Clinical audit in veterinary practice: theory v reality

CLINICAL AUDIT is an effective tool for assessing and improving the clinical care provided to patients. Good guidance has previously been provided in the veterinary literature as to how to conduct clinical audit in veterinary practice (Mosedale 1998, Viner 2009, 2010, 2012, Dunn 2012, RCVS Knowledge 2015). These resources go into depth about how to conduct audit and the types of topics to choose. However, the combination of the limited veterinary evidence-base and the reality of practice makes traditional clinical audit as per the framework derived from the medical field challenging to implement in the veterinary setting. Despite this, it can still be a rewarding and valuable tool to use in practice

A Model for Sustaining Participation with Hard-to-Serve Clients: The Learning Continuum

This article reports on a model developed by the Florida Crown Workforce Board in cooperation with the University of Florida\u27 s Welfare to Work Initiative. The model proposes a sustained educational experience that includes a variety of activities to enable welfare transition clients to become employed and self-sufficient. The concept of a Learning Continuum is described, and implications for Extension are discussed

User perceptions of multi-source feedback tools for junior doctors

Context:  The effectiveness of multi-source feedback (MSF) tools, which are increasingly important in medical careers, will be influenced by their users’ attitudes. This study compared perceptions of two tools for giving MSF to UK junior doctors, of which one provides mainly textual feedback and one provides mainly numerical feedback. We then compared the perceptions of three groups, including: trainees; raters giving feedback, and supervisors delivering feedback. Methods:  Postal questionnaires about the usability, usefulness and validity of a feedback system were distributed to trainees, raters and supervisors across the north of England. Results:  Questionnaire responses were analysed to compare opinions of the two tools and among the different user groups. Overall there were few differences. Attitudes towards MSF in principle were positive and the tools were felt to be usable, but there was little agreement that they could effectively identify doctors in difficulty or provide developmental feedback. The text-oriented tool was rated as more useful for giving feedback on communication and attitude, and as more useful for identifying a doctor in difficulty. Raters were more positive than other users about the usefulness of numerical feedback, but, overall, text was felt to be more useful. Some trainees expressed concern that feedback was based on insufficient knowledge of their work. This was not supported by raters’ responses, although many did use indirect information. Trainees selected raters mainly for the perceived value of their feedback, but also based on personal relationships and the simple pragmatics of getting a tool completed. Discussion:  Despite positive attitudes to MSF, the perceived effectiveness of the tools was low. There are small but significant preferences for textual feedback, although raters may prefer numerical scales. Concerns about validity imply that greater awareness of contextual and psychological influences on feedback generation is necessary to allow the formative benefits of MSF to be optimised and to negate the risk of misuse in high-stakes contexts

B -> K^* gamma from D -> K^* l nu

The B -> K^* gamma branching fraction is predicted using heavy quark spin symmetry at large recoil to relate the tensor and (axial-)vector form factors, using heavy quark flavor symmetry to relate the B decay form factors to the measured D -> K^* l nu form form factors, and extrapolating the semileptonic B decay form factors to large recoil assuming nearest pole dominance. This prediction agrees with data surprisingly well, and we comment on its implications for the extraction of |Vub| from B -> rho l nu.Comment: 10 page

Re-evaluating the factor structure of the Tolerance of Ambiguity of Medical Students And Doctors (TAMSAD) scale in newly qualified doctors

This is the final version. Available on open access from MedEdPublish via the DOI in this recordData availability: Underlying data: Newcastle University: Questionnaire data files for study of interim Foundation Year 1 (FiY1) doctors transition to practice in 2000. https://doi.org/10.25405/data.ncl.2253709926. The project contains the following underlying data: - final phase 1 data for repository.csv - final phase 2 data for repository.csv Extended data: Newcastle University: Questionnaire data files for study of interim Foundation Year 1 (FiY1) doctors transition to practice in 2000. https://doi.org/10.25405/data.ncl.2253709926. The project contains the following extended data: - README.txt (brief description of the contents of all files) - Phase 1 questionnaire.pdf - Phase 2 questionnaire.pdf - questionnaire field key for repository.xlsx Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).Background Ambiguity and uncertainty are inherent within the practice of medicine. While theory suggests the construct may be multidimensional, scales such as the Tolerance of Ambiguity of Medical Students And Doctors (TAMSAD) act unidimensionally, at least in a local population. Therefore, the dimensionality of the Tolerance of Ambiguity (ToA) construct remains unclear. This study aims to explore the dimensionality of ToA in early postgraduate doctors using the TAMSAD scale in a UK national sample and consider the implications of this dimensionality for theory and practice. Methods We used data from 428 respondents in a national research project examining the experiences of newly qualified doctors in the UK (2020). We undertook an exploratory factor analysis (extracting one-factor to six-factor solutions) of the 29-item TAMSAD scale and compared findings to an existing integrative model of uncertainty tolerance. Results The analysis suggested that the ToA construct is multidimensional. The three-factor model and five-factor model provided clinically interpretable factors and had different merits. It appears that having an affinity for complexity is not simply the opposite of experiencing discomfort from uncertainty, and that a professional’s epistemological beliefs about the nature of medicine may influence their ToA. Conclusions These findings support an extension to a key integrative model of uncertainty tolerance, and support development of interventions to increase ToA in doctors. For example, through encouraging increased reflection on an individual’s own epistemological beliefs about medicine and the role of doctors. The potential impact of such interventions can be evaluated using scales such as the TAMSAD

Constraining Supergravity Scenarios through the b→s,γb\to s,\gamma Decay.

We evaluate the branching ratio BR($b\rightarrow s,\gamma$) in the minimal supersymmetric standard model (MSSM), determining the corresponding phenomenological restrictions on two attractive supergravity scenarios, namely minimal supergravity and a class of models with a natural solution to the $\mu$ problem. We have included in the calculation some one--loop refinements that have a substantial impact on the results. The numerical results show some disagreements with part of the previous results in the literature, while they are in agreement with others. For minimal supergravity the CLEO upper and lower bounds put important restrictions on the scalar and gaugino masses in both cases $\mu0$. For the other supergravity scenarios the relevant CLEO bound is the upper one. It is stressed the fact that an eventual improvement of the experimental bounds of order $10^{-4}$ would strengthen the restrictions on the MSSM dramatically. This would be enough to discard these supergravity scenarios with $\mu<0$ if no discrepancy is found with the standard model prediction, while for $\mu>0$ there will remain low-energy windows.Comment: 13 pages + 8 figures included in a separate file, Latex, requires psfig.sty. We have corrected a mistake affecting some figures and their corresponding quotations in the text, as well as several misprints

Gauge Theories on a 2+2 Anisotropic Lattice

The implementation of gauge theories on a four-dimensional anisotropic lattice with two distinct lattice spacings is discussed, with special attention to the case where two axes are finely and two axes are coarsely discretized. Feynman rules for the Wilson gauge action are derived and the renormalizability of the theory and the recovery of the continuum limit are analyzed. The calculation of the gluon propagator and the restoration of Lorentz invariance in on-shell states is presented to one-loop order in lattice perturbation theory for $SU(N_c)$ on both 2+2 and 3+1 lattices.Comment: 27 pages, uses feynmf. Font compatibility adjuste