Can Safe Clinical Thinking be Taught?

OBJECTIVES: To determine if: (a) safe clinical decision making can be taught to undergraduate final year medical students and (b) if such students can be taught to specifically recognise illness severity from nominal clinical data. 
METHODS: 115 final year undergraduate medical students completed a 3 hour interactive Safe Thinking Workshop which focussed entirely on nontechnical skills such as potential perceptive pitfalls, attention to detail, teamwork and safe clinical decision making. The study involved students inspecting and interpreting a set of arterial blood gas results relating to a patient with acute respiratory distress, then answering a short questionnaire addressing biochemical diagnosis, clinical diagnosis and effective management. A separate question was embedded in the questionnaire to determine if astute students could determine the severity of the illness from the CO2 value provided. The study group (n = 58) completed the questionnaire immediately after the Safe Thinking Workshop, whilst the control group (n = 57) completed the questionnaire prior to the Workshop.
RESULTS: The mean total score for study students was 80.51%, with a mean total score of 63.86% for the control group (Student’s t-test; p<0.05). Correct classification of illness severity was observed in 10.35% of study students, compared with 3.51% of control students (p<0.05). 
CONCLUSION: These results suggest that safe clinical decision making and recognition of illness severity can be fostered by specific teaching in the nontechnical skill areas described above.

Metacognition in Patient Safety

OBJECTIVES: To determine if cognitive reflection has a positive influence on clinical decision making in undergraduate medical students. METHODS: 153 final year undergraduate medical students completed a 3 hour interactive Safe Thinking Workshop on nontechnical skills and patient safety, incorporating an introduction to metacognitive concepts. All students underwent augmented Cognitive Reflective Testing during the workshop. Students then inspected and interpreted a set of arterial blood gas results relating to a patient with acute respiratory distress, then answered a short questionnaire addressing biochemical diagnosis, clinical diagnosis and effective management. A separate question was embedded in the questionnaire to determine if astute students could determine the severity of the illness. The study group (n = 78) completed the questionnaire immediately after the Safe Thinking Workshop, whilst the control group (n = 75) completed the questionnaire prior to the Workshop.RESULTS: The mean total score for study students was 80.51%, with a mean total score of 57.9% for the control group (t-test; p<0.05). Correct classification of illness severity was observed in 13.2% of study students, compared with 4.1% of control students (p<0.05). CONCLUSION: These results suggest that clinical decision making and recognition of illness severity can be enhanced by specific teaching in nontechnical skills, metacognitiion and cognitive reflection.

Attitudes of students, parents, and teachers toward glasses use in rural China.

OBJECTIVE:

To use focus groups to understand barriers to glasses use among children in rural China.

METHODS:

Separate focus groups were conducted between December 17, 2007, and August 5, 2008, for the following 3 groups at each of 3 schools in rural China: children aged 14 to 18 years with myopia of less than -0.5 diopters in both eyes, those children's parents, and those children's teachers. Participants were also asked to rank their responses to questions about glasses use. The focus group transcripts were coded independently by 2 investigators using qualitative data management software.

RESULTS:

Respondents of all 3 types indicated that glasses purchase and wear should be delayed in children with early myopia and might be harmful to the eyes. Parents and students reported being uncertain about children's actual myopia status and whether glasses should be worn. Parents ranked their most common reason for not buying glasses as being "too busy with work," whereas "too expensive" ranked low. Inconvenience was ranked as an important reason for not wearing glasses among all 3 student groups. "Accuracy of lens power" was the first-ranked requirement for glasses among all student groups, whereas "new and attractive styles" was ranked last by all. All 3 types of respondents believed that wearing glasses or failing to wear them might worsen myopia.

CONCLUSIONS:

Educational programs are needed to address significant knowledge gaps in families and schools about glasses use in rural China. Cost and the need for attractive styles may not be significant barriers to use in this setting, raising the possibility of paying for such programs through cost recovery.

Assistive software tools for secondary-level students with literacy difficulties.

Study conducted to evaluate the effectiveness of four assistive technology (AT) tools on literacy: (1) speech synthesis, (2) spellchecker, (3) homophone tool, and (4) dictionary. All four of these programs are featured in TextHelp’s Read&Write Gold software package. A total of 93 secondary-level students with reading disabilities participated in the study. The participants completed a number of computer-based literacy tests after being assigned to a Read&Write group or a control group that utilized Microsoft Word. The results indicated that improvements in the following areas for the Read&Write group: (1) reading comprehension, (2) homophone error detection, (3) spelling error detection, and (4) word meanings. The Microsoft Word group also improved in the areas of word meanings and error detection, though performed worse on homophone error detection. The authors contend that these results indicate that speech synthesis, spell checkers, homophone tools, and dictionary programs have a positive effect on literacy among students with reading disabilities. This study was conducted by researchers at the Queen’s University in Belfast, Ireland.

Search for 1-10 Hz modulations in coronal emission with SECIS during the August 11, 1999 eclipse

Results of the search of the periodic changes of the 530.3 nm line intensity emitted by selected structures of the solar corona in the frequency range 1-10 Hz are presented. A set of 12 728 images of the section of the solar corona extending from near the north pole to the south-west were taken simultaneously in the 530.3 nm ("green") line and white-light with the Solar Eclipse Coronal Imaging System (SECIS) during the 143-seconds- long totality of the 1999 August 11 solar eclipse observed in Shabla, Bulgaria. The time resolution of the collected data is better than 0.05 s and the pixel size is approximately 4 arcsec. Using classical Fourier spectral analysis tools, we investigated temporal changes of the local 530.3 nm coronal line brightness in the frequency range 1-10 Hz of thousands of points within the field of view. The various photometric and instrumental effects have been extensively considered. We did not find any indisputable, statistically significant evidence of periodicities in any of the investigated points (at significance level alpha = 0.05).

The Teaching Space Allocation Problem with splitting

A standard problem within universities is that of teaching space allocation which can be thought of as the assignment of rooms and times to various teaching activities. The focus is usually on courses that are expected to fit into one room. However, it can also happen that the course will need to be broken up, or ‘split’, into multiple sections. A lecture might be too large to fit into any one room. Another common example is that of seminars or tutorials. Although hundreds of students may be enrolled on a course, it is often subdivided into particular types and sizes of events dependent on the pedagogic requirements of that particular course. Typically, decisions as to how to split courses need to be made within the context of limited space requirements. Institutions do not have an unlimited number of teaching rooms, and need to effectively use those that they do have. The efficiency of space usage is usually measured by the overall ‘utilisation’ which is basically the fraction of the available seat-hours that are actually used. A multi-objective optimisation problem naturally arises; with a trade-off between satisfying preferences on splitting, a desire to increase utilisation, and also to satisfy other constraints such as those based on event location and timetabling conflicts. In this paper, we explore such trade-offs. The explorations themselves are based on a local search method that attempts to optimise the space utilisation by means of a ‘dynamic splitting’ strategy. The local moves are designed to improve utilisation and satisfy the other constraints, but are also allowed to split, and un-split, courses so as to simultaneously meet the splitting objectives.

Consulting pupils in Assessment for Learning classrooms: the twists and turns of working with students as co-researchers

This is an invited paper to a special issue on pupil voice focusing on methodological issues arising from the ESRC/TLRP project on consulting pupils about assessment practices in their classrooms. The issue of consulting pupils about assessment has rarely been researched before but what this article illustrates are some of the difficulties, tensions and positive outcomes of engaging with students as researchers within a nationally funded (and therefore externally driven), university-based project. This study adds considerably to the body of knowledge in this area by engaging students in the process as researchers in different capacities within the project. Issues discussed include the use of student advisory groups, ethical negotiation, students undertaking videotaped classroom observations and their subsequent role in co-interpreting video excerpts and visual images. The paper has attracted considerable interest already through the ESRC pupil seminar series forum and also from a prior paper presentation to the European Educational Research Association in September 2006 in Switzerland to the Childrens' Rights SIG becasue of researchers' current interests in embedding democratic principles and practices within research with children and young people.

Application of a Generic Curriculum Change Management Process to Motivate and Excite Students

The School of Mechanical and Aerospace Engineering at Queen’s University Belfast is committed to enhancing the quality of student learning. A plan to implement curriculum change around this goal has been formulated and is already several years underway. A specific part of the plan involved instigating a first year introductory module to engage the students in the practice of their engineering discipline. The complicated nature of devising this type of module with regard to objectives, resources, timeframe and the number of students involved meant that a very systematic approach had to be adopted. This paper presents the simple but definitive change management process that facilitated in the creation of a first year Introduction to Engineering module. The generic nature of this process is described and its application to other facets of curriculum change is discussed. Within this process the importance of collaboration to establish a forward momentum is emphasised. This enables academic staff to progress as a group and build curriculum development based on their own experiences, expertise and established practice

The Design Process- Making It Relevant For Students

Within the ever-changing arenas of architectural design and education, the core element of architectural education remains: that of the design process. The consideration of how to design in addition to what to design presents architectural educators with that most constant and demanding challenge of how do we best teach the design process?

This challenge is arguably most acute at a student's early stages of their architectural education. In their first years in architecture, students will commonly concentrate on the end product rather than the process. This is, in many ways, understandable. A great deal of time, money and effort go into their final presentations. They believe that it is what is on the wall that is going to be assessed. Armed with new computer skills, they want to produce eye-catching graphics that are often no more than a celebration of a CAD package. In an era of increasing speed, immediacy of information and powerful advertising it is unsurprising that students want to race quickly to presenting an end-product.

Recognising that trend, new teaching methods and models were introduced into the second year undergraduate studio over the past two years at Queen's University Belfast, aimed at promoting student self-reflection and making the design process more relevant to the students. This paper will first generate a critical discussion on the difficulties associated with the design process before outlining some of the methods employed to help promote the following; an understanding of concept, personalisation of the design process for the individual student; adding realism and value to the design process and finally, getting he students to play to their strengths in illustrating their design process like an element of product. Frameworks, examples, outcomes and student feedback will all be presented to help illustrate the effectiveness of the new strategies employed in making the design process firstly, more relevant and therefore secondly, of greater value, to the architecture student.