Structured training in intraosseous infusion to improve potentially life saving skills in pediatric emergencies - Results of an open prospective national quality development project over 3 years

BACKGROUND: Children in emergencies need peripheral intravenous (IV) access in order to receive drugs or fluids. The success of IV access is associated with the age of patients and fails in up to 50% of children younger than 6 years. In such situations, it is essential that physicians and paramedics have a tool and easily learnable skills with a high chance of success. According to international guidelines intraosseous (IO) access would be the next step after failed IV access. Our hypothesis was that the success rate in IO puncturing can be improved by standardizing the training; so we developed an IO workshop. METHODS: Twenty-eight hospitals and ambulance services participated in an evaluation process over 3 years. IO workshops and the distribution of standardized IO sets were coordinated by the study group of the University Hospital of Berne. Any attempted or successful IO punctures were evaluated with a standardized interview. RESULTS: We investigated 35 applications in 30 patients (a total of 49 punctures) between November 2001 and December 2004. IO puncture was not successful in 5 patients. The success rate depended neither on the occupation nor the experience of users. Attendance at a standardized IO workshop increased the overall success rate from 77% to 100%, which was statistically not significant (P = 0.074). CONCLUSIONS: Standardized training in IO puncturing seems to improve success more than previous experience and occupation of providers. However, we could not show a significant increase in success rate after this training. Larger supranational studies are needed to show a significant impact of teaching on rarely used emergency skills.

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

Development of multidisciplinary workshops between different subjects as an innovative teaching methodology for the acquisition of professional skills of the future architect

The implantation of the new Architecture Degree and the important normative changes in the building sector imply the need to use new teaching methodologies that enhance skills and competences in order to response to the increasing requirements demanded by society to the future architect. The aim of this paper is to present, analyze and discuss the development of multidisciplinary workshops as a new teaching methodology used in several Construction subjects of the Architecture Degree in the University of Alicante. Workshops conceived with the aim to synthesize and complement the technical knowledge acquired by the students during the Degree and to enhance the skills and competencies necessary for the professional practice. With that purpose, we decided to experiment on current subjects of the degree during this academic year, by applying the requirements defined in the future Architecture Degree in a practical way, through workshops between different subjects, superposing the technical knowledge with the resolution of constructive problems in the development of an architectural project. Developing these workshops between subjects we can dissolve the traditional boundaries between different areas of the Degree. This multidisciplinary workshop methodology allows the use of all the global knowledge acquired by students during their studies and at the same time, it enhances students’ ability to communicate and discuss their ideas and solutions in public. It also increases their capacity of self-criticism, and it foments their ability to undertake learning strategies and research in an autonomous way. The used methodology is based on the development of a practical work common to several subjects of different knowledge areas within the "Technology Block" of the future Architecture Degree. Thus, students work approaching the problem in a global way discussing simultaneously with teachers from different areas. By using these new workshops we stimulate an interactive class versus a traditional lecture. Work is evaluated continuously, valuing the participative pupil´s attitude, working in groups in class time, reaching weekly objectives and stimulating the individual responsibility and positive interdependence of the pupil inside the working group. The exercises are designed to improve students’ ability to transmit their ideas and solutions in public, knowing how to discuss and defend their technical resolutions to peers and teachers (Peer Reviewing), their capacity for self-criticism and their capacity to undertake strategies and autonomous learning processes at the same time they develop a personal research into new technologies, systems and materials. Students have shown their majority preference for this teaching methodology by the multidisciplinary workshops offered in the last years, with very satisfactory academic results. In conclusion, it can be verified nowadays the viability of the introduction of new contents and new teaching methodologies necessary for the acquisition of the skills in the future Architecture Degree, through workshops between several subjects that have had a great acceptance in students and positive contrasted academic results.

Transfer of Pattern Recall Skills May Contribute to the Development of Sport Expertise

Superior recall of domain-specific patterns is well established as a defining attribute of expert performers. Recent studies on the developmental histories of expert team ball sport players (e.g. Baker, Côté, & Abernethy, 2003a) also suggest that experts characteristically receive exposure to a wide range of sports in their developing years and that this related sports experience may reduce the amount of sport-specific training needed to become an expert. This study examined whether the facilitation of expertise associated with other sport experience might arise from positive transfer of pattern recall skills from one sport to another. Expert netball, basketball and field hockey players and experienced non-experts performed a recall task for patterns of play derived from each of these sports. Experts from sports different to those shown in the presented pattern consistently outperformed non-experts in their recall of defensive player positions, suggesting some selective transfer of pattern recall skills may indeed be possible

The development of collaborative skills in young children

This thesis examines young children's early collaborative development when engaged in joint tasks with both a peer and a parent. It begins by examining how the term "collaborative" has been applied and researched in previous literature. As collaboration is found to usually require dialogue, and intersubjectivity is seen as an important component in the construction of both collaboration and dialogue, the ability to construct intersubjectivity is the subject of the rest of the chapter. The chapter concludes by introducing the research questions that underpin the experiments that follow. A number of experiments are then described. Experiments 1 and 2 investigate age differences in interaction styles and the communication strategies used by similar aged dyads. Experiments 3 and 4 investigate differences due to the age of the child and/or the status of the information giver (either parent or child) in the styles of interaction and the communication strategies used by parent and child dyads. Experiment 5 investigates the benefits of collaborating with a parent, and finally, Experiment 6 examines the collaborative ability of pre-schools. The thesis identifies a series of skills required for successful collaboration. These include recognition of a joint goal and the need to suppress individual desires, the ability to structure joint interaction, moving from role-based to a negotiating style, and communicative skills, for example, asking for clarification. Other reasons for children's failure in collaborative tasks involve task-related skills, such as the development of spatial terms, and failure to recognise the need for accuracy. The findings support Vygotsky's theory that when working with an adult, children perform at a higher level than when working with a peer. Evidence was also found of parents scaffolding the interaction for their children. However, further research is necessary to establish that such scaffolding skills affect the child's development of collaborative interactive skills.

The development and operation of the effective interpersonal relationship skills relevant to career development problems from staff assessment at an industrial research laboratory

This study concerns the application of a model of effective interpersonal relationships to problems arising from staff assessment at I.C.I. Ltd. Corporate Laboratory between 1972 and 1974. In collaboration with academic and industrial supervision, the study commenced with a survey of management and supervisor opinions about the effectiveness of current staff (work) relationships, with particular reference to the problem of recognising and developing creative potential. This survey emphasised a need to improve the relationships between staff in the staff assessment context. A survey of research into creativity emphasised the importance of the interpersonal environment for obtaining creative behaviour in an organisation context. A further survey of theories of how inter­personal behaviour related to personal creativity (therapeutic psychology) provided a model of effective interpersonal behaviour (Carkhuff, 1969) that could be applied to the organisation context of staff assessment. The objective of the project was redefined as a need to improve the conditions of interpersonal behaviour in relation to certain (career development) problems arising from staff assessment practices. In order to demonstrate the application of the model of effective interpersonal behaviour, the research student recorded interviews between himself and members of staff designed to develop and operate the dimensions of the model. Different samples of staff were used to develop the 'facilitative' and the 'action oriented' dimensions of bahaviour, and then for the operation of a helping programme (based on vocational guidance tests). These interactions have been analysed, according to the scales of measurement in the model ana the results are presented in case study form in this thesis. At each stage of the project, results and conclusions were presented to the sponsoring organisation (e.g. industrial supervisor) in order to assess their (subjective) opinion of relevance to the organ­ isation. Finally, recommendations on further actions towards general improvement of the work relationships in the laboratory were presented in a brief report to the sponsor.

Selection & development of short-term project team members:developmental stability as an indicator of interpersonal skills

Short-term project teams do not have the advantage of prior performance or long-term membership to facilitate development of effective team performance. Research suggests interpersonal skills are crucial to success but this is under researched longitudinally. Evolutionary psychology can provide a lens to explain how people develop differing levels of interpersonal skills via the relationship between fluctuating asymmetry and pro-social behaviours. This research aims to investigate the relationship between fluctuating asymmetry and interpersonal skills, the impact of training and to further the evolutionary psychology field by embedding research in a real-world context as opposed to solely in laboratory or student settings.

Development of Variational Thinking Skills in Programming Teaching

The paper presents an example of methodological approach to the development of variational thinking skills in teaching programming. Various ways in solving a given task are implemented for the purpose. One of the forms, through which the variational thinking is manifested, is related to trail practical actions. In the process of comprehension of the properties thus acquired, students are doing their own (correct or incorrect) conclusions for other, hidden properties and at the same time they discover possibilities for new ways of action and acquiring of new effects. The variability and the generalizing function of thinking are in a close interrelation, and their interaction to a great extend determines the dynamics of the cognitive activity of the student.