A three-arm single blind randomised control trial of naïve medical students performing a shoulder joint clinical examination

Background Technological advances have previously been hailed as a new dawn in Higher Education, with the advent of ‘massive open online courses’ (MOOCs) and online learning. Virtual platforms have potential advantages such as accessibility and availability but simply transferring educational material to the online environment may not ensure high quality learning. Clinical examination is a fundamental principle of medical assessment, and this study aimed to assess the role of technology in teaching these skills. Aims/objectives To determine whether three teaching modalities were of equal efficacy in teaching examination of the shoulder joint to naïve medical students. Methods Sixty-seven pre-clinical medical students naïve to large joint examination were recruited. Participants completed a learning style questionnaire and were then block randomised to three study: textbook study, face-to-face seminar, or video tutorial via online platform. The same examination technique was taught in all groups, with the intervention being the method of delivery All second year students were eligible for inclusion. The single exclusion criteria was previous exposure to clinical examination teaching. Students were assessed using a standardised scoring system at baseline (pre-intervention), and days 5 and 19 post-intervention (maximum score 30). Assessors were blinded to group allocation. The primary outcome was assessment score at day 5 post intervention. Results There was no difference between the three groups at baseline assessment (mean scores 2.4 for textbook, 2.8 for face-to-face, and 3.1 for video; p = 0.267). Mean post-intervention scores were 16.5 textbook, 25.5 face-to-face, and 22.4 video (p < 0.001, η2 = .449). There was no change between day 5 and day 19 post-intervention assessment scores in any group (p = 0.373), Preferred learning style did not affect scores (p = 0.543). Conclusion Face-to-face teaching was the most effective method for teaching clinical examination of the shoulder. Technology can potentially increase accessibility and remove geographic barriers, but is not as effective if teaching techniques are simply mirrored in an online format. Online platforms allow in depth data analysis of how learners interact with educational material and this may have value in improving the design of online educational materials, and is a potential area for further research

Evaluation of pulse-oximetry oxygen saturation taken through skin protective covering

BACKGROUND: The hard edges of adult finger clip probes of the pulse oximetry oxygen saturation (POOS) monitor can cause skin damage if used for prolonged periods in a neonate. Covering the skin under the probe with Micropore surgical tape or a gauze piece might prevent such injury. The study was done to see if the protective covering would affect the accuracy of the readings. METHODS: POOS was studied in 50 full-term neonates in the first week of life. After obtaining consent from their parents the neonates had POOS readings taken directly (standard technique) and through the protective covering. Bland-Altman plots were used to compare the new method with the standard technique. A test of repeatability for each method was also performed. RESULTS: The Bland-Altman plots suggest that there is no significant loss of accuracy when readings are taken through the protective covering. The mean difference was 0.06 (SD of 1.39) and 0.04 (SD 1.3) with Micropore and gauze respectively compared to the standard method. The mean difference was 0.22 (SD 0.23) on testing repeatability with the standard method. CONCLUSION: Interposing Micropore or gauze does not significantly affect the accuracy of the POOS reading. The difference between the standard method and the new method was less than the difference seen on testing repeatability of the standard method

Indústria e universidade: a cooperação internacional e institucional e o protagonismo da mobilidade estudantil nos sistemas de inovação da Alemanha

Resumo O presente trabalho visa apresentar um quadro sobre as políticas empreendidas pela República Federal da Alemanha no sentido de captar as potencialidades técnico-científicas ao redor do mundo, por meio da atração de estudantes e pesquisadores para as universidades do país, levando em consideração as motivações que originaram tal necessidade para a manutenção de sua competitividade industrial, trespassando percalços e desafios econômicos e sociais percebidos e inserindo tal processo no campo da cooperação internacional. Para tanto, o artigo procurará promover a discussão sobre o papel da universidade no processo de produção de conhecimento e, em seguida, ressaltando a cooperação internacional e interinstitucional como elemento fundamental para a mobilidade estudantil e a produção e troca de conhecimento, buscará situar o processo de migração na Alemanha. A partir disso, estabelecendo relações entre produção de conhecimento e geração de inovação, procurará avaliar como essa realidade se manifesta na competitividade industrial alemã. Assim, além de pesquisa bibliográfica sobre o tema, o artigo estará amparado pelo levantamento dos dados disponíveis que demonstram não só a necessidade da iniciativa, mas como ela vem alterando a disposição e a articulação entre os setores com tal finalidade, buscando avaliar os resultados até então observados. Nesse sentido, serão analisados: a circulação de estudantes do mundo em relação à Alemanha; a participação das áreas privadas, estatais e universitárias em pesquisa e inovação; e os resultados apresentados. O período de 2000 a 2012 foi dividido para que se possa delinear a realidade enfrentada pelo país, resultando na implementação do programa. Ainda com base nas informações disponíveis, o artigo procurará delimitar o programa de inovação alemão de maneira a concluir com a indicação de um eventual modelo de geração de inovação passível de reprodução por países em desvantagem em termos de desenvolvimento frente à Alemanha

Some psychosocial and cultural factors in the Arab-Israeli conflict: a review of the literature

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66497/2/10.1177_002200277201600210.pd

Towards a positive cross-cultural lexicography: Enriching our emotional landscape through 216 ‘untranslatable’ words pertaining to well-being

Although much attention has been paid to culture-specific psychopathologies, there have been no comparable attempts to chart positive mental states that may be particular to certain cultures. This paper outlines the beginnings of a positive cross-cultural lexicography of ‘untranslatable’ words pertaining to wellbeing, culled from across the world’s languages. A quasi-systematic search uncovered 216 such terms. Using grounded theory, these words were organised into three categories: feelings (comprising positive and complex feelings); relationships (comprising intimacy and pro-sociality); and character (comprising personal resources and spirituality). The paper has two main aims. First, it aims to provide a window onto cultural differences in constructions of wellbeing, thereby enriching our understanding of wellbeing. Second, a more ambitious aim is that this lexicon may help expand the emotional vocabulary of English speakers (and indeed speakers of all languages), and consequently enrich their experiences of wellbeing. The paper concludes by setting out a research agenda to pursue these aims further

Development and validation of a virtual reality haptic femoral nailing simulator

OBJECTIVE: To create a virtual reality (VR) femoral nailing simulator combining haptics and image intensifier functionality and then carry out validation studies to assess its educational value. DESIGN: The simulator consisted of a 3D virtual environment, a haptic device and 3D printed drill handle and a VR headset. The environment was created using a video game development engine, interfaced with plugins to allow haptic feedback and image intensifier functionality. Two tasks were created within the simulator as part of an antegrade femoral intramedullary (IM) nail procedure: proximal guidewire entry and distal locking.For the validation study, participants performed the above tasks on the simulator. Metrics were collected including time taken, number of X-rays and tool distance travelled and used to assess construct validity. A questionnaire was then completed to assess authenticity and content validity. SETTING: Simulator development in centre for simulation and engagement science laboratory. Validation study in a teaching hospital environment. PARTICIPANTS: Orthopedic specialist trainees and consultants. RESULTS: Surgeon experience (number of IM nails performed/postgraduate year) correlated with significantly improved task performance. More experienced surgeons took less time, used fewer X-rays and had greater economy of movement than less experienced surgeons. Authenticity and content validity were well rated, with criticisms primarily due to hardware limitations. CONCLUSIONS: To our knowledge this is the first orthopedic simulator to combine immersive VR with haptics and full image intensifier functionality. By combining multiple aspects of surgical practice within a single device, we aimed to improve participant immersion and educational value. Our work so far has focused on technical skills, demonstrating good authenticity, content and construct validity, however our findings show promise in other applications such as nontechnical skill development and assessment

Surgical anatomy of the lacrimal fossa - a prospective computed tomodensitometry scan analysis

General view photographed 1974