A simulação como método de ensino de habilidades no curso de medicina: relato de uma experiência com punção lombar

The teaching of the lumbar puncture (LP) technique with simulator is not well systematized in the curricula of medical schools. Studies show that training in the simulator provides learning technical skills, acquisition and retention of knowledge, improve self-confidence of the learner and enables the transfer to clinical practice. We intend this study to introduce simulated training in LP in medical course at the Universidade Federal do Rio Grande do Norte evaluating the experience taking into account quantitative aspects (performance on standardized tests) and qualitative (perception of the students regarding the method and the teaching process learning). The study was conducted in two phases. In the first phase practical training in PL was introduced in the 3rd year of medical school. Seventy-seven students were trained in small groups, guided by a checklist developed in the model Objective Structured Assessment of Technical Skill (OSATS), at this moment they knew they were not under performance evaluation. They were also asked whether they had prior chances to make an LP in patients. At the end of the first phase the students evaluated training in the following areas: teaching technique, simulator realism, time available per group, number of participants per group and relevance to medical practice. In the second phase, two years later, 18 students trained in first stage performed a new LP on the mannequin simulator, and its performance was evaluated through the same checklist of training in order to verify the technical retention. In addition, they answered a multiple choice test about practical aspects of the LP technique. Each participant received individual feedback on their performance at the end of their participation in the study. In the first phase of the study we found that only 4% of students had performed a lumbar puncture in patients until the 3rd year. The training of LP technique with simulator mannequin was considered relevant and the teaching methods was thoroughly evaluated. In the second phase, all participants were successful in implementing the lumbar puncture on the mannequin simulator, compliance with the most steps in a reasonable time, suggesting that would be able to perform the procedure in a patient.

An alternative to BlackboardTM? Student use of web-based textbook teaching and learning material

This paper investigates the use of web-based textbook supplementary teaching and learning materials which include multiple choice test banks, animated demonstrations, simulations, quizzes and electronic versions of the text. To gauge their experience of the web-based material students were asked to score the main elements of the material in terms of usefulness. In general it was found that while the electronic text provides a flexible platform for presentation of material there is a need for continued monitoring of student use of this material as the literature suggests that digital viewing habits may mean there is little time spent in evaluating information, either for relevance, accuracy or authority. From a lecturer perspective these materials may provide an effective and efficient way of presenting teaching and learning materials to the students in a variety of multimedia formats, but at this stage do not overcome the need for a VLE such as Blackboard™.

To what extent does the Health Professions Admission Test-Ireland predict performance in early undergraduate tests of communication and clinical skills? – An observational cohort study

Background: Internationally, tests of general mental ability are used in the selection of medical students. Examples include the Medical College Admission Test, Undergraduate Medicine and Health Sciences Admission Test and the UK Clinical Aptitude Test. The most widely used measure of their efficacy is predictive validity.A new tool, the Health Professions Admission Test- Ireland (HPAT-Ireland), was introduced in 2009. Traditionally, selection to Irish undergraduate medical schools relied on academic achievement. Since 2009, Irish and EU applicants are selected on a combination of their secondary school academic record (measured predominately by the Leaving Certificate Examination) and HPAT-Ireland score. This is the first study to report on the predictive validity of the HPAT-Ireland for early undergraduate assessments of communication and clinical skills. Method. Students enrolled at two Irish medical schools in 2009 were followed up for two years. Data collected were gender, HPAT-Ireland total and subsection scores; Leaving Certificate Examination plus HPAT-Ireland combined score, Year 1 Objective Structured Clinical Examination (OSCE) scores (Total score, communication and clinical subtest scores), Year 1 Multiple Choice Questions and Year 2 OSCE and subset scores. We report descriptive statistics, Pearson correlation coefficients and Multiple linear regression models. Results: Data were available for 312 students. In Year 1 none of the selection criteria were significantly related to student OSCE performance. The Leaving Certificate Examination and Leaving Certificate plus HPAT-Ireland combined scores correlated with MCQ marks.In Year 2 a series of significant correlations emerged between the HPAT-Ireland and subsections thereof with OSCE Communication Z-scores; OSCE Clinical Z-scores; and Total OSCE Z-scores. However on multiple regression only the relationship between Total OSCE Score and the Total HPAT-Ireland score remained significant; albeit the predictive power was modest. Conclusion: We found that none of our selection criteria strongly predict clinical and communication skills. The HPAT- Ireland appears to measures ability in domains different to those assessed by the Leaving Certificate Examination. While some significant associations did emerge in Year 2 between HPAT Ireland and total OSCE scores further evaluation is required to establish if this pattern continues during the senior years of the medical course.

Next generation e-learning platform: virtual laboratory simulations

Bioscience subjects require a significant amount of training in laboratory techniques to produce highly skilled science graduates. Many techniques which are currently used in diagnostic, research and industrial laboratories require expensive equipment for single users; examples of which include next generation sequencing, quantitative PCR, mass spectrometry and other analytical techniques. The cost of the machines, reagents and limited access frequently preclude undergraduate students from using such cutting edge techniques. In addition to cost and availability, the time taken for analytical runs on equipment such as High Performance Liquid Chromatography (HPLC) does not necessarily fit with the limitations of timetabling. Understanding the theory underlying these techniques without the accompanying practical classes can be unexciting for students. One alternative from wet laboratory provision is to use virtual simulations of such practical which enable students to see the machines and interact with them to generate data. The Faculty of Science and Technology at the University of Westminster has provided all second and third year undergraduate students with iPads so that these students all have access to a mobile device to assist with learning. We have purchased licences from Labster to access a range of virtual laboratory simulations. These virtual laboratories are fully equipped and require student responses to multiple answer questions in order to progress through the experiment. In a pilot study to look at the feasibility of the Labster virtual laboratory simulations with the iPad devices; second year Biological Science students (n=36) worked through the Labster HPLC simulation on iPads. The virtual HPLC simulation enabled students to optimise the conditions for the separation of drugs. Answers to Multiple choice questions were necessary to progress through the simulation, these focussed on the underlying principles of the HPLC technique. Following the virtual laboratory simulation students went to a real HPLC in the analytical suite in order to separate of asprin, caffeine and paracetamol. In a survey 100% of students (n=36) in this cohort agreed that the Labster virtual simulation had helped them to understand HPLC. In free text responses one student commented that "The terminology is very clear and I enjoyed using Labster very much”. One member of staff commented that “there was a very good knowledge interaction with the virtual practical”.

Perception of Filtered Speech by Children with Developmental Dyslexia and Children with Specific Language Impairments

Here we use two filtered speech tasks to investigate children’s processing of slow (<4 Hz) versus faster (∼33 Hz) temporal modulations in speech. We compare groups of children with either developmental dyslexia (Experiment 1) or speech and language impairments (SLIs, Experiment 2) to groups of typically-developing (TD) children age-matched to each disorder group. Ten nursery rhymes were filtered so that their modulation frequencies were either low-pass filtered (<4 Hz) or band-pass filtered (22 – 40 Hz). Recognition of the filtered nursery rhymes was tested in a picture recognition multiple choice paradigm. Children with dyslexia aged 10 years showed equivalent recognition overall to TD controls for both the low-pass and band-pass filtered stimuli, but showed significantly impaired acoustic learning during the experiment from low-pass filtered targets. Children with oral SLIs aged 9 years showed significantly poorer recognition of band pass filtered targets compared to their TD controls, and showed comparable acoustic learning effects to TD children during the experiment. The SLI samples were also divided into children with and without phonological difficulties. The children with both SLI and phonological difficulties were impaired in recognizing both kinds of filtered speech. These data are suggestive of impaired temporal sampling of the speech signal at different modulation rates by children with different kinds of developmental language disorder. Both SLI and dyslexic samples showed impaired discrimination of amplitude rise times. Implications of these findings for a temporal sampling framework for understanding developmental language disorders are discussed.

Applied behavior analysis: What do teachers of students with autism spectrum disorder know?

With rising numbers of school-aged children with autism educated in mainstream classroomsand applied behavior analysis (ABA) considered the basis of best practice, teachers’ knowledgein this field has become a key concern for inclusion. Self-reported knowledge of ABA of specialneeds teachers (n=165) was measured and compared to their actual knowledge of ABAdemonstrated in accurate responses to a multiple-choice test. Findings reported here show thatteachers’ self-perceived knowledge exceeded actual knowledge and that actual knowledge ofABA was not

Is Our Students Learning - QuestionMark: Extending E-Assessment Systems for Adapative Marking and Feedback

Our key contribution is a flexible, automated marking system that adds desirable functionality to existing E-Assessment systems. In our approach, any given E-Assessment system is relegated to a data-collection mechanism, whereas marking and the generation and distribution of personalised per-student feedback is handled separately by our own system. This allows content-rich Microsoft Word feedback documents to be generated and distributed to every student simultaneously according to a per-assessment schedule.

The feedback is adaptive in that it corresponds to the answers given by the student and provides guidance on where they may have gone wrong. It is not limited to simple multiple choice which are the most prescriptive question type offered by most E-Assessment Systems and as such most straightforward to mark consistently and provide individual per-alternative feedback strings. It is also better equipped to handle the use of mathematical symbols and images within the feedback documents which is more flexible than existing E-Assessment systems, which can only handle simple text strings.

As well as MCQs the system reliably and robustly handles Multiple Response, Text Matching and Numeric style questions in a more flexible manner than Questionmark: Perception and other E-Assessment Systems. It can also reliably handle multi-part questions where the response to an earlier question influences the answer to a later one and can adjust both scoring and feedback appropriately.

New question formats can be added at any time provided a corresponding marking method conforming to certain templates can also be programmed. Indeed, any question type for which a programmatic method of marking can be devised may be supported by our system. Furthermore, since the student’s response to each is question is marked programmatically, our system can be set to allow for minor deviations from the correct answer, and if appropriate award partial marks.

Investigating high-achieving sixth grade students' erroneous answers on the angle concept in Yozgat

The angle concept is a multifaceted concept having static and dynamic definitions. The static definition of the angle refers to “the space between two rays” or “the intersection of two rays at the same end point” (Mitchelmore & White, 1998), whereas the dynamic definition of the angle concept highlights that the size of angle is the amount of rotation in direction (Fyhn, 2006). Since both definitions represent two diverse situations and have unique limitations (Henderson & Taimina, 2005), students may hold misconceptions about the angle concept. In this regard, the aim of this research was to explore high achievers’ knowledge regarding the definition of the angle concept as well as to investigate their erroneous answers on the angle concept.

104 grade 6 students drawn from four well-established elementary schools of Yozgat, Turkey were participated in this research. All participants were selected via a purposive sampling method and their mathematics grades were 4 or 5 out of 5, and. Data were collected through four questions prepared by considering the learning competencies set out in the grade 6 curriculum in Turkey and the findings of previous studies whose purposes were to identify students’ misconceptions of the angle concept. The findings were analyzed by two researchers, and their inter-rater agreement was calculated as 0.91, or almost perfect. Thereafter, coding discrepancies were resolved, and consensus was established.

The angle concept is a multifaceted concept having static and dynamic definitions.The static definition of the angle refers to “the space between two rays” or“the intersection of two rays at the same end point” (Mitchelmore & White, 1998), whereas the dynamicdefinition of the angle concept highlights that the size of angle is the amountof rotation in direction (Fyhn, 2006). Since both definitionsrepresent two diverse situations and have unique limitations (Henderson & Taimina, 2005), students may holdmisconceptions about the angle concept. In this regard, the aim of thisresearch was to explore high achievers’ knowledge regarding the definition ofthe angle concept as well as to investigate their erroneous answers on theangle concept.

A literature review to Examine the Validity and Reliability of group poster presentations as an assessment method of a module in an undergraduate nursing degree programme

The introduction of a poster presentation as a formative assessment method over a multiple choice examination after the first phase of a three phase “health and well-being” module in an undergraduate nursing degree programme was greeted with a storm of criticism from fellow lecturers stating that poster presentations are not valid or reliable and totally irrelevant to the assessment of learning in the module. This paper seeks to investigate these criticisms by investigating the literature regarding producing nurses fit for practice, nurse curriculum development and wider nurse education, the purpose of assessment, validity and reliability to critically evaluate the poster presentation as a legitimate assessment method for these aims.

Assessing the Role of Vocabulary Breadth and Depth in Reading Comprehension: A Quantitative Study of Finnish EFL Learners

In this MA thesis, Finnish learners of English were studied in order to examine the relationship between second language vocabulary size, vocabulary depth, and reading comprehension. In addition, given the well-established connection between vocabulary size and reading comprehension, the second aim of the study was to see whether assessing vocabulary depth could add another dimension in predicting and explaining reading comprehension proficiency. Two groups were studied: the first group consisted of 39 Finnish upper secondary school students (the TOKA group) whereas the second group consisted of 19 university students of English at the University of Turku (the YLI group). Thus, comparisons were made between the results of a less advanced and a very advanced group of English learners, which was the third aim of the study. The participants in both groups filled in a background information form and took three tests: a multiple-choice reading comprehension test, a multiple-choice vocabulary size test, and a test designed to elicit information on learners’ depth of vocabulary knowledge of certain English words. The data were analysed using statistical methods. The results of the study show that the scores on the three tests were positively correlated in both study groups as well as in the two groups together. However, the correlations were higher in the TOKA group and in the two groups in total than in the YLI group. When examining the variance in reading comprehension test scores explained by vocabulary size and vocabulary depth, the figures of explained variance were again higher in the TOKA group and in the two groups in total than in the YLI group. When it comes to the results of the YLI group, vocabulary depth did not indeed seem to add any explained variance into the explanation of reading comprehension test scores. Based on the results of the study, it seems that vocabulary size and depth have a less significant role in the reading comprehension skills of more advanced learners of English. When looking at the less advanced TOKA group, on the other hand, vocabulary size and depth seem to be clear indicators of reading proficiency. In addition, the test results of the YLI group were clearly more uniform than those of the TOKA group. The variance in the test results of the TOKA group was large.

Growing Well-beings: the Positive Experience of Care Farms

Objectives: Care farms enable people who are in some way vulnerable to engage with agricultural places and farming activities. This study investigates how this impacts on the health and well-being of service users and explores associated processes and outcomes. Design: A mixed methods design was adopted that allowed for the integration of quantitative measurements of change with qualitative descriptions of this change. A pragmatic approach provided sufficient flexibility to support the investigation of complex contexts. Methods: A total of 216 service users completed an initial questionnaire, and 137 (63%) of this number provided comparative data in a follow-up questionnaire. Questionnaires contained multiple choice and open-ended questions alongside standardized health and well-being measures requiring Likert-format responses. Semi-structured interviews with 33 service users allowed personal experiences to be detailed. Results: Statistical analysis of well-being measure scores identified significant positive relationships with the length of time people had been attending the care farm. Questionnaire and interview data presented health benefits as being enabled by the farm environment, the positive experience as supporting personal development, and associated social interactions as becoming increasingly influential as time progressed. Conclusions: The health and well-being outcomes that result from participating at a care farm influence multiple elements of the human condition and apply amongst vulnerable people with a wide range of personal needs. Care farms have access to a potentially unique range of resources that can support many service users in becoming happier and healthier individuals.

Clickers versus hand-raising in the physics college classroom : do clickers make a difference?

Abstract: Students who are actively involved in the learning process tend to develop deeper knowledge than those in traditional lecture classrooms (Beatty, 2007; Crouch & Mazur, 2001; Hake, 1998; Richardson, 2003). An instructional strategy that promotes active involvement is Peer Instruction. This strategy encourages student engagement by asking them to respond to conceptual multiple-choice questions intermittently throughout the lecture. These questions can be responded to by using an electronic hand-held device commonly known as a clicker that enables students’ responses to be displayed on a screen. When clickers are not available, a show of hands or other means can be used. The literature suggests that the impact on student learning is the same, whether the teacher uses clickers or simply asks students to raise their hand or use flashcards when responding to the questions (Lasry, 2007). This critical analysis argues that using clickers to respond to these in-class conceptual multiple-choice questions as opposed to using a show of hands leads to deeper conceptual understanding, better performance on tests, and greater overall enjoyment during class.||Résumé: Les étudiants qui sont activement impliqués dans le processus d'apprentissage ont tendance à développer des connaissances plus approfondies que lors de cours traditionnels (Beatty, 2007; Crouch & Mazur, 2001; Hake, 1998; Richardson, 2003). Une stratégie d'enseignement qui favorise la participation active est l’apprentissage par les pairs. Cette stratégie d’enseignement encourage l'engagement des élèves en leur demandant de répondre à des questions à choix multiples conceptuelles à plusieurs reprises durant le déroulement du cours. Ces questions peuvent être répondues à l'aide d'un appareil portatif électronique (un « clicker ») qui permet d’afficher de façon anonyme les réponses des élèves sur un écran. Si les clickers ne sont pas disponibles, les étudiants peuvent aussi répondre aux questions en levant la main. La littérature suggère que la méthode utilisée n’a pas d’impact sur l'apprentissage des élèves, que l'enseignant utilise des clickers, des flashcards ou qu’il demande simplement aux élèves de lever la main pour répondre aux questions (Lasry, 2007). Cette analyse critique fait valoir que l'utilisation de clickers pour répondre à ces questions à choix multiples conceptuelles en classe, plutôt que de faire lever la main aux étudiants, résulte en une compréhension conceptuelle plus approfondie, une meilleure performance aux examens et plus de plaisir pendant les cours.

Special Issues in the Young and Pregnant Patient with Breast Cancer

This chapter presents a series of multiple choice questions and answers on the special issues in the young and pregnant patient with breast cancer. It also presents a series of case studies with questions and answers on the special issues in the young and pregnant patient with breast cancer. The chapter examines whether the genomic testing by Oncotype DX or MammaPrint be helpful in managing the patient. It also examines the factors that are the most important in determining the risk of chemotherapyinduced amenorrhea (CIA) in the patient, and a role for sentinel lymph node biopsy (SLNB) in patients diagnosed with breast cancer during pregnancy. The chapter discusses counselling of a patient who became accidentally pregnant on maintenance therapy with trastuzumab or tamoxifen. In addition, It examines the options that could be offered to preserve fertility.

Análise dos fatores que influenciam os estudantes na seleção da Instituição de Ensino Superior no Estado do Rio Grande do Sul - Brasil

Esta dissertação de mestrado busca analisar os fatores que influenciam os estudantes na seleção do Instituto de Ensino Superior no Estado do Rio Grande do Sul – Brasil. Como problemática, buscou-se analisar o que motiva os alunos do ensino superior na hora de definir a instituição de ensino? O estudo apresentou como objetivo conhecer os fatores influenciadores na região do estudo. Foi utilizado abordagem exploratória e descritiva na qual buscou-se conhecer o assunto e posterior geração de hipóteses. Já a pesquisa descritiva complementou o estudo pois tem o objetivo de descrever as características de uma população e estabelecer a relação entre as variáveis no objeto de estudo analisado. Estima-se uma população de aproximadamente 378.000 alunos matriculados divididos em 131 estabelecimentos de ensino superior, caracterizadas na categoria privada e pública, com organização acadêmica de faculdade, centro universitário, universidade e instituto federal de educação, ciência e tecnologia. Para a coleta de dados foi utilizado um instrumento de pesquisa disponível online, onde foi criado 15 questões de múltiplas escolhas, mais 4 blocos de questões para identificação dos fatores onde se abordou áreas como ensino, instalações, serviços e influências, totalizando 19 questões. Como técnica de estatística de amostragem, utilizou-se o modelo “bola de neve”, em que, após enviado o questionário para o responsável da instituição de ensino superior era repassado aos demais para participação. A população alcançada foi de 423 questionários respondidos por alunos residentes em 49 municípios do Estado. Constatou-se que fatores como qualidade do ensino, capacidade de transmissão do conhecimento por parte dos docentes, corpo docente qualificado, empregabilidade ou reconhecimento do diploma no mercado como também infraestrutura das salas de aulas, laboratórios e bibliotecas, conectividade, segurança física, limpeza e visita as instalações são fatores predominantemente importantes no momento da seleção da instituição de ensino.

3D-grafiikan selaintekniikat, erikoistapauksena karttasovellukset

Harava on karttapohjainen kyselypalvelu, jonka avulla voidaan kerätä tietoa erilaisista kyselykohteista. Harava-kyselypalvelussa kyselyihin voidaan vastata muun muassa tekstikentillä, monivalinnoilla ja merkitsemällä alueita ja pisteitä karttapohjaan. Tutkielman tavoitteena oli löytää Harava-kyselypalvelun 2D-karttojen rinnalle 3D-karttavaihtoehto. Aluksi tutkittiin, mitä eri vaihtoehtoja löytyy 3D-komponenttien esittämiseen selaimessa. Tutkituista vaihtoehdoista parhaimmaksi tähän tarkoitukseen osoittautui WebGL-kirjasto. WebGL-kirjaston käyttö suoraan osoittautui vaikeaksi, joten etsittiin rajapintaa, jonka avulla WebGL-kirjaston käyttö helpottuisi. Käsittelyyn otettiin karttapalveluita sekä 3D-mallien esittämiseen tarkoitettuja JavaScript-kirjastoja, jotka käyttävät WebGL-kirjastoa rajapinnan kautta. Näistä sopivimmaksi osoittautui Cesium. Cesium on JavaScript-kirjasto, jonka avulla voidaan toteuttaa 2D-kartta ja 3D-karttapallo sekä upottaa karttapohjaan 3D-elementtejä.