Designing for Practice Development in a Social Learning System: Communicating Norms and Vicarious Experience

Over the past quarter century, the United States has experienced an increase in demand for health services. Expanded use of community health workers (CHWs) has been identified as a strategic response for more effective distribution of healthcare resources by alleviating pressures on clinical personnel and infusing prevention education into the community-to-clinical care continuum. Expansion of the CHW workforce poses many challenges. For CHWs to effectively reduce costs and pressures on the healthcare system, ‘expansion’ implies not only increasing their numbers, but also assuring a workforce that has the capacity to perform in diverse settings. I propose a theoretical framework for practice development in a healthcare workforce and use the framework as a guide to test whether system design can motivate specific types of communications in an online social learning system. The results have important implications for 1) system design for development of a diverse healthcare workforce like CHWs, 2) designing for specific types of learning communications, and 3) the theoretical support for practice development. We successfully designed a social learning system to motivate what we believe to be norm affirming and self-efficacy developing communications. Further studies will determine whether this supports practice in healthcare as proposed by the theoretical framework

Data Driven Quality Improvement of Health Professions Education: Design and Development of CLUE – An Interactive Curriculum Data Visualization Tool

Curriculum Mapping and dynamic visualization is quickly becoming an integral aspect of quality improvement in support of innovations which drive curriculum quality assurance processes in medical education. CLUE (Curriculum Explorer) a highly interactive, engaging and independent platform was developed to support curriculum transparency, enhance student engagement, and enable granular search and display. Reflecting a design based approach to meet the needs of the school's varied stakeholders, CLUE employs an iterative and reflective approach to drive the evolution of its platform, as it seeks to accommodate the ever-changing needs of our stakeholders in the fast pace world of medicine and medical education today. CLUE exists independent of institutional systems and in this way, is uniquely positioned to deliver a data driven quality improvement resource, easily adaptable for use by any member of our health care professions

Large-scale migration into Britain during the Middle to Late Bronze Age

Present-day people from England and Wales harbour more ancestry derived from Early European Farmers (EEF) than people of the Early Bronze Age . To understand this, we generated genome-wide data from 793 individuals, increasing data from the Middle to Late Bronze and Iron Age in Britain by 12-fold, and Western and Central Europe by 3.5-fold. Between 1000 and 875 BC, EEF ancestry increased in southern Britain (England and Wales) but not northern Britain (Scotland) due to incorporation of migrants who arrived at this time and over previous centuries, and who were genetically most similar to ancient individuals from France. These migrants contributed about half the ancestry of Iron Age people of England and Wales, thereby creating a plausible vector for the spread of early Celtic languages into Britain. These patterns are part of a broader trend of EEF ancestry becoming more similar across central and western Europe in the Middle to Late Bronze Age, coincident with archaeological evidence of intensified cultural exchange . There was comparatively less gene flow from continental Europe during the Iron Age, and Britain's independent genetic trajectory is also reflected in the rise of the allele conferring lactase persistence to ~50% by this time compared to ~7% in central Europe where it rose rapidly in frequency only a millennium later. This suggests that dairy products were used in qualitatively different ways in Britain and in central Europe over this period. [Abstract copyright: © 2021. The Author(s), under exclusive licence to Springer Nature Limited.