Clinical reasoning: The relative contribution of identification, interpretation and hypothesis errors to misdiagnosis

The aim of this study was to identify and describe the types of errors in clinical reasoning that contribute to poor diagnostic performance at different levels of medical training and experience. Three cohorts of subjects, second- and fourth- (final) year medical students and a group of general practitioners, completed a set of clinical reasoning problems. The responses of those whose scores fell below the 25th centile were analysed to establish the stage of the clinical reasoning process - identification of relevant information, interpretation or hypothesis generation - at which most errors occurred and whether this was dependent on problem difficulty and level of medical experience. Results indicate that hypothesis errors decrease as expertise increases but that identification and interpretation errors increase. This may be due to inappropriate use of pattern recognition or to failure of the knowledge base. Furthermore, although hypothesis errors increased in line with problem difficulty, identification and interpretation errors decreased. A possible explanation is that as problem difficulty increases, subjects at all levels of expertise are less able to differentiate between relevant and irrelevant clinical features and so give equal consideration to all information contained within a case. It is concluded that the development of clinical reasoning in medical students throughout the course of their pre-clinical and clinical education may be enhanced by both an analysis of the clinical reasoning process and a specific focus on each of the stages at which errors commonly occur.

Arts-based research in design education

There is an urgent need in terms of changing world conditions to move beyond the dualist paradigm that has traditionally informed design research, education and practice. Rather than attempt to reduce uncertainty, novelty and complexity as is the conventional approach, an argument is presented in this article that seeks to exploit these qualities through a reconceptualisation of design in creative as well as systematic, rigorous and ethical terms. Arts-based research, which 'brings together the systematic and rigorous qualities of inquiry with the creative and imaginative qualities of the arts', is presented as being central to this reconceptualisation. This is exemplified in the application of art-informed inquiry in a research unit for graduating tertiary-level interior design students. The application is described in this article and is shown to rely substantially on the image and its capacity to open up and reveal new possibilities and meaning.

Property case competition : multi-stakeholder reflection

Pacific Rim Real Estate Society has conducted four property case competitions from 2009 to 2012. The competition provides opportunities for undergraduate students to present their proposal on a given case study. All students were locked down with their four team members for five hours without external help to ensure a level playing field across participants. Students prepared their presentation and defended their arguments in front of experts in property industry and academia. The aim of this paper is reflecting on the feedback received from stakeholders involved in the case competition. Besides exploring what students have gained from the competitions, this paper provides an insight on the opportunities and challenges for the new format of competition to be introduced in 2013. Over the last four competitions, there were three universities participated in all the four consecutive events, four universities partook in two events and another four universities only competed once. Some universities had a great advantage by having previous experiences by participating in similar international business competitions. Findings show that the students have benefited greatly from the event including improving their ability in problem solving and other non-technical skills. Despite the aforementioned benefits, the PRRES closed-book case competition is proven not viable thus future competition needs to minimise the travel and logistic cost.

Improving usability of e-commerce websites via tag-based customisation : a study on online and mobile banking

This thesis is an exploration of customisation in online and mobile banking. It investigates the application of user-tags to facilitate customised interactions in desktop and mobile devices, and its impact on usability. The thesis through a comparative study explains that customisation can positively affect usability especially for younger users, leading to higher levels of satisfaction.

The development and evaluation of a medical imaging training immersive environment

Introduction A novel realistic 3D virtual reality (VR) application has been developed to allow medical imaging students at Queensland University of Technology to practice radiographic techniques independently outside the usual radiography laboratory. Methods A flexible agile development methodology was used to create the software rapidly and effectively. A 3D gaming environment and realistic models were used to engender presence in the software while tutor-determined gold standards enabled students to compare their performance and learn in a problem-based learning pedagogy. Results Students reported high levels of satisfaction and perceived value and the software enabled up to 40 concurrent users to prepare for clinical practice. Student feedback also indicated that they found 3D to be of limited value in the desktop version compared to the usual 2D approach. A randomised comparison between groups receiving software-based and traditional practice measured performance in a formative role play with real equipment. The results of this work indicated superior performance with the equipment for the VR trained students (P = 0.0366) and confirmed the value of VR for enhancing 3D equipment-based problem-solving skills. Conclusions Students practising projection techniques virtually performed better at role play assessments than students practising in a traditional radiography laboratory only. The application particularly helped with 3D equipment configuration, suggesting that teaching 3D problem solving is an ideal use of such medical equipment simulators. Ongoing development work aims to establish the role of VR software in preparing students for clinical practice with a range of medical imaging equipment.

Blackboard as an online learning environment : what do teacher education students and staff think?

Abstract: As online learning environments now have an established presence in higher education we need to ask the question: How effective are these environments for student learning? Online environments can provide a different type of learning experience than traditional face-to-face contexts (for on-campus students) or print-based materials (for distance learners). This article identifies teacher education student and staff perceptions of teaching and learning using the online learning management system, Blackboard. Perceptions of staff and students are compared and implications for teacher education staff interested in providing high quality learning environments within an online space are discussed.

Bilingual asynchronous online discussion groups : design and delivery of an e-Learning distance study module for nurse academics in a developing country

The advent of eLearning has seen online discussion forums widely used in both undergraduate and postgraduate nursing education. This paper reports an Australian university experience of design, delivery and redevelopment of a distance education module developed for Vietnamese nurse academics. The teaching experience of Vietnamese nurse academics is mixed and frequently limited. It was decided that the distance module should attempt to utilise the experience of senior Vietnamese nurse academics - asynchronous online discussion groups were used to facilitate this. Online discussion occurred in both Vietnamese and English and was moderated by an Australian academic working alongside a Vietnamese translator. This paper will discuss the design of an online learning environment for foreign correspondents, the resources and translation required to maximise the success of asynchronous online discussion groups, as well as the rationale of delivering complex content in a foreign language. While specifically addressing the first iteration of the first distance module designed, this paper will also address subsequent changes made for the second iteration of the module and comment on their success. While a translator is clearly a key component of success, the elements of simplicity and clarity combined with supportive online moderation must not be overlooked.

No borders : virtual communities in online learning

It can be argued that technological advances and increasing familiarity with technology in the general population has created a huge potential for expansion of online learning (OL) across the educational spectrum. The growth of OL at the university level over the last few years has brought with it an increasing need to understand the learning processes and social processes involved in the ‘cyber’ or ‘virtual’ lecture hall and seminar room by asking questions such as: What are ‘virtual universities’? How – or more critically whether – virtual learning environments are different from face-to-face (F2F) ones? In other words, there is a critical need to explore how students relate to each other and their lecturer(s) in a literal ‘school without walls’? This paper explores the development of a virtual community within a wholly online MA in Applied Linguistics program within the framework of online community development proposed by Haythornthwaite et al (2000).

Blog and design education : facilitating reflective learning

This paper discusses about effectiveness of blogs for reflective learning in design education. Students in two animation units were asked to complete their online journal via blog in terms of reflective learning. Students were encouraged to respond their weekly outcomes and project development process to their blog and share it with other students. A survey was undertaken to evaluate their learning experience and one of the key outcomes indicates that interaction design for social network is significantly important to blog based learning design.

Learning approach and perception of learning context in economics education : a causality test

In the study of student learning literature, the traditional view holds that when students are faced with heavy workload, poor teaching, and content that they cannot relate to – important aspects of the learning context, they will more likely utilise the surface approach to learning due to stresses, lack of understanding and lack of perceived relevance of the content (Kreber, 2003; Lizzio, Wilson, & Simons, 2002; Ramdsen, 1989; Ramsden, 1992; Trigwell & Prosser, 1991; Vermunt, 2005). For example, in studies involving health and medical sciences students, courses that utilised student-centred, problem-based approaches to teaching and learning were found to elicit a deeper approach to learning than the teacher-centred, transmissive approach (Patel, Groen, & Norman, 1991; Sadlo & Richardson, 2003). It is generally accepted that the line of causation runs from the learning context (or rather students’ self reported data on the learning context) to students’ learning approaches. That is, it is the learning context as revealed by students’ self-reported data that elicit the associated learning behaviour. However, other research studies also found that the same teaching and learning environment can be perceived differently by different students. In a study of students’ perceptions of assessment requirements, Sambell and McDowell (1998) found that students “are active in the reconstruction of the messages and meanings of assessment” (p. 391), and their interpretations are greatly influenced by their past experiences and motivations. In a qualitative study of Hong Kong tertiary students, Kember (2004) found that students using the surface learning approach reported heavier workload than students using the deep learning approach. According to Kember if students learn by extracting meanings from the content and making connections, they will more likely see the higher order intentions embodied in the content and the high cognitive abilities being assessed. On the other hand, if they rote-learn for the graded task, they fail to see the hierarchical relationship in the content and to connect the information. These rote-learners will tend to see the assessment as requiring memorising and regurgitation of a large amount of unconnected knowledge, which explains why they experience a high workload. Kember (2004) thus postulate that it is the learning approach that influences how students perceive workload. Campbell and her colleagues made a similar observation in their interview study of secondary students’ perceptions of teaching in the same classroom (Campbell et al., 2001). The above discussions suggest that students’ learning approaches can influence their perceptions of assessment demands and other aspects of the learning context such as relevance of content and teaching effectiveness. In other words, perceptions of elements in the teaching and learning context are endogenously determined. This study attempted to investigate the causal relationships at the individual level between learning approaches and perceptions of the learning context in economics education. In this study, students’ learning approaches and their perceptions of the learning context were measured. The elements of the learning context investigated include: teaching effectiveness, workload and content. The authors are aware of existence of other elements of the learning context, such as generic skills, goal clarity and career preparation. These aspects, however, were not within the scope of this present study and were therefore not investigated.

Implicit online learning

Online learning algorithms have recently risen to prominence due to their strong theoretical guarantees and an increasing number of practical applications for large-scale data analysis problems. In this paper, we analyze a class of online learning algorithms based on fixed potentials and nonlinearized losses, which yields algorithms with implicit update rules. We show how to efficiently compute these updates, and we prove regret bounds for the algorithms. We apply our formulation to several special cases where our approach has benefits over existing online learning methods. In particular, we provide improved algorithms and bounds for the online metric learning problem, and show improved robustness for online linear prediction problems. Results over a variety of data sets demonstrate the advantages of our framework.

Scaffolding techniques : a teacher training for cooperative learning in Thailand primary education

In general, the benefits of using cooperative learning include academic achievement, communication skills, problem-solving, social skills and student motivation. Yet cooperative learning as a Western educational concept may be ineffective in a different learning system. The study aims to investigate scaffolding techniques for cooperative learning in Thailand primary education. The program was designed to foster Thai primary school teachers’ cooperative learning implementation that includes the basic tenets of cooperative learning and socio-cognitive based learning. Two teachers were invited to participate in this experimental teacher training program for one and a half weeks. Then the teachers implemented a cooperative learning in their mathematics class for six weeks. The data from teacher interview and classroom observation indicated that the both teachers are able to utilise questions to scaffold their students’ engagement in cooperative learning. This initiative study showed that difficulty or failure of implementing cooperative learning in Thailand education may not be derived from cultural difference. The paper discussed the techniques the participant teachers applied with proactive scaffolding, reactive scaffolding and scaffolding questions that can be used to facilitate the implementation of cooperative learning in Thai school.

Design minds : an online design education platform for non-designers to enact cultural change

Education in the 21st century demands a model for understanding a new culture of learning in the face of rapid change, open access data and geographical diversity. Teachers no longer need to provide the latest information because students themselves are taking an active role in peer collectives to help create it. This paper examines, through an Australian case study entitled ‘Design Minds’, the development of an online design education platform as a key initiative to enact a government priority for state-wide cultural change through design-based curriculum. Utilising digital technology to create a supportive community, ‘Design Minds’ recognises that interdisciplinary learning fostered through engagement will empower future citizens to think, innovate, and discover. This paper details the participatory design process undertaken with multiple stakeholders to create the platform. It also outlines a proposed research agenda for future measurement of its value in creating a new learning culture, supporting regional and remote communities, and revitalising frontline services. It is anticipated this research will inform ongoing development of the online platform, and future design education and research programs in K-12 schools in Australia.

Using real-time authentic online learning scenarios to teach criminal intelligence

Criminal intelligence is an area of expertise highly sought-after internationally and within a variety of justice-related professions; however, producing university graduates with the requisite professional knowledge, as well as analytical, organisational and technical skills presents a pedagogical and technical challenge to university educators. The situation becomes even more challenging when students are undertaking their studies by distance education. This best practice session showcases the design of an online undergraduate unit for final year justice students which uses an evolving real-time criminal scenario as the focus of authentic learning activities in order to prepare students for graduate roles within the criminal intelligence and justice professions. Within the unit, students take on the role of criminal intelligence analysts, applying relevant theories, models and strategies to solve a complex but realistic crime and complete briefings and documentation to industry standards as their major summative assessment task. The session will demonstrate how the design of the online unit corresponds to authentic learning principles, and will specifically map the elements of the unit design to Herrington & Oliver’s instructional design framework for authentic learning (2000; Herrington & Herrington 2006). The session will show how a range of technologies was used to create a rich learning experience for students that could be easily maintained over multiple unit iterations without specialist technical support. The session will also discuss the unique pedagogical affordances and challenges implicated in the location of the unit within an online learning environment, and will reflect on some of the lessons learned from the development which may be relevant to other authentic online learning contexts.