Up the e-learning curve : ensuring quality online education within an Australian university

The paper describes the implementation of a project within Australian Catholic University designed to launch the Faculties into online education in a manner which ensured quality in all aspects of the teaching-learning experiences of academics and students. Key elements of the strategic approach adopted by the project leaders, including the involvement of a specialist commercial provider of web-based delivery systems as a partner in the project, mechanisms to support the initiative through the first stages, careful choice of the programs offered online, and staff development matched to the emerging needs of those involved in the teaching of courses, are described. Challenges encountered in the implementation process, and the factors which assisted in overcoming these problems are identified. The paper draws upon this experience to raise some important issues relevant to the successful introduction of online education as an integral component of the teaching repertoire of Faculties.

Sector analysis provides additional spatial information on the permanent prostate brachytherapy learning curve

PURPOSE: To evaluate the permanent prostate brachytherapy (PPB) learning curve using postimplant multisector dosimetric analysis and to assess the correlation between sector -specific dosimetry and patient-reported outcome measures (PROMs).

METHODS AND METHODS: First 200 patients treated with (125)I PPB monotherapy (145 Gy) at a single institution were assessed. Postimplant dosimetry (PID) using CT was evaluated for whole prostate (global) and 12 sectors, assessing minimum dose to 90% of prostate (D90) and dose to 0.1 cm(3) of rectum (D0.1cc). Global and sector PID results were evaluated to investigate changes in D90 with case number. Urinary and bowel PROMs were assessed using the International Prostate Symptom Score and the Expanded Prostate Cancer Index Composite questionnaire. The correlation between global and individual sector PID and urinary/bowel PROMs was also evaluated.

RESULTS: Linear regression confirmed a significant improvement in global D90 with case number (r(2) = 0.20; p = 0.001) at a rate of 0.11 Gy/case. Postimplant D90 of base sectors increased at a rate of 0.11-0.15 Gy/case (p = 0.0001) and matched global improvement. The regression lines of midgland and apex sectors were significantly different from global D90 (p = 0.01). Posterior midgland sectors showed a significant reduction in D90 with case number at a rate of 0.13-0.19 Gy/case (p = 0.01). Dose to posterior midgland sectors correlated with rectal D0.1cc dose but not bowel PROMs. Dose to posterior midgland sectors correlated with urinary International Prostate Symptom Score change, which was not apparent when global D90 alone was considered.

CONCLUSIONS: Sector analysis provided increased spatial information regarding the PPB learning curve. Furthermore, sector analysis correlated with urinary PROMs and rectal dose.

Learning curve for robotic-assisted laparoscopic colorectal surgery.

BACKGROUND: Robotic-assisted laparoscopic surgery (RALS) is evolving as an important surgical approach in the field of colorectal surgery. We aimed to evaluate the learning curve for RALS procedures involving resections of the rectum and rectosigmoid. METHODS: A series of 50 consecutive RALS procedures were performed between August 2008 and September 2009. Data were entered into a retrospective database and later abstracted for analysis. The surgical procedures included abdominoperineal resection (APR), anterior rectosigmoidectomy (AR), low anterior resection (LAR), and rectopexy (RP). Demographic data and intraoperative parameters including docking time (DT), surgeon console time (SCT), and total operative time (OT) were analyzed. The learning curve was evaluated using the cumulative sum (CUSUM) method. RESULTS: The procedures performed for 50 patients (54% male) included 25 AR (50%), 15 LAR (30%), 6 APR (12%), and 4 RP (8%). The mean age of the patients was 54.4 years, the mean BMI was 27.8 kg/m(2), and the median American Society of Anesthesiologists (ASA) classification was 2. The series had a mean DT of 14 min, a mean SCT of 115.1 min, and a mean OT of 246.1 min. The DT and SCT accounted for 6.3% and 46.8% of the OT, respectively. The SCT learning curve was analyzed. The CUSUM(SCT) learning curve was best modeled as a parabola, with equation CUSUM(SCT) in minutes equal to 0.73 × case number(2) - 31.54 × case number - 107.72 (R = 0.93). The learning curve consisted of three unique phases: phase 1 (the initial 15 cases), phase 2 (the middle 10 cases), and phase 3 (the subsequent cases). Phase 1 represented the initial learning curve, which spanned 15 cases. The phase 2 plateau represented increased competence with the robotic technology. Phase 3 was achieved after 25 cases and represented the mastery phase in which more challenging cases were managed. CONCLUSIONS: The three phases identified with CUSUM analysis of surgeon console time represented characteristic stages of the learning curve for robotic colorectal procedures. The data suggest that the learning phase was achieved after 15 to 25 cases.

Upper and lower bounds on the learning curve for Gaussian processes

In this paper we introduce and illustrate non-trivial upper and lower bounds on the learning curves for one-dimensional Gaussian Processes. The analysis is carried out emphasising the effects induced on the bounds by the smoothness of the random process described by the Modified Bessel and the Squared Exponential covariance functions. We present an explanation of the early, linearly-decreasing behavior of the learning curves and the bounds as well as a study of the asymptotic behavior of the curves. The effects of the noise level and the lengthscale on the tightness of the bounds are also discussed.

Minimally invasive video-assisted thyroid surgery: how can we improve the learning curve?

Objective. Minimally invasive video-assisted thyroidectomy (MIVAT) is a technically demanding procedure and requires a surgical team skilled in both endocrine and endoscopic surgery. A time consuming learning and training period is mandatory at the beginning of the experience. The aim of our report is to focus some aspects of the learning curve of the surgeon who practices video-assisted thyroid procedures for the first time, through the analysis of our preliminary series of 36 cases. Patients and methods. From September 2004 to April 2005 we selected 36 patients for minimally invasive video-assisted surgery of the thyroid. The patients were considered eligible if they presented with a nodule not exceeding 35mm in maximum diameter; total thyroid volume within normal range; absence of biochemical and echographic signs of thyroiditis. We analyzed surgical results, conversion rate, operating time, post-operative complications, hospital stay, cosmetic outcome of the series. Results. We performed 36 total thyroidectomy. The procedure was successfully carried out in 33/36 cases. Post-operative complications included 3 transient recurrent nerve palsies and 2 transient hypocalcemias; no definitive hypoparathyroidism was registered. All patients were discharged 2 days after operation. The cosmetic result was considered excellent by most patients. Conclusions. Advances in skills and technology have enabled surgeons to reproduce most open surgical techniques with video-assistance or laparoscopically. Training is essential to acquire any new surgical technique and it should be organized in detail to exploit it completely.

Different Learning Curves for Axillary Brachial Plexus Block: Ultrasound Guidance versus Nerve Stimulation

Little is known about the learning of the skills needed to perform ultrasound- or nerve stimulator-guided peripheral nerve blocks. The aim of this study was to compare the learning curves of residents trained in ultrasound guidance versus residents trained in nerve stimulation for axillary brachial plexus block. Ten residents with no previous experience with using ultrasound received ultrasound training and another ten residents with no previous experience with using nerve stimulation received nerve stimulation training. The novices' learning curves were generated by retrospective data analysis out of our electronic anaesthesia database. Individual success rates were pooled, and the institutional learning curve was calculated using a bootstrapping technique in combination with a Monte Carlo simulation procedure. The skills required to perform successful ultrasound-guided axillary brachial plexus block can be learnt faster and lead to a higher final success rate compared to nerve stimulator-guided axillary brachial plexus block.

Learning Curves of Temporary Workers in Manual Order Picking Activities

Person-to-stock order picking is highly flexible and requires minimal investment costs in comparison to automated picking solutions. For these reasons, tradi-tional picking is widespread in distribution and production logistics. Due to its typically large proportion of manual activities, picking causes the highest operative personnel costs of all intralogistics process. The required personnel capacity in picking varies short- and mid-term due to capacity requirement fluctuations. These dynamics are often balanced by employing minimal permanent staff and using seasonal help when needed. The resulting high personnel fluctuation necessitates the frequent training of new pickers, which, in combination with in-creasingly complex work contents, highlights the im-portance of learning processes in picking. In industrial settings, learning is often quantified based on diminishing processing time and cost requirements with increasing experience. The best-known industrial learning curve models include those from Wright, de Jong, Baloff and Crossman, which are typically applied to the learning effects of an entire work crew rather than of individuals. These models have been validated in largely static work environments with homogeneous work contents. Little is known of learning effects in picking systems. Here, work contents are heterogeneous and individual work strategies vary among employees. A mix of temporary and steady employees with varying degrees of experience necessitates the observation of individual learning curves. In this paper, the individual picking performance development of temporary employees is analyzed and compared to that of steady employees in the same working environment.

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

Purpose: Surgical simulators are currently essential within any laparoscopic training program because they provide a low-stakes, reproducible and reliable environment to acquire basic skills. The purpose of this study is to determine the training learning curve based on different metrics corresponding to five tasks included in SINERGIA laparoscopic virtual reality simulator. Methods: Thirty medical students without surgical experience participated in the study. Five tasks of SINERGIA were included: Coordination, Navigation, Navigation and touch, Accurate grasping and Coordinated pulling. Each participant was trained in SINERGIA. This training consisted of eight sessions (R1–R8) of the five mentioned tasks and was carried out in two consecutive days with four sessions per day. A statistical analysis was made, and the results of R1, R4 and R8 were pair-wise compared with Wilcoxon signed-rank test. Significance is considered at P value <0.005. Results: In total, 84.38% of the metrics provided by SINERGIA and included in this study show significant differences when comparing R1 and R8. Metrics are mostly improved in the first session of training (75.00% when R1 and R4 are compared vs. 37.50% when R4 and R8 are compared). In tasks Coordination and Navigation and touch, all metrics are improved. On the other hand, Navigation just improves 60% of the analyzed metrics. Most learning curves show an improvement with better results in the fulfillment of the different tasks. Conclusions: Learning curves of metrics that assess the basic psychomotor laparoscopic skills acquired in SINERGIA virtual reality simulator show a faster learning rate during the first part of the training. Nevertheless, eight repetitions of the tasks are not enough to acquire all psychomotor skills that can be trained in SINERGIA. Therefore, and based on these results together with previous works, SINERGIA could be used as training tool with a properly designed training program.

User Interface Design for Electronic Learning Software: Promoting Usability and Facilitating Learning for Children

Computing devices have become ubiquitous in our technologically-advanced world, serving as vehicles for software applications that provide users with a wide array of functions. Among these applications are electronic learning software, which are increasingly being used to educate and evaluate individuals ranging from grade school students to career professionals. This study will evaluate the design and implementation of user interfaces in these pieces of software. Specifically, it will explore how these interfaces can be developed to facilitate the use of electronic learning software by children. In order to do this, research will be performed in the area of human-computer interaction, focusing on cognitive psychology, user interface design, and software development. This information will be analyzed in order to design a user interface that provides an optimal user experience for children. This group will test said interface, as well as existing applications, in order to measure its usability. The objective of this study is to design a user interface that makes electronic learning software more usable for children, facilitating their learning process and increasing their academic performance. This study will be conducted by using the Adobe Creative Suite to design the user interface and an Integrated Development Environment to implement functionality. These are digital tools that are available on computing devices such as desktop computers, laptops, and smartphones, which will be used for the development of software. By using these tools, I hope to create a user interface for electronic learning software that promotes usability while maintaining functionality. This study will address the increasing complexity of computing software seen today – an issue that has risen due to the progressive implementation of new functionality. This issue is having a detrimental effect on the usability of electronic learning software, increasing the learning curve for targeted users such as children. As we make electronic learning software an integral part of educational programs in our schools, it is important to address this in order to guarantee them a successful learning experience.

User Interface Design for Electronic Learning Software: Promoting Usability and Facilitating Learning for Children

Computing devices have become ubiquitous in our technologically-advanced world, serving as vehicles for software applications that provide users with a wide array of functions. Among these applications are electronic learning software, which are increasingly being used to educate and evaluate individuals ranging from grade school students to career professionals. This study will evaluate the design and implementation of user interfaces in these pieces of software. Specifically, it will explore how these interfaces can be developed to facilitate the use of electronic learning software by children. In order to do this, research will be performed in the area of human-computer interaction, focusing on cognitive psychology, user interface design, and software development. This information will be analyzed in order to design a user interface that provides an optimal user experience for children. This group will test said interface, as well as existing applications, in order to measure its usability. The objective of this study is to design a user interface that makes electronic learning software more usable for children, facilitating their learning process and increasing their academic performance. This study will be conducted by using the Adobe Creative Suite to design the user interface and an Integrated Development Environment to implement functionality. These are digital tools that are available on computing devices such as desktop computers, laptops, and smartphones, which will be used for the development of software. By using these tools, I hope to create a user interface for electronic learning software that promotes usability while maintaining functionality. This study will address the increasing complexity of computing software seen today – an issue that has risen due to the progressive implementation of new functionality. This issue is having a detrimental effect on the usability of electronic learning software, increasing the learning curve for targeted users such as children. As we make electronic learning software an integral part of educational programs in our schools, it is important to address this in order to guarantee them a successful learning experience.

Learning curves: analysing pace and challenge in four successful puzzle games

The pace at which challenges are introduced in a game has long been identified as a key determinant of both the enjoyment and difficulty experienced by game players, and their ability to learn from game play. In order to understand how to best pace challenges in games, there is great value in analysing games already demonstrated as highly engaging. Play-through videos of four puzzle games (Portal, Portal 2 Co-operative mode, Braid and Lemmings), were observed and analysed using metrics derived from a behavioural psychology understanding of how people solve problems. Findings suggest that; 1) the main skills learned in each game are introduced separately, 2) through simple puzzles that require only basic performance of that skill, 3) the player has the opportunity to practice and integrate that skill with previously learned skills, and 4) puzzles increase in complexity until the next new skill is introduced. These data provide practical guidance for designers, support contemporary thinking on the design of learning structures in games, and suggest future directions for empirical research.

Nurse-determined assessment of cardiac output. Comparing a non-invasive cardiac output device and pulmonary artery catheter: a prospective observational study.

Background The accurate measurement of Cardiac output (CO) is vital in guiding the treatment of critically ill patients. Invasive or minimally invasive measurement of CO is not without inherent risks to the patient. Skilled Intensive Care Unit (ICU) nursing staff are in an ideal position to assess changes in CO following therapeutic measures. The USCOM (Ultrasonic Cardiac Output Monitor) device is a non-invasive CO monitor whose clinical utility and ease of use requires testing. Objectives To compare cardiac output measurement using a non-invasive ultrasonic device (USCOM) operated by a non-echocardiograhically trained ICU Registered Nurse (RN), with the conventional pulmonary artery catheter (PAC) using both thermodilution and Fick methods. Design Prospective observational study. Setting and participants Between April 2006 and March 2007, we evaluated 30 spontaneously breathing patients requiring PAC for assessment of heart failure and/or pulmonary hypertension at a tertiary level cardiothoracic hospital. Methods SCOM CO was compared with thermodilution measurements via PAC and CO estimated using a modified Fick equation. This catheter was inserted by a medical officer, and all USCOM measurements by a senior ICU nurse. Mean values, bias and precision, and mean percentage difference between measures were determined to compare methods. The Intra-Class Correlation statistic was also used to assess agreement. The USCOM time to measure was recorded to assess the learning curve for USCOM use performed by an ICU RN and a line of best fit demonstrated to describe the operator learning curve. Results In 24 of 30 (80%) patients studied, CO measures were obtained. In 6 of 30 (20%) patients, an adequate USCOM signal was not achieved. The mean difference (±standard deviation) between USCOM and PAC, USCOM and Fick, and Fick and PAC CO were small, −0.34 ± 0.52 L/min, −0.33 ± 0.90 L/min and −0.25 ± 0.63 L/min respectively across a range of outputs from 2.6 L/min to 7.2 L/min. The percent limits of agreement (LOA) for all measures were −34.6% to 17.8% for USCOM and PAC, −49.8% to 34.1% for USCOM and Fick and −36.4% to 23.7% for PAC and Fick. Signal acquisition time reduced on average by 0.6 min per measure to less than 10 min at the end of the study. Conclusions In 80% of our cohort, USCOM, PAC and Fick measures of CO all showed clinically acceptable agreement and the learning curve for operation of the non-invasive USCOM device by an ICU RN was found to be satisfactorily short. Further work is required in patients receiving positive pressure ventilation.