Validity evidence and reliability of a simulated patient feedback instrument

Contains fulltext : 110154.pdf (publisher's version ) (Open Access)BACKGROUND: In the training of healthcare professionals, one of the advantages of communication training with simulated patients (SPs) is the SP's ability to provide direct feedback to students after a simulated clinical encounter. The quality of SP feedback must be monitored, especially because it is well known that feedback can have a profound effect on student performance. Due to the current lack of valid and reliable instruments to assess the quality of SP feedback, our study examined the validity and reliability of one potential instrument, the 'modified Quality of Simulated Patient Feedback Form' (mQSF). METHODS: Content validity of the mQSF was assessed by inviting experts in the area of simulated clinical encounters to rate the importance of the mQSF items. Moreover, generalizability theory was used to examine the reliability of the mQSF. Our data came from videotapes of clinical encounters between six simulated patients and six students and the ensuing feedback from the SPs to the students. Ten faculty members judged the SP feedback according to the items on the mQSF. Three weeks later, this procedure was repeated with the same faculty members and recordings. RESULTS: All but two items of the mQSF received importance ratings of > 2.5 on a four-point rating scale. A generalizability coefficient of 0.77 was established with two judges observing one encounter. CONCLUSIONS: The findings for content validity and reliability with two judges suggest that the mQSF is a valid and reliable instrument to assess the quality of feedback provided by simulated patients

Are female students in general and nursing students more ready for teamwork and interprofessional collaboration in healthcare?

<p>Abstract</p> <p>Background</p> <p>Interprofessional Education (IPE) is now spreading worldwide and many universities are now including IPE in their curricula. The aim of this study was to investigate whether or not such student characteristics as gender, previous working experience in healthcare, educational progress and features of the learning environment, such as educational programmes and curriculum design, have an impact on their open-mindedness about co-operation with other professions.</p> <p>Methods</p> <p>Medical and nursing students at two Swedish universities were invited to fill in the Readiness for Interprofessional Learning Scale (RIPLS). Totally, 955 students were invited and 70.2% (n = 670) participated in the study. A factor analysis of the RIPLS revealed four item groupings (factors) for our empirical data, but only one had sufficient internal consistency. This factor was labelled "Team Player".</p> <p>Results</p> <p>Regardless of the educational programme, female students were more positive to teamwork than male students. Nursing students in general displayed more positive beliefs about teamwork and collaboration than medical students. Exposure to different interprofessional curricula and previous exposure to interprofessional education were only to a minor extent associated with a positive attitude towards teamwork. Educational progress did not seem to influence these beliefs.</p> <p>Conclusions</p> <p>The establishment of interprofessional teamwork is a major challenge for modern healthcare. This study indicates some directions for more successful interprofessional education. Efforts should be directed at informing particularly male medical students about the need for teamwork in modern healthcare systems. The results also imply that study of other factors, such as the student's personality, is needed for fully understanding readiness for teamwork and interprofessional collaboration in healthcare. We also believe that the RIPL Scale still can be further adjusted.</p

A four-year, systems-wide intervention promoting interprofessional collaboration

Background: A four-year action research study was conducted across the Australian Capital Territory health system to strengthen interprofessional collaboration (IPC) through multiple intervention activities. Methods: We developed 272 substantial IPC intervention activities involving 2,407 face-to-face encounters with health system personnel. Staff attitudes toward IPC were surveyed yearly using Heinemann et al’s Attitudes toward Health Care Teams and Parsell and Bligh’s Readiness for Interprofessional Learning scales (RIPLS). At study’s end staff assessed whether project goals were achieved. Results: Of the improvement projects, 76 exhibited progress, and 57 made considerable gains in IPC. Educational workshops and feedback sessions were well received and stimulated interprofessional activities. Over time staff scores on Heinemann’s Quality of Interprofessional Care subscale did not change significantly and scores on the Doctor Centrality subscale increased, contrary to predictions. Scores on the RIPLS subscales of Teamwork & Collaboration and Professional Identity did not alter. On average for the assessment items 33% of staff agreed that goals had been achieved, 10% disagreed, and 57% checked ‘neutral’. There was most agreement that the study had resulted in increased sharing of knowledge between professions and improved quality of patient care, and least agreement that between-professional rivalries had lessened and communication and trust between professions improved. Conclusions: Our longitudinal interventional study of IPC involving multiple activities supporting increased IPC achieved many project-specific goals, but improvements in attitudes over time were not demonstrated and neutral assessments predominated, highlighting the difficulties faced by studies targeting change at the systems level and over extended periods

Predictability, efference copies, and non-retinotopic motion

Perception is usually non-retinotopic. For example, visual perception is stable even though the retinal image is constantly changing due to eye and body movements. Likewise, a reflector on the wheel of a bicycle is perceived to rotate on a circular orbit, while its “true” motion (in retinotopic or exogenous coordinates) is cycloidal. In the first example, the brain uses efference copies to predict and compensate for eye movements. But how does the brain compensate for motion without efference copies? To investigate non-retinotopic motion perception, we used the Ternus-Pikler display. Two disks are flashed on a computer screen. A dot moves linearly up-down in the left disk and left-right in the right disk (retinotopic percept). If a third disk is added alternatingly to the left and right, the three disks form a group moving back and forth horizontally. The dot in the central disk now appears to move on a circular orbit (non-retinotopic percept), because the brain subtracts the horizontal group motion from the combination of the up-down and left-right motion. Here, we asked whether predictability is necessary to compute non-retinotopic motion. In experiment 1, the three disks moved randomly in any direction, rather than horizontally back and forth. Still, a strong non-retinotopic dot rotation was perceived. In experiment 2, we additionally varied the shape and contrast polarity of the stimuli from frame to frame. Still, a strong non-retinotopic dot rotation was perceived. Hence, the visual system can flexibly solve the non-retinotopic motion correspondence problem, even when the retinotopic reference motion is unpredictable. It seems that, in the case of non-retinotopic motion, the brain computes the reference-frame in real-time and does not need efference copy-like signals based on the predictability of the stimulus

Investigating prospective memory via eye tracking: No evidence for a monitoring deficit in older adults

Prospective memory (PM) refers to remembering to perform intended actions in the future. Older adults in particular have been shown to be negatively affected by PM tasks that require a high amount of attentional resources (i.e., nonfocal tasks). This age-related PM deficit has been attributed to reduced target monitoring in this age group older adults. However, this conclusion was based on indirect measures of monitoring, such as costs of the ongoing task. The present study set out to 1) investigate older adults' PM target monitoring by, for the first time, employing a direct measure (i.e., eye tracking), 2) assess differences in monitoring between PM tasks that differ in their focality, and 3) examine whether differences in PM monitoring can indeed explain older adults' reduced PM performance in nonfocal tasks. Results demonstrate that while older, but not younger adults, showed reduced performance in a nonfocal PM task, overt monitoring (eye movements) of these groups did not differ between focality conditions. Further analyses showed that older adults' performance was still reduced on the strategically more demanding task after controlling for overt target monitoring (i.e., including only trials in which the participant monitored). In contrast to indirect measures of cue monitoring, our findings illustrate that older adults' deficits on non-focal PM tasks cannot (exclusively) be explained by reduced monitoring. Instead, processing that takes place after target monitoring are discussed as possible mechanisms underlying older adults' reduced PM performance in nonfocal tasks

Unpredictability does not hamper nonretinotopic motion perception

The motion of parts of an object is usually perceived relative to the object, i.e., nonretinotopically, rather than in retinal coordinates. For example, we perceive a reflector to rotate on the wheel of a moving bicycle even though its trajectory is cycloidal on the retina. The rotation is perceived because the motion of the object (bicycle) is discounted from the motion of its parts (reflector). It seems that the visual system can easily compute the object motion and subtract it from the part motion. Bikes move usually rather predictably. Given the complexity of real-world motion computations, including many ill-posed problems such as the motion correspondence problem, predictability of an object's motion may be essential for nonretinotopic perception. Here, we used the Ternus-Pikler display to investigate this question. Performance was not impaired when contrast polarity, shape, and motion trajectories changed unpredictably. Our findings suggest that predictability is not crucial for nonretinotopic motion processing