Temporary tattoos:a novel OSCE assessment tool

Background: There are many issues regarding the use of real patients in objective structured clinical examinations (OSCEs). In dermatology OSCE stations, standardised patients (SPs) with clinical photographs are often used. Temporary transfer tattoos can potentially simulate skin lesions when applied to an SP. This study aims to appraise the use of temporary malignant melanoma tattoos within an OSCE framework. Method: Within an 11-station OSCE, a temporary malignant melanoma tattoo was developed and applied to SPs in a 'skin lesion' OSCE station. A questionnaire captured the opinions of the candidate, SP and examiners, and the degree of perceived realism of each station was determined. Standard post hoc OSCE analysis determined the psychometric reliability of the stations. Results: The response rates were 95.9 per cent of candidates and 100 per cent of the examiners and SPs. The 'skin lesion' station achieved the highest realism score compared with other stations: 89.0 per cent of candidates felt that the skin lesion appeared realistic; only 28 per cent of candidates had ever seen a melanoma before in training. The psychometric performance of the melanoma station was comparable with, and in many instances better than, other OSCE stations. Discussion: Transfer tattoo technology facilitates a realistic dermatology OSCE station encounter. Temporary tattoos, alongside trained SPs, provide an authentic, standardised and reliable experience, allowing the assessment of integrated dermatology clinical skills.

A pilot study to develop an assessment tool for sheep welfare after long journey transport

Sheep transport within Europe involves 9.5 million animals yearly, 63% of which travel over longjourneys (> 8 h). Livestock transport, particularly over long journeys, gives rise to concern about the welfare of transported animals. The European Commission stimulates the development of market-oriented animal welfare standards for all phases of livestock production, providing an alternative to the 'regulatory approach'. This study aimed to develop and test a new sheep welfare assessment protocol to be used following transport, irrespective of the journey purpose. The protocol included outcome (animal-based measures) and input variables (resource-based and management-based measures), being welfare-relevant aspects of both transport and unloading procedures. Weighted Cohen's Kappa and Heiss' Kappa index of agreement were calculated to evaluate the raters accuracy and the inter-observer reliability.Overall, good agreement levels were found. The protocol was tested on 40 commercial transports arriving at previously selected assembly centres and slaughterhouses in Italy and Greece. The protocol was found to be feasible when applied to commercial transports, allowing for a comprehensive and quick sheep welfare assessment during unloading, without impairing stockman work. Univariate analysis was carried out to evaluate associations between outcome and input variables. In this study, significant association between outcome measures and risk factors were identified when associated to unloading procedures but not to travel conditions. In collaboration with the relevant stakeholders, this protocol might be developed into a tool for routine checks for certification purposes and could provide direct feedback to all professionals involved in animal transportation on the weaknesses and strengths of their work.

Exploring the mobile structural assessment tool: Concept maps for learning website: Concept Maps for Learning Website

In this paper, we describe how the pathfinder algorithm converts relatedness ratings of concept pairs to concept maps; we also present how this algorithm has been used to develop the Concept Maps for Learning website (www.conceptmapsforlearning.com) based on the principles of effective formative assessment. The pathfinder networks, one of the network representation tools, claim to help more students memorize and recall the relations between concepts than spatial representation tools (such as Multi- Dimensional Scaling). Therefore, the pathfinder networks have been used in various studies on knowledge structures, including identifying students’ misconceptions. To accomplish this, each student’s knowledge map and the expert knowledge map are compared via the pathfinder software, and the differences between these maps are highlighted. After misconceptions are identified, the pathfinder software fails to provide any feedback on these misconceptions. To overcome this weakness, we have been developing a mobile-based concept mapping tool providing visual, textual and remedial feedback (ex. videos, website links and applets) on the concept relations. This information is then placed on the expert concept map, but not on the student’s concept map. Additionally, students are asked to note what they understand from given feedback, and given the opportunity to revise their knowledge maps after receiving various types of feedback.

Jigsaw Java: Intelligent, Automated Marking

The popularity of Computing degrees in the UK has been increasing significantly over the past number of years. In Northern Ireland, from 2007 to 2015, there has been a 40% increase in acceptances to Computer Science degrees with England seeing a 60% increase over the same period (UCAS, 2016). However, this is tainted as Computer Science degrees also continue to maintain the highest dropout rates.
In Queen’s University Belfast we currently have a Level 1 intake of over 400 students across a number of computing pathways. Our drive as staff is to empower and motivate the students to fully engage with the course content. All students take a Java programming module the aim of which is to provide an understanding of the basic principles of object-oriented design. In order to assess these skills, we have developed Jigsaw Java as an innovative assessment tool offering intelligent, semi-supervised automated marking of code.
Jigsaw Java allows students to answer programming questions using a drag-and-drop interface to place code fragments into position. Their answer is compared to the sample solution and if it matches, marks are allocated accordingly. However, if a match is not found then the corresponding code is executed using sample data to determine if its logic is acceptable. If it is, the solution is flagged to be checked by staff and if satisfactory is saved as an alternative solution. This means that appropriate marks can be allocated and should another student have submitted the same placement of code fragments this does not need to be executed or checked again. Rather the system now knows how to assess it.
Jigsaw Java is also able to consider partial marks dependent on code placement and will “learn” over time. Given the number of students, Jigsaw Java will improve the consistency and timeliness of marking.

Depression associates with Mini Nutritional Assessment (MNA), Vitamin B12 and Folate status::Findings from Belfast Elderly Longitudinal Free-Living Ageing STudy (BELFAST)

Introduction: An association between depression and folate has been found in clinical studies. Depression and dementia can contribute to nutritional deficiency. This study clinical depression in in octo/nonagenarians from the BELFAST study.
Method: In the BELFAST study, 38 free-living octo/nonagenarians (mean age 82 years), who apparently well and cognitively intact were followed up at 5 years and assessed using the Geriatric Depression Scale (GDS), Folstein (30 point), Mini Nutritional Assessment Tool (MNA) together with serum folate and vitamin B12 levels.
Results: Mean GDS was 3.4 (SD 2.5), serum folate 7.1 umol/l (SD 5.3) and B12 553 umol/l (458). With mean MNA and Folstein -25.8 (SD 2.7) and 27.6 (SD 2.7) respectively with no sex difference (p = 0.78; p = 0.36). 25% of subjects showed a GDS >5 indicating risk of mild depression and 21% had compromised nutritional status. MNA associated with GDS in male (r2 = 0.56 p = 0.01), but not in female elderly subjects (r2 = 0.01; p = 0.44). GDS score and lower serum folate were associated (r2 = -0.23; p = 0.01).
Conclusion: Overall there was the suggestion that nutritional status and depression might be linked in male subjects at 5 year follow-up in octo/nonagenarians from the BEFLAST study. The lower folate in subjects categorised at risk of mild depression might suggest vitamin supplementation could be useful.

Automated Methods for Aircraft Design Integrated with Manufacturing

Aircraft design is a complex, long and iterative process that requires the use of various specialties and optimization tools. However these tools and specialities do not include manufacturing, which is often considered later in the product development process leading to higher cost and time delays. This work focuses on the development of an automated design tool that accounts for manufacture during the design process focusing on early geometry definition which in turn informs assembly planning. To accomplish this task the design process needs to be open to any variation in structural configuration while maintaining the design intent. Redefining design intent as a map which links a set of requirements to a set of functions using a numerical approach enables the design process itself to be considered as a mathematical function. This definition enables the design process to utilise captured design knowledge and translate it into a set of mathematical equations that design the structure. This process is articulated in this paper using the structural design and definition for an aircraft fuselage section as an exemplar.

Standardizing the assessment of clinical competence: an overview of intensive care course design.

Rationale for the development of the Certificate in Health Studies: Intensive Care and High Dependency for Adults course developed at Queens University Belfast, Northern Ireland. Structure and content of clinical module reviewed. Clinical assessment strategy discussed. Focus on the utilization of a standardized portfolio, individualized learning contract and objective structured clinical examination (OSCE) to evaluate clinical competence. Evaluation of OSCE as an assessment tool and of the course provision.

Neurology assessment by objective structured video examination (OSVE)

Summary
Background
The ability to carry out a neurological examination and make an appropriate differential diagnosis is one of the mainstays of our final Bachelor of Medicine (MB) exam; however, with the introduction of objective structured clinical examinations (OSCEs) it has become impossible to arrange for adequate numbers of suitable real patients to participate in the exam.

Context
It is vital that newly qualified doctors can perform a basic neurological examination, interpret the physical signs and formulate a differential diagnosis.

It is vital that newly qualified doctors can perform a basic neurological examination

Innovation
Since 2010 we have introduced an objective structured video examination (OSVE) of a neurological examination of a real patient as part of our final MB OSCE exam. The students view clips of parts of the examination process. They answer questions on the signs that are demonstrated and formulate a differential diagnosis.

Implications
This type of station is logistically a lot easier to organise than a large number of real patients at different examination sites. The featured patients have clearly demonstrated signs and, as every student sees the same patient, are perfectly standardised. It is highly acceptable to examiners and performed well as an assessment tool. There are, however, certain drawbacks in that we are not examining the student's examination technique or their interaction with the patient. Also, certain signs, in particular the assessment of muscle tone and power, are more difficult for a student to estimate in this situation

A tool for the evaluation of slaughter horse welfare during unloading

This study aimed to develop a scientific and practical tool to be used to assess horse welfare after commercial transport over long journeys. A set of physical, behavioural and environmental measures was selected, covering welfare aspects of both transport and unloading procedures. The protocol was field-tested on 51 intra-EU commercial transports arriving at different sites in Italy. Univariate analysis was implemented to look for associations between the input variables (environmental hazards potentially affecting the animal well-being during long transports) and the outcome variables (direct evaluation of the animal condition). No severe welfare impairments were recorded (ie dead on arrival, severe injuries, non-ambulatory animals), while milder ones were more frequent at unloading (eg slipping; 36.7%, reluctance to move; 9.6%). Correlations emerged between ramp slope and falling; type of ramp floor and slipping; fast gait and the presence of gaps between the ramp and the floor. The horses' behaviour was also related to the type of handling procedure used. The measures were repeatable and practical to apply and score during real-time unloading. This work provides a sound basis for a new and practical welfare assessment tool for horses travelling over long journeys. Careful and constant application of this protocol would provide stakeholders with the opportunity to track and monitor changes in the industry over time, as well as to identify high risk areas in transport routines.

Routine delirium monitoring in a UK critical care unit

Introduction Delirium in the intensive care unit (ICU) is associated with increased morbidity and mortality. Using an assessment tool has been shown to improve the ability of clinicians in the ICU to detect delirium. The confusion assessment method for the ICU (CAM-ICU) is a validated delirium-screening tool for critically ill intubated patients. The aim of this project was to establish the feasibility of routine delirium screening using the CAM-ICU and to identify the incidence of delirium in a UK critical care unit.