The Acute Care Undergraduate TEaching (ACUTE) initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom

Background: The care of the acutely ill patient in hospital is often sub-optimal. Poor recognition of critical illness combined with a lack of knowledge, failure to appreciate the clinical urgency of a situation, a lack of supervision, failure to seek advice and poor communication have been identified as contributory factors. At present the training of medical students in these important skills is fragmented. The aim of this study was to use consensus techniques to identify the core competencies in the care of acutely ill or arrested adult patients that medical students should possess at the point of graduation. Design: Healthcare professionals were invited to contribute suggestions for competencies to a website as part of a modified Delphi survey. The competency proposals were grouped into themes and rated by a nominal group comprised of physicians, nurses and students from the UK. The nominal group rated the importance of each competency using a 5-point Likert scale. Results: A total of 359 healthcare professionals contributed 2,629 competency suggestions during the Delphi survey. These were reduced to 88 representative themes covering: airway and oxygenation; breathing and ventilation; circulation; confusion and coma; drugs, therapeutics and protocols; clinical examination; monitoring and investigations; team-working, organisation and communication; patient and societal needs; trauma; equipment; pre-hospital care; infection and inflammation. The nominal group identified 71 essential and 16 optional competencies which students should possess at the point of graduation. Conclusions: We propose these competencies form a core set for undergraduate training in resuscitation and acute care.

Time course of gag protein assembly in HIV-1-infected cells: a study by immunoelectron microscopy

Recent biochemical studies have identified high molecular complexes of the HIV Gag precursor in the cytosol of infected cells. Using immunoelectron microscopy we studied the time course of the synthesis and assembly of a HIV Gag precursor protein (pr55gag) in Sf9 cells infected with recombinant baculovirus expressing the HIV gag gene. We also immunolabeled for pr55gag human T4 cells acutely or chronically infected with HIV-1. In Sf9 cells, the time course study showed that the first Gag protein appeared in the cytoplasm at 28-30 h p.i. and that budding started 6-8 h later. Colloidal gold particles, used to visualize the Gag protein, were first scattered randomly throughout the cytoplasm, but soon clusters representing 100 to 1000 copies of pr55gag were also observed. By contrast, in cells with budding or released virus-like particles the cytoplasm was virtually free of gold particles while the released virus-like particles were heavily labeled. Statistical analysis showed that between 80 and 90% of the gold particles in the cytoplasm were seen as singles, as doublets, or in small groups of up to five particles probably representing small oligomers. Clusters of gold particles were also observed in acutely infected lymphocytes as well as in multinuclear cells of chronically infected cultures of T4 cells. In a few cases small aggregates of gold particles were found in the nuclei of T4 lymphocytes. These observations suggest that the Gag polyprotein forms small oligomers in the cytoplasm of expressing cells but that assembly into multimeric complexes takes place predominantly at the plasma membrane. Large accumulations of Gag protein in the cytoplasm may represent misfolded molecules destined for degradation.

Purpose built teaching equipment for a laboratory based course in three phase machines and drives

The hazards associated with high voltage three phase inverters ond the rotating sha@s of large electrical machines have resulted in most of the engineering courses covering these topics to be predominantly theoretical. This paper describes a set of purpose built, low voltage and low cost teaching equipment which allows the “hands on I’ instruction of three phase inverters and rotating machines. By using low voltages, the student can experiment freely with the motors and inverter and can access all of the current and voltage waveforms, which until now could only be studied in text books or observed as part of laboratory demonstrations. Both the motor and the inverter designs are optimized for teaching purposes, cost around $25 and can be made with minimal effort.

Three-phase machines and drives - Equipment for a laboratory-based course

The hazards associated with high-voltage three-phase inverters and high-powered large electrical machines have resulted in most of the engineering courses covering three-phase machines and drives theoretically. This paper describes a set of purpose-built, low-voltage, and low-cost teaching equipment that allows the hands-on instruction of three-phase inverters and rotating machines. The motivation for moving towards a system running at low voltages is that the students can safely experiment freely with the motors and inverter. The students can also access all of the current and voltage waveforms, which until now could only be studied in textbooks or observed as part of laboratory demonstrations. Both the motor and the inverter designs are for teaching purposes and require minimal effort and cost.

Time course of oculomotor inhibition revealed by saccade trajectory modulation

Selecting a stimulus as the target for a goal-directed movement involves inhibiting other competing possible responses. Both target and distractor stimuli activate populations of neurons in topographic oculomotor maps such as the superior colliculus. Local inhibitory interconnections between these populations ensure only one saccade target is selected. Suppressing saccades to distractors may additionally involve inhibiting corresponding map regions to bias the local competition. Behavioral evidence of these inhibitory processes comes from the effects of distractors on oculomotor and manual trajectories. Individual saccades may initially deviate either toward or away from a distractor, but the source of this variability has not been investigated. Here we investigate the relation between distractor-related deviation of trajectory and saccade latency. Targets were presented with, or without, distractors, and the deviation of saccade trajectories arising from the presence of distractors was measured. A fixation gap paradigm was used to manipulate latency independently of the influence of competing distractors. Shorter- latency saccades deviated toward distractors and longer-latency saccades deviated away from distractors. The transition between deviation toward or away from distractors occurred at a saccade latency of around 200 ms. This shows that the time course of the inhibitory process involved in distractor related suppression is relatively slow.

Electronic voting systems in undergraduate teaching

One of the major differences undergraduates experience during the transition to university is the style of teaching. In schools and colleges most students study key stage 5 subjects in relatively small informal groups where teacher–pupil interaction is encouraged and two-way feedback occurs through question and answer type delivery. On starting in HE students are amazed by the sizes of the classes. For even a relatively small chemistry department with an intake of 60-70 students, biologists, pharmacists, and other first year undergraduates requiring chemistry can boost numbers in the lecture hall to around 200 or higher. In many universities class sizes of 400 are not unusual for first year groups where efficiency is crucial. Clearly the personalised classroom-style delivery is not practical and it is a brave student who shows his ignorance by venturing to ask a question in front of such an audience. In these environments learning can be a very passive process, the lecture acts as a vehicle for the conveyance of information and our students are expected to reinforce their understanding by ‘self-study’, a term, the meaning of which, many struggle to understand. The use of electronic voting systems (EVS) in such situations can vastly change the students’ learning experience from a passive to a highly interactive process. This principle has already been demonstrated in Physics, most notably in the work of Bates and colleagues at Edinburgh.1 These small hand-held devices, similar to those which have become familiar through programmes such as ‘Who Wants to be a Millionaire’ can be used to provide instant feedback to students and teachers alike. Advances in technology now allow them to be used in a range of more sophisticated settings and comprehensive guides on use have been developed for even the most techno-phobic staff.

Researcher development: the impact of undergraduate research opportunity programmes on students in the UK

Undergraduate research opportunity programmes (UROP) are common in North America where research has confirmed their benefits. These schemes are gaining ground in the UK, and this article provides evidence for how UK students are benefiting from the experience. Results suggest UROP makes a significant contribution to the research capabilities and confidence of participating students, boosting their understanding of both research and their own subjects. Whilst offering considerable benefits to student learning, there is no evidence that UROP schemes on their current small scale attract additional students to postgraduate research, since the majority that participate are already interested in postgraduate study. However, at an individual level, most students report increased confidence and appreciation of the realities of the research process, and desire to progress on to postgraduate study following the placement, indicating that schemes may have the potential to cultivate new research confidence and interest if expanded.

The long and the short of it: negotiating the right space for Asian theatre in the university drama curriculum

This article compares two approaches to teaching Asian theatre at undergraduate level in the United Kingdom. One approach samples a variety of different traditions as a means to challenge students to produce performance for a combined audience of hearing and deaf, whereas the other focuses on the effect of exploring one geographical area intensively over the course of one academic year. The article seeks to highlight the merits and pitfalls of both approaches, and questions whether student work that actively questions ethnicity and identity, as well as the tension between innovation and tradition, might be considered diasporic in character.