A pilot study of orthopaedic resident self-assessment using a milestones' survey just prior to milestones implementation.

OBJECTIVE: To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education. METHODS: In June 2012, an email was sent to Program Directors and administrative coordinators of the 154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. RESULTS: Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible. Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. CONCLUSIONS: Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents' rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones. Milestone self-assessment may be a useful tool as one component of a program's overall performance assessment strategy.

Integrated Construction Project Delivery System in the U.S. Public Sector: An Information Modeling Framework

Integrated project delivery (IPD) method has recently emerged as an alternative to traditional delivery methods. It has the potential to overcome inefficiencies of traditional delivery methods by enhancing collaboration among project participants. Information and communication technology (ICT) facilitates IPD by effective management, processing and communication of information within and among organizations. While the benefits of IPD, and the role of ICT in realizing them, have been generally acknowledged, the US public construction sector is very slow in adopting IPD. The reasons are - lack of experience and inadequate understanding of IPD in public owner as confirmed by the results of the questionnaire survey conducted under this research study. The public construction sector should be aware of the value of IPD and should know the essentials for effective implementation of IPD principles - especially, they should be cognizant of the opportunities offered by advancements in ICT to realize this. In order to address the need an IPD Readiness Assessment Model (IPD-RAM) was developed in this research study. The model was designed with a goal to determine IPD readiness of a public owner organization considering selected IPD principles, and ICT levels, at which project functions were carried out. Subsequent analysis led to identification of possible improvements in ICTs that have the potential to increase IPD readiness scores. Termed as the gap identification, this process was used to formulate improvement strategies. The model had been applied to six Florida International University (FIU) construction projects (case studies). The results showed that the IPD readiness of the organization was considerably low and several project functions can be improved by using higher and/or advanced level ICT tools and methods. Feedbacks from a focus group comprised of FIU officials and an independent group of experts had been received at various stages of this research and had been utilized during development and implementation of the model. Focus group input was also helpful for validation of the model and its results. It was hoped that the model developed would be useful to construction owner organizations in order to assess their IPD readiness and to identify appropriate ICT improvement strategies.

Design and Implementation of Tools for STM Studies in UHV and at the Solid-Liquid Interface

This thesis presents details of the design and development of novel tools and instruments for scanning tunneling microscopy (STM), and may be considered as a repository for several years' worth of development work. The author presents design goals and implementations for two microscopes. First, a novel Pan-type STM was built that could be operated in an ambient environment as a liquid-phase STM. Unique features of this microscope include a unibody frame, for increased microscope rigidity, a novel slider component with large Z-range, a unique wiring scheme and damping mechanism, and a removable liquid cell. The microscope exhibits a high level of mechanical isolation at the tunnel junction, and operates excellently as an ambient tool. Experiments in liquid are on-going. Simultaneously, the author worked on designs for a novel low temperature, ultra-high vacuum (LT-UHV) instrument, and these are presented as well. A novel stick-slip vertical coarse approach motor was designed and built. To gauge the performance of the motor, an in situ motion sensing apparatus was implemented, which could measure the step size of the motor to high precision. A new driving circuit for stick-slip inertial motors is also presented, that o ffers improved performance over our previous driving circuit, at a fraction of the cost. The circuit was shown to increase step size performance by 25%. Finally, a horizontal sample stage was implemented in this microscope. The build of this UHV instrument is currently being fi nalized. In conjunction with the above design projects, the author was involved in a collaborative project characterizing N-heterocyclic carbene (NHC) self-assembled monolayers (SAMs) on Au(111) films. STM was used to characterize Au substrate quality, for both commercial substrates and those manufactured via a unique atomic layer deposition (ALD) process by collaborators. Ambient and UHV STM was then also used to characterize the NHC/Au(111) films themselves, and several key properties of these films are discussed. During this study, the author discovered an unexpected surface contaminant, and details of this are also presented. Finally, two models are presented for the nature of the NHC-Au(111) surface interaction based on the observed film properties, and some preliminary theoretical work by collaborators is presented.

Estimating Dynamic Treatment Effects from Project STAR (Working Paper 36)

This paper considers the analysis of data from randomized trials which offer a sequence of interventions and suffer from a variety of problems in implementation. In experiments that provide treatment in multiple periods (T>1), subjects have up to 2^{T}-1 counterfactual outcomes to be estimated to determine the full sequence of causal effects from the study. Traditional program evaluation and non-experimental estimators are unable to recover parameters of interest to policy makers in this setting, particularly if there is non-ignorable attrition. We examine these issues in the context of Tennessee's highly influential randomized class size study, Project STAR. We demonstrate how a researcher can estimate the full sequence of dynamic treatment effects using a sequential difference in difference strategy that accounts for attrition due to observables using inverse probability weighting M-estimators. These estimates allow us to recover the structural parameters of the small class effects in the underlying education production function and construct dynamic average treatment effects. We present a complete and different picture of the effectiveness of reduced class size and find that accounting for both attrition due to observables and selection due to unobservable is crucial and necessary with data from Project STAR

An Examination of Current Approaches to Integrative Indigenous and Western Knowledge System Implementation in Water Research and Management: A Case Study Encompassing the Colonized Geographies of Canada, Australia, New Zealand, and the United States

The commodification of natural resources and the pursuit of continuous growth has resulted in environmental degradation, depletion, and disparity in access to these life-sustaining resources, including water. Utility-based objectification and exploitation of water in some societies has brought us to the brink of crisis through an apathetic disregard for present and future generations. The ongoing depletion and degradation of the world’s water sources, coupled with a reliance on Western knowledge and the continued omission of Indigenous knowledge to manage our relationship with water has unduly burdened many, but particularly so for Indigenous communities. The goal of my thesis research is to call attention to and advance the value and validity of using both Indigenous and Western knowledge systems (also known as Two-Eyed Seeing) in water research and management to better care for water. To achieve this goal, I used a combined systematic and realist review method to identify and synthesize the peer-reviewed, integrative water literature, followed by semi-structured interviews with first authors of the exemplars from the included literature to identify the challenges and insights that researchers have experienced in conducting integrative water research. Findings suggest that these authors recognize that many previous attempts to integrate Indigenous knowledges have been tokenistic rather than meaningful, and that new methods for knowledge implementation are needed. Community-based participatory research methods, and the associated tenets of balancing power, fostering trust, and community ownership over the research process, emerged as a pathway towards the meaningful implementation of Indigenous and Western knowledge systems. Data also indicate that engagement and collaborative governance structures developed from a position of mutual respect are integral to the realization of a given project. The recommendations generated from these findings offer support for future Indigenous-led research and partnerships through the identification and examination of approaches that facilitate the meaningful implementation of Indigenous and Western knowledge systems in water research and management. Asking Western science questions and seeking Indigenous science solutions does not appear to be working; instead, the co-design of research projects and asking questions directed at the problem rather than the solution better lends itself to the strengths of Indigenous science.

An implementation architecture for scenario-based simulations

The past years have witnessed an increased use of applied games for developing and evaluating communication skills. These skills benefit from in-terpersonal interactions. Providing feedback to students practicing communica-tion skills is difficult in a traditional class setting with one teacher and many students. This logistic challenge may be partly overcome by providing training using a simulation in which a student practices with communication scenarios. A scenario is a description of a series of interactions, where at each step the player is faced with a choice. We have developed a scenario editor that enables teachers to develop scenarios for practicing communication skills. A teacher can develop a scenario without knowledge of the implementation. This paper presents the implementation architecture for such a scenario-based simulation.

UK consensus project on quality in palliative day services: developing a quality indicator set using the RAND/UCLA appropriateness method

Introduction
Evaluating quality of palliative day services is essential for assessing care across diverse settings, and for monitoring quality improvement approaches.

Aim
To develop a set of quality indicators for assessment of all aspects (structure, process and outcome) of care in palliative day services.

Methods
Using a modified version of the RAND/UCLA appropriateness method (Fitch et al., 2001), a multidisciplinary panel of 16 experts independently completed a survey rating the appropriateness of 182 potential quality indicators previously identified during a systematic evidence review. Panel members then attended a one day, face-to-face meeting where indicators were discussed and subsequently re-rated. Panel members were also asked to rate the feasibility and necessity of measuring each indicator.

Results
71 indicators classified as inappropriate during the survey were removed based on median appropriateness ratings and level of agreement. Following the panel discussions, a further 60 were removed based on appropriateness and feasibility ratings, level of agreement and assessment of necessity. Themes identified during the panel discussion and findings of the evidence review were used to translate the remaining 51 indicators into a final set of 27.

Conclusion
The final indicator set included information on rationale and supporting evidence, methods of assessment, risk adjustment, and recommended performance levels. Further implementation work will test the suitability of this ‘toolkit’ for measurement and benchmarking. The final indicator set provides the basis for standardised assessment of quality across services, including care delivered in community and primary care settings.

Reference

• Fitch K, Bernstein SJ, Aguilar MD, et al. The RAND/UCLA Appropriateness Method User’s Manual. Santa Monica, CA: RAND Corporation; 2001. http://www.rand.org/pubs/monograph_reports/MR1269

Using AHP and the IPMA Competence Baseline in the project managers selection process

This paper proposes the joint use of the AHP (Analytic Hierarchy Process) and the ICB (IPMA Competence Baseline), as a tool for the decision-making process of selecting the most suitable managers for projects. A hierarchical structure, comprising the IPMA’s ICB 3.0 contextual, behavioural and technical competence elements, is constructed for the selection of project managers. It also describes the AHP implementation, illustrating the whole process with an example using all the 46 ICB competence elements as model criteria. This tool can be of high interest to decision-makers because it allows comparing the candidates for managing a project using a systematic and rigorous process with a rich set of proven criteria.

Evaluation, Selection and Planning the Implementation of a Pavement Management Optimization Model: Optimization Recommendations, 1994

This document briefly summarizes the pavement management activities under the existing Iowa Department of Transportation (DOT) Pavement Management System. The second part of the document provides projected increase in use due to the implementation of the Iowa DOT Pavement Management Optimization System. All estimates of existing time devoted to the Pavement Management System and project increases in time requirements are estimates made by the appropriate Iowa DOT office director or function manager. Included is the new Pavement Management Optimization Structure for the three main offices which will work most closely with the Pavement Management Optimization System (Materials, Design, and Program Management).

Evaluation, Selection and Planning the Implementation of a Pavement Management Optimization Model, Phase II Report, 1994

The missions of the research are to assist the Iowa Department of Transortation (Iowa DOT) to: Define pavement management (PM) optimization; Identify the characteristics of PM optimization systems being developed or implemented; Identify specific and achievable objectives for the Iowa DOT pavement management optimization; Evaluate different PM optimization methodologies; Identify a methodology to perform PM optimization that best satisfies the Iowa DOT's objectives; Develop a plan for the implementation of the PM optimization selected. The project is divided into three (3) phases. The first phase has been completed and accomplished the first three missions (identified above). The second phase has been completed and accomplished the next two missions. Phase three will accomplish the last mission.

European life project: a global strategy for the responsible use of a coastal lagoon: a case study from Portugal

Rin de Aveiro is a coastal lagoon located at the Central Region of Portugal subjected to the influence of the tides, resulting in a set of characteristic biotopes favouring anthropic and natural processes. Once managed and controlled correctly, each of these biotopes will allow simultaneously the biodiversity and integration in the making of the wetland landscape. In 1998, one of the final conclusions of the "MARIA" Demonstration Programme for the Integrated Management of Ria de Aveiro was that the poor current state of the environment area resulted from a set of interrelated factors. The Programme selected four (4) pilot-projects towards the integrated management of the lagoon biotopes as possible scenarios for an intervention. This selection was based in criteria related to environmental priorities and the maintenance of traditional economic activities in the region. The idea of choosing projects that would involve the whole geographic space of the Ria, without forgetting the other important themes interrelated with the Management Structure, emerged as a relevant aspect for their definition. Thus, and as a first test of this Management Structure functionality, the following task forces were put forward: Recovery and valorisation of the piers; Recovery of the former salt pans; Management of the agricultural fields of Baixo-Vouga; Implementation of measures for the classification of the Protected Landscape Area of the River Caster Mouth. This payer will report the main results of these pilot-projects attained during their first year period, especially the intervention strategies defined by the Partnership created for this aim.

Highway Location Reference Procedure Project, 1990

The purpose of the proposed Highway Location Reference Procedure is stated in the contract as follows: "Establishment of a highway network locational reference process that will primarily allow for the proper correlation of pavement management data, and secondarily provide the basis for other existing and future data base integration and for the planned Iowa DOT Geographic Information System. In addition, the locational reference process will be able to correlate network applications with a statewide spatial location method to facilitate the relationship of Iowa DOT data to that of other agencies and to allow for the graphic display of the network in map form." The Design Specifications and Implementation Plan, included in this Final Report, are intended to provide the basis for proceeding with immediate development and implementation of the pavement management system. These specifications will also support the future Iowa DOT implementation of other integrated data bases and/or the planned Geographic Information System.

Online Alpha Wave detector: an Embedded hardware-software implementation

The recent trend on embedded system development opens a new prospect for applications that in the past were not possible. The eye tracking for sleep and fatigue detection has become an important and useful application in industrial and automotive scenarios since fatigue is one of the most prevalent causes of earth-moving equipment accidents. Typical applications such as cameras, accelerometers and dermal analyzers are present on the market but have some inconvenient. This thesis project has used EEG signal, particularly, alpha waves, to overcome them by using an embedded software-hardware implementation to detect these signals in real time

NGL Project: Sub-project “Flipped Classroom” : Course “Organization Theory” (FÖ1039)

This paper is the final report from the NGL project implementing the flipped classroom approach into the undergraduate course "Organization Theory". The report describes the implementation and evaluates the outcomes of flipped classroom teaching/learning using the students' survey and statistics from YouTube analytics and the learning management platform Fronter.

An appraisal of adaptive management planning and implementation in ecological restoration: case studies from the San Francisco Bay Delta, USA

Adaptive management has been defined and redefined in the context of natural resource management, yet there are few examples of its successful application in ecological restoration. Although the 2009 Delta Reform Act now legally requires adaptive management for all restoration efforts in the Sacramento-San Joaquin Delta, in California, USA, projects in this region still encounter problems with implementation. We used a comparative case study analysis to examine adaptive management planning and implementation both in and around the Delta, assessing not only why adaptive management is not yet well implemented, but also what changes can be made to facilitate the adaptive management approach without sacrificing scientific rigor. Adaptive management seems to be directly and indirectly affected by a variety of challenges and convoluted by ambiguity in both planning documents and practitioner’s interpretations of the concept. Addressing these challenges and ambiguities at the project level may facilitate the adaptive management process and help make it more accessible to practitioners.