Development and evaluation of the Clinician Suicide Risk Assessment Checklist

This paper describes the development and evaluation of a new instrument - the Clinician Suicide Risk Assessment Checklist (CSRAC). The instrument assesses the clinician's competency in three areas: clinical interviewing, assessment of specific suicide risk factors, and formulating a management plan. A draft checklist was constructed by integrating information from 1) literature review 2) expert clinician focus group and 3) consultation with experts. It was utilised in a simulated clinical scenario with clinician trainees and a trained actor in order to test for inter-rater agreement. Agreement was calculated and the checklist was re-drafted with the aim of maximising agreement. A second phase of simulated clinical scenarios was then conducted and inter-rater agreement was calculated for the revised checklist. In the first phase of the study, 18 of 35 items had inadequate inter-rater agreement (60%>), while in the second phase, using the revised version, only 3 of 39 items failed to achieve adequate inter-rater agreement. Further evidence of reliability and validity are required. Continued development of the CSRAC will be necessary before it can be utilised to assess the effectiveness of risk assessment training programs.

When non-significance maybe significant: lessons learned from a study into the development, implementation and evaluation of a risk assessment tool for fleet settings

Introduction This study reports on the development of a self report assessment tool to increase the efficacy of crash prediction within Australian Fleet settings Over last 20 years an array of measures have been produced (Driver anger scale, Driving Skill Inventory, Manchester Driver Behaviour Questionnaire, Driver Attitude Questionnaire, Driver Stress Inventory, Safety Climate Questionnaire) While these tools are useful, research has demonstrated limited ability to accurately identify individuals most likely to be involved in a crash. Reasons cited include; - Crashes are relatively rare - Other competing factors may influence crash event - Ongoing questions regarding the validity of self report measures (common method variance etc) - Lack of contemporary issues relating to fleet driving performance

Measuring the effect of motorcycle rider training on psychosocial influences for risk taking

Aim: Whilst motorcycle rider training is commonly incorporated into licensing programs in many developed nations, little empirical support has been found in previous research to prescribe it as an effective road safety countermeasure. It has been posited that the lack of effect of motorcycle rider training on crash reduction may, in part, be due to the predominant focus on skills-based training with little attention devoted to addressing attitudes and motives that influence subsequent risky riding. However, little past research has actually endeavoured to measure attitudinal and motivational factors as a function of rider training. Accordingly, this study was undertaken to assess the effect of a commercial motorcycle rider training program on psychosocial factors that have been shown to influence risk taking by motorcyclists. Method: Four hundred and thirty-eight motorcycle riders attending a competency-based licence training course in Brisbane, Australia, voluntarily participated in the study. A self-report questionnaire adapted from the Rider Risk Assessment Measure (RRAM) was administered to participants at the commencement of training, then again at the conclusion of training. Participants were informed of the independent nature of the research and that their responses would in no way effect their chance of obtaining a licence. To minimise potential demand characteristics, participants were instructed to seal completed questionnaires in envelopes and place them in a sealed box accessible only by the research team (i.e. not able to be viewed by instructors). Results: Significant reductions in the propensity for thrill seeking and intentions to engage in risky riding in the next 12 months were found at the end of training. In addition, a significant increase in attitudes to safety was found. Conclusions: These findings indicate that rider training may have a positive short-term influence on riders’ propensity for risk taking. However, such findings must be interpreted with caution in regard to the subsequent safety of riders as these factors may be subject to further influence once riders are licensed and actively engage with peers during on-road riding. This highlights a challenge for road safety education / training programs in regard to the adoption of safety practices and the need for behavioural follow-up over time to ascertain long-term effects. This study was the initial phase of an ongoing program of research into rider training and risk taking framed around Theory of Planned Behaviour concepts. A subsequent 12 month follow-up of the study participants has been undertaken with data analysis pending.

When non-significance may be significant : lessons learned from a study of the development, implementation and evaluation of a fleet risk assessment tool

This paper reports on the development and implementation of a self-report risk assessment tool that was developed in an attempt to increase the efficacy of crash prediction within Australian fleet settings. This study forms a part of a broader program of research into work related road safety and identification of driving risk. The first phase of the study involved a series of focus groups being conducted with 217 professional drivers which revealed that the following factors were proposed to influence driving performance: Fatigue, Knowledge of risk, Mood, Impatience and frustration, Speed limits, Experience, Other road users, Passengers, Health, and Culture. The second phase of the study involved piloting the newly developed 38 item Driving Risk Assessment Scale - Work Version (DRAS-WV) with 546 professional drivers. Factor analytic techniques identified a 9 factor solution that was comprised of speeding, aggression, time pressure, distraction, casualness, awareness, maintenance, fatigue and minor damage. Speeding and aggressive driving manoeuvres were identified to be the most frequent aberrant driving behaviours engaged in by the sample. However, a series of logistic regression analyses undertaken to determine the DRAS-WV scale’s ability to predict self-reported crashes revealed limited predictive efficacy e.g., 10% of crashes. This paper outlines proposed reasons for this limited predictive ability of the DRAS-WV as well as provides suggestions regarding the future of research that aims to develop methods to identify “at risk” drivers.

The use of computerised simulators for training of transthoracic and transoesophageal echocardiography. The future of echocardiographic training?

Echocardiography is the commonest form of non-invasive cardiac imaging and is fundamental to patient management. However, due to its methodology, it is also operator dependent. There are well defined pathways in training and ongoing accreditation to achieve and maintain competency. To satisfy these requirements, significant time has to be dedicated to scanning patients, often in the time pressured clinical environment. Alternative, computer based training methods are being considered to augment echocardiographic training. Numerous advances in technology have resulted in the development of interactive programmes and simulators to teach trainees the skills to perform particular procedures, including transthoracic and transoesophageal echocardiography. 82 sonographers and TOE proceduralists utilised an echocardiographic simulator and assessed its utility using defined criteria. 40 trainee sonographers assessed the simulator and were taught how to obtain an apical 2 chamber (A2C) view and image the superior vena cava (SVC). 100% and 88% found the simulator useful in obtaining the SVC or A2C view respectively. All users found it easy to use and the majority found it helped with image acquisition and interpretation. 42 attendees of a TOE training day utilising the simulator assessed the simulator with 100% finding it easy to use, as well as the augmented reality graphics benefiting image acquisition. 90% felt that it was realistic. This study revealed that both trainee sonographers and TOE proceduralists found the simulation process was realistic, helped in image acquisition and improved assessment of spatial relationships. Echocardiographic simulators may play an important role in the future training of echocardiographic skills.

A simulation-based training system for surgical wound debridement

A simulation-based training system for surgical wound debridement was developed and comprises a multimedia introduction, a surgical simulator (tutorial component), and an assessment component. The simulator includes two PCs, a haptic device, and mirrored display. Debridement is performed on a virtual leg model with a shallow laceration wound superimposed. Trainees are instructed to remove debris with forceps, scrub with a brush, and rinse with saline solution to maintain sterility. Research and development issues currently under investigation include tissue deformation models using mass-spring system and finite element methods; tissue cutting using a high-resolution volumetric mesh and dynamic topology; and accurate collision detection, cutting, and soft-body haptic rendering for two devices within the same haptic space.

Motorcycle Safety Research Project Interim Report 2 : Review of the Consistent Assessment Process (CAP)

Motorcycle trauma is a serious road safety issue in Queensland and throughout Australia. In 2009, Queensland Transport (later Transport and Main Roads or TMR) appointed CARRS-Q to provide a three-year program of Road Safety Research Services for Motorcycle Rider Safety. Funding for this research originated from the Motor Accident Insurance Commission. This program of research was undertaken to produce knowledge to assist TMR to improve motorcycle safety by further strengthening the licensing and training system to make learner riders safer by developing a pre-learner package (Deliverable 1), and by evaluating the Q-Ride CAP program to ensure that it is maximally effective and contributes to the best possible training for new riders (Deliverable 2), which is the focus of this report. Deliverable 3 of the program identified potential new licensing components that will reduce the incidence of risky riding and improve higher-order cognitive skills in new riders. This report provides a summary of Deliverables 2.1 through to 2.4.

Faculty mentoring, evidence-based assessment, and student learning : an Australian exploration of American initiatives

There have been many improvements in Australian engineering education since the 1990s. However, given the recent drive for assuring the achievement of identified academic standards, more progress needs to be made, particularly in the area of evidence-based assessment. This paper reports on initiatives gathered from the literature and engineering academics in the USA, through an Australian National Teaching Fellowship program. The program aims to establish a process to help academics in designing and implementing evidence-based assessments that meet the needs of not only students and the staff that teach them, but also industry as well as accreditation bodies. The paper also examines the kinds and levels of support necessary for engineering academics, especially early career ones, to help meet the expectations of the current drive for assured quality and standards of both research and teaching. Academics are experiencing competing demands on their time and energy with very high expectations in research performance and increased teaching responsibilities, although many are researchers who have not had much pedagogic training. Based on the literature and investigation of relevant initiatives in the USA, we conducted interviews with several identified experts and change agents who have wrought effective academic cultural change within their institutions and beyond. These reveal that assuring the standards and quality of student learning outcomes through evidence-based assessments cannot be appropriately addressed without also addressing the issue of pedagogic training for academic staff. To be sustainable, such training needs to be complemented by a culture of on-going mentoring support from senior academics, formalised through the university administration, so that mentors are afforded resources, time, and appropriate recognition.

iRAP Malaysia training course: Decade of Action for Road Safety. Report to Department of Foreign Affairs and Trade, Australia-Malaysia Institute

The International Road Assessment Program (iRAP) is a not-for-profit organisation that works in partnership with governments and non-government organisations in all parts of the world to make roads safe. The iRAP Malaysia pilot study on 3,700km of road identified the potential to save 31,800 deaths and serious injuries over the next 20 years from proven engineering improvements. To help ensure the iRAP data and results are available to planners and engineers, iRAP, together with staff from the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) and the Malaysian Institute of Road Safety Research (MIROS) developed a 5-day iRAP training course that covers the background, theory and practical application of iRAP protocols, with a special focus on Malaysian case studies. Funding was provided by a competitive grant from the Australian-Malaysia Institute.

Quality Assessment Matrix : A Collaborative Evaluation Using Multiple Lines of Evidence

Welcome to the Quality assessment matrix. This matrix is designed for highly qualified discipline experts to evaluate their course, major or unit in a systematic manner. The primary purpose of the Quality assessment matrix is to provide a tool that a group of academic staff at universities can collaboratively review the assessment within a course, major or unit annually. The annual review will result in you being read for an external curricula review at any point in time. This tool is designed for use in a workshop format with one, two or more academic staff, and will lead to an action plan for implementation.

Comparison of moped, scooter and motorcycle crashes : implications for rider training and education

Scooter and moped sales have increased at a faster rate than motorcycle sales over the last decade in countries such as Australia, Canada and the United States. This may be particularly evident in jurisdictions where moped riding is permitted for car license holders and a motorcycle license is not required, such as in Queensland, Australia. Having historically comprised only a small proportion of powered two-wheelers (PTWs) outside of Europe and Asia, the safety of scooters and mopeds has received relatively little focused research attention. However, the recent trends in sales and crash involvement have stimulated greater interest in these PTW types. The current paper examines differences and similarities between scooters (over 50cc), mopeds (up to 50cc) and motorcycles in crash involvement and crash characteristics through analyses of crash and registration data from Queensland, Australia. The main findings include that moped and scooter riders are similar in terms of usage patterns, but the evidence suggests superior skills, greater experience and safer behaviour among scooter riders than moped riders. The requirement in Queensland for scooter riders but not moped riders to hold a motorcycle license, usually obtained through competency-based training and assessment, may help to explain some of this difference. Findings also suggest that scooter riders are safer than motorcycle riders in some respects, despite both being subject to the same licensing requirements which encourage participation in rider training. Safer attitudes and motivations rather than superior skills and knowledge may therefore underlie the differences between scooter and motorcycle riders. In summary, riders of larger scooters exhibit a combination of skills and behavior suggestive of safer riding than both their moped and motorcycle riding counterparts. It is reasonable to expect that mopeds and scooters will remain popular and that their usage may increase further, along with that of motorcycles. This research therefore has important practical implications regarding pathways to improved PTW safety. Future policy and planning should consider options for encouraging moped riders to acquire better riding skills and greater safety awareness, as apparent among scooter riders, including rider training, education and licensing. As is noted in recent literature and reflected in some contemporary rider training programs, motorcycle safety may be improved by addressing rider attitudes more comprehensively in addition to developing skills and knowledge.

A 3D virtual medical imaging suite : bridging the academic-clinical training boundary

Aims The Medical Imaging Training Immersive Environment (MITIE) system is a recently developed virtual reality (VR) platform that allows students to practice a range of medical imaging techniques. The aim of this pilot study was to harvest user feedback about the educational value of the application and inform future pedagogical development. This presentation explores the use of this technology for skills training and blurring the boundaries between academic learning and clinical skills training. Background MITIE is a 3D VR environment that allows students to manipulate a patient and radiographic equipment in order to produce a VR-generated image for comparison with a gold standard. As with VR initiatives in other health disciplines (1-6) the software mimics clinical practice as much as possible and uses 3D technology to enhance immersion and realism. The software was developed by the Medical Imaging Course Team at a provider University with funding from a Health Workforce Australia “Simulated Learning Environments” grant. Methods Over 80 students undertaking the Bachelor of Medical Imaging Course were randomised to receive practical experience with either MITIE or radiographic equipment in the medical radiation laboratory. Student feedback about the educational value of the software was collected and performance with an assessed setup was measured for both groups for comparison. Ethical approval for the project was provided by the university ethics panel. Results This presentation provides qualitative analysis of student perceptions relating to satisfaction, usability and educational value as well as comparative quantitative performance data. Students reported high levels of satisfaction and both feedback and assessment results confirmed the application’s significance as a pre-clinical training tool. There was a clear emerging theme that MITIE could be a useful learning tool that students could access to consolidate their clinical learning, either during their academic timetables or their clinical placement. Conclusion Student feedback and performance data indicate that MITIE has a valuable role to play in the clinical skills training for medical imaging students both in the academic and the clinical environment. Future work will establish a framework for an appropriate supporting pedagogy that can cross the boundary between the two environments. This project was possible due to funding made available by Health Workforce Australia.

OSCE online : making assessment of clinical competencies transparent, accountable & authentic

Creating an authentic assessment which at once assesses competencies, scene management, communication and overall patient care is challenging in the competitive tertiary education market. Increasing student numbers and the cost of evaluating scenario based competencies serve to ensure the need for consistent objectivity and need for timely feedback to students on their performance. Objective structured clinical examination (OSCE) is currently the most flexible approach to competency based formative and summative assessment and widely used within paramedic degree programs. Students are understandably compelled to perform well and can be frustrated by not receiving timely and appropriate feedback. Increasingly a number of products aimed at providing a more efficient and paperless approach have begun to enter the market. These products, it is suggested are aimed at medicine programs and not at allied health professions and limited to one operating system and therefore ignore issues surrounding equity and accessibility. OSCE Online aims to address this gap in the market and is tailored to these disciplines. The application will provide a service that can be both tailored and standardised from a pre-written bank, depending upon requirement to fit around the needs of clinical competency assessment. Delivering authentic assessments to address student milestones in their training to become paramedics is the cornerstone of OSCE Online. By not being restricted to a specific device it will address issues of functionality, adaptability, accessibility, authenticity and importantly: transparency and accountability by producing contemporaneous data allowing issues to be easily identified and rectified.

Accelerometer based performance assessment of basic routines in classical ballet

Classical ballet requires dancers to exercise significant muscle control and strength both while stationary and when moving. Following the Royal Academy of Dance (RAD) syllabus, 8 male and 27 female dancers (aged 20.2 + 1.9 yr) in a fulltime university undergraduate dance training program were asked to stand in first position for 10 seconds and then perform 10 repeats of a demi-plié exercise to a counted rhythm. Accelerometer records from the wrist, sacrum, knee and ankle were compared with the numerical scores from a professional dance instructor. The sacrum mounted sensor detected lateral tilts of the torso in dances with lower scores (Spearman’s rank correlation coefficient r = -0.64, p < 0.005). The RMS acceleration amplitude of wrist mounted sensor was linearly correlated to the movement scores (Spearman’s rank correlation coefficient r = 0.63, p < 0.005). The application of sacrum and wrist mounted sensors for biofeedback during dance training is a realistic, low cost option.

Exploring potential factors leading to effective training : an exclusive study on commercial banks in Cambodia

Purpose A previous study found that the quality of education in Cambodia is poor compared to other developing countries. However, the working performance of commercial banks in Cambodia is high. It was speculated that effective training was the main factor underlying this contradiction. Therefore, the main purpose of this article is to explore the elements of training conducted by commercial banks in Cambodia and to examine their relationship with training effectiveness. Design/methodology/approach The research focuses on six factors: training needs assessment; training program; flexibility of training; self-efficacy; social support; and transfer of knowledge. The data came in the form of questionnaires and desk research. A descriptive analytical approach is then used to describe these six factors. Findings The banking industry in Cambodia offers very effective training to its employees. It is also worth noting that more than 80 percent of employees are satisfied with the training, despite few attempts on the part of management to elicit opinions from employees on what training methods should be employed. Research limitations/implications As research studies involving Cambodia are relatively rare, it was difficult for to gather primary data. Because of this limitation and the purpose of this study, descriptive data interpretation was employed. Practical implications – Even though training can make up for poor education, it is only a short-term solution. In the long term, education needs to be enhanced to increase working performance. Originality/value This research provides a good framework for commercial banks in other developing countries to compare. A cross-cultural study is also proposed for future research.