Patience, Persistence and Pragmatism: Experiences and Lessons Learnt from the Implementation of Clinically Integrated Teaching and Learning of Evidence-Based Health Care - A Qualitative Study

Background

Clinically integrated teaching and learning are regarded as the best options for improving evidence-based healthcare (EBHC) knowledge, skills and attitudes. To inform implementation of such strategies, we assessed experiences and opinions on lessons learnt of those involved in such programmes.

Methods and Findings

We conducted semi-structured interviews with 24 EBHC programme coordinators from around the world, selected through purposive sampling. Following data transcription, a multidisciplinary group of investigators carried out analysis and data interpretation, using thematic content analysis. Successful implementation of clinically integrated teaching and learning of EBHC takes much time. Student learning needs to start in pre-clinical years with consolidation, application and assessment following in clinical years. Learning is supported through partnerships between various types of staff including the core EBHC team, clinical lecturers and clinicians working in the clinical setting. While full integration of EBHC learning into all clinical rotations is considered necessary, this was not always achieved. Critical success factors were pragmatism and readiness to use opportunities for engagement and including EBHC learning in the curriculum; patience; and a critical mass of the right teachers who have EBHC knowledge and skills and are confident in facilitating learning. Role modelling of EBHC within the clinical setting emerged as an important facilitator. The institutional context exerts an important influence; with faculty buy-in, endorsement by institutional leaders, and an EBHC-friendly culture, together with a supportive community of practice, all acting as key enablers. The most common challenges identified were lack of teaching time within the clinical curriculum, misconceptions about EBHC, resistance of staff, lack of confidence of tutors, lack of time, and negative role modelling.

Conclusions

Implementing clinically integrated EBHC curricula requires institutional support, a critical mass of the right teachers and role models in the clinical setting combined with patience, persistence and pragmatism on the part of teachers.

Proposing the deep dynamic Bayesian network as a future computer based medical system

The development of new learning models has been of great importance throughout recent years, with a focus on creating advances in the area of deep learning. Deep learning was first noted in 2006, and has since become a major area of research in a number of disciplines. This paper will delve into the area of deep learning to present its current limitations and provide a new idea for a fully integrated deep and dynamic probabilistic system. The new model will be applicable to a vast number of areas initially focusing on applications into medical image analysis with an overall goal of utilising this approach for prediction purposes in computer based medical systems.

The VINEYARD Approach: Versatile, Integrated, Accelerator-Based, Heterogeneous Data Centres.

Emerging web applications like cloud computing, Big Data and social networks have created the need for powerful centres hosting hundreds of thousands of servers. Currently, the data centres are based on general purpose processors that provide high flexibility buts lack the energy efficiency of customized accelerators. VINEYARD aims to develop an integrated platform for energy-efficient data centres based on new servers with novel, coarse-grain and fine-grain, programmable hardware accelerators. It will, also, build a high-level programming framework for allowing end-users to seamlessly utilize these accelerators in heterogeneous computing systems by employing typical data-centre programming frameworks (e.g. MapReduce, Storm, Spark, etc.). This programming framework will, further, allow the hardware accelerators to be swapped in and out of the heterogeneous infrastructure so as to offer high flexibility and energy efficiency. VINEYARD will foster the expansion of the soft-IP core industry, currently limited in the embedded systems, to the data-centre market. VINEYARD plans to demonstrate the advantages of its approach in three real use-cases (a) a bio-informatics application for high-accuracy brain modeling, (b) two critical financial applications, and (c) a big-data analysis application.

A Proposed Framework for Simulation Based Learning of Inheritance

Different types of serious games have been used in elucidating computer science areas such as computer games, mobile games, Lego-based games, virtual worlds and webbased games. Different evaluation techniques have been conducted like questionnaires, interviews, discussions and tests. Simulation have been widely used in computer science as a motivational and interactive learning tool. This paper aims to evaluate the possibility of successful implementation of simulation in computer programming modules. A framework is proposed to measure the impact of serious games on enhancing students understanding of key computer science concepts. Experiments will be held on the EEECS of Queen’s University Belfast students to test the framework and attain results.

Approved Social Work Training in Northern Ireland: Using Research to Examine Competence-Based Learning and Influence Policy Change

This article reports on how research activity helped describe and analyse ASW (Approved Social Worker) learning experience as well as acting as a catalyst for change and development in policy and practice in Northern Ireland. The paper contextualizes the study by outlining the legislation, the main features of the ASW role and the approach to ASW training in Northern Ireland, and by reviewing the literature on the efficacy and value of competence-based learning. While the findings do not provide conclusive evidence that a competence-based approach is inherently more effective than previous courses, they do indicate that candidates who were trained in this way were moderately more satisfied than those who had participated in non-competence based programmes. The research also highlights the importance of the interrelationship between training, practice experience and support in developing and sustaining competence. The paper concludes with a review of the recommendations arising from the study and an analysis of the developments in training and regulations relating to practice experience and re-approval of ASWs since publication of the research. The study is of contemporary interest given the proposed changes to the role of ASWs/Mental Health Officers in the context of the reviews of UK mental health law.