Implementation of virtual OSCE in Health Professions Education: a Systematic Review

Introduction: The Objective Structured Clinical Examination (OSCE) has been widely used in health professions education since the 1970s. The global disruption caused by the COVID-19 pandemic restricted in-person assessments and medical educators globally sought alternative means to assess and certify students and trainees to meet the acute demand for health-care workers. One such solution was through virtual OSCE (vOSCE), which modified traditional in-person OSCE using videoconference platforms. This meta-ethnography sought to synthesise qualitative literature on candidates' and assessors' experiences of vOSCE to evaluate whether it may have a role in future assessment practices. Methods: In June 2022, we systematically searched PsycINFO, Medline and ERIC for peer-reviewed qualitative and mixed-methods articles that described candidates' and assessors' experiences of virtual OSCE in health professions education. Of 1069 articles identified, 17 were synthesised using meta-ethnography. Results: The final synthesis represented 1190 candidates and assessors from faculties of medicine, dentistry, nursing, pharmacy and osteopathy. We developed our findings into four key concepts. ‘Strengthening confidence in a virtual environment’ highlighted attempts to overcome and mitigate concerns associated with transitioning from in-person to virtual assessment. ‘Understanding the scope of use as an assessment’ reflected on the suitability of vOSCE in assessing various skills. ‘Refining operational processes’ emphasised the technical challenges of implementing vOSCE and impacts on accessibility and resources. ‘Envisioning its future role’ considered the applicability of vOSCE in the climate of rapid development in telehealth. Conclusion: This meta-ethnography highlighted that although vOSCE was primarily considered a temporary and crisis response, candidates and assessors recognised positive, as well as negative, consequences of the transition towards them. Moving forward, medical education policymakers should carefully consider the extent to which elements of vOSCE could be incorporated into assessment systems, particularly in light of the rise of telehealth in clinical practice

Adoption of Problem-Based Learning in Medical Schools in Non-Western Countries: A Systematic Review

Phenomenon: In recent decades, medical education practices developed in Western countries have been widely adopted in non-Western countries. Problem-based Learning (PBL) was first developed in North America and it relies on Western educational and cultural values, thereby raising concerns about its 'lift and shift' to non-Western settings. Approach: This review systematically identified and interpretively synthesized studies on students' and teachers' experiences of PBL in non-Western medical schools. Three databases (ERIC, PsycINFO, and MEDLINE) were searched. Forty-one articles were assessed for quality using the Critical Appraisal Skills Program (CASP) checklist and synthesized using meta-ethnography. The final synthesis represented over 5,400 participants from 18 countries. Findings: Findings were categorized into three different constructs: Student Engagement, Tutor Skills, and Organization and Planning. Our synthesis demonstrates that medical students and teachers in non-Western countries have varied experiences of PBL. Students engage variably with PBL, consider knowledge to be better acquired from authoritative figures, and deem PBL to be ineffective for assessment preparation. Student participation is limited by linguistic challenges when they are not native English speakers. Teachers are often unfamiliar with the underlying philosophical assumptions of PBL and struggle with the facilitation style needed. Both students and teachers have developed modifications to ensure that PBL better fits in their local settings. Insights: Given the significant adjustments and resource requirements needed to adopt PBL, medical school leaders and policy makers in non-Western countries should carefully consider possible consequences of its implementation for their students and teachers, and proactively consider ways to 'hybridize' it for local contexts

Staff Knowledge, Adherence to Infection Control Recommendations and Seroconversion Rates in Hemodialysis Centers in Khartoum

Introduction: We evaluated hemodialysis (HD) staff knowledge, adherence to infection control recommendations and seroconversion rates for hepatitis B virus (HBV) and hepatitis C virus (HCV) in 13 centers that continuously provided HD services in Khartoum State between June 2009 and November 2010. Methods: The knowledge of 182 HD staff members was evaluated by a self-filled questionnaire. Relevant data were obtained from 1011 HD patients by direct interviews and record review. Adherence of staff members to infection control recommendations was evaluated by direct observation. Results: HD staff members achieved a median score of 81% in knowledge evaluation (range 44-100%). Better scores were achieved by more experienced staff. We identified serious gaps in knowledge related to the environmental risk of viral transmission. Regular screening by enzyme-linked immunoassay (ELISA) was performed in 46% of centers. Only half susceptible patients were vaccinated against HBV. Staff dedicated for treatment of HBV positive patients were found in only 57% of centers that served such patients. Hand washing recommendations were strictly observed in 15% of centers, disinfection of HD stations between patients was strictly observed in 23% of centers, medications were prepared in a separate area in 8% of centers and delivered separately to each patient in none of the centers. There were 2.5 HCV seroconversions and 0.6 HBV seroconversions per 100 patient-years. Center characteristics that predicted HCV seroconversion were accommodation of HCV-positive patients in the same center, using ELISA for patient screening, and assigning more than 3 patients for one HD nurse. Conclusion: There are serious gaps in HD staff knowledge and adherence to infection control recommendations. A structured training program for HD staff members is urgently required. Keywords: Hemodialysis; HBV; HCV; Infection Control; Khartou

Harmonic-suppression Using Adaptive Surface Meshing and Genetic Algorithms

yesA novel design strategy for microstrip harmonic-suppression antennas is presented. The computational method is based on an integral equation solver using adaptive surface meshing driven by a genetic algorithm. Two examples are illustrated, all involving design of coaxially-fed air-dielectric patch antennas implanted with shorting and folded walls. The characteristics of the antennas in terms of the impedance responses and far ¯eld radiation patterns are discussed theoretically and experimentally. The performances of all of the GA-optimised antennas were shown to be excellent and the presented examples show the capability of the proposed method in antenna design using GA.MSCR

A Frequency Tunable PIFA Design for Handset Applications.

yesA frequency tunable planar inverted F antenna (PIFA) is presented for use in the following bands: DCS, PCS, and UMTS. Initially, the tuning was achieved by placing a lumped capacitor, with values in the range of 1.5 to 4 pF, along the slot of the radiator. The final tuning circuit uses a varactor diode, and discrete lumped elements are fully integrated with the antenna. The antenna prototype is tunable over from 1850 MHz to 2200 MHz, with an associated volume of 21×13.5×5 mm3, making it suitable for potential integration in a commercial handset or mobile user terminal

Synthesis and Microwave Absorption Properties of Doped Expanded Polystyrene with Silver Nanoparticles

Polystyrene (PS) is found to become a future major environmental issue and aggressive attempt by scientists to recycle PS into useful functional, recycle materials are becoming recent research trend. Polystyrene has been considered as a potential conductive and wave absorber materials. Doping PS with metal nanomaterials are found to enhance PS physical properties, thus enable the fine tuning of its conductive and wave absorbing properties. In this report, expanded polystyrene as source of PS waste materials are dissolved in tetrahydrofuran (THF), later added into deionized (DI) water to form precipitate polystyrene nanoparticles. This procedure enables easy access of dope silver (Ag) nanoparticles into PS in a colloidal form especially for homogeneity consideration. The UV-Vis spectroscopy (Ultra-Violet Visible), Field Emission Scanning Electron Microscopy (FESEM), Fourier Transformation Infrared Spectroscopy (FTIR), and Vector Network Analysis (VNA) are used to investigate the doped PS nanocomposite of its morphology, molecular vibrations, electrical and electromagnetic properties. The results indicate promising effects of the electrical and electromagnetic properties of doped polystyrene metal nanocomposite as potential conductive and wave absorber material. Results show that these properties are highly dependent on the type of doping materials

Evaluation of persistent-mode operation in a superconducting MgB2 coil in solid nitrogen

We report the fabrication of a magnesium diboride (MgB2) coil and evaluate its persistent-mode operation in a system cooled by a cryocooler with solid nitrogen (SN2) as a cooling medium. The main purpose of SN2 was to increase enthalpy of the cold mass. For this work, an in situ processed carbon-doped MgB2 wire was used. The coil was wound on a stainless steel former in a single layer (22 turns), with an inner diameter of 109 mm and height of 20 mm without any insulation. The two ends of the coil were then joined to make a persistent-current switch to obtain the persistent-current mode. After a heat treatment, the whole coil was installed in the SN2 chamber. During operation, the resultant total circuit resistance was estimated to be \u3c7.4x10−14 Ω at 19.5 K±1.5 K, which meets the technical requirement for magnetic resonance imaging application

Invisible Diaspora?:English Ethnicity in the United States before 1920

The article presents an examination into the English population of the United States during the 19th and early 20th centuries, examining their ethnic identity as a diaspora community. Introductory details are given noting the relative lack of attention given to English Americans as an ethnic group. Topics addressed include reasons behind the invisibility of the English immigrant identity in the U.S., the existence of English ethnic organizations, and an overview of their activities