Development of a programme to facilitate interprofessional simulation-based training for final year undergraduate healthcare students

Original report can be found at: http://www.health.heacademy.ac.uk/publications/miniproject/alinier260109.pdfIntroduction: Students have few opportunities to practise alongside students from other disciplines. Simulation offers an ideal context to provide them with concrete experience in a safe and controlled environment. This project was about the development of a programme to facilitate interprofessional scenario-based simulation training for final year undergraduate healthcare students and explored whether simulation improved trainees’ knowledge of other healthcare discipline’s roles and skills. Methods: A multidisciplinary academic project team was created and trained for the development and facilitation of this project. The team worked on the development of appropriate multiprofessional scenarios and a strategy to recruit the final year students on a volunteer basis to the project. By the end of the project 95 students were involved in small groups to one of fifteen 3-hour interprofessional simulation sessions. Staff role played the relatives, doctor on call, and patient when it was more appropriate than using a patient simulator (Laerdal SimMan/SimBaby) in the simulated community setting and paediatric or adult emergency department. Each session had 3 to 4 of the following disciplines represented (Adult/Children/Learning Disability Nursing, Paramedic, Radiography, Physiotherapy) and each student observed and took part in one long and relevant high-fidelity scenario. Half the students were randomly selected to fill in a 40-item questionnaire testing their knowledge of other disciplines before the simulation (control group) and the others after (experimental group). Students were assessed on the questions relating to the disciplines represented in their session. Results: By the end of the project 95 questionnaires were collected of which 45 were control group students (Questionnaire before simulation) and 50 experimental group students (Questionnaire after simulation). Both groups were comparable in terms of gender, discipline and age representation. Participants were: Adult nurses (n=46), Children’s nurses (n=4), Learning Disability nurses (n=7), Nurses, Paramedics (n=8), Radiographers (n=20), Physiotherapists (n=8). 15 sessions were run with an average of around 7 participants and at least 3 disciplines represented. The knowledge test results about the disciplines represented was significantly different between the control and experimental groups (Control 73.80%, 95% CI 70.95-76.65; and Experimental 78.81%, 95% CI 75.76-81.87, p=0.02). In addition, there were sometimes reliable differences between the groups in their view of multidisciplinary training; confidence about working as part of a multidisciplinary team was 3.33 (SD=0.80, Control) and 3.79 (SD=0.90, Experimental), p=0.011; their anticipation that working as part of a multidisciplinary team would make them feel anxious was 2.67 (SD=1.17, Control) and 2.25 (SD=1.04, Experimental), p=0.073; their perception of their knowledge of what other healthcare professionals can or cannot do was 3.00 (SD=0.91, Control) and 3.35 (SD=0.93, Experimental), p=0.066; their view that learning with other healthcare students before qualification will improve their relationship after qualification was 3.93 (SD=1.14, Control) and 4.33 (SD=0.81, Experimental), p=0.055; their opinion about interprofessional learning helping them to become better team workers before qualification was 3.96 (SD=1.24, Control) and 4.42 (SD=0.77, Experimental), p=0.036. Conclusions: Although the difference is relatively small (~5%), the results demonstrate that students gained confidence and knowledge about the skills and role of other disciplines involved in their session. Through simulation, the positivism of students about different aspects of learning or working with other healthcare disciplines has significantly improved. Students gained knowledge of other disciplines simply by being given the opportunity to take part in a multiprofessional scenario and observe another one. The results of the test and their reported perception about multidisciplinary team working suggest that they are better prepared to enter the healthcare workforce. Discussions during the debriefings highlighted the fact that multidisciplinary training is important. The main challenges identified have been the voluntary student attendance and timetabling issues forcing us to run the session late in the day due to the number of disciplines involved in each session and their different placement rota. The aim is now to timetable formally this session within their curriculum. Introducing simulation in the undergraduate curriculum should facilitate its implementation as Continuing Professional Development once these students become qualified healthcare professionals

Commentary: Matrix metalloproteinase-13 unlucky for the forming thrombus

Matrix metalloproteinases (MMPs) are calcium‐dependent zinc‐containing endoproteases involved in extracellular matrix and non‐matrix protein degradation.1 In the latest issue of Research and Practice in Thrombosis and Haemostasis, Howes and colleagues2 investigated the role of MMP‐13 in platelet aggregation and thrombus formation and identified that MMP‐13 could engage important platelet receptors and influence platelet function in vitro. MMP‐13 is of great cardiovascular interest as expression of this metalloproteinase is significantly upregulated in a host of atherothrombotic and inflammatory conditions.

Cal Poly\u27s Western Bonanza Junior Livestock Show Hosts First Annual Livestock Auction: The Best in the West Livestock Auction

Through this senior project, the authors researched whether or not Cal Poly\u27s Western Bonanza Junior Livestock Show\u27s first ever livestock auction was viable. Through their research, they found the addition of a livestock show to be successful and something that should continue

On the classification of (2,1) heterotic strings

We classify all untwisted (2,1) heterotic strings. The only solutions are the three already known cases, having massless spectra consisting either of 24 chiral fermions, or of 24 bosons, or of 8 scalars and 8 fermions of each chirality.Comment: Phyzzx and Tables macro packages require

Winter Food Habits and Preferences of Northern Bobwhites in East Texas

During late winter, 1994 and 1995, we investigated food habits and preferences of northern bobwhites (Colinus virginianus; hereafter, bobwhites) collected on forested lands in east Texas. Crops for bobwhites were collected from areas under 3 management regimes, namely intensively managed for bobwhites (QMA) (i.e., tree basal area reduced, annually burned, numerous multi-stage food plots, etc.), extensively managed for timber and wildlife (NBS) (i.e., burned every 3-5 years, scattered 2-stage food plots with corn feeders), and unmanaged for wildlife (i.e., burned every 5-7 years). With years pooled, partridge pea (Cassia fasciculata), Hercules club (Zanthoxylum clava-herculis), and pine (Pinus spp.) seeds, and clover leaflets (Trifolium spp.) comprised 93% by weight of foods of 79 bobwhites foods on QMA. On NBS, 81% of 40 bobwhite diets was butterfly pea (Centrosema virginianum), browntop millet, pine, wild bean (Strophostyles spp.), and corn seeds and clover leaflets; millet and corn were from food plots and feeders, respectively. For unmanaged areas, 79% of 19 bobwhite diets was butterfly pea, rush (Juncus spp.), pine, partridge pea, and American beautyberry (Callicarpa americana) seeds, and clover leaflets. Top-ranked food items on QMA were pine

Winter Food Habits and Preferences of Northern Bobwhites in East Texas

During late winter, 1994 and 1995, we investigated food habits and preferences of northern bobwhites (Colinus virginianus; hereafter, bobwhites) collected on forested lands in east Texas. Crops for bobwhites were collected from areas under 3 management regimes, namely intensively managed for bobwhites (QMA) (i.e., tree basal area reduced, annually burned, numerous multi-stage food plots, etc.), extensively managed for timber and wildlife (NBS) (i.e., burned every 3-5 years, scattered 2-stage food plots with corn feeders), and unmanaged for wildlife (i.e., burned every 5-7 years). With years pooled, partridge pea (Cassia fasciculata), Hercules club (Zanthoxylum clava-herculis), and pine (Pinus spp.) seeds, and clover leaflets (Trifolium spp.) comprised 93% by weight of foods of 79 bobwhites foods on QMA. On NBS, 81% of 40 bobwhite diets was butterfly pea (Centrosema virginianum), browntop millet, pine, wild bean (Strophostyles spp.), and corn seeds and clover leaflets; millet and corn were from food plots and feeders, respectively. For unmanaged areas, 79% of 19 bobwhite diets was butterfly pea, rush (Juncus spp.), pine, partridge pea, and American beautyberry (Callicarpa americana) seeds, and clover leaflets. Top-ranked food items on QMA were pine, hairy vetch, and Hercules club seeds in 1994 and butterfly pea, partridge pea, and wax myrtle (Myrica cerifera) seeds in 1995 (P \u3c 0.05). On NBS, hawthorn (Crataegus spp.) and beautyberry seeds were top-ranked in 1994 as were kobe lespedeza, wild bean, and butterfly pea seeds in 1995. On unmanaged areas, butterfly pea and partridge pea seeds and clover leaflets were highest ranked in 1995. On forested lands, activities (e.g., disking, burning, establishing food plots) which provide seed-bearing plants, especially legumes, and clover greenery benefit bobwhites

On the completeness of quantum computation models

The notion of computability is stable (i.e. independent of the choice of an indexing) over infinite-dimensional vector spaces provided they have a finite "tensorial dimension". Such vector spaces with a finite tensorial dimension permit to define an absolute notion of completeness for quantum computation models and give a precise meaning to the Church-Turing thesis in the framework of quantum theory. (Extra keywords: quantum programming languages, denotational semantics, universality.)Comment: 15 pages, LaTe

Deer Use of Riparian Zones and Adjacent Pine Plantations in Texas

The authors monitored white-tailed deer (Odocoileus virginianus) use of riparian zones (RZ’s) and adjacent pine plantations of 3 age classes (young, 1 to 3 years old; intermediate, 5 to 7 years old; and older, 9 to 13 years old) using radio telemetry for 2 years on a 1,300 ha study area near Alto, TX. Riparian zones comprised 22.0 percent of the area; young, intermediate, and older pine plantations comprised 19.1 percent, 45.7 percent, and 13.2 percent, respectively. Based on data from 4 to 9 deer the first year and 12 to 17 deer the second year, home ranges averaged 103, 71, 95, and 114 ha during spring, summer, fall, and winter, respectively, and were composed primarily of intermediate-age plantations and RZ’s. Deer showed significant preferences for intermediate-age pine plantations during all seasons and for RZ’s during fall and winter. Older plantations produced little forage due to canopy closure, and were generally avoided throughout the year. Young plantations, which provided the most forage but the least cover, received relatively light yearlong use and were a minor component of deer home ranges. For females and young males, this study demonstrates that, where available, RZ’s may comprise an important component of deer home ranges in intensively managed forests