Development of a programme to facilitate interprofessional simulation-based training for final year undergraduate healthcare students

Original report can be found at: http://www.health.heacademy.ac.uk/publications/miniproject/alinier260109.pdfIntroduction: Students have few opportunities to practise alongside students from other disciplines. Simulation offers an ideal context to provide them with concrete experience in a safe and controlled environment. This project was about the development of a programme to facilitate interprofessional scenario-based simulation training for final year undergraduate healthcare students and explored whether simulation improved trainees’ knowledge of other healthcare discipline’s roles and skills. Methods: A multidisciplinary academic project team was created and trained for the development and facilitation of this project. The team worked on the development of appropriate multiprofessional scenarios and a strategy to recruit the final year students on a volunteer basis to the project. By the end of the project 95 students were involved in small groups to one of fifteen 3-hour interprofessional simulation sessions. Staff role played the relatives, doctor on call, and patient when it was more appropriate than using a patient simulator (Laerdal SimMan/SimBaby) in the simulated community setting and paediatric or adult emergency department. Each session had 3 to 4 of the following disciplines represented (Adult/Children/Learning Disability Nursing, Paramedic, Radiography, Physiotherapy) and each student observed and took part in one long and relevant high-fidelity scenario. Half the students were randomly selected to fill in a 40-item questionnaire testing their knowledge of other disciplines before the simulation (control group) and the others after (experimental group). Students were assessed on the questions relating to the disciplines represented in their session. Results: By the end of the project 95 questionnaires were collected of which 45 were control group students (Questionnaire before simulation) and 50 experimental group students (Questionnaire after simulation). Both groups were comparable in terms of gender, discipline and age representation. Participants were: Adult nurses (n=46), Children’s nurses (n=4), Learning Disability nurses (n=7), Nurses, Paramedics (n=8), Radiographers (n=20), Physiotherapists (n=8). 15 sessions were run with an average of around 7 participants and at least 3 disciplines represented. The knowledge test results about the disciplines represented was significantly different between the control and experimental groups (Control 73.80%, 95% CI 70.95-76.65; and Experimental 78.81%, 95% CI 75.76-81.87, p=0.02). In addition, there were sometimes reliable differences between the groups in their view of multidisciplinary training; confidence about working as part of a multidisciplinary team was 3.33 (SD=0.80, Control) and 3.79 (SD=0.90, Experimental), p=0.011; their anticipation that working as part of a multidisciplinary team would make them feel anxious was 2.67 (SD=1.17, Control) and 2.25 (SD=1.04, Experimental), p=0.073; their perception of their knowledge of what other healthcare professionals can or cannot do was 3.00 (SD=0.91, Control) and 3.35 (SD=0.93, Experimental), p=0.066; their view that learning with other healthcare students before qualification will improve their relationship after qualification was 3.93 (SD=1.14, Control) and 4.33 (SD=0.81, Experimental), p=0.055; their opinion about interprofessional learning helping them to become better team workers before qualification was 3.96 (SD=1.24, Control) and 4.42 (SD=0.77, Experimental), p=0.036. Conclusions: Although the difference is relatively small (~5%), the results demonstrate that students gained confidence and knowledge about the skills and role of other disciplines involved in their session. Through simulation, the positivism of students about different aspects of learning or working with other healthcare disciplines has significantly improved. Students gained knowledge of other disciplines simply by being given the opportunity to take part in a multiprofessional scenario and observe another one. The results of the test and their reported perception about multidisciplinary team working suggest that they are better prepared to enter the healthcare workforce. Discussions during the debriefings highlighted the fact that multidisciplinary training is important. The main challenges identified have been the voluntary student attendance and timetabling issues forcing us to run the session late in the day due to the number of disciplines involved in each session and their different placement rota. The aim is now to timetable formally this session within their curriculum. Introducing simulation in the undergraduate curriculum should facilitate its implementation as Continuing Professional Development once these students become qualified healthcare professionals

Oscillation-free method for semilinear diffusion equations under noisy initial conditions

Noise in initial conditions from measurement errors can create unwanted oscillations which propagate in numerical solutions. We present a technique of prohibiting such oscillation errors when solving initial-boundary-value problems of semilinear diffusion equations. Symmetric Strang splitting is applied to the equation for solving the linear diffusion and nonlinear remainder separately. An oscillation-free scheme is developed for overcoming any oscillatory behavior when numerically solving the linear diffusion portion. To demonstrate the ills of stable oscillations, we compare our method using a weighted implicit Euler scheme to the Crank-Nicolson method. The oscillation-free feature and stability of our method are analyzed through a local linearization. The accuracy of our oscillation-free method is proved and its usefulness is further verified through solving a Fisher-type equation where oscillation-free solutions are successfully produced in spite of random errors in the initial conditions.Comment: 19 pages, 9 figure

BIOTECHNOLOGY IN AGRICULTURE: IMPLICATIONS FOR FARM-LEVEL RISK MANAGEMENT

This study examines the risks associated with adoption of biotech crops and discusses their implications for risk management at the farm level. We develop an analytical risk evaluation matrix framework to illustrate changes in production and marketing risks of biotech and non-biotech crops. Price uncertainty generated by consumer concerns is the major risk facing biotech farmers, while cross-pollination with biotech crops and preservation of non-biotech status are major concerns for non-biotech farmers. Improved market infrastructure to handle biotech products and modification of the current risk management tools to accommodate new risks are essential in reducing the farm-level risks.biotechnology, genetically modified organisms, marketing risks, production risks, risk evaluation matrix, risk management, Research and Development/Tech Change/Emerging Technologies, Risk and Uncertainty,

Gun Control: State Versus Federal Regulation of Firearms

William Harwood addresses the complex question of whether gun control should be regulated by the federal or state government, or by some combination of both. In a thorough look at the history of federal and Maine state gun control—and at the various ways the issue of gun violence can be framed—Harwood concludes that neither level of government has a clear mandate to regulate exclusively. Rather, he argues for a more cooperative federal-state approach that allows the federal government to apply uniform regulations when appropriate and the states to experiment with further regulations if so desired

Fold-thrust tectonism in the southern Berkshire massif, Connecticut and Massachusetts

Guidebook for field trips in western Massachusetts, northern Connecticut and adjacent areas of New York: 67th annual meeting October 10, 11, and 12, 1975: Trip B-2; C-

Nature of the Taconic Orogeny in the Cupsuptic Quadrangle, West-Central Maine

Guidebook for field trips in the Rangeley Lakes - Dead River Basin region, western Maine: 62nd annual meeting October 2, 3, and 4, 1970: Trip

Radar Imagery - Parmachenee Lake Area, West Central Maine

Geologic evaluation of aerial radar photographs of Parmachenee Lake area, Main

Development and application of operational techniques for the inventory and monitoring of resources and uses for the Texas coastal zone. Volume 1: Text

The author has identified the following significant results. Image interpretation and computer-assisted techniques were developed to analyze LANDSAT scenes in support of resource inventory and monitoring requirements for the Texas coastal region. Land cover and land use maps, at a scale of 1:125,000 for the image interpretation product and 1:24,000 for the computer-assisted product, were generated covering four Texas coastal test sites. Classification schemes which parallel national systems were developed for each procedure, including 23 classes for image interpretation technique and 13 classes for the computer-assisted technique. Results indicate that LANDSAT-derived land cover and land use maps can be successfully applied to a variety of planning and management activities on the Texas coast. Computer-derived land/water maps can be used with tide gage data to assess shoreline boundaries for management purposes

Development and application of operational techniques for the inventory and monitoring of resources and uses for the Texas coastal zone. Volume 2: Appendices

There are no author-identified significant results in this report

Confirmatory factor analysis of the Test of Performance Strategies (TOPS) among adolescent athletes

The aim of the present study was to examine the factorial validity of the Test of Performance Strategies (TOPS; Thomas et al., 1999) among adolescent athletes using confirmatory factor analysis. The TOPS was designed to assess eight psychological strategies used in competition (i.e. activation, automaticity, emotional control, goal-setting, imagery, negative thinking, relaxation and self-talk,) and eight used in practice (the same strategies except negative thinking is replaced by attentional control). National-level athletes (n = 584) completed the 64-item TOPS during training camps. Fit indices provided partial support for the overall measurement model for the competition items (robust comparative fit index = 0.92, Tucker-Lewis index = 0.88, root mean square error of approximation = 0.05) but minimal support for the training items (robust comparative fit index = 0.86, Tucker-Lewis index = 0.81, root mean square error of approximation = 0.06). For the competition items, the automaticity, goal-setting, relaxation and self-talk scales showed good fit, whereas the activation, emotional control, imagery and negative thinking scales did not. For the practice items, the attentional control, emotional control, goal-setting, imagery and self-talk scales showed good fit, whereas the activation, automaticity and relaxation scales did not. Overall, it appears that the factorial validity of the TOPS for use with adolescents is questionable at present and further development is required