learning need much more support and feedback thanin a traditional course. There is a potential threat that these students feel isolated in their own online world and may notengage with this virtual educational environment properly.</jats:p

Implementation of Critical Threshold Concept in Clinical Transplantation: A New Horizon in Distance Learning

Background: While variations in medical practice are a norm and each patient poses a multitude of challenges, many clinicians are not comfortable in dealing with unexpected complex issues even though they may have enough knowledge as demonstrated by passing a number of tricky certifying (or exit) examinations. One reason for the lack of self-efficacy, even if being endowed with good knowledge, is that we are not good in learning from errors. A regular reflective practice offers superb learning opportunities when a clinician is “stuck in a mire”. Difficult clinical situations warrant a flexible and, at the same time, an evidence-based approach to ensure that crucial decision-making process is correct and efficient. Each clinical case offers a great opportunity to reinforce these “threshold concepts”, however, not everyone of us is “blessed” with these crucial not-so-difficult-to-acquire skills so necessary to be a life-long learner. The faculty of this course (a totally on-line MSc in Transplant Sciences) aims for unceasing engagement with students in order to facilitate them to negotiate through “stuck places” and “tricky bends” in their own work place. This course, not just meant for knowledge transfer, provides a platform that allows participants (the students and faculty) to learn from each other’s experience by using “e-blackboard”. The mainstay of this course are twofold: (a) Emphasis on achieving critical decision-making skills, (b) Regular feedback to allow reflective practice and, thereby, constantly learning from errors and reinforcing good practices. The aim of this article is to assess the performance of educators and how well the “ethos of critical threshold” has been accepted from the perspective of students. Methods: The critical thresholds of each chapter in 4 modules of this totally on-line course were defined to a razor-sharp precision. Learning objectives of learning activity were defined to achieve constructive alignment with critical threshold. We employed level 1, 2, 4 and 5 of Kirkpatrick pyramid, (a) for the evaluation of performance of educators of program, and (b) to evaluate the acceptance of this non-traditional format in clinical medicine education by postgraduate 80 students in 22 countries.Results: Students’ survey (Kirkpatrick level 1) was done only for module 1 of cohort 1 reported students’ satisfaction rate of 93%. Excluding a total of 12 drop-outs in 2 modules (n=10 in first cohort’s module 1, and n=2 in module 2), as many as 93% of students of first cohort passed module. Nine out of 60 registrants of module 1 in 2nd cohort took recess for one year requesting to join back as a part of 3rd cohort commencing one year later, all 51 who continued passed though 3 of them had to resit. All those who passed module 1 (both cohorts) and 2 (1st cohort) registered for their respective next module (return on investment Kirkpatrick level 5). Conclusion: For a successful model in distance learning in clinical transplantation it is imperative for the students to accomplish well defined “critical-decision making” skills. In order to learn critical thresholds, a regular feedback is integral to learning from reflective practice. This course equips the students to develop skills of negotiating “sticky mire”, as obvious from perceived high return of investment

Review Article - Head injury research: What have we learnt?

non

A Novel Approach to Low-Resolution Occupancy Sensing Using Dynamic Feedback Comparison on Successive Pixelized Still Images

A NOVEL APPROACH TO LOW-RESOLUTION OCCUPANCY SENSING USING DYNAMIC FEEDBACK COMPARISON ON SUCCESSIVE PIXELIZED STILL IMAGES Arpan Guha, Ph.D. University of Nebraska, 2020 Advisor: Dale K. Tiller, D.Phil Occupancy sensing has been extensively researched over the past three decades and various commercially available sensor technology exist today. Amongst standalone sensors, passive Infra-red (PIR), ultrasonic (UL), and dual-technology sensors are commercially popular because of their cost-effectiveness. However, PIR, UL, and dual-technology sensors have low data resolution and require data acquisition systems to collect and analyze the data obtained. Their inability to detect static occupancy is an often-cited flaw where the sensors time out when there is little or no detected movement caused by occupants in the monitored space. Camera-based systems are possibly the most reliable method of occupancy sensing simply because of the high resolution of data acquired, but they have their share of disadvantages in terms of the cost of the technology and data acquisition system, and most importantly, the privacy invasion aspect. Taking these factors into account, this dissertation describes a method where information extracted from pixelized still images can be analyzed to predict occupancy, and all this has been implemented using an inexpensive RaspberryPi infra-red camera module. The camera module captures images, pixelizes them, converts them into an array of numbers, and analyzes the relationships between successive arrays to characterize occupancy. Pixelizing the images ensures that privacy is preserved while the hardware module collects and analyzes its own data which results in a small form factor and much lesser cost. The proposed method successfully separated signal (human occupancy/motion) from noise (potential extraneous confounding stimuli) and yielded an overall detection accuracy of 97.92% compared to the ground truth, which affirms its potential of being extended to commercial applications

The P-POSSUM scoring systems for predicting the mortality of neurosurgical patients undergoing craniotomy: Further validation of usefulness and application across healthcare systems

Background and Aims: Continuous audit of clinical practice is an essential part of making improvements in medicine and enhancing patient care. Validated tools are needed to gather evidence for comparisons. Recently, Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM) and Portsmouth-POSSUM (P-POSSUM) scores were evaluated in Indian patients undergoing elective craniotomy and it was concluded that P-POSSUM was highly accurate in predicting overall mortality. We wished to study whether this system could be used in a different country and health care system [United Kingdom, UK]. We have evaluated these scores in patients undergoing elective and emergency craniotomies in a tertiary centre in the UK. Methods: Data was collected from all neurosurgical patients who underwent craniotomy overone year. Preoperative variables were collected prior to induction of anaesthesia, and operative variables were also collected. Chi-square test was used for expected and actual mortality differences. Survivor and non-survivor demographics were compared by one-way ANOVA for continuous and Chi-square for categorical variables. Results: One hundred and forty-five patients were studied. Mean [SD] physiologic score of the patients was 18.83 [5.07], and mean [SD] operative score was 18.09 [3.75]. P-POSSUM was a better predictor for elective patients and for those undergoing immediate life-saving surgery. Conclusion: This study confirms and validates the findings of previous work that P-POSSUM is an accurate and reliable tool for estimating in-hospital mortality. It also confirms its usefulness in comparison of results across healthcare systems internationally. Larger scale evaluations may be needed to examine its usefulness in emergency procedures