Enhancing paramedics procedural skills using a cadaveric model

Background Paramedic education has evolved in recent times from vocational post-employment to tertiary pre-employment supplemented by clinical placement. Simulation is advocated as a means of transferring learned skills to clinical practice. Sole reliance of simulation learning using mannequin-based models may not be sufficient to prepare students for variance in human anatomy. In 2012, we trialled the use of fresh frozen human cadavers to supplement undergraduate paramedic procedural skill training. The purpose of this study is to evaluate whether cadaveric training is an effective adjunct to mannequin simulation and clinical placement. Methods A multi-method approach was adopted. The first step involved a Delphi methodology to formulate and validate the evaluation instrument. The instrument comprised of knowledge-based MCQs, Likert for self-evaluation of procedural skills and behaviours, and open answer. The second step involved a pre-post evaluation of the 2013 cadaveric training. Results One hundred and fourteen students attended the workshop and 96 evaluations were included in the analysis, representing a return rate of 84%. There was statistically significant improved anatomical knowledge after the workshop. Students' self-rated confidence in performing procedural skills on real patients improved significantly after the workshop: inserting laryngeal mask (MD 0.667), oropharyngeal (MD 0.198) and nasopharyngeal (MD 0.600) airways, performing Bag-Valve-Mask (MD 0.379), double (MD 0.344) and triple (MD 0.326,) airway manoeuvre, doing 12-lead electrocardiography (MD 0.729), using McGrath(R) laryngoscope (MD 0.726), using McGrath(R) forceps to remove foreign body (MD 0.632), attempting thoracocentesis (MD 1.240), and putting on a traction splint (MD 0.865). The students commented that the workshop provided context to their theoretical knowledge and that they gained an appreciation of the differences in normal tissue variation. Following engagement in/ completion of the workshop, students were more aware of their own clinical and non-clinical competencies. Conclusions The paramedic profession has evolved beyond patient transport with minimal intervention to providing comprehensive both emergency and non-emergency medical care. With limited availability of clinical placements for undergraduate paramedic training, there is an increasing demand on universities to provide suitable alternatives. Our findings suggested that cadaveric training using fresh frozen cadavers provides an effective adjunct to simulated learning and clinical placements.

Online video in education : acquisition, value & ROI

The session explores the potential for “Patron Driven Acquisition” (PDA) as a model for the acquisition of online video. Today, PDA has become a standard model of acquisition in the eBook market, more effectively aligning spend with use and increased return on investment (ROI). PDA is an unexplored model for acquisition of video, for which library collection development is complicated by higher storage and delivery costs, labor overheads for content selection and acquisition, and a dynamic film industry in which media and the technology that supports it is changing daily. Queensland University of Technology (QUT) and La Trobe University in Australia launched a research project in collaboration with Kanopy to explore the opportunity for PDA of video. The study relied on three data sources: (1) national surveys to compare the video purchasing and use practices of colleges, (2) on-campus pilot projects of PDA models to assess user engagement and behavior, and (3) testing of various user applications and features to support the model. The study incorporates usage statistics and survey data and builds upon a peer-reviewed research paper presented at the VALA 2014 conference in Melbourne, Australia. This session will be conducted by the researchers and will graphically present the results from the study. It will map out a future for video PDA, and how libraries can more cost-effectively acquire and maximize the discoverability of online video. The presenters will also solicit input and welcome questions from audience members.

Antecedent factors of knowledge sharing in research supervision

Today’s economy is a knowledge-based economy in which knowledge is a crucial facilitator to individuals, as well as being an instigator of success. Due to the impact of globalisation, universities face new challenges and opportunities. Accordingly, they ought to be more innovative and have their own competitive advantages. One of the most important goals of universities is the promotion of students as professional knowledge workers. Therefore, knowledge sharing and transfer at the tertiary level between students and supervisors is vital in universities, as it decreases the budget and provides an affordable way to do research. Knowledge-sharing impact factors can be categorised in three groups, namely: organisational, individual, and technical factors. Individual barriers to knowledge sharing include: the lack of time and trust and the lack of communication skills and social networks. IT systems such as elearning, blogs and portals can increase the knowledge-sharing capability. However, it must be stated that IT systems are only tools and not solutions. Individuals are still responsible for sharing information and knowledge. This paper proposes a new research model to examine the effect of individual factors, organisational factors (learning strategy, trust culture, supervisory support) and technological factors on knowledge sharing in the research supervision process.

Epithelial-mesenchymal transition and mesenchymal-epithelial transition are essential for the acquisition of stem cell properties in hTERT-immortalised oral epithelial cells

BACKGROUND INFORMATION: Evidence has shown that mesenchymal-epithelial transition (MET) and epithelial-mesenchymal transition (EMT) are linked to stem cell properties. We currently lack a model showing how the occurrence of MET and EMT in immortalised cells influences the maintenance of stem cell properties. Thus, we established a project aiming to investigate the roles of EMT and MET in the acquisition of stem cell properties in immortalised oral epithelial cells. RESULTS: In this study, a retroviral transfection vector (pLXSN-hTERT) was used to immortalise oral epithelial cells by insertion of the hTERT gene (hTERT(+)-oral mucosal epithelial cell line [OME]). The protein and RNA expression of EMT transcriptional factors (Snail, Slug and Twist), their downstream markers (E-cadherin and N-cadherin) and embryonic stem cell markers (OCT4, Nanog and Sox2) were studied by reverse transcription PCR and Western blots in these cells. Some EMT markers were detected at both mRNA and protein levels. Adipocytes and bone cells were noted in the multi-differentiation assay, showing that the immortal cells underwent EMT. The differentiation assay for hTERT(+)-OME cells revealed the recovery of epithelial phenotypes, implicating the presence of MET. The stem cell properties were confirmed by the detection of appropriate markers. Altered expression of alpha-tubulin and gamma-tubulin in both two-dimensional-cultured (without serum) and three-dimensional-cultured hTERT(+)-OME spheroids indicated the re-programming of cytoskeleton proteins which is attributed to MET processes in hTERT(+)-OME cells. CONCLUSIONS: EMT and MET are essential for hTERT-immortalised cells to maintain their epithelial stem cell properties.

Using a visually-based assignment to reinforce and assess design history knowledge and understanding

This paper presents a visual timeline-based assignment used in an undergraduate Industrial Design History, Theory and Critcism unit. The assignment was developed in order to find a better way of supporting design history learning than an exam or essay assessment. It was developed using constructive alignment and it allows design students to use their strong visual thinking skills to understand unfamiliar content, develop their visual literacy of design history, and think deeply about the links between the designs, styles, movements, events and people in their timeline. The task produced a variety of responses, from websites and electronic presentations to large paper timelines, scrolls and 3D models. These have been admired by peers and used for end of year shows and permanent displays. Questionnaires were issued to students to gain feedback about the assessment. Students stated that the visual nature of the assignment helped them to understand how different aspects of design history related to each other, assisted with retaining the information, and that it was more interesting and fun than a report or an exam. This paper explores the theories behind and the benefits of using such methods of assessment for design history courses.

The knowledge of doing: Exploring the knowledge of support to older people with an intellectual disability

This ethnography presents a contextualised understanding of frontline knowledge used in the support to people ageing with an intellectual disability who live in accommodation and support services in south-east Queensland. The study identified that disability support workers accessed a range of knowledges which they synthesised into a dynamic and responsive locale knowledge, and subsequently translated into everyday acts of support within contexts of multi-faceted complexity. Findings from the study have numerous implications for the knowledge development activities of formal service and educational systems within Australia's newly implemented National Disability Insurance Scheme.

Resistances, facilitators and influences on professionals' knowledge sharing behaviour : a case study

The centrality of knowledge sharing to organisations' sustainability has been established. This case study illustrates the influences on individual knowledge sharing decision-making and behaviour among professionals and paraprofessionals - specifically civil engineers and design drafters - in a large public sector organisation that provides transportation infrastructure. The case examines the ways in which overlapping sets of values and behavioural drivers affect knowledge sharing orientation and practices in a collective of experts and novices working in an environment that is largely project-based. The alignment among sector, profession and organisation values provides a supportive environment for knowledge sharing, however individual behaviour is found to be most strongly influenced by the presence and quality of relational capital.

On the operationalisation of conceptions of learning in higher education and their association with students’ knowledge and experiences of their learning

Conceptions of learning, as well as other associated aspects of prior knowledge, are theoretically important factors in influencing the manner in which the content and context of learning are engaged. The present study reports on: (a) the operationalisation of some of these factors aimed at isolating sources of explanatory variation that can be used for modelling purposes; and (b) a conservative exploration of the discriminatory power of, and exhibited patterns of association between, such sources of variation as have been isolated. Based on a conservative analytical approach, the results of the present study do not support a single clearly defined empirical model of conceptions of learning and associated constructs. Instead, there is consistent evidence that underlying empirical structures appear to be sensitive to the response context and other factors.

User-led innovation in call center knowledge work

So called “knowledge work” is seen as integral to post-industrial society and, for some, information and communications technologies (ICTs) are critical enablers of the associated practices. Many still propose the technologically deterministic route of rolling out ICTs and expecting that users will, and indeed can, “download” what they know into a system that can then be used in a number of ways. This approach is usually underpinned by the predominant assumption that the system will be developed by one group (developers) and used by another group (users). In this paper, we report on an exploratory case study of the enactment of ICT supported knowledge work in a human resources contact center which illustrates the negotiable boundary between the developer and user in local level innovation processes. Drawing upon ideas from the social shaping of technology, we examine how discussions regarding producer-user relations in innovation processes require a degree of greater sophistication as we show how users often develop (or produce) technologies and work practices in situ—in this case, to enable knowledge work practices and contribute to the project of constructing the knowledge component of professional identity. Much has been made of contextualizing the user; further work is required to contextualize the developer as a user and understand the social actors in ICT innovation environments who straddle both domains

The knowing client : a processual perspective on knowledge shaping in consulting engagements

This thesis extends current understanding in management consulting research by investigating the ways in which management consultants and their clients shaped knowing over the course of nine different consulting engagements. The research illuminates the client experience of using consulting knowledge in organisations, and proposes a theoretical reconceptualisation of knowledge shaping in consulting engagements which incorporates how the knowing client is enacted. The research shows that knowledge shaping activities are planned and enacted to support novelty reduction in consulting engagements; that asymmetries in the structuring of the consultant–client relationship hamper knowledge transformation and the establishment of knowing; and that understanding of how the role identities of consultants and clients are established and maintained over the course of an engagement is integral to understanding knowledge shaping in consulting engagements.

Knowledge integration within innovation process : a technopreneurial perspective

Knowledge Integration (KI) is one of the major aspects driving innovation within an organisation. In this paper, we attempt to develop a better understanding of responses to the challenges of knowledge integration within the innovation process in technology-based firms. Using four technology-based Australian firms, we investigated how knowledge integration may be managed within the context of innovation in technology firms. Previous research highlights the role of four KI tasks that affect the innovation capability within technology-oriented firms, namely team building capability, capturing tacit knowledge, role of Knowledge Management (KM) systems and technological systemic integration. Our findings indicate that in addition to these four tasks, a strategic approach to integrating knowledge for innovation, as well as leadership and management, are essential to achieving effective KI across multiple levels of engagement. Our findings also offer practical insights into how knowledge can be integrated within innovation process, with specific implications for managers.

The dynamics of expertise acquisition in sport : the role of affective learning design

Objectives The aim of this position paper is to discuss the role of affect in designing learning experiences to enhance expertise acquisition in sport. The design of learning environments and athlete development programmes are predicated on the successful sampling and simulation of competitive performance conditions during practice. This premise is captured by the concept of representative learning design, founded on an ecological dynamics approach to developing skill in sport, and based on the individual-environment relationship. In this paper we discuss how the effective development of expertise in sport could be enhanced by the consideration of affective constraints in the representative design of learning experiences. Conclusions Based on previous theoretical modelling and practical examples we delineate two key principles of Affective Learning Design: (i) the design of emotion-laden learning experiences that effectively simulate the constraints of performance environments in sport; (ii) recognising individualised emotional and coordination tendencies that are associated with different periods of learning. Considering the role of affect in learning environments has clear implications for how sport psychologists, athletes and coaches might collaborate to enhance the acquisition of expertise in sport.

Knowledge Transfer in Transnational Programmes : Opportunities and Challenges for the Pacific Region

The globalised world: The current higher education community The last decade has seen rapid changes in the landscape of higher education (HE) throughout the world, largely as a product of globalisation. A major effect has been to propel the interconnectedness between nations and people across the globe (Scholte, 2005). The use of information and communication technology (ICT) has diminished the distance between countries. The world’s economies are becoming more integrated and interrelated through neoliberal economic policies, free trade agreements and open access of goods and services beyond national borders, policies promulgated by organisations such as the World Trade Organization and The World Bank (Marginson & Ordorika, 2011; Mok, 2011). As a consequence, universities are operating at global, national and local levels simultaneously. In the Pacific region, new universities are emerging. For example, Fiji now has one regional and two national universities; Samoa has a national university and Solomon Islands has an institute of higher education. These new players add to regional competition as they open opportunities for global partnerships and transnational programmes. Thus, participating at these multiple levels is inevitable, and no university is immune to these changes (Marginson, Kaur & Sawir, 2011a). Universities are now part of the global HE community that cannot be confined within a nation’s borders. Transitional HE programmes are perhaps one of the most evident demonstrations of the interconnectedness of universities across countries in this global era.

Doctors' knowledge of the law on withholding and withdrawing life-sustaining medical treatment

Objectives To examine the level of knowledge of doctors about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity, and factors associated with a higher level of knowledge. Design, setting and participants Postal survey of all specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in New South Wales, Victoria and Queensland. Survey initially posted to participants on 18 July 2012 and closed on 31 January 2013. Main outcome measures Medical specialists’ levels of knowledge about the law, based on their responses to two survey questions. Results Overall response rate was 32%. For the seven statements contained in the two questions about the law, the mean knowledge score was 3.26 out of 7. State and specialty were the strongest predictors of legal knowledge. Conclusions Among doctors who practise in the end-of-life field, there are some significant knowledge gaps about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity. Significant consequences for both patients and doctors can flow from a failure to comply with the law. Steps should be taken to improve doctors’ legal knowledge in this area and to harmonise the law across Australia.

‘It's all scientific to me’ : focus group insights into why young people do not apply safe-sex knowledge

Despite rising levels of safe-sex knowledge in Australia, sexually transmitted infection notifications continue to increase. A culture-centred approach suggests it is useful in attempting to reach a target population first to understand their perspective on the issues. Twenty focus groups were conducted with 89 young people between the ages of 14 and 16 years. Key findings suggest that scientific information does not articulate closely with everyday practice, that young people get the message that sex is bad and they should not be preparing for it and that it is not appropriate to talk about sex. Understanding how young people think about these issues is particularly important because the focus groups also found that young people disengage from sources of information that do not match their own experiences.