Examining first year students' preparedness for studying engineering

The purpose of this paper is to report on initial descriptive data of this longitudinal project which will examine the knowledge, motivation, personality, and learning approaches of first year engineering students and how well they each predict subsequent retention and academic performance. These outcomes are yet to be achieved and are beyond the scope of this paper

Educational technologies and learning objectives

Technologies such as online tools, simulations, and remote labs are often used in learning and training environments, both academic and vocational, to deliver content in an accessible manner. They promise efficiencies of scale, flexibility of delivery, and face validity for a generation brought up on electronic devices. However, learning outcomes are not the same in all circumstances and sometimes contextual and cultural factors can lead to the failure of a technology which has been successful elsewhere. This paper draws on studies of the use of simulators and simulations within the vocational environment of the rail industry and uses Realistic Evaluation to assess and specify what works for whom in what circumstances. It is postulated that this evaluation framework could be a useful tool in the assessment of educational technologies used in engineering education. © Tibbits et. al., 201

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Understanding the community: Getting engineers on track

It is vital for engineers to develop an understanding of the community or industry they are working in or with and its values. Engineers seeking to be involved with communities without awareness may not create successful outcomes. This research reflects on work within the rail industry and how that culture resists the adoption of simulator technology. The paper details how using a theoretical framework for understanding culture can elucidate why any culture adopts a technology successfully or not

The development role of competence assurance

Competence assurance (CA) is a process of ensuring that the workforce is able to carry out its work in a safe and competent manner. It can entail disruptive and expensive regular assessments of workers' performance, require employers to 'backfill' positions during the process, and provide little obvious direct benefit for the business. It may not provide accurate assessment if workers are withdrawn from duties for assessment as their performance obviously cannot be the same as under working conditions. If workers are assessed in media res there are issues around the potential observer effect on assessment outcomes. Employers and workplace assessors need ways of assessing performance that accurately target what is of interest with minimum disruption and risk. However, we will argue that the CA process represents an opportunity lost in terms of workforce development, if what is of interest is narrowly defined as present job skills with little attention paid to workers' competencies as a whole. The key theoretical issues to be addressed here relate to authenticity in assessment in workplace training and include consideration of how competence/competency is defined. We consider how to achieve authentic assessment in safety-critical workplace settings in a way that will allow for targeted workforce development in the future. A change away from current practices to portfolio-based and 360-degree assessment has the potential to describe more accurately where skills and deficits lie, help companies identify personnel with needed competencies and provide relevant support for their development within a chosen career path, and to help workers identify their skills and goals and how they may be pursued within the industry/company

Get set for success: an update on the EngCAT project

In 2011, the Office for Learning and Teaching (OLT) funded a national project entitled 'Get set for success: Using online self-assessments to motivate first year engineering students to engage in and manage their learning'. This research project aims to identify factors that lead to success in first year engineering studies. The project will deliver a prototype model of the Engineering Career Appraisal Tool (EngCAT), an online educational resource that enables individuals to self-assess their cognitive (e.g., spatial, mathematical, and technical skills) and non-cognitive (e.g., personality traits, career interests and approaches to learning) abilities. Initial data have been collected and some initial results are available for the EngCAT project. Commencing engineering students across five Australian universities completed cognitive and noncognitive tests to help them self-assess their readiness for the programs and to empower them with self-awareness and learning skills