Development and validation of the ACE tool: Assessing medical trainees' competency in evidence based medicine

BACKGROUND: While a variety of instruments have been developed to assess knowledge and skills in evidence based medicine (EBM), few assess all aspects of EBM - including knowledge, skills attitudes and behaviour - or have been psychometrically evaluated. The aim of this study was to develop and validate an instrument that evaluates medical trainees’ competency in EBM across knowledge, skills and attitude. METHODS: The ‘Assessing Competency in EBM’ (ACE) tool was developed by the authors, with content and face validity assessed by expert opinion. A cross-sectional sample of 342 medical trainees representing ‘novice’, ‘intermediate’ and ‘advanced’ EBM trainees were recruited to complete the ACE tool. Construct validity, item difficulty, internal reliability and item discrimination were analysed. RESULTS: We recruited 98 EBM-novice, 108 EBM-intermediate and 136 EBM-advanced participants. A statistically significant difference in the total ACE score was observed and corresponded to the level of training: on a 0-15-point test, the mean ACE scores were 8.6 for EBM-novice; 9.5 for EBM-intermediate; and 10.4 for EBM-advanced (p < 0.0001). Individual item discrimination was excellent (Item Discrimination Index ranging from 0.37 to 0.84), with internal reliability consistent across all but three items (Item Total Correlations were all positive ranging from 0.14 to 0.20). CONCLUSION: The 15-item ACE tool is a reliable and valid instrument to assess medical trainees’ competency in EBM. The ACE tool provides a novel assessment that measures user performance across the four main steps of EBM. To provide a complete suite of instruments to assess EBM competency across various patient scenarios, future refinement of the ACE instrument should include further scenarios across harm, diagnosis and prognosis

Measuring frequency fluctuations in nonlinear nanomechanical resonators

Advances in nanomechanics within recent years have demonstrated an always expanding range of devices, from top-down structures to appealing bottom-up MoS$_2$ and graphene membranes, used for both sensing and component-oriented applications. One of the main concerns in all of these devices is frequency noise, which ultimately limits their applicability. This issue has attracted a lot of attention recently, and the origin of this noise remains elusive up to date. In this Letter we present a very simple technique to measure frequency noise in nonlinear mechanical devices, based on the presence of bistability. It is illustrated on silicon-nitride high-stress doubly-clamped beams, in a cryogenic environment. We report on the same $T/f$ dependence of the frequency noise power spectra as reported in the literature. But we also find unexpected {\it damping fluctuations}, amplified in the vicinity of the bifurcation points; this effect is clearly distinct from already reported nonlinear dephasing, and poses a fundamental limit on the measurement of bifurcation frequencies. The technique is further applied to the measurement of frequency noise as a function of mode number, within the same device. The relative frequency noise for the fundamental flexure $\delta f/f_0$ lies in the range $0.5 - 0.01~$ppm (consistent with literature for cryogenic MHz devices), and decreases with mode number in the range studied. The technique can be applied to {\it any types} of nano-mechanical structures, enabling progresses towards the understanding of intrinsic sources of noise in these devices.Comment: Published 7 may 201

Geometry of lines and degeneracy loci of morphisms of vector bundles

Corrado Segre played a leading role in the foundation of line geometry. We survey some recent results on degeneracy loci of morphisms of vector bundles where he still is of profound inspiration.Comment: 10 pages. To appear in the proceedings of the conference "Homage to Corrado Segre

On the Transmission of Colour Image Over Double Generalized Gamma FSO Channel

In this paper performance analysis of colour image Free Space Optics (FSO) transmission over Double Generalized Gamma (DGG) turbulence communication channel is carried out. At the reception side, we have used an average bit error rate (ABER) for reconstructed image performance measure, as the function of FSO link transmission parameters, such as propagation distance, Rytov variance and turbulence shaping and severity parameters (γ1, γ2, m1, m2). Obtained results cover a large number of colour image FSO transmission scenarios, for Gamma-Gamma, Double-Weibull and K turbulence models channels considered as special cases