The effectiveness of debriefing in simulation-based learning for health professionals: A systematic review

© the authors 2012. Background: Simulation is defined as a technique used to replace or amplify real experiences with guided experiences that evoke or replace substantial aspects of the real world in a fully interactive manner. The use of simulation for educational purposes began decades ago with the use of low-fidelity simulations and has evolved at an unprecedented pace. Debriefing is considered by many to be an integral and critical part of the simulation process. However, different debriefing approaches have developed with little objective evidence of their effectiveness. Objectives: The aim of this review was to identify, appraise and synthesise the best available evidence for the effectiveness of debriefing as it relates to simulation-based learning for health professionals

Investigating Predictors of True and False Guilty Pleas

An estimated 90% to 95% of convictions are obtained via guilty pleas, and roughly 11% of individuals exonerated with the help of the Innocence Project falsely pleaded guilty (innocenceproject.org). Despite the prevalence of guilty pleas (and the existence of false guilty pleas), relatively little scholarship has examined what influences a defendant to plead guilty (Redlich, 2010). In this study, we investigated factors that affected whether guilty and innocent students who were accused of cheating pleaded guilty or took their case before the Student Conduct Committee in a hearing (analogous to a trial). Using social psychological literature on social influence (Cialdini & Goldstein, 2004), we manipulated two legally and theoretically relevant factors: the attorney’s recommendation and the guilt of the defendant. Overall, guilty individuals were more likely to accept a guilty plea than innocent individuals. Advocate recommendation affected innocent and guilty participants’ plea decisions; however, the effect was stronger for innocent individuals. Innocent participants advised to go to trial were less likely to falsely plead guilty (M = 4%) compared with those without an advocate (M = 35%), those who were given educational information (M = 47%), or those who were advised to plead guilty (M = 58%). Overall, findings suggest that innocent individuals may be more vulnerable to the effects of social influence when considering advice from an advocate compared with guilty individuals. (PsycINFO Database Record (c) 2018 APA, all rights reserved

Design and conduct of 'Xtreme Alps' : a double-blind, randomised controlled study of the effects of dietary nitrate supplementation on acclimatisation to high altitude

The study of healthy human volunteers ascending to high altitude provides a robust model of the complex physiological interplay that emulates human adaptation to hypoxaemia in clinical conditions. Nitric oxide (NO) metabolism may play an important role in both adaptation to high altitude and response to hypoxaemia during critical illness at sea level. Circulating nitrate and nitrite concentrations can be augmented by dietary supplementation and this is associated with improved exercise performance and mitochondrial efficiency. We hypothesised that the administration of a dietary substance (beetroot juice) rich in nitrate would improve oxygen efficiency during exercise at high altitude by enhancing tissue microcirculatory blood flow and oxygenation. Furthermore, nitrate supplementation would lead to measurable increases in NO bioactivity throughout the body. This methodological manuscript describes the design and conduct of the ‘Xtreme Alps’ expedition, a double-blind randomised controlled trial investigating the effects of dietary nitrate supplementation on acclimatisation to hypobaric hypoxia at high altitude in healthy human volunteers. The primary outcome measure was the change in oxygen efficiency during exercise at high altitude between participants allocated to receive nitrate supplementation and those receiving a placebo. A number of secondary measures were recorded, including exercise capacity, peripheral and microcirculatory blood flow and tissue oxygenation. Results from this study will further elucidate the role of NO in adaption to hypoxaemia and guide clinical trials in critically ill patients. Improved understanding of hypoxaemia in critical illness may provide new therapeutic avenues for interventions that will improve survival in critically ill patients

Neutron inelastic scattering investigation of the magnetic excitations in Cu_2Te_2O_5X_2 (X=Br, Cl)

Neutron inelastic scattering investigations have been performed on the spin tetrahedral system Cu_2Te_2O_5X_2 (X = Cl, Br). We report the observation of magnetic excitations with a dispersive component in both compounds, associated with the 3D incommensurate magnetic order that develops below $T^{Cl}_{N}$=18.2 K and $T^{Br}_{N}$=11.4 K. The excitation in Cu_2Te_2O_5Cl_2 softens as the temperature approaches $T^{Cl}_{N}$, leaving diffuse quasi-elastic scattering above the transition temperature. In the bromide, the excitations are present well above $T^{Br}_{N}$, which might be attributed to the presence of a degree of low dimensional correlations above $T^{Br}_{N}$ in this compound

Designing a Women’s Refuge: An Interdisciplinary Health, Architecture and Landscape Collaboration

University programs are currently faced with a number of challenges: how to engage students as active learners, how to ensure graduates are ‘work ready’ with broad and relevant professional skills, and how to support students to see their potential as agents of social change and contributors to social good. This paper presents the findings from a study that explored the impact of an authentic, interdisciplinary project with health, architecture and landscape students. This project facilitated students’ entrée into the lived experience of women and children requiring refuge services as a result of homelessness and/or domestic violence. Students collaborated with stakeholders from the refuge sector, visiting sites, undertaking individual research, exchanging ideas and problem-solving, to develop a design guide for a women’s refuge. Focus groups were conducted at the conclusion of the activity to gauge students’ perceptions of the value of the activity. Results indicated that the ‘hands-on’ and collaborative nature of the learning experience in a real-world context was valued, primarily due to its direct relevance to professional practice. Architecture and landscape participants reported an increase in their understanding and knowledge of refuge clients, and many expressed a commitment to further learning and contribution to the sector. Nursing students felt that the authentic learning experience helped prepare them for the ‘real world’ of practice and that it aided the development of their professional identities and capacity to effect real-world change. The learning activity had a positive impact on knowledge acquisition and students’ confidence to act as agents of social change

Recommendations from recent graduates in medicine, nursing and pharmacy on improving interprofessional education in university programs: A qualitative study

Background: Interprofessional education (IPE) has been recognized as an innovative approach for the development of a collaborative, practice-ready health workforce, but is not used consistently in undergraduate health professional programs. We sought to explore the reflections of graduates on the IPE experiences they had during their undergraduate education and training. It was anticipated that having completed their pre-vocational education and spent up to two years working in a clinical environment, recent graduates would be well-placed to provide insights into the value of the IPE opportunities they had, and to suggest approaches for improving these opportunities in undergraduate programs. Methods. This study was part of a larger research project (Interprofessional Education for the Quality use of Medicines; IPE for QuM) which used focus groups as part of an interpretive research design to inform other aspects of the research. Here, we report on focus groups with recent graduates recruited from area health services across Australia. Results: Sixty-eight recent graduates working in New South Wales, Western Australia, and Tasmania participated in 12 focus group sessions. In this paper, we report on new graduates' reflections on their experiences of IPE as part of their university degree, as well as their recommendations to improve interprofessional education before graduation. The new graduates were unanimous in valuing IPE from their current perspective of being in the health workforce. Most IPE experiences recalled were regarded as positive, but those valued most highly were experiences that involved genuine engagement and opportunities to interact with students in other professions working on a relevant problem. Clinical placement was a missed opportunity with few structured meaningful interprofessional learning experiences. Surprisingly there was little social contact between professions in universities even when programs were co-located, thus reinforcing professional silos. Conclusions: The graduates provided many insightful reflections about the value of university-based IPE and their preparedness for clinical practice. Although universally acclaimed as a good idea there is much room for improvement. We put forward a set of suggestions to improve IPE and guide the design of future IPE efforts. © 2014 Gilligan et al.; licensee BioMed Central Ltd

A Cross‐Sectional Assessment of Frailty, Falls and Perceptions of Ageing in People Living with HIV Using an mHealth Platform

Objective: To evaluate frailty, falls and perceptions of ageing among clinically stable individuals with HIV, engaged with remote healthcare delivered via a novel smartphone application. Methods: This was a multi-centre European cross-sectional, questionnaire-based sub-study of EmERGE participants. Frailty was assessed using the five-item FRAIL scale. Present criteria were summed and categorized as follows: 0, robust; 1-2, pre-frail; 3-5, frail. Falls history and EQ-5D-5L quality of life measure were completed. Participants were asked their felt age and personal satisfaction with ageing. Results: A total of 1373 participated, with a mean age of 45 (± 9.8) years. Frailty was uncommon at 2%; 12.4% fell in the previous year, 58.8% of these recurrently. Mood symptoms and pain were prevalent, at 43.3% and 31.8%, respectively. Ageing satisfaction was high at 76.4%, with 74.6% feeling younger than their chronological age; the mean felt age was 39.3 years. In multivariable analysis, mood symptoms and pain were positively associated with frailty, falls and ageing dissatisfaction. An increase in pain severity and mood symptoms were respectively associated with 34% and 63% increased odds of pre-frailty/frailty. An increment in pain symptoms was associated with a 71% increase in odds of falling. Pain was associated with ageing poorly, as were mood symptoms, with odds of dissatisfaction increasing by 34% per increment in severity. Conclusions: Although uncommon, frailty, falls and ageing dissatisfaction were seen in a younger cohort with medically stable HIV infection using a remote care model, promoting screening as advocated by European guidelines. These were more common in those with pain or mood symptoms, which should be proactively managed in clinical care and explored further in future research.info:eu-repo/semantics/publishedVersio

Generation Y Health Professional Students’ Preferred Teaching and Learning Approaches: A Systematic Review

Generation Y or Millennials are descriptors for those born between 1982 and 2000. This cohort has grown up in the digital age and is purported to have different learning preferences from previous generations. Students are important stakeholders in identifying their preferred teaching and learning approaches in health professional programs. This study aimed to identify, appraise, and synthesize the best available evidence regarding the teaching and learning preferences of Generation Y health professional students. The review considered any objectively measured or self-reported outcomes of teaching and learning reported from Generation Y health professional student perspectives. In accordance with a previously published Joanna Briggs Institute Protocol, a three-step search strategy was completed. Two research articles (nursing and dental hygiene students) and three dissertations (nursing) were critically appraised. All studies were cross-sectional descriptive studies. A range of pedagogical approaches was reported, including lecture, group work, and teaching clinical skills. Based on the Joanna Briggs Institute levels of evidence, reviewers deemed the evidence as Level 3. Some generational differences were reported, but these were inconsistent across the studies reviewed. There is, therefore, insufficient evidence to provide specific recommendations for the preferred educational approaches of health professional students and further research is warrante

Generic First Order Orientation Transition of Vortex Lattices in Type II Superconductors

First order transition of vortex lattices (VL) observed in various superconductors with four-fold symmetry is explained microscopically by quasi-classical Eilenberger theory combined with nonlocal London theory. This transition is intrinsic in the generic successive VL phase transition due to either gap or Fermi velocity anisotropies. This is also suggested by the electronic states around vortices. Ultimate origin of this phenomenon is attributed to some what hidden frustrations of a spontaneous symmetry broken hexagonal VL on the underlying four-fold crystalline symmetry.Comment: 4 pages, 5 figures, some typos are correcte