Keeping it real! Enhancing realism in standardised patient OSCE stations

Background: Objective structured clinical examinations (OSCEs) are a
commonly used method of assessing clinical competency in healthcare education. They can providean opportunity to observe candidates interacting with patients.
There are many challenges in using real patients in OSCEs, and increasingly standardised patients are being used as a preference. However, by using standardised patients there is a risk of making the encounter arti?cial and removed from actual clinical practice.
Context: Efforts made in terms of cognitive, auditory, visual, tactile, psychological and emotional cues can minimise the differences between a simulated
and real clinical scenario. However, a number of factors, including feasibility, cost and usability, need to be considered if such techniques are to be practicable
within an OSCE framework.
Innovation: This article describes a series of techniques that have been used in our institution to enhance the realism of a standardised patient encounter in an
OSCE. Efforts in preparing standardised patient roles, and how they portray these roles, will be considered. A wide variety of equipment can also be used in
combination with a patient and the surrounding environment, which can further enhance the authenticity of the simulated scenario.
Implications: By enhancing the realism in simulated patient OSCE encounters, there is potential to trigger more authentic conscious responses from candidates and implicit reactions that the candidates themselves may be less
aware of. Furthermore, using such techniques may allow faculty members to select scenarios that were previously not thought possible in an OSCE

Collisions Strengths and Effective Collision Strengths for transitions within the ground state configuration of S III

We have carried out a 29-state R-matrix calculation in order to calculate collision strengths and effective collision strengths for the electron impact excitation of S III. The recently developed parallel RMATRX II suite of codes have been used, which perform the calculation in intermediate coupling. Collision strengths have been generated over an electron energy range of 0-12 Ryd, and effective collision strength data have been calculated from these at electron temperatures in the range 1000-100,000 K. Results are here presented for the fine-structure transitions between the ground-state configurations of 3s(2)3p(2) P-3(0,1,2), D-1(2), and S-1(0), and the values given resolve a discrepancy between two previous R-matrix calculations.

Handwritten undergraduate case reports

Background: This article describes a 'back to the future' approach to case 'write-ups', with medical students producing handwritten instead of word-processed case reports during their clinical placements. Word-processed reports had been found to have a number of drawbacks, including the inappropriate use of 'cutting and pasting', undue length and lack of focus. Method: We developed a template to be completed by hand, based on the hospital 'clerking-in process', and matched this to a new assessment proforma. An electronic survey was conducted of both students and assessors after the first year of operation to evaluate impact and utility. Results: The new template was well received by both students and assessors. Most students said they preferred handwriting the case reports (55.6%), although a significant proportion (44.4%) preferred the word processor. Many commented that the template enabled them to effectively learn the structure of a case history and to improve their history-taking skills. Most assessors who had previously marked case reports felt the new system represented an improvement. The average time spent marking each report fell from 23.56 to 16.38minutes using the new proforma. Discussion: Free text comments from the survey have led to the development of a more flexible case report template better suited to certain specialties (e.g. dermatology). This is an evolving process and there will be opportunities for further adaptation as electronic medical records become more common in hospital. © Blackwell Publishing Ltd 2012.

Scaled Heavy-Ball Acceleration of the Richardson-Lucy Algorithm

The Richardson-Lucy algorithm is one of the most important algorithms in the image deconvolution area. However, one of its drawbacks is slow convergence. A very significant acceleration is obtained by the technique proposed by Biggs and Andrews (BA), which is implemented in the deconvlucy function of the Image Processing MATLAB toolbox. The BA method was developed heuristically with no proof of convergence. In this paper, we introduce the Heavy-Ball (H-B) method for Poisson data optimization and extend it to a scaled H-B method, which includes the BA method as a special case. The method has proof of the convergence rate of O(k-2), where k is the number of iterations. We demonstrate the superior convergence performance of the scaled H-B method on both synthetic and real 3D images.

Asset Tracking in Critical Power Communications Infrastructures using Passive Techniques

Active network scanning injects traffic into a network and observes responses to draw conclusions about the network. Passive network analysis works by looking at network meta data or by analyzing traffic as it traverses a fixed point on the network. It may be infeasible or inappropriate to scan critical infrastructure networks. Techniques exist to uniquely map assets without resorting to active scanning. In many cases, it is possible to characterize and identify network nodes by passively analyzing traffic flows. These techniques are considered in particular with respect to their application to power industry critical infrastructure.

Undergraduate interprofessional education using high-fidelity paediatric simulation

BACKGROUND: High-fidelity simulation is becoming increasingly important in the delivery of teaching and learning to health care professionals within a safe environment. Its use in an interprofessional context and at undergraduate level has the potential to facilitate the learning of good communication and teamworking, in addition to clinical knowledge and skills.

METHODS: Interprofessional teaching and learning workshops using high-fidelity paediatric simulation were developed and delivered to undergraduate medical and nursing students at Queen's University Belfast. Learning outcomes common to both professions, and essential in the clinical management of sick children, included basic competencies, communication and teamworking skills. Quantitative and qualitative evaluation was undertaken using published questionnaires.

RESULTS: Quantitative results - the 32-item questionnaire was analysed for reliability using spss. Responses were positive for both groups of students across four domains - acquisition of knowledge and skills, communication and teamworking, professional identity and role awareness, and attitudes to shared learning. Qualitative results - thematic content analysis was used to analyse open-ended responses. Students from both groups commented that an interprofessional education (IPE) approach to paediatric simulation improved clinical and practice-based skills, and provided a safe learning environment. Students commented that there should be more interprofessional and simulation learning opportunities.

DISCUSSION: High-fidelity paediatric simulation, used in an interprofessional context, has the potential to meet the requirements of undergraduate medical and nursing curricula. Further research is needed into the long-term benefits for patient care, and its generalisability to other areas within health care teaching and learning.

Ultraviolet emission lines of Si II in cool star and solar spectra

Recent atomic physics calculations for Si II are employed within the CLOUDY modelling code to analyse Hubble Space Telescope (HST) STIS ultraviolet spectra of three cool stars, β Geminorum, α Centauri A and B, as well as previously published HST/GHRS observations of α Tau, plus solar quiet Sun data from the High Resolution Telescope and Spectrograph. Discrepancies found previously between theory and observation for line intensity ratios involving the 3s²3p ²PJ-3s3p^{2 4}P^J' intercombination multiplet of Si II at ~ 2335 Å are significantly reduced, as are those for ratios containing the 3s²3p ²PJ-3s3p^{2 2}DJ ~ transitions at ~1816 Å. This is primarily due to the effect of the new Si II transition probabilities. However, these atomic data are not only very different from previous calculations, but also show large disagreements with measurements, specifically those of Calamai et al. for the intercombination lines. New measurements of transition probabilities for Si II are hence urgently required to confirm (or otherwise) the accuracy of the recently calculated values. If the new calculations are confirmed, then a long-standing discrepancy between theory and observation will have finally been resolved. However, if the older measurements are found to be correct, then the agreement between theory and observation is simply a coincidence and the existing discrepancies remain.