Fostering interprofessional communication through case discussions and simulated ward rounds in nursing and medical education: A pilot project

Background: Poor communication between physicians and nursing staff could result in inadequate interprofessional collaboration with negative effects on patient health. In order to ensure optimal health care for patients, it is important to strengthen interprofessional communication and collaboration between physicians and nurses during their education. Aim: The aim of this project is to foster communication for medical and nursing students through interprofessional case discussions and simulated ward rounds as a form of training. Method: In 2013-15 a total of 39 nursing students and 22 medical students participated in eight seminars, each covering case discussions and simulated ward rounds. The seminar was evaluated based on student assessment of the educational objectives. Results: Students who voluntarily signed up for the seminar profited from the interprofessional interaction and gathered positive experiences working in a team. Conclusion: Through practicing case discussions and ward rounds as a group, interprofessional communication could be fostered between medical and nursing students. Students took advantage of the opportunity to ask those from other profession questions and realized that interprofessional interaction can lead to improved health care

Social Policy in the EU — Reform Barometer 2016. Bertelsmann Stiftung Social Inclusion Monitor Europe

The Social Inclusion Monitor Europe (SIM Europe) project invited social policy experts from across Europe to participate in the Reform Barometer 2016 survey and assess the reform need, activity and quality with respect to 55 policy objectives in the 28 member states of the European Union between July 2014 and January 2016. This report presents the analysis of the replies from over 1,000 survey participants in five dimensions: Poverty Prevention, Equitable Education, Labour Market Access, Social Cohesion and Non-discrimination, and Health.1 For each member state, the experts’ quantitative assessments have been aggregated to different levels of analysis, yielding a reform need score, an activity rate and a quality score at the levels of policy objectives and of dimensions as well as at the overall level. In addition, the reform performance score is a composite measure that captures each member state’s reform activity and quality using a single number. In what follows, we present a summary of the key findings

Learning to diagnose accurately through virtual patients: do reflection phases have an added benefit?

BACKGROUND Simulation-based learning with virtual patients is a highly effective method that could potentially be further enhanced by including reflection phases. The effectiveness of reflection phases for learning to diagnose has mainly been demonstrated for problem-centered instruction with text-based cases, not for simulation-based learning. To close this research gap, we conducted a study on learning history-taking using virtual patients. In this study, we examined the added benefit of including reflection phases on learning to diagnose accurately, the associations between knowledge and learning, and the diagnostic process. METHODS A sample of N = 121 medical students completed a three-group experiment with a control group and pre- and posttests. The pretest consisted of a conceptual and strategic knowledge test and virtual patients to be diagnosed. In the learning phase, two intervention groups worked with virtual patients and completed different types of reflection phases, while the control group learned with virtual patients but without reflection phases. The posttest again involved virtual patients. For all virtual patients, diagnostic accuracy was assessed as the primary outcome. Current hypotheses were tracked during reflection phases and in simulation-based learning to measure diagnostic process. RESULTS Regarding the added benefit of reflection phases, an ANCOVA controlling for pretest performance found no difference in diagnostic accuracy at posttest between the three conditions, F(2, 114) = 0.93, p = .398. Concerning knowledge and learning, both pretest conceptual knowledge and strategic knowledge were not associated with learning to diagnose accurately through reflection phases. Learners' diagnostic process improved during simulation-based learning and the reflection phases. CONCLUSIONS Reflection phases did not have an added benefit for learning to diagnose accurately in virtual patients. This finding indicates that reflection phases may not be as effective in simulation-based learning as in problem-centered instruction with text-based cases and can be explained with two contextual differences. First, information processing in simulation-based learning uses the verbal channel and the visual channel, while text-based learning only draws on the verbal channel. Second, in simulation-based learning, serial cue cases are used to gather information step-wise, whereas, in text-based learning, whole cases are used that present all data at once

The variable magnetic field of V889 Her and the challenge of detecting exoplanets around young Suns using Gaussian process regression

Discovering exoplanets orbiting young Suns can provide insight into the formation and early evolution of our own solar system, but the extreme magnetic activity of young stars obfuscates exoplanet detection. Here we monitor the long-term magnetic field and chromospheric activity variability of the young solar analogue V889 Her, model the activity-induced radial velocity variations and evaluate the impacts of extreme magnetism on exoplanet detection thresholds. We map the magnetic field and surface brightness for 14 epochs between 2004 and 2019. Our results show potential 3-4 yr variations of the magnetic field which evolves from weak and simple during chromospheric activity minima to strong and complex during activity maxima but without any polarity reversals. A persistent, temporally-varying polar spot coexists with weaker, short-lived lower-latitude spots. Due to their different decay time-scales, significant differential rotation and the limited temporal coverage of our legacy data, we were unable to reliably model the activity-induced radial velocity using Gaussian Process regression. Doppler Imaging can be a useful method for modelling the magnetic activity jitter of extremely active stars using data with large phase gaps. Given our data and using Doppler Imaging to filter activity jitter, we estimate that we could detect Jupiter-mass planets with orbital periods of $\sim$3 d. A longer baseline of continuous observations is the best observing strategy for the detection of exoplanets orbiting highly active stars.Comment: Accepted by MNRA

The variable magnetic field of V889 Her and the challenge of detecting exoplanets around young Suns using Gaussian process regression

Discovering exoplanets orbiting young Suns can provide insight into the formation and early evolution of our own solar system, but the extreme magnetic activity of young stars obfuscates exoplanet detection. Here we monitor the long-term magnetic field and chromospheric activity variability of the young solar analogue V889 Her, model the activity-induced radial velocity variations and evaluate the impacts of extreme magnetism on exoplanet detection thresholds. We map the magnetic field and surface brightness for 14 epochs between 2004 and 2019. Our results show potential 3-4 yr variations of the magnetic field which evolves from weak and simple during chromospheric activity minima to strong and complex during activity maxima but without any polarity reversals. A persistent, temporally-varying polar spot coexists with weaker, short-lived lower-latitude spots. Due to their different decay time-scales, significant differential rotation and the limited temporal coverage of our legacy data, we were unable to reliably model the activity-induced radial velocity using Gaussian Process regression. Doppler Imaging can be a useful method for modelling the magnetic activity jitter of extremely active stars using data with large phase gaps. Given our data and using Doppler Imaging to filter activity jitter, we estimate that we could detect Jupiter-mass planets with orbital periods of ∼3 d. A longer baseline of continuous observations is the best observing strategy for the detection of exoplanets orbiting highly active stars

The relation between learners' experience in simulations and diagnostic accuracy: generalizability across medical and teacher education

Simulation-based learning is being increasingly implemented across different domains of higher education to facilitate essential skills and competences (e.g. diagnostic skills, problem-solving, etc.). However, the lack of research that assesses and compares simulations used in different contexts (e.g., from design perspective) makes it challenging to effectively transfer good practices or establish guidelines for effective simulations across different domains. This study suggests some initial steps to address this issue by investigating the relations between learners' experience in simulation-based learning environments and learners' diagnostic accuracy across several different domains and types of simulations, with the goal of facilitating cross-domain research and generalizability. The findings demonstrate that used learners' experience ratings are correlated with objective performance measures, and can be used for meaningful comparisons across different domains. Measures of perceived extraneous cognitive load were found to be specific to the simulation and situation, while perceived involvement and authenticity were not. Further, the negative correlation between perceived extraneous cognitive load and perceived authenticity was more pronounced in interaction-based simulations. These results provide supporting evidence for theoretical models that highlight the connection between learners' experience in simulated learning environments and their performance. Overall, this research contributes to the understanding of the relationship between learners’ experience in simulation-based learning environments and their diagnostic accuracy, paving the way for the dissemination of best practices across different domains within higher education

Phase II study of capecitabine and oxaliplatin given prior to and concurrently with preoperative pelvic radiotherapy in patients with locally advanced rectal cancer

This multicentre phase II study evaluated the efficacy and safety of preoperative capecitabine plus oxaliplatin and radiotherapy (RT) in patients with locally advanced rectal cancer (T3/T4 rectal adenocarcinoma with or without nodal involvement). Treatment consisted of one cycle of XELOX (capecitabine 1000 mg m−2 bid on days 1–14 and oxaliplatin 130 mg m−2 on day 1), followed by RT (1.8 Gy fractions 5 days per week for 5 weeks) plus CAPOX (capecitabine 825 mg m−2 bid on days 22–35 and 43–56, and oxaliplatin 50 mg m−2 on days 22, 29, 43 and 50). Surgery was recommended 5 weeks after completion of chemoradiotherapy. The primary end point was pathological complete tumour response (pCR). Sixty patients were enrolled. In the intent-to-treat population, the pCR rate was 23% (95% CI: 13–36%). 58 patients underwent surgery; R0 resection was achieved in 57 (98%) patients, including all 5 patients with T4 tumours. Sphincter preservation was achieved in 49 (84%) patients. Tumour and/or nodal downstaging was observed in 39 (65%) patients. The most common grade 3/4 adverse events were diarrhoea (20%) and lymphocytopaenia (43%). Preoperative capecitabine, oxaliplatin and RT achieved encouraging rates of pCR, R0 resection, sphincter preservation and tumour downstaging in patients with locally advanced rectal cancer