The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group

Objective: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. Methods: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. Results: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. Conclusion: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking. Keywords: national final examination, licensing examination, summative assessment, OSCE, action research

From Connecting Hindus to Uniting Global Hinduism: History and Guiding Principles of Hinduism Today

Hinduism Today is a quarterly magazine that appears in roughly 15.000 copies, shipped to nearly 60 countries worldwide. The majority of readers are Hindus in diverse diaspora countries, mainly Singapur, Malaysia, Mauritius, Trinidad und the USA. Its editors are monks of Kauai Adheenam, belonging to the Śaiva Siddhānta Church, situated in Kauai, Hawai’i, USA. One of the magazine’s declared goals is to foster global Hindu solidarity and educate Hindus worldwide about their religion. In this paper, I want to take a look at the history of this magazine in connection with the Śaiva Siddhānta Church, and at the development of the expressed aims behind its publication. For this, I draw on fieldwork done in Kauai in January, 2014. After a brief introduction to some theoretical and methodological preliminaries of my work, I shall, give an overview of the history of the Śaiva Siddhānta Church, founded by Satguru Sivaya Subramuniyaswami. Following this, I will deal in more detail with the origins and development of the magazine and the websites connected with it. I will focus especially on the role the magazine was intended to play for global Hindu diasporas. A fourth chapter will analyze the modes of definition employed in order to depict Hinduism as a unified global religion. In conclusion, I shall briefly reflect upon the specific agenda of “Global Hinduism” and the strategies of positioning as followed by the publishers of Hinduism Today.

Sustainable Development Appraisal (SDA): A methodological tool for the participatory assessment of sustainability from local to regional planning levels

The term 'sustainable development' is receiving increasing attention in development co-operation and at the global level. However, practical tools which can help local users and multi-disciplinary teams to work together and apply this general concept at the local to regional levels have' emerged only very recently. This paper describes a tool called 'Sustainable Development Appraisal' (SDA), which is based on the principles of sustainable development, and can be applied by small interdisciplinary teams using a transdisciplinary approach, i.e. in participation with local land users and other stakeholders at various levels of intervention. The SDA has been applied in different parts of the globe. It is receiving considerable attention, and may fulfil most requirements contained in the concept of sustainable development, and yet be practically applicable and useful in the local to regional context. Examples from Eritrea and Ethiopia are used in this paper 'to illustrate the practicability of SDA for development planning and implementation.

Implications of the sustainable development paradigm for Switzerland

The sustainable development paradigm raises issues of global, intra- and intergenerational social equity as well as respect for nature, and economic welfare. Switzerland is confronted by these issues within its own country, and has a moral responsibility vis-a-vis the rest of the world. Syndromes of global change are affecting many eco-regions, not only in developing and transition countries, but to a lesser extent also the affluent countries. Switzerland as a nation has an impact on syndromes through its far-reaching economic activities, which are non-sustainable. At the global level, more modest consumption patterns, a considerably slowed demographic change, a nonconsumptive but sustainable use of natural resources, and conflict transformation are the main prerequisites for improving sustainability. Switzerland's current contribution to sustainability is much less than what it could be, hence the need for additional action along general principles in,accordance with Swiss traditions and innovative potentials. A number of concrete actions could be taken immediately. These are: labelling the socially and ecologically sustainable production of goods and services, and their negotiation at WTO level; enhancing international cooperation and research; strengthening education and research for sustainability, and emphasizing energy and material flux efficiency at home and abroad.

The utility of rapid participatory appraisal for community assessment, diagnosis, and policy development

The selection of a model to guide the understanding and resolution of community problems is an important issue relating to the foundation of public health practice: assessment, policy development, and assurance. Many assessment models produce a diagnosis of community weaknesses, but fail to promote planning and interventions. Rapid Participatory Appraisal (RPA) is a participatory action research model which regards assessment as the first step in the problem solving process, and claims to achieve assessment and policy development within limited resources of time and money. Literature documenting the fulfillment of these claims, and thereby supporting the utility of the model, is relatively sparse and difficult to obtain. Very few articles discuss the changes resulting from RPA assessments in urban areas, and those that do describe studies conducted outside the U.S.A. ^ This study examines the utility of the RPA model and its underlying theories: systems theory, grounded theory, and principles of participatory change, as illustrated by the case study of a community assessment conducted for the Texas Diabetes Institute (TDI), San Antonio, Texas, and subsequent outcomes. Diabetes has a high prevalence and is a major issue in San Antonio. Faculty and students conducted the assessment by informal collaboration between two nursing and public health assessment courses, providing practical student experiences. The study area was large, and the flexibility of the model tested by its use in contiguous sub-regions, reanalyzing aggregated results for the study area. Official TDI reports, and a mail survey of agency employees, described policy development resulting from community diagnoses revealed by the assessment. ^ The RPA model met the criteria for utility from the perspectives of merit, worth, efficiency, and effectiveness. The RPA model best met the agencies' criteria (merit), met the data needs of TDI in this particular situation (worth), provided valid results within budget, time, and personnel constraints (efficiency), and stimulated policy development by TDI (effectiveness). ^ The RPA model appears to have utility for community assessment, diagnosis, and policy development in circumstances similar to the TDI diabetes study. ^

A summative evaluation of a HIV/AIDS Early Childhood Care, Education and Development Teacher Training Workshop in Mongu, Zambia

Objective. To conduct a summative evaluation of an Early Childhood Care, Education and Development (ECCED) Teacher Training Workshop in Mongu, Zambia by assessing changes in knowledge, attitudes and intent to use the information. ^ Study design. A matched cohort survey design was used with additional qualitative data collected by structured observation of workshop sessions, daily facilitator and participant debriefs and participant interviews. ^ Results. Matching pre and post tests were completed by 27 individuals in addition to daily debriefs, structured workshop observation and participant interviews with 22% of the group. The participant population was predominantly female individuals aged 15-44 years old that had completed high school and additional post-secondary training, been teaching children aged 0 – 8 years for 2-5 years in the Western Province and received other HIV/AIDS and ECCED education. Pre-tests indicated a strong understanding of ECCED principles and misconceptions regarding HIV transmission, prevention and the disease's impact on early childhood development. The workshop was found to significantly increase the participants' knowledge of topics covered by the curriculum (paired t-test, N=27, p = 0.004, 95% CI 1.8, 8.6). Participants began with a more limited understanding of HIV/AIDS than ECCED, but the mean gain was much greater at 7.4 +/- 12.3 points. Significantly more participants believed at post-test that HIV/AIDS education should increase for future educators. The 77.8% of participants that increased their knowledge scores at post-test expressed significantly less fear of having a child with HIV/AIDS in the classroom (Independent Samples t-test, N= 27, p = 0.011). Overall participant fear decreased 15.5%. 92.6% and 88.9% of participants planned at post-test to respectively use and share the taught information in their daily professional lives and reported on innovative strategies to communicate with the community. ^ Conclusions. Teacher training workshops can significantly increase HIV/AIDS awareness and promote positive attitudes in educators working with children affected by HIV/AIDS. Using participant suggested teaching techniques such as poems and songs and translating the materials to the local language could assist future facilitators to both culturally and professionally relate to the workshop audience as well as increase participant capacity to share the information with the local community. ^

Development and institutionalization of communitarian thought in Thailand

In Thailand, communitarian ideas have been widely accepted and even institutionalized as a principle of national development plans and the Constitution of Thailand. This paper examines how and why the communitarian body of thought, described as "community culture thought," and originally created and shared within a small circle of social activists and academics in the early 1980s, came to be disseminated and authorized in Thai society. Contributors and participants, ways of expression, and avenues for disseminating this paradigm are the main topics in this paper. The paper reveals that these thoughts and concepts have been diversified and used as guiding principles by state elites, anti-state activists, and social reformists since the late 1980s. These people with such different political ideologies were connected through some key individuals. These critical connections networked them onto the same side for promoting communitarian thought in Thailand. When such leading advocates assumed key political positions, it was easy for them to push communitarian ideas into the guidelines and principles of state administration.

Development of Interactive Materials by Engineering Students Using the Descartes Applets.

In a degree course such as Forestry Engineering, the general teaching objectives consist of explaining and helping students to understand the principles of Mechanics. For some time now we have encountered significant difficulties in teaching this subject due to the students' lack of motivation and to their insufficient prior preparation for the topic. If we add to this the discipline's inherent complexity and the students' preconceptions about the subject, these teaching difficulties become considerable. For this reason a series of didactic activities have been introduced sequentially in the teaching of this subject. This work describes the methodology, procedure and results for the action of developing a work project in groups using Descartes software. The results of this experiment can be considered very positive. Some of the critical preconceptions for learning the subject can be corrected, and the tutoring process in the classroom contributes to an improvement in teacherstudent communication. Since this scheme was established, the number of students taking part each academic year has increased, and this is the group with the greatest percentage of passing scores.

Sustainable Air Traffic Management System Development Methodology

As it is defined in ATM 2000+ Strategy (Eurocontrol 2001), the mission of the Air Traffic Management (ATM) System is: “For all the phases of a flight, the ATM system should facilitate a safe, efficient, and expedite traffic flow, through the provision of adaptable ATM services that can be dimensioned in relation to the requirements of all the users and areas of the European air space. The ATM services should comply with the demand, be compatible, operate under uniform principles, respect the environment and satisfy the national security requirements.” The objective of this paper is to present a methodology designed to evaluate the status of the ATM system in terms of the relationship between the offered capacity and traffic demand, identifying weakness areas and proposing solutions. The first part of the methodology relates to the characterization and evaluation of the current system, while a second part proposes an approach to analyze the possible development limit. As part of the work, general criteria are established to define the framework in which the analysis and diagnostic methodology presented is placed. They are: the use of Air Traffic Control (ATC) sectors as analysis unit, the presence of network effects, the tactical focus, the relative character of the analysis, objectivity and a high level assessment that allows assumptions on the human and Communications, Navigation and Surveillance (CNS) elements, considered as the typical high density air traffic resources. The steps followed by the methodology start with the definition of indicators and metrics, like the nominal criticality or the nominal efficiency of a sector; scenario characterization where the necessary data is collected; network effects analysis to study the relations among the constitutive elements of the ATC system; diagnostic by means of the “System Status Diagram”; analytical study of the ATC system development limit; and finally, formulation of conclusions and proposal for improvement. This methodology was employed by Aena (Spanish Airports Manager and Air Navigation Service Provider) and INECO (Spanish Transport Engineering Company) in the analysis of the Spanish ATM System in the frame of the Spanish airspace capacity sustainability program, although it could be applied elsewhere.

Building lean thinking in a telecom software development organization: strengths and challenges.

The potential shown by Lean in different domains has aroused interest in the software industry. However, it remains unclear how Lean can be effectively applied in a domain such as software development that is fundamentally different from manufacturing. This study explores how Lean principles are implemented in software development companies and the challenges that arise when applying Lean Software Development. For that, a case study was conducted at Ericsson R&D Finland, which successfully adopted Scrum in 2009 and subsequently started a comprehensible transition to Lean in 2010. Focus groups were conducted with company representatives to help devise a questionnaire supporting the creation of a Lean mindset in the company (Team Amplifier). Afterwards, the questionnaire was used in 16 teams based in Finland, Hungary and China to evaluate the status of the transformation. By using Lean thinking, Ericsson R&D Finland has made important improvements to the quality of its products, customer satisfaction and transparency within the organization. Moreover, build times have been reduced over ten times and the number of commits per day has increased roughly five times.The study makes two main contributions to research. First, the main factors that have enabled Ericsson R&D?s achievements are analysed. Elements such as ?network of product owners?, ?continuous integration?, ?work in progress limits? and ?communities of practice? have been identified as being of fundamental importance. Second, three categories of challenges in using Lean Software Development were identified: ?achieving flow?, ?transparency? and ?creating a learning culture?

Technological development in Spanish gothic vaults design

The principle of complexity as the evolution vector of the gothic style was an idea largely developed by Paul Frankl. The high complexity reached in the 15th and 16th centuries was possible thanks to the geometrical resources developed in the workshops of the medieval stonemasons. The search for more sophisticated designs was possible also with the higher standardization, so that the most complex ribbed vault could be built with ribs that had all the same curvature and with voussoirs that were therefore identical. Spanish Gothic architecture has been deeply studied from a historical and artistic point of view. The present paper, as a complement to these analyses, aims to point out some of the geometrical methods and technological improvements that late medieval masons were able to develop. In that way, some selected vaults have been measured, in order to study their geometry and design process. Also scale models of some vaults have been built at the Escuela de Arquitectura (Madrid) to validate these geometrical principles. More than just a research method, the scale models allow to understand the medieval construction techniques, and they are a powerful pedagogical tool with which pupils can reach a rewarding experience based on the “medieval-way” praxis.

Supporting the design and development of Project Based Learning courses.

The use of Project Based Learning has spread widely over the last decades, not only throughout countries but also among disciplines. One of the most significant characteristics of this methodology is the use of ill-structured problems as central activity during the course, which represents an important difficulty for both teachers and students. This work presents a model, supported by a tool, focused on helping teachers and students in Project Based Learning, overcoming these difficulties. Firstly, teachers are guided in designing the project following the main principles of this methodology. Once the project has been specified at the desired level of depth, the same tool helps students to finish the project specification and organize the implementation. Collaborative work among different users is allowed in both phases. This tool has been satisfactorily tested designing two real projects used in Computer Engineering and Software Engineering degrees.

LDP4j: a framework for the development of interoperable read-write linked data applications

Enterprises are increasingly using a wide range of heterogeneous information systems for executing and governing their business activities. Even if the adoption of service orientation has improved loose coupling and reusability, applications are still isolated data silos whose integration requires complex transformations and mediations. However, by leveraging Linked Data principles those data silos can now be seamlessly integrated, and this opens the door to new data-driven approaches for Enterprise Application Integration (EAI). In this paper we present LDP4j, an open souce Java-based framework for the development of interoperable read-write Linked Data applications, based on the W3C Linked Data Platform (LDP) specification.

Integrated Water Resources Management: Principles for Coordination in the Coal River Watershed, West Virginia

Mountaintop removal (MTR) coal mining has had a significant influence on the water sources within the Coal River watershed of West Virginia. Using an approach such as Integrated Water Resources Management (IWRM) may improve management for the long-term protection and sustainability of the Coal River watershed‰Ûªs water resources. This Capstone project analyzes current site-specific information related to water quality and quantity and the impacts of MTR in the region, reviews current management challenges, and identifies key stakeholders to be included in IWRM planning. This information provided a foundation for the development of a preliminary IWRM coordination plan for the Coal River watershed based on IWRM principles and guidelines. It is hoped that this preliminary plan will contribute to the development of a final coordinated IWRM plan.

Robotic control systems based on bioinspired multi-agent systems: application of the principles of neuroscience to robotics

Robotics is a field that presents a large number of problems because it depends on a large number of disciplines, devices, technologies and tasks. Its expansion from perfectly controlled industrial environments toward open and dynamic environment presents a many new challenges, such as robots household robots or professional robots. To facilitate the rapid development of robotic systems, low cost, reusability of code, its medium and long term maintainability and robustness are required novel approaches to provide generic models and software systems who develop paradigms capable of solving these problems. For this purpose, in this paper we propose a model based on multi-agent systems inspired by the human nervous system able to transfer the control characteristics of the biological system and able to take advantage of the best properties of distributed software systems.