Twitter: an effective learning tool within medical education

Educational social media platforms such as dedicated Facebook pages and Twitter hashtags are increasingly being used by anatomy educators as learning support tools with positive outcomes such as: increasing student engagement with the subject of anatomy, facilitating communication with educators and reducing student anxiety levels in the lead up to assessments by offering learning support information. There have been less reports on whether these platforms impact on student’s anatomy knowledge. One previous investigation demonstrated that the frequency of student engagement with a dedicated Twitter hashtag did not increase their exam scores, however the methodology did not provide specific learning feedback opportunities to students. Since then, Twitter introduced a polling tool. This project investigated whether the polling tool could effectively be used to deliver regular MCQ style questions (followed by feedback) to students and whether student’s use of this tool had an effect on exam scores. Second year medical students enrolled on the Musculoskeletal and Immunity Module 2015 (n=140) at Brighton Sussex Medical School were offered the #m204anatomy Twitter hashtag as a learning support tool which included weekly Twitter polls questioning student’s anatomy knowledge. Students were invited to complete a questionnaire asking whether they had answered Twitter polls and for consent to use their exam scores to compare against their use of the polls. Student opinions on the hashtag were also obtained during a focus group with five students. Ninety-three students successfully completed the questionnaire and gave consent. 62% of students didn’t used the Twitter polls and their mean anatomy exam score was 59.7%. 38% of students did answer the Twitter polls and their mean exam score was 67.2%, which showed to be significantly higher (p = 0.012) than those who did not use the Twitter polling tool. This indicates that the Twitter polling tool can be used as a formative assessment tool to enhance student anatomy knowledge. However, the majority of students are reluctant to engage with educational social media platforms and findings from this study indicate this is due to a fear that students will be identified as lacking knowledge and breaching professionalism guidelines. Keywords: Social media, Twitter, Medical education, Professionalism, Learning experienc

Social media guidelines: a review for health professionals and faculty members

Background The rising societal use of social media has encouraged health professionals to use social media in their professional activities; however, this can be a daunting task, particularly for those who are uncertain about the boundaries for the professional use of social media. This article summarises the guidelines provided by medical governing bodies on social media use and provides practical advice on how social media can be used, which is transferrable across the health professions. Methods Nine guidance documents published by medical governing bodies in major international English‐speaking countries were reviewed and analysed to identify their key common messages. Findings Five key themes were identified across all of the guidance documents, as follows: maintain patient confidentiality; defamation is unacceptable; privacy cannot be guaranteed; responsibility to maintain public trust; and reasons to use social media. Conclusions The guidelines predominantly focus on the risks of using social media. Although this is necessary, it is likely to inhibit the exploration of the potential uses of social media in health care education and practice. All of the guidance documents from governing bodies encourage the use of social media to engage with patients and to network with colleagues; however, there is relatively little practical guidance on how to use social media as a health professional. This article offers some practical advice for faculty members who wish to run development sessions on how to use social media for professional purposes

Student expectations: what is university really about?

Students spend 12 to 14 years in school learning in a carefully controlled and structured system.  It appears that many students enter university with unrealistic conceptions of what is expected of them in many aspects of teaching and learning, including assessment. Hence, when they reach university they are faced with the challenge of adjusting to radically different styles of teaching, learning and assessment. It follows that this lack of preparedness is key reason why students drop out or take longer to complete their studies.  To compound the issue, university teachers may not fully appreciate students' expectations and are unable to anticipate and address these in curriculum development and delivery.  Therefore, developing a better understanding of students’ perceptions, expectations and experiences is crucial to being able to deliver programmes of study that support students in the transition from school to university and as they move through their university life.  This paper explores the perceptions of Level 5 and Level 6 students on two LJMU programmes in the Faculty of Education, Health and Community with the overarching aim to investigate key aspects of the student experience relating to induction, support and transition.  By exploring students’ ideas around key areas we hope to be able to better understand what the student expectation is and identify strategies to bridge any gap that exists between staff and student beliefs

Development and evaluation of a concise food list for use in a web-based 24-h dietary recall tool

Foodbook24 is a self-administered web-based 24-h dietary recall tool developed to assess food and nutrient intakes of Irish adults. This paper describes the first step undertaken in developing Foodbook24 which was to limit participant burden by establishing a concise list of food items for inclusion in the tool. The aim of the present study was to evaluate whether using a concise food list (as opposed to an extensive list) with generic composition data would influence the estimates of nutrient intakes in a nationally representative sample of Irish adults. A 2319-item food list generated from the Irish National Adult Nutrition Survey (NANS) (2008-2010) (n 1500) was used as the basis for a shortened food list for integration into the tool. Foods similar in nutritional composition were recoded with a generic type food code to produce a concise list of 751 food codes. The concise food list was applied to the NANS food consumption dataset and intake estimates of thirty-five nutrients were compared with estimates derived using the original extensive list. Small differences in nutrient intakes (90% of intakes similarly categorised according to dietary reference values). This indicates that a concise food list is suitable for use in a web-based 24-h dietary recall tool for Irish adults

Carbapenemase-producing enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Background: Hospitals in any given region can be considered as part of a network, where facilities are connected to one another – and hospital pathogens potentially spread – through the movement of patients between them. We sought to describe the hospital admission patterns of patients known to be colonised with carbapenemase-producing Enterobacterales (CPE), and compare them with CPE-negative patient cohorts, matched on comorbidity information. Methods: We performed a linkage study in Victoria, Australia, including datasets with notifiable diseases (CPE notifications) and hospital admissions (admission dates and diagnostic codes) for the period 2011 to 2020. Where the CPE notification date occurred during a hospital admission for the same patient, we identified this as the ‘index admission’. We determined the number of distinct health services each patient was admitted to, and time to first admission to a different health service. We compared CPE-positive patients with four cohorts of CPE-negative patients, sampled based on different matching criteria. Results: Of 528 unique patients who had CPE detected during a hospital admission, 222 (42%) were subsequently admitted to a different health service during the study period. Among these patients, CPE diagnosis tended to occur during admission to a metropolitan public hospital (86%, 190/222), whereas there was a greater number of metropolitan private (23%, 52/222) and rural public (18%, 39/222) hospitals for the subsequent admission. Median time to next admission was 4 days (IQR, 0–75 days). Admission patterns for CPE-positive patients was similar to the cohort of CPE-negative patients matched on index admission, time period, and age-adjusted Charlson comorbidity index. Conclusions: Movement of CPE-positive patients between health services is not a rare event. While the most common movement is from one public metropolitan health service to another, there is also a trend for movement from metropolitan public hospitals into private and rural hospitals. After accounting for clinical comorbidities, CPE colonisation status does not appear to impact on hospital admission frequency or timing. These findings support the potential utility of a centralised notification and outbreak management system for CPE positive patients

Protocol for a definitive randomised controlled trial and economic evaluation of a community-based rehabilitation programme following hip fracture:fracture in the elderly multidisciplinary rehabilitation-phase III (FEMuR III)

Introduction: Proximal femoral (hip) fracture is common, serious and costly. Rehabilitation may improve functional recovery but evidence of effectiveness and cost-effectiveness are lacking. An enhanced rehabilitation intervention was previously developed and a feasibility study tested the methods used for this randomised controlled trial (RCT). The objectives are to compare the effectiveness and cost-effectiveness of the enhanced rehabilitation programme following surgical repair of proximal femoral fracture in older people compared with usual care.  Methods and analysis: Protocol for phase III, parallel-group, two-armed, superiority, pragmatic RCT with 1:1 allocation ratio; allocation sequence by minimisation programme with a built-in random element; secure web-based allocation concealment. The two treatments will be usual care (control) and usual care plus an enhanced rehabilitation programme (intervention). The enhanced rehabilitation will consist of a patient-held information workbook, goal setting diary and up to six additional therapy sessions. Outcome assessment and statistical analysis will be performed blind; patient and carer participants will be unblinded. Outcomes will be measured at baseline, 17 and 52 weeks' follow-up. Primary outcome at 52 weeks will be the Nottingham Extended Activities of Daily Living scale. Secondary outcomes will measure anxiety and depression, health utility, cognitive status, hip pain intensity, falls self-efficacy, fear of falling, grip strength and physical function. Carer strain, anxiety and depression will be measured in carers. All safety events will be recorded, and serious adverse events will be assessed to determine whether they are related to the intervention and expected. Concurrent economic evaluation will be a cost-utility analysis from a health service and personal social care perspective. An embedded process evaluation will determine the mechanisms and processes that explain the implementation and impacts of the enhanced rehabilitation programme.  Ethics and dissemination: National Health Service research ethics approval reference 18/NE/0300. Results will be disseminated by peer-reviewed publication.  Trial registration number ISRCTN28376407; Pre-results registered on 23 November 2018

Present and Future CP Measurements

We review theoretical and experimental results on CP violation summarizing the discussions in the working group on CP violation at the UK phenomenology workshop 2000 in Durham.Comment: 104 pages, Latex, to appear in Journal of Physics

Can sleep and resting behaviours be used as indicators of welfare in shelter dogs (Canis lupusfamiliaris)?

Previous research on humans and animals suggests that the analysis of sleep patterns may reliably inform us about welfare status, but little research of this kind has been carried out for non-human animals in an applied context. This study explored the use of sleep and resting behaviour as indicators of welfare by describing the activity patterns of dogs (Canis lupus familiaris) housed in rescue shelters, and comparing their sleep patterns to other behavioural and cognitive measures of welfare. Sleep and activity patterns were observed over five non-consecutive days in a population of 15 dogs. Subsequently, the characteristics of sleep and resting behaviour were described and the impact of activity on patterns of sleep and resting behaviour analysed. Shelter dogs slept for 2.8% of the day, 14.3% less than previously reported and experienced less sleep fragmentation at night (32 sleep bouts). There were no statistically significant relationships between behaviours exhibited during the day and sleep behaviour. A higher proportion of daytime resting behaviour was significantly associated with a positive judgement bias, less repetitive behaviour and increased time spent coded as ‘relaxed’ across days by shelter staff. These results suggest that, in the context of a busy shelter environment, the ability to rest more during the day could be a sign of improved welfare. Considering the non-linear relationship between sleep and welfare in humans, the relationship between sleep and behavioural indicators of welfare, including judgement bias, in shelter dogs may be more complex than this study could detect