Tangrams: a simple visual tool for communicating the complexities of professionalism.

Professionalism is vital for high quality healthcare and fundamental to health profession education. It is however complex, hard to define and can be challenging to teach, learn about and assess. We describe the development and use of an innovative visual tool, using a tangram analogy, to introduce and explore core professionalism concepts, which are often troublesome for both learners and educators. These include the hidden curriculum, capability, professional identity and the difference between unprofessionalism and high professional standards.  Understanding these concepts can help individuals to see professionalism differently, encourage faculty to design professionalism programmes which focus on professional excellence, support assessors to feel more confident in identifying and addressing underperformance and facilitate learners to appreciate the complexity and uncertainty inherent in professionalism and to become more alert to the hidden curriculum and its potential impact. We have used the tangram model to educate for professionalism in multiple contexts with learners and educators. Participants regularly report that it leads to a deeper understanding and important new insights around professionalism and helps them identify ways of changing their practice.  We believe this approach has relevance across the health professions and suggest ways it could be further developed to explore wider professionalism issues such as reflective practice, resilience and teamworking

Tangrams: a simple visual tool for communicating the complexities of professionalism

Professionalism is vital for high quality healthcare and fundamental to health profession education. It is however complex, hard to define and can be challenging to teach, learn about and assess. We describe the development and use of an innovative visual tool, using a tangram analogy, to introduce and explore core professionalism concepts, which are often troublesome for both learners and educators. These include the hidden curriculum, capability, professional identity and the difference between unprofessionalism and high professional standards.  Understanding these concepts can help individuals to see professionalism differently, encourage faculty to design professionalism programmes which focus on professional excellence, support assessors to feel more confident in identifying and addressing underperformance and facilitate learners to appreciate the complexity and uncertainty inherent in professionalism and to become more alert to the hidden curriculum and its potential impact. We have used the tangram model to educate for professionalism in multiple contexts with learners and educators. Participants regularly report that it leads to a deeper understanding and important new insights around professionalism and helps them identify ways of changing their practice.  We believe this approach has relevance across the health professions and suggest ways it could be further developed to explore wider professionalism issues such as reflective practice, resilience and teamworking.</ns4:p

Preparing Health Profession Students for Practice in Complex Real World Settings: How Do Educators Respond to a Model of Capability?

Undergraduate education often leaves future healthcare professionals insufficiently prepared for the complex and unpredictable workplace. Competency-based medical education (CBME) is widely utilised in health professions’ education, but a growing literature highlights its limitations. Capability is a complex concept which builds on competence, while embedding the integration and adaptation of knowledge, skills and personal qualities. While capability can prepare learners for uncertainty and complexity, the concept has been slow to progress within health professions’ education. We introduced the concept of capability to over 110 international health profession educators through six conference workshops, using a visual model to facilitate understanding. Participants’ post-workshop qualitative feedback was collated and thematically analysed. One hundred and thirty-three free text comments were received and four main themes identified: conceptualising capability, capability as curriculum goal, educating for capability, challenges to implementation. The need for capability resonated with participants, although most were unfamiliar with the concept prior to the workshop. The workshop enabled participants to recognise the limitations of CBME’s ‘tick box’ culture when preparing learners to address complexity. The model helped educators grasp the concept of capability and its potential value in health professions’ education. Participants were then able to identify challenges and suggest approaches for implementing capability in practice. Educating for capability is fundamental for preparing students successfully for the ‘real world’ of professional practice. Most participants agreed it should be the end goal of healthcare education curricula. Healthcare educators are likely, however, to need support to embrace this paradigm shift.</jats:p

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Current and advanced act control system definition study. Volume 2: Appendices

The current status of the Active Controls Technology (ACT) for the advanced subsonic transport project is investigated through analysis of the systems technical data. Control systems technologies under examination include computerized reliability analysis, pitch axis fly by wire actuator, flaperon actuation system design trade study, control law synthesis and analysis, flutter mode control and gust load alleviation analysis, and implementation of alternative ACT systems. Extensive analysis of the computer techniques involved in each system is included

Educating for capability and preparing for practice: Integrating theory and skills

Capability is the ability to perform clinical skills in ever‐changing real world contexts, adapting to challenges and integrating technical and non‐technical skills and competencies, for example, cannulating an uncooperative patient at night. Going beyond teaching competency and ensuring capability is imperative, as recommended by the national outcomes for medical graduates. A course on intravenous cannulation was developed with e‐learning modules and high‐fidelity complex simulation scenarios, aiming to promote capability in practice. The course delivered an intravenous cannulation e‐learning package between two practical simulations to 10 final‐year medical students. The hybrid simulation design consisted of an actor with a bespoke cannulation part‐task trainer strapped to their arm. Each simulation delivered a challenging scenario, requiring the integration of procedural and behavioural skills to succeed. Simulations were video recorded, and participants reviewed their performances before completing semi‐structured interviews. Transcribed interviews were thematically analysed. Interview analysis demonstrated two overarching themes: ‘Impact on Capability’ and ‘Preparedness for Practice’. There was consistent recognition of improved capability from the interviews. Simulation exercises were described as the most valuable tool for developing capability. The e‐learning helped with structure, facilitating students' adaptation to scenarios. Participants felt that training in medical school was largely competency‐based and did not tackle complex interactions. Following e‐learning and simulations, students felt more prepared for clinical practice. The course structure has value for medical professionals in developing capability and preparing for clinical practice, helping to reach standards expected of graduates. Plans to assess capability across multiple undergraduate programmes through Entrustable Professional Activities are in progress