Dynamic confidence during simulated clinical tasks

Objective: Doctors' confidence in their actions is important for clinical performance. While static confidence has been widely studied, no study has examined how confidence changes dynamically during clinical tasks. Method: The confidence of novice (n = 10) and experienced (n = 10) trainee anaesthetists was measured during two simulated anaesthetic crises, bradycardia (easy task) and failure to ventilate (difficult task). Results: As expected, confidence was high in the novice and experienced groups in the easy task. What was surprising, however, was that confidence during the difficult task decreased for both groups, despite appropriate performance. Conclusions: Given that confidence affects performance, it is alarming that doctors who may be acting unsupervised should lose dynamic confidence so quickly. Training is needed to ensure that confidence does not decrease inappropriately during a correctly performed procedure. Whether time on task interacts with incorrect performance to produce further deficits in confidence should now be investigated

Understanding decreases in land relative humidity with global warming: conceptual model and GCM simulations

Climate models simulate a strong land-ocean contrast in the response of near-surface relative humidity to global warming: relative humidity tends to increase slightly over oceans but decrease substantially over land. Surface energy balance arguments have been used to understand the response over ocean but are difficult to apply over more complex land surfaces. Here, a conceptual box model is introduced, involving moisture transport between the land and ocean boundary layers and evapotranspiration, to investigate the decreases in land relative humidity as the climate warms. The box model is applied to idealized and full-complexity (CMIP5) general circulation model simulations, and it is found to capture many of the features of the simulated changes in land relative humidity. The box model suggests there is a strong link between fractional changes in specific humidity over land and ocean, and the greater warming over land than ocean then implies a decrease in land relative humidity. Evapotranspiration is of secondary importance for the increase in specific humidity over land, but it matters more for the decrease in relative humidity. Further analysis shows there is a strong feedback between changes in surface-air temperature and relative humidity, and this can amplify the influence on relative humidity of factors such as stomatal conductance and soil moisture.Comment: Submitted to Journal of Climate on May 1st, 201

Scratching the Surface and Digging Deeper: Exploring Ecological Theories in Urban Soils

Humans have altered the Earth more extensively during the past 50 years than at any other time in history (Millennium Assessment 2003). A significant part of this global change is the conversion of land covers from native ecosystems to those dominated by human activities (Kareiva et al. 2007; Ellis and Ramankutty 2008). Although agricultural needs have historicall

Supporting development for the preliminary design of an intermediate water recovery system

Supporting development of experimental design for water recovery syste