Case teaching in medicine;

Mode of access: Internet.

An innovative approach to teaching structural induction for computer science

Proofs by induction are central to many computer science areas such as data structures, theory of computation, programming languages, program efficiency-time complexity, and program correctness. Proofs by induction can also improve students’ understanding and performance of computer science concepts such as programming languages, algorithm design, and recursion, as well as serve as a medium for teaching them. Even though students are exposed to proofs by induction in many courses of their curricula, they still have difficulties understanding and performing them. This impacts the whole course of their studies, since proofs by induction are omnipresent in computer science. Specifically, students do not gain conceptual understanding of induction early in the curriculum and as a result, they have difficulties applying it to more advanced areas later on in their studies. The goal of my dissertation is twofold: (1) identifying sources of computer science students’ difficulties with proofs by induction, and (2) developing a new approach to teaching proofs by induction by way of an interactive and multimodal electronic book (e-book). For the first goal, I undertook a study to identify possible sources of computer science students’ difficulties with proofs by induction. Its results suggest that there is a close correlation between students’ understanding of inductive definitions and their understanding and performance of proofs by induction. For designing and developing my e-book, I took into consideration the results of my study, as well as the drawbacks of the current methodologies of teaching proofs by induction for computer science. I designed my e-book to be used as a standalone and complete educational environment. I also conducted a study on the effectiveness of my e-book in the classroom. The results of my study suggest that, unlike the current methodologies of teaching proofs by induction for computer science, my e-book helped students overcome many of their difficulties and gain conceptual understanding of proofs induction.

An Innovative Approach to Teaching Structural Induction for Computer Science

Proofs by induction are central to many computer science areas such as data structures, theory of computation, programming languages, program efficiency-time complexity, and program correctness. Proofs by induction can also improve students’ understanding of and performance with computer science concepts such as programming languages, algorithm design, and recursion, as well as serve as a medium for teaching them. Even though students are exposed to proofs by induction in many courses of their curricula, they still have difficulties understanding and performing them. This impacts the whole course of their studies, since proofs by induction are omnipresent in computer science. Specifically, students do not gain conceptual understanding of induction early in the curriculum and as a result, they have difficulties applying it to more advanced areas later on in their studies. The goal of my dissertation is twofold: 1. identifying sources of computer science students’ difficulties with proofs by induction, and 2. developing a new approach to teaching proofs by induction by way of an interactive and multimodal electronic book (e-book). For the first goal, I undertook a study to identify possible sources of computer science students’ difficulties with proofs by induction. Its results suggest that there is a close correlation between students’ understanding of inductive definitions and their understanding and performance of proofs by induction. For designing and developing my e-book, I took into consideration the results of my study, as well as the drawbacks of the current methodologies of teaching proofs by induction for computer science. I designed my e-book to be used as a standalone and complete educational environment. I also conducted a study on the effectiveness of my e-book in the classroom. The results of my study suggest that, unlike the current methodologies of teaching proofs by induction for computer science, my e-book helped students overcome many of their difficulties and gain conceptual understanding of proofs induction.

Does pedagogy still rule?

Theories on teaching and learning for adult learners are constantly being reviewed and discussed in the higher educational environment. Theories are not static and appear to be in a constant developmental process. This paper discusses three of these theories: pedagogy, andragogy and heutagogy. It is argued that although educators engage in many of the principles of either student-centered (andragogy) and self-determined (heutagogy) learning, it is not possible to fully implement either theory. The two main limitations are the requirements of both internal and external stakeholders, such as accrediting bodies and requirements to assess all student learning. A reversion to teacher-centered learning (pedagogy) ensues. In summary, we engage in many action-oriented learning activities but revert to teacher-centered approaches in terms of content and assessment.

Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

Daylighting design in the architectural design studio

This paper discusses two different approaches to teaching design and their modes of delivery and reflects upon their successes and failures. Two small groups of third year design students have been given projects focussing on incorporation of daylighting to architectural design in studios having different design themes. In association with the curriculum, the themes were Digital Tools and Sustainability. Although both studios had the topic of daylighting, the aim and methodology used were different. Digital Tool studio’s aim was to teach how to design daylighting by using a digital tool, where as, Sustainability studio aimed at using scale modelling as a tool to learn about daylighting and integrating it into design. Positive results for providing student learning success within the University context were the students’ chance to learn and practice some new skills –using a new tool for designing; integration of the tutors’ extensive research expertise to their teaching practice; and the students’ construction of their own understanding of knowledge in a student-centred educational environment. This environment created a very positive attitude in the form of exchanging ideas and collaboration among the students of Digital Tools students at the discussion forum. Sustainability group students were enthusiastic about designing and testing various proposals. Problems that both studios experienced were mainly related to timing. Synchronizing with other groups of their studios and learning of a new skill on top of an already complicated process of design learning were the setbacks.

Emergency department triage revisited

Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countries and efforts made to ensure consistency of application. However, the ongoing crowding of emergency departments resulting from access block and increased demand has led to calls for a review of systems of triage. In addition, international variance in triage systems limits the capacity for benchmarking. The aim of this paper is to provide a critical review of the literature pertaining to emergency department triage in order to inform the direction for future research. While education, guidelines and algorithms have been shown to reduce triage variation, there remains significant inconsistency in triage assessment arising from the diversity of factors determining the urgency of any individual patient. It is timely to accept this diversity, what is agreed, and what may be agreeable. It is time to develop and test an International Triage Scale (ITS) which is supported by an international collaborative approach towards a triage research agenda. This agenda would seek to further develop application and moderating tools and to utilise the scales for international benchmarking and research programmes.

Emergency department surge capacity : Recommendations of the Australasian surge strategy working group

Background For more than a decade emergency medicine organizations have produced guidelines, training and leadership for disaster management. However to date, there have been limited guidelines for emergency physicians needing to provide a rapid response to a surge in demand. The aim of this study is to identify strategies which may guide surge management in the Emergency Department. Method A working group of individuals experienced in disaster medicine from the Australasian College for Emergency Medicine Disaster Medicine Subcommittee (the Australasian Surge Strategy Working Group) was established to undertake this work. The Working Group used a modified Delphi technique to examine response actions in surge situations. The Working Group identified underlying assumptions from epidemiological and empirical understanding and then identified remedial strategies from literature and from personal experience and collated these within domains of space, staff, supplies, and system operation. Findings These recommendations detail 22 potential actions available to an emergency physician working in the context of surge. The Working Group also provides detailed guidance on surge recognition, triage, patient flow through the emergency department and clinical goals and practices. Discussion These strategies provide guidance to emergency physicians confronting the challenges of a surge in demand. The paper also identifies areas that merit future research including the measurement of surge capacity, constraints to strategy implementation, validation of surge strategies and measurement of strategy impacts on throughput, cost, and quality of care.

Comprehensive standardized data definitions for acute coronary syndrome research in emergency departments in Australasia

Patients with chest discomfort or other symptoms suggestive of acute coronary syndrome (ACS) are one of the most common categories seen in many Emergency Departments (EDs). While the recognition of patients at high-risk of ACS has improved steadily, identifying the majority of chest pain presentations who fall into the low-risk group remains a challenge. Research in this area needs to be transparent, robust, applicable to all hospitals from large tertiary centres to rural and remote sites, and to allow direct comparison between different studies with minimum patient spectrum bias. A standardised approach to the research framework using a common language for data definitions must be adopted to achieve this. The aim was to create a common framework for a standardised data definitions set that would allow maximum value when extrapolating research findings both within Australasian ED practice, and across similar populations worldwide. Therefore a comprehensive data definitions set for the investigation of non-traumatic chest pain patients with possible ACS was developed, specifically for use in the ED setting. This standardised data definitions set will facilitate ‘knowledge translation’ by allowing extrapolation of useful findings into the real-life practice of emergency medicine.

Flood fatalities in contemporary Australia (1997-2008) : disaster medicine

Objective: Flood is the most common natural disaster in Australia and causes more loss of life than any other disaster. This article describes the incidence and causes of deaths directly associated with floods in contemporary Australia. ---------- Methods: The present study compiled a database of flood fatalities in Australia in the period of 1997–2008 inclusive. The data were derived from newspapers and historic accounts, as well as government and scientific reports. Assembled data include the date and location of fatalities, age and gender of victims and the circumstances of the death. ---------- Results: At least 73 persons died as a direct result of floods in Australia in the period of 1997–2008. The largest number of fatalities occurred in New South Wales and Queensland. Most fatalities occurred during February, and among men (71.2%). People between the ages of 10 and 29 and those over 70 years are overrepresented among those drowned. There is no evident decline in the number of deaths over time. 48.5% fatalities related to motor vehicle use. 26.5% fatalities occurred as a result of inappropriate or high-risk behaviour during floods. ---------- Conclusion: In modern developed countries with adequate emergency response systems and extensive resources, deaths that occur in floods are almost all eminently preventable. Over 90% of the deaths are caused by attempts to ford flooded waterways or inappropriate situational conduct. Knowledge of the leading causes of flood fatalities should inform public awareness programmes and public safety police enforcement activities.

A national framework for disaster health education in Australia

INTRODUCTION: Recent events have heightened awareness of disaster health issues and the need to prepare the health workforce to plan for and respond to major incidents. This has been reinforced at an international level by the World Association for Disaster and Emergency Medicine, which has proposed an international educational framework. ----------- OBJECTIVE: The aim of this paper is to outline the development of a national educational framework for disaster health in Australia. ----------- METHODS: The framework was developed on the basis of the literature and the previous experience of members of a National Collaborative for Disaster Health Education and Research. The Collaborative was brought together in a series of workshops and teleconferences, utilizing a modified Delphi technique to finalize the content at each level of the framework and to assign a value to the inclusion of that content at the various levels. ----------- FRAMEWORK: The framework identifies seven educational levels along with educational outcomes for each level. The framework also identifies the recommended contents at each level and assigns a rating of depth for each component. The framework is not intended as a detailed curriculum, but rather as a guide for educationalists to develop specific programs at each level. ----------- CONCLUSIONS: This educational framework will provide an infrastructure around which future educational programs in Disaster Health in Australia may be designed and delivered. It will permit improved articulation for students between the various levels and greater consistency between programs so that operational responders may have a consistent language and operational approach to the management of major events.

Health impacts of floods

Introduction: Floods are the most common hazard to cause disasters and have led to extensive morbidity and mortality throughout the world. The impact of floods on the human community is related directly to the location and topography of the area, as well as human demographics and characteristics of the built environment. Objectives: The aim of this study is to identify the health impacts of disasters and the underlying causes of health impacts associated with floods. A conceptual framework is developed that may assist with the development of a rational and comprehensive approach to prevention, mitigation, and management. Methods: This study involved an extensive literature review that located >500 references, which were analyzed to identify common themes, findings, and expert views. The findings then were distilled into common themes. Results: The health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the mediumterm, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy. Conclusions: This article proposes a structured approach to the classification of the health impacts of floods and a conceptual framework that demonstrates the relationships between floods and the direct and indirect health consequences.