Self-assessment insufficiently predicts performance in emergency skills

Background: Residents demonstrate a broad range of performance levels for clinical skills, with some at an inadequate level. Adequate self-assessment is important for life long learning. However, its accuracy is questioned extensively. The aim of this study was to evaluate how far the residents’ self-assessment predicts their performance in an expert assessment of emergency skills. Summary of work: Twelve skills were identified as being relevant for the emergency duties of residents in smaller hospitals. Fifteen first-year residents from the departments of internal medicine and general surgery at a district hospital rated their performance on a questionnaire (self-assessment). This was followed by a structured, practical in vivo assessment by an anaesthesiologist (expert assessment). For both, a visual analogue scale from 0 to 10 was used, on which 0 stands for novice and 10 for expert. Predictive validity was described by Spearman’s correlation, which was significant in 3 out of 12 skills only. Median correlation (r) was 0.50 (range 0.16 to 0.93). Conclusion: At the beginning of postgraduate training, self-assessment alone is not sufficient to guide self-directed learning. Take-home message: At the beginning of their residency, physicians need structured feedback in emergency skills which can be offered by anaesthesiologists.

Gaze perception in social anxiety and social anxiety disorder

Clinical observations suggest abnormal gaze perception to be an important indicator of social anxiety disorder (SAD). Experimental research has yet paid relatively little attention to the study of gaze perception in SAD. In this article we first discuss gaze perception in healthy human beings before reviewing self-referential and threat-related biases of gaze perception in clinical and non-clinical socially anxious samples. Relative to controls, socially anxious individuals exhibit an enhanced self-directed perception of gaze directions and demonstrate a pronounced fear of direct eye contact, though findings are less consistent regarding the avoidance of mutual gaze in SAD. Prospects for future research and clinical implications are discussed.

Self-recognition in primates: phylogeny and the salience of species-typical features.

Self-recognition has been explored in nonlinguistic organisms by recording whether individuals touch a dye-marked area on visually inaccessible parts of their face while looking in a mirror or inspect parts of their body while using the mirror's reflection. Only chimpanzees, gorillas, orangutans, and humans over the age of approximately 2 years consistently evidence self-directed mirror-guided behavior without experimenter training. To evaluate the inferred phylogenetic gap between hominoids and other animals, a modified dye-mark test was conducted with cotton-top tamarins (Saguinus oedipus), a New World monkey species. The white hair on the tamarins' head was color-dyed, thereby significantly altering a visually distinctive species-typical feature. Only individuals with dyed hair and prior mirror exposure touched their head while looking in the mirror. They looked longer in the mirror than controls, and some individuals used the mirror to observe visually inaccessible body parts. Prior failures to pass the mirror test may have been due to methodological problems, rather than to phylogenetic differences in the capacity for self-recognition. Specifically, an individual's sensitivity to experimentally modified parts of its body may depend crucially on the relative saliency of the modified part (e.g., face versus hair). Moreover, and in contrast to previous claims, we suggest that the mirror test may not be sufficient for assessing the concept of self or mental state attribution in nonlinguistic organisms.

The design studio as liminal space

The context of this research focuses on the efficacy of design studio as a form of teaching and learning. The established model of project-based teaching makes simple parallels between studio and professional practice. However, through comparison of the discourses it is clear that they are of different character. The protocols of the tutorial tradition can act to position the tutor as a defender of the knowledge community rather than a discourse guide for the student. The question arises as to what constitutes the core knowledge that would enable better self-directed study. Rather than focus on key knowledge, there has been an attempt in other fields to agree and share ‘threshold concepts’ within disciplinary knowledge. Meyer and Land describe threshold concepts as representing “a transformed way of understanding, or interpreting or viewing something without which the learner cannot progress [1]. The tutor’s role should be to assist in transforming student’s understanding through the mastery of the ‘troublesome knowledge’ that threshold concepts may embody. Teaching and learning environments under such approaches have been described as ‘liminal’: holding the learner in an ‘in-between’ state new understanding may be difficult and involve identity shifts. Research on the consequence of pressures on facilities and studio space concur, and indicate that studio spaces can be much better used in assisting the path of learning [2]. Through an overview map of threshold concepts, the opportunities for blended learning in supporting student learning in the liminal space of the design studio become much clearer [3] Design studio needs to be recontextualised within the discourse of higher education scholarship, based on a clarified curriculum built from an understanding of what constitutes its threshold concepts. The studio needs to be reconsidered as a space quite unlike that of the practitioner, a liminal space. 1. Meyer, J.H.F. and R. Land, Threshold concepts and troublesome knowledge. Overcoming Barriers to Student Learning: Threshold concepts and troublesome knowledge., 2006: p. 19. 2. Cai, H. and S. Khan, The Common First Year Studio in a Hot-desking Age: An Explorative Study on the Studio Environment and Learning. Journal for Education in the Built Environment 2010. 5(2): p. 39-64. 3. Pektas, S.T., The Blended Design Studio: An Appraisal of New Delivery Modes in Design Education. Procedia - Social and Behavioral Sciences, 2012. 51(0): p. 692-697.

La carpeta de aprendizaje y la evaluación entre iguales de los estudiantes. Resultados de una innovación docente en los estudios universitarios de las artes

Students reflect more on their learning in course subjects when they participate in managing their teaching–learning environment. As a form of guided participation, peer assessment serves the following purposes: (a) it improves the student’s understanding of previously established learning objectives; (b) it is a powerful metacognitive tool; (c) it transfers to the student part of the responsibility for assessing learning, which means deciding which learning activities are important and choosing the degree of effort a course subject will require; (d) it emphasizes the collective aspect of the nature of knowledge; and (e) the educational benefits derived from peer assessment clearly justify the efforts required to implement activities. This paper reports on the relative merits of a learning portfolio compiled during fine arts-related studies in which peer assessment played an important role. The researchers analyzed the student work load and the final marks students received for compulsory art subjects. They conclude that the use of a closed learning portfolio with a well-structured, sequential and analytical design can have a positive effect on student learning and that, although implementing peer assessment may be complex and students need to become familiar with it, its use is not only feasible but recommendable.

Student attitudes to plagiarism and collusion within computer science

There is a widespread perception among staff in Computer Science that plagiarism is a major problem particularly in the form of collusion in programming exercises. While departments often make use of electronic detection measures, the time consumed prosecuting plagiarism offences remains a problem. As a result departments continue to seek ways to reduce the amount of plagiarism and collusion that occurs. This paper reports the findings of a questionnaire based study which attempted to assess the students' attitudes to the issues involved in the hope that such an understanding might result in practical measures for minimizing the problem. The study revealed that while students did understand the definition of plagiarism in its most extreme cases they were often confused about less clear-cut situations. Changes in the previous experience of incoming students meeting modules originally designed on the assumption that students already had some programming background and were equipped for self-directed study would also appear to be a contributory factor in the extent of collusion in programming exercises.

Apprendre à être un Leader dans un Programme de Leadership: Perceptions, Éxpérience Préalable en Leadership et Sexe de l’Étudiant

The purpose of this study was to examine whether leadership can be learned through the Community Recreation and Leadership Training (CRLT) program and how effective the program is in terms of changing the perceptions and abilities of the students. The intentions of the researcher were to discover crucial learning moments as perceived by students and to gain insights that could lead to future improvements to enhance and enrich learning in a leadership program. To continue to be a viable program and to keep step with the demands of the recreation/leisure industry and society's wide-ranging needs, this study may help to inform the program's 'action plan' for continued success. This study employed a mixed method approach to determine how college students develop effective leadership ability in a three-year Community Recreation and Leadership Training (CRLT) college career program. First, a number of statistical tests were carried out to examine the four research questions used to guide the study. The SPSS software was used to analyze the data collected. The first research question asked how perceptions of leadership change as a result of being in a three-year leadership program. This study, using the Student Leadership Practice Inventory (SLPI), compared the five SLPI leadership dimensions by year. The SLPI was administered to all the first, second, and third year CRLT students ( N = 84). A one-way analysis of variance in participants' scores was conducted. No significant differences were revealed in any of the five dimensions of the SLPI among the first, second, and third year students at p < .05. However, two dimensions (model and encourage) approached significance and may hint at a possible influence the program is having on its students as they progress into the third year. The second research question asked whether perceptions of leadership vary by gender. Comparing the mean scores between the males and females on the five dimensions of the SLPI, no significant differences were found. The third research question asked whether prior leadership experience results in better academic performance for CRLT students in their 1st term. A one-way analysis of variance was conducted to evaluate the relationship between prior leadership experience and mean scores on academic performance. No significant correlations were found between grades and low, medium, or high levels of prior leadership experience F(2,79) = 2.67, p = .08. A correlation coefficient was also computed to determine whether there was a relationship between the Recreation Leadership I course grade and prior leadership experience. The correlation coefficient (.02) was statistically significant, r(80) = .24, p < .05. However, further studies with a larger sample size would be necessary to help determine this. The fourth question asked whether there was a correlation between students' first semester grades and their scores on the Student Leadership Practice Inventory (SLPI). Bivariate correlations (Pearson) were computed for the five SLPI dimensions with academic performance. None of the correlations using the five SLPI indicators was significant. Qualitative data was examined to discover what factors and experiences help students to assert a more effective leadership role. The study relied on content analysis of personal statements, and focus groups. Student perceptions of an effective leader, students' perceptions of their own abilities, and the strengths of the program were explored. A content analysis of the 'Personal Statements' was carried out to determine how students defined leadership prior to their having had any formal teaching in a college program. The result of the analysis of personal statements provided eight leadership categories used as an initial baseline for the study. Six focus groups (totaling N = 30) were conducted. Students responded to four key questions: how they define leadership. What is the single most effective quality of a leader? What leadership skills did they feel they had gained? How had the program helped them obtain their skills? Students credited the CRLT program with helping them develop a variety of leadership skills. Students revealed that they had gained skills such as confidence, knowledge and understanding of people's needs, and becoming more self-directed. They attributed their skill development to such things as good course design, intensive outdoor education and fieldwork courses, "hands on" learning approaches, group work, skill practice, the support they received from teachers, and encouragement they were given by their peers. A common finding among genders was defining an effective leader as someone who is "confident". However, the definition of the most important quality of a leader varied by gender. While males showed a tendency to prefer a leader being "confident," females preferred a leader being a "teacher".

An historical analysis of the development of thinking in the principal writings of Malcolm Knowles

Malcolm Shepherd Knowles was a key writer and theorist in the field of adult education in the United States. He died in 1997 and left a large legacy of books and journal articles. This thesis traced the development of his thinking over the 46-year period from 1950 to 1995. It examined the 25 works authored, co-authored, edited, reissued and revised by him during that period. The writings were scrutinised using a literature research methodology to expose the theoretical content, and a history of thought lens to identify and account for the development of major ideas. The methodology enabled a gradual unfolding of the history. A broadly-consistent and sequential pattern of thought focusing on the notion of andragogy emerged. The study revealed that after the initial phases of exploratory thinking, Knowles developed a practical-theoretical framework he believed could function as a comprehensive theory of adult learning. As his thinking progressed, his theory developed into a unified framework for human resource development and, later, into a model for the development of self-directed lifelong learners. The study traced the development of Knowles’ thinking through the phases of thought, identified the writings that belonged within each phase and produced a series of diagrammatic representations showing the evolution of his conceptual framework. The production of a history of the development of Knowles’ thought is the major outcome of the study. In addition to plotting the narrative sequence of thought-events, the history helps to explicate the factors and conditions that influenced Knowles’ thinking and to show the interrelationships between ideas. The study should help practitioners in their use and appreciation of Knowles’ works.

Transforming Queensland VET : Challenges and Opportunities (Volume 3)

The volume is the third in a series that addresses change and development in the delivery of VET programs in Queensland. The chapters address a breadth of issues that relate to the changing landscape for teaching and learning in VET programs through e-learning. Organisational change is a key focus of this volume. James Waterson examines business and pedagogical perspectives for SkillsTech Australia to create teaching and learning environments that will enrich the learning experience for staff and students. Kerry Emerson explores the ways in which printing teachers might change current practices in order to deliver their training to apprentices and trainees – off-the-job, onthe- job and online, through e-learning. The chapter by Erik Dodwell takes up issues of user-friendly RPL interviews and the challenges to develop a model that may be applied consistently across all industry areas using conversational interviews. The chapters by Linda Roberston, Nina Woodrow, and Anushka Weerackody discuss teaching and learning for specific groups of students. Linda Roberston proposes a vision for learning support teachers in which the learner is encouraged to be a self-directed and autonomous learner who is capable of utilising e-learning resources and is information literate. Nina Woodrow presents a case for the diminished sense of occupational identity by adult literacy teachers and the implications of this loss of expertise across the VET sector. Constructive strategies for change are outlined. The chapter by Anushka Weerackody explores ideas to enhance the practices of ESL teachers in TAFE Queensland through an online community of practice. The issues of on-the-job training through e-learning for various trades is considered by Anne-Louise Johnston and the benefits and challenges for SkillsTech Australia in developing training partnerships with industry to deliver these changes. These papers were completed by the authors as a part of their postgraduate studies at QUT. The views reported are those of the authors and should not be attributed to the Queensland Department of Education and Training. Donna Berthelsen and Lauren Vogel Faculty of Education Queensland University of Technology December 2009

Enhancing the capacity of oncology nurses to provide supportive care for patients with advanced cancer : evaluation of an educational intervention

Aim: This study aimed to enhance the capacity of oncology nurses to provide supportive care for patients with advanced cancer who have dependent children. ---------- Method: This was a pilot study of an educational intervention comprising a study-developed self-directed learning manual, supported by a day-long communication skills training workshop. Evaluation pre- and post-training included measures of stress and burnout, self-reports of confidence and attitudes, responses to clinical vignettes and video-taped interviews with simulated patients.---------- Results: Nurses found the educational intervention highly acceptable, and reported increased confidence in their ability to provide information and support for parents, and to initiate discussion about emotional issues. There were significant improvements in general communication skills and skills specific to this training, as well as reduced use of blocking.---------- Conclusion: Brief communication skills training supplemented with tailored educational resources can enhance confidence skills and knowledge of oncology nurses regarding their supportive care of parents with advanced cancer.

The impact of psychosocial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers

Aims To identify self-care activities undertaken and determine relationships between self-efficacy, depression, quality of life, social support and adherence to compression therapy in a sample of patients with chronic venous insufficiency. Background Up to 70% of venous leg ulcers recur after healing. Compression hosiery is a primary strategy to prevent recurrence, however, problems with adherence to this strategy are well documented and an improved understanding of how psychosocial factors influence patients with chronic venous insufficiency will help guide effective preventive strategies. Design Cross-sectional survey and retrospective medical record review. Method All patients previously diagnosed with a venous leg ulcer which healed between 12–36 months prior to the study were invited to participate. Data on health, psychosocial variables and self-care activities were obtained from a self-report survey and data on medical and previous ulcer history were obtained from medical records. Multiple linear regression modelling was used to determine the independent influences of psychosocial factors on adherence to compression therapy. Results In a sample of 122 participants, the most frequently identified self-care activities were application of topical skin treatments, wearing compression hosiery and covering legs to prevent trauma. Compression hosiery was worn for a median of 4 days/week (range 0–7). After adjustment for all variables and potential confounders in a multivariable regression model, wearing compression hosiery was found to be significantly positively associated with participants’ knowledge of the cause of their condition (p=0.002), higher self-efficacy scores (p=0.026) and lower depression scores (p=0.009). Conclusion In this sample, depression, self-efficacy and knowledge were found to be significantly related to adherence to compression therapy. Relevance to clinical practice These findings support the need to screen for and treat depression in this population. In addition, strategies to improve patient knowledge and self-efficacy may positively influence adherence to compression therapy.

An identification of factors influencing police workplace motivation

Police work tasks are diverse and require the ability to take command, demonstrate leadership, make serious decisions and be self directed (Beck, 1999; Brunetto & Farr-Wharton, 2002; Howard, Donofrio & Boles, 2002). This work is usually performed in pairs or sometimes by an officer working alone. Operational police work is seldom performed under the watchful eyes of a supervisor and a great amount of reliance is placed on the high levels of motivation and professionalism of individual officers. Research has shown that highly motivated workers produce better outcomes (Whisenand & Rush, 1998; Herzberg, 2003). It is therefore important that Queensland police officers are highly motivated to provide a quality service to the Queensland community. This research aims to identify factors which motivate Queensland police to perform quality work. Researchers acknowledge that there is a lack of research and knowledge in regard to the factors which motivate police (Beck, 1999; Bragg, 1998; Howard, Donofrio & Boles, 2002; McHugh & Verner, 1998). The motivational factors were identified in regard to the demographic variables of; age, sex, rank, tenure and education. The model for this research is Herzberg’s two-factor theory of workplace motivation (1959). Herzberg found that there are two broad types of workplace motivational factors; those driven by a need to prevent loss or harm and those driven by a need to gain personal satisfaction or achievement. His study identified 16 basic sub-factors that operate in the workplace. The research utilised a questionnaire instrument based on the sub-factors identified by Herzberg (1959). The questionnaire format consists of an initial section which sought demographic information about the participant and is followed by 51 Likert scale questions. The instrument is an expanded version of an instrument previously used in doctoral studies to identify sources of police motivation (Holden, 1980; Chiou, 2004). The questionnaire was forwarded to approximately 960 police in the Brisbane, Metropolitan North Region. The data were analysed using Factor Analysis, MANOVAs, ANOVAs and multiple regression analysis to identify the key sources of police motivation and to determine the relationships between demographic variables such as: age, rank, educational level, tenure, generation cohort and motivational factors. A total of 484 officers responded to the questionnaire from the sample population of 960. Factor analysis revealed five broad Prime Motivational Factors that motivate police in their work. The Prime Motivational Factors are: Feeling Valued, Achievement, Workplace Relationships, the Work Itself and Pay and Conditions. The factor Feeling Valued highlighted the importance of positive supportive leaders in motivating officers. Many officers commented that supervisors who only provided negative feedback diminished their sense of feeling valued and were a key source of de-motivation. Officers also frequently commented that they were motivated by operational police work itself whilst demonstrating a strong sense of identity with their team and colleagues. The study showed a general need for acceptance by peers and an idealistic motivation to assist members of the community in need and protect victims of crime. Generational cohorts were not found to exert a significant influence on police motivation. The demographic variable with the single greatest influence on police motivation was tenure. Motivation levels were found to drop dramatically during the first two years of an officer’s service and generally not improve significantly until near retirement age. The findings of this research provide the foundation of a number of recommendations in regard to police retirement, training and work allocation that are aimed to improve police motivation levels. The five Prime Motivational Factor model developed in this study is recommended for use as a planning tool by police leaders to improve motivational and job-satisfaction components of police Service policies. The findings of this study also provide a better understanding of the current sources of police motivation. They are expected to have valuable application for Queensland police human resource management when considering policies and procedures in the areas of motivation, stress reduction and attracting suitable staff to specific areas of responsibility.

Understanding the optimal learning environment in palliative care

The learning experiences of student nurses undertaking clinical placement are reported widely, however little is known about the learning experiences of health professionals undertaking continuing professional development (CPD) in a clinical setting, especially in palliative care. The aim of this study, which was conducted as part of the national evaluation of a professional development program involving clinical attachments with palliative care services (The Program of Experience in the Palliative Approach [PEPA]), was to explore factors influencing the learning experiences of participants over time. Thirteen semi-structured, one-to-one telephone interviews were conducted with five participants throughout their PEPA experience. The analysis was informed by the traditions of adult, social and psychological learning theories and relevant literature. The participants' learning was enhanced by engaging interactively with host site staff and patients, and by the validation of their personal and professional life experiences together with the reciprocation of their knowledge with host site staff. Self-directed learning strategies maximised the participants' learning outcomes. Inclusion in team activities aided the participants to feel accepted within the host site. Personal interactions with host site staff and patients shaped this social/cultural environment of the host site. Optimal learning was promoted when participants were actively engaged, felt accepted and supported by, and experienced positive interpersonal interactions with, the host site staff.