French translation and validation of the OSATS tool for the assessment of surgical skill

AIM OF THE STUDY

The OSATS rating scale is one of the tools most widely used in the scientific literature for assessing technical surgical skill. The aim of this study was to translate this scale into French (OSATS-FR) and validate it.

METHODS

OSATS was translated into French by two independent translators. The two translations were pooled and back-translated by a third translator into English to produce a consensus version (OSATS-FR). Three independent assessors then used it to assess surgical skill in tracheostomy videos. The reproducibility of the scoring was measured.

RESULTS

The OSATS-FR version was easily understood and used by all three assessors. In all, 18 procedures were assessed, performed by 14 interns and 4 senior surgeons. The mean OSATS-FR score was 18.6±4.08 for the interns and 31.6±1.62 for the seniors (p<0.0001). The Pearson correlation coefficient was 0.937 CI95% [0.867-1.269] between assessors 1 and 2, 0.977 CI95% [0.899-1.149] between assessors 1 and 3, and 0.965 CI95% [0.876-1.196] between assessors 2 and 3. Cronbach's alpha was greater than 0.9 for each assessor.

CONCLUSION

OSATS-FR can distinguish between two groups with different surgical expertise and assess surgical skill with an inter-assessor reproducibility and internal consistency comparable to those of the English version.

Associations of food choice values and food literacy with overall diet quality: a nationwide cross-sectional study in Japanese adults

To date, a limited number of studies have examined aspects of food choice values and food literacy in relation to some aspects of dietary behaviours. The aim of this cross-sectional study was to comprehensively examine the associations of food choice values and food literacy with diet quality. In total, 2231 Japanese adults aged 19-80 years completed questionnaires asking about food choice values (accessibility, convenience, health/weight control, tradition, sensory appeal, organic, comfort and safety) and food literacy characterised by nutrition knowledge, cooking skills, food skills and eating behaviours (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness and slowness in eating). As a measure of diet quality, the Healthy Eating Index-2015 (HEI-2015) was calculated using a brief-type diet history questionnaire (BDHQ) or a food combination questionnaire (FCQ). In males, after adjustment for potential confounding factors (including age, BMI and the ratio of reported energy intake to estimated energy requirement), the HEI-2015 derived from BDHQ and that derived from FCQ were associated significantly (P ≤ 0·02) and positively with the food choice values of organic and inversely with food fussiness. In females, the HEI-2015 showed positive associations with the food choice values of health/weight control, nutrition knowledge and cooking skills and an inverse association with food fussiness, irrespective of the dietary assessment questionnaire (P ≤ 0·03). In conclusion, this study suggests that several aspects of food choice values and food literacy were associated with diet quality, and the aspects related differed between males and females.

Evidence-based practice confidence and behavior throughout the curriculum of four physical therapy education programs: a longitudinal study

BACKGROUND

Evidence-based practice (EBP) is a foundational process taught in health professional education, yet it is unclear when EBP confidence and skills are obtained. Increases in EBP confidence and behaviors from the start of physical therapy programs to post graduation have been reported in studies that evaluated a single program or used non-valid questionnaires. This study aimed to describe changes in EBP confidence and behavior using validated questionnaires of students from four physical therapy education programs throughout their curriculum and one year post graduation.

METHODS

One hundred and eighty-one students from a potential pool of 269 (67.3%) consented to participate. Students completed the Evidence-Based Practice Confidence (EPIC) Scale and the Evidence-Based Practice Implementation Scale (EBPIS) at 6 timepoints: start of the program, prior to first clinical experience, after first clinical experience, at the end of classroom instruction, graduation, and one year post. Medians (Mdn) and 25th and 75th percentiles (P25, P75) were calculated for 42 (23.2%) students with complete data across all timepoints. Change between timepoints was assessed using Friedman's test and Wilcoxon signed rank test with a Bonferroni correction for post hoc analysis.

RESULTS

There were significant changes in EPIC scores (p < 0.001) from enrollment (Mdn 50.0, P25, P75 35.5, 65.9) to prior to first clinical experience (Mdn 65.5, P25, P75 57.3, 72.5) and after the first clinical experience (Mdn 67.3, P25, P75, 58.9, 73.2) to the end of classroom instruction (Mdn 78.6, P25, P75, 72.0, 84.1). Significant increases on the EBPIS (p < 0.01) were only seen from after the first year of training (Mdn 15, P25, P75, 10.0, 22.5) to end of the first clinical experience (Mdn 21.5, P25, P75 12.0, 32.0).

CONCLUSIONS

EBP confidence increased significantly after classroom instruction but remained the same after clinical experiences and at one year post graduation. EBP behavior significantly increased only after the first clinical experience and remained the same through graduation. Confidence and behavior scores were higher than were previously reported in practicing professionals. Ongoing assessment of EBP confidence and behavior may help instructors build appropriate curricula to achieve their outlined EBP objectives.

Characterization of the skill of the CORDEX-Africa regional climate models to simulate regional climate setting in the East African Transboundary Omo Gibe River Basin, Ethiopia

Regional climate models (RCMs) that produce good outputs in one region or for specific variables may underperform for others. Thereby, assessing the performance of various model simulations and their corresponding mean ensemble is critical in identifying the most suitable models. In this regard, a study was conducted to evaluate the performance of ten RCMs against observations from multiple ground-based stations in the East African Transboundary Omo Gibe River Basin, Ethiopia, during the baseline period of 1986-2005. The study evaluated the models' ability to replicate various aspects of climatic variables and their corresponding statistical indicators. The results confirmed that RCMs have varying abilities to reproduce climatic conditions across the basin. The ensembles and RACMO22T (EC-EARTH) were better at replicating the average annual precipitation distribution. Meanwhile, the CCLM4-8-17 (MPI) together with the ensembles better captured the measured precipitation annually, despite the discrepancies in the actual magnitudes. All RCMs were able to simulate the seasonal precipitation patterns effectively, with RACMO22T (EC-EARTH), CCLM4-8-17 (CNRM), RCA4 (CNRM), CCLM4-8-17 (MPI), and REMO2009 (MPI) models captured superior, excluding the maximum value. Interannual and seasonal rainfall pattern variations were more significant than variations in air temperature. Additionally, a better correlation was observed between actual and simulated precipitation at multiple separate monitoring places. The RCA4 (MPI) and CCLM4-8-17 (MPI) demonstrated reasonable minimum and maximum temperatures. The RCA4 (MIROC5) model was more effective in reproducing extreme precipitation events. However, all RCMs and their ensembles tended to overestimate the return periods of these events. In general, the research highlights the importance of selecting reliable RCMs that better replicate observed climatic settings and employing the ensemble mean of top-performing models following systematic bias adjustment for a specific application.

From FITT to FISTT: The task-skills fit before the introduction of assistive, digital health technologies

Objective

To enhance the predictive power of the Fit between Individuals, Task and Technology (FITT) framework in mobile, individual consumer settings by restructuring the individual-task fit to prominently emphasise the task-skills fit.

Design

A mixed study involving a quantitative survey of 679 potential patients (adopters) and a qualitative content analysis of ten semi-structured interviews with clinic assistants.

Setting

For the survey, three combined random samples of potential patients from Atteridgeville, Bapong and Garankuwa (South Africa). Ten Unjani clinic assistants were also interviewed about their tasks, skills, and related properties and attributes using a semi-structured interview guide.

Participants

Participants in the survey were potential patients over 18 years of age in the three sampled locations. In the qualitative study, interviewed participants were employed as clinic assistants in ten clinics within the Unjani Clinic Network.

Main outcome measures

in the quantitative study, the statistical significance of the relationships between smartphone experience and health motivation on the one hand and the adopter's perceived self-efficacy on the other. In the qualitative study, the extent to which task properties, context, and the adopters' levels of education and training affect their perceived self-efficacy.

Findings

There is a significant relationship between smartphone experience and perceived self-efficacy and a moderately significant relationship between health motivation and perceived self-efficacy. Furthermore, task properties, task context, and an adopter's level of education and training considerably influence their perceived self-efficacy on a given future assistive digital health technology (ADHT).

Conclusion

Extending the FITT to the FISTT framework to explicitly include the task-skills fit may improve the explanatory and predictive power of the traditional FITT framework in mobile individual consumer settings.

The effect of bedside assistant technical performance on outcomes in robotic surgery

Technical performance in surgery has been associated with patient outcomes. Robotic surgery is unique in that both a console surgeon and bedside surgeon are required. A systematic review according to PRISMA guidelines identified all pertinent literature regarding skill level of the bedside assistant with regards to patient outcomes in robotic surgery. 10 studies met inclusion criteria. In all studies, the skill level of the assistant was based on experience, either by post-graduate year of the resident or number of cases previously performed by the assistant. Five studies reported significant, shorter operative times with increasing experience of the bedside assistant. No study reported a significant difference in postoperative outcomes. The existing literature fails to show improved patient outcomes with more experienced bedside assistants in robotic surgery. Metrics should be developed to measure actual technical performance of the bedside assistant rather than using arbitrary assessments of experience in future studies.

Development and assessment of a vaccine administration training course for medical students

BACKGROUND

Vaccine administration skills are very important for physicians, especially in the era of global pandemics. However, medical students have reported that practical sessions to develop these skills are insufficient. Therefore, the aim of our study was to develop a vaccination training course for medical students. We also examined its educational effectiveness.

METHODS

5th- and 6th-year medical students at the University of Tokyo were recruited to attend the vaccine administration training course in 2021. These students were our study participants. Our course consisted of an orientation part, which included a lecture on the indications, adverse events, and vaccination techniques of flu vaccines and practice on a simulator, and a main part in which the staff of the University of Tokyo Hospital were actually vaccinated. Before and after the main part of the course, study participants completed an online questionnaire that assessed their confidence in vaccine administration technique through a five-point Likert scale. We also surveyed their feedback about the course content and process. At the beginning and end of the main part, their technical competence in vaccination was assessed by two independent doctors. These doctors used a validated checklist scale (ranging from 16 to 80) and a global rating scale (ranging from 0 to 10). We used their mean scores for analysis. The quantitative data were analyzed through the Wilcoxon signed-rank test. For the qualitative data of the questionnaire, thematic analysis was conducted.

RESULTS

All 48 course participants participated in our study. Participants' confidence in vaccination technique (Z = -5.244, p < 0.05) and vaccination skill significantly improved (checklist rating: Z = -5.852, p < 0.05; global rating: Z = -5.868, p < 0.05). All participants rated the course as, "overall educational." Our thematic analysis identified four emerging themes: interest in medical procedures, efficacy of supervision and feedback, efficacy of "near-peer" learning, and very instructive course.

CONCLUSIONS

In our study, we developed a vaccine administration course for medical students, assessed their vaccination techniques and confidence in those techniques, and investigated their perceptions of the course. Students' vaccination skills and confidence improved significantly after the course, and they positively evaluated the course based on a variety of factors. Our course will be effective in educating medical students about vaccination techniques.

Simulation-based learning in nursing curriculum- time to prepare quality nurses: A systematic review and meta-analysis

Background

Simulation-based learning (SBL) emerged as an imperative pedagogical approach adaptable to situations involving widely varying clinical content without exposing patients to the risks inherent in trainee learning. The purpose of the present review was to assess the outcome of SBL on the domains of learning i.e cognitive, affective, and psychomotor.

Methods

We searched PubMed, Embase, Cochrane library, Clinical Trial database, and other sources to evaluate the effectiveness of SBL versus traditional teaching methods among nursing students till March 2021. Two authors individually extracted the data and identified the risk of bias and analyzed the data.

Results

The selected studies with a total of 364 nursing students were included for analysis. Overall, it was found that learning via simulation has beneficial effects. In combined subgroup analysis, use of simulation showed significant effects on students' understanding (SMD = 1.31, 95% CI [0.80, 1.82], P < 0.00001), Self-confidence (SMD = 1.93, 95% CI [1.01,2.84], P < 0.0001), (SMD = 1.83, 95% CI [0.91,2.74], P < 0.0001), Learning satisfaction [E:17.94, C-17.60] and Skill (SMD = 1.62, 95% CI [0.62,2.62], P = 0.002) and psychological care (SMD = 1.60, 95%CI [0.61,2.58], P = 0.001). Heterogeneity ranging from I2 = 54%-86% was found during the analysis.

Conclusion

The findings of the present study considered simulation as an effective teaching method to enhance cognitive, affective, and psychomotor skills.

Implementation of a Low-Cost, Multi-component, Web-Based Training for Trauma-Focused Cognitive-Behavioral Therapy

Effective, interactive trainings in evidence-based practices remain expensive and largely inaccessible to most practicing clinicians. To address this need, the current study evaluated the impact of a low-cost, multi-component, web-based training for Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) on clinicians' TF-CBT knowledge, strategy use, adherence and skill. Clinician members of a practice-based research network were recruited via email and randomized to either an immediate training group (N = 89 assigned) or waitlist control group (N = 74 assigned) that was offered access to the same training after six months, with half of each group further randomized to receive or not receive incentives for participation. Clinicians completed assessments at baseline, 6 months, and 12 months covering TF-CBT knowledge, strategy use, and for a subset of clinicians (n = 28), TF-CBT adherence and skill. Although significant differences in overall TF-CBT skillfulness and readiness were found, there were no significant differences between the training and waitlist control group on TF-CBT knowledge and strategy use at six months. However, there was considerable variability in the extent of training completed by clinicians. Subsequent post-hoc analyses indicated a significant, positive association between the extent of training completed by clinicians and clinician TF-CBT knowledge, strategy use, demonstrated adherence and skill across the three TF-CBT components, and overall TF-CBT readiness. We also explored whether incentives predicted training participation and found no differences in training activity participation between clinicians who were offered an incentive and those who were not. Findings highlight the limitations of self-paced web-based trainings. Implications for web-based trainings are discussed.

Unravelling the skillset of point-of-care ultrasound: a systematic review

BACKGROUND

The increasing number of physicians that are trained in point-of-care ultrasound (POCUS) warrants critical evaluation and improvement of current training methods. Performing POCUS is a complex task and it is unknown which (neuro)cognitive mechanisms are most important in competence development of this skill. This systematic review was conducted to identify determinants of POCUS competence development that can be used to optimize POCUS training.

METHODS

PubMed, Web of Science, Cochrane Library, Emcare, PsycINFO and ERIC databases were searched for studies measuring ultrasound (US) skills and aptitude. The papers were divided into three categories: "Relevant knowledge", "Psychomotor ability" and 'Visuospatial ability'. The 'Relevant knowledge' category was further subdivided in 'image interpretation', 'technical aspects' and 'general cognitive abilities'. Visuospatial ability was subdivided in visuospatial subcategories based on the Cattell-Horn-Carroll (CHC) Model of Intelligence v2.2, which includes visuospatial manipulation and visuospatial perception. Post-hoc, a meta-analysis was performed to calculate pooled correlations.

RESULTS

26 papers were selected for inclusion in the review. 15 reported on relevant knowledge with a pooled coefficient of determination of 0.26. Four papers reported on psychomotor abilities, one reported a significant relationship with POCUS competence. 13 papers reported on visuospatial abilities, the pooled coefficient of determination was 0.16.

CONCLUSION

There was a lot of heterogeneity in methods to assess possible determinants of POCUS competence and POCUS competence acquisition. This makes it difficult to draw strong conclusions on which determinants should be part of a framework to improve POCUS education. However, we identified two determinants of POCUS competence development: relevant knowledge and visuospatial ability. The content of relevant knowledge could not be retrieved in more depth. For visuospatial ability we used the CHC model as theoretical framework to analyze this skill. We could not point out psychomotor ability as a determinant of POCUS competence.

Comparison Between Self-Deliberate Practice and Directed Learning Training Methods for Basic Life Support Knowledge and High-Quality Cardiopulmonary Resuscitation Skill Retention in Second-Year Medical Students 3 and 6 Months After Training

Background

Cardiopulmonary resuscitation (CPR) requires well-trained medical personnel. Multiple learning methods can be done for CPR skills training. This study aimed to compare self-deliberate practice (SDP) method and directed learning (DL) method to improve basic life support (BLS) knowledge and CPR skill performance in medical students.

Methods

This is an experimental, single-blind, randomized controlled trial study of 40 medical students from February to July 2019. Forty subjects were randomly assigned into SDP and DL groups through a voluntary sampling method. Both groups attended a 1-day course and then practiced once a month for 3 months. The DL group had practice sessions with assigned tutors, while the SDP group had to practice by themselves. Examination of BLS knowledge and CPR performance quality (compression depth, rate, and performance score) was collected before and after course lecture, after a skills training, 3 and 6 months after training.

Results

Subject characteristics of both groups were comparable. Significant knowledge and skill improvement were found in the DL group and the SDP group when compared to their knowledge and skill before training. There were no significant differences between both groups in BLS knowledge and CPR performance quality in all examination periods.

Conclusion

Both SDP and DL teaching methods show significant improvement and excellent retention in BLS knowledge and high-quality CPR performance. These two learning methods are both feasible and bring positive results for students.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01746-7.

The obligation to succeed when it matters the most-The influence of skill and pressure on the success in football penalty kicks

In order to gain a more comprehensive understanding of the influence of skill and pressure on the success in football penalty kicks, we analyzed 1711 penalties taken over a 15-year period in major international tournaments. We conducted a multiple correspondence analysis in order to reduce six variables that are associated with skill and pressure to two dimensions that reflect our target concepts. Then, we used these two factors as independent variables in a logistic regression and fit different models using three binary dependent variables. The results show that high situational pressure significantly increases the probability of missing the goal entirely by about 6%, independent of the player's skill level. The probability that the goalkeeper saves a penalty significantly decreases by roughly 4% when a highly skilled player takes the shot. In general, high situational pressure decreases the probability of scoring a penalty kick. Furthermore, the probability to score a penalty increases if a highly skilled player takes the kick which indicates that a high skill level can act as a kind of buffer against debilitating effects caused by performance pressure.

Impact of Using Educational Multimedia on Knowledge, Skill, and Reduction of Medical Error Following Bronchoscopy

Background

Achieving procedural skills is one of the pillars of health higher education which is in line with the social responsibility of medical education. Since it is not possible to encounter important cases in bronchoscopy during the training course, the common cases that the students encounter in their future work environment were prepared as an educational video. Therefore, the purpose of this study was to find out the impact of using bronchoscopy educational video intervention on medical assistants' knowledge, skill, and medical error comparing it with the traditional method at Dr. Masih Daneshvari Hospital.

Materials and Methods

In this experimental study, two groups were randomly assigned: the experimental and the control. Each one consists of 15 participants. The first group used mannequins (traditional method) and the second used multimedia as the experimental group. Both groups were evaluated by pre and post-tests. Multiple choices (MCQs) were given to evaluate the knowledge and a checklist for skills. A comparison of the impact of intervention before and after education in both groups was statistically analyzed using the independent t-test.

Results

There were statistically significant differences between the experimental group and the control group at a significance level of 0.042 for the skill. An average increase of 3 points was observed in the experiment group, while the control group increased by 1.4 points. No significant difference was seen for knowledge. The number of patients with pneumothorax was also decreased.

Conclusion

Results showed that the multimedia training method effectively promotes the assistants' skills and reduces medical errors following bronchoscopy Administration. It is recommended to use educational videos (multimedia) to improve assistants' skills. It is suggested to apply the new model of education rather than sticking to the traditional one.

Evaluation of a scoring system to assess proficiency in cerebral angiography for neuroendovascular surgery education

Objective

Cerebral angiography is indispensable for endovascular neurosurgeons. However, there is no established system to evaluate the competency of trainees. We established a scoring system and statistically analyzed its characteristics.

Methods

Endovascular neurosurgeons scored the operators of 177 cerebral angiography based on ten evaluation items. Preoperative explanation, device selection, and device assembly were classified as "preparation," communication with the patient, radiation protection and angiography system as "attention," and catheter operation, blood loss, procedure completion, and sheath insertion as "skill". The sum of the scores were compared using the Mann-Whitney test according to the status of the operator (trainee (TR), neurosurgeon (NS), or endovascular neurosurgeon (EVNS)).

Results

The highest average for each item was 0.89 for communication, and the lowest was 0.68 for catheter operation. The mean ± standard deviation of the total score was 7.82 ± 2.02, and scores by status were 7.08 ± 2.12 for TR, 8.32 ± 1.35 for NS, and 9.33 ± 1.20 for EVNS with significant differences among each status (p < 0.05). The sum scores of the preparation, attention, and skill sections also showed significant differences between each status except between NS and EVNS in the preparation section and TR and NS in the skill section (p < 0.05).

Conclusions

There were significant differences in the total score between statuses, suggesting that the scoring system may be an indicator of proficiency in cerebral angiography. It was suggested that dividing each item into preparation, attention, and skill sections may indicate the characteristics of proficiency.

Comparison of real-time feedback and debriefing by video recording on basic life support skill in nursing students

BACKGROUND

Cardiopulmonary resuscitation skill have a direct impact on its success rate. Choosing the right method to acquire this skill can lead to effective performance. This investigation was conducted to compare the effect of Real-time feedback and debriefing by video recording on basic life support skill in nursing students.

METHODS

This quasi-experimental study was performed on 67 first year nursing students. First, a theoretical basic life support (BLS) training session was held for the all participants, at the end of session the pre-test was taken. Students were randomly assigned to two groups. A 4-hour practical BLS training session was conducted in the real - time feedback group as well as the debriefing by video recording group, and at the end of the training, a post-test was taken from each group. Each group received a post-test. Data were analyzed using SPSS 25 software.

RESULTS

Results showed a significant difference between mean (SD) of debriefing by video recording group in pre-test and post-test (p < 0.001) and in the real-time feedback group there was a significant difference between mean (SD) in pre-test and post-test (p < 0.001), respectively. In addition, there was no significant difference between the mean score of basic life support skill in real-time feedback and debriefing by video recording.

CONCLUSIONS

Both real-time feedback and debriefing by video recording were effective on basic life support skill.

The moderating effect of parental skills for antibiotic identification on the link between parental skills for antibiotic use and inappropriate antibiotic use for children in China

BACKGROUND

Inappropriate antibiotic consumption promotes antibiotic resistance. However, findings on the association between antibiotic-related knowledge and behaviors are inconsistent and contradictory, resulting in unjustified guidance of interventions. The mechanisms between the different kinds of antibiotic-related skills contained in knowledge modules in some previous studies are indistinct and rarely studied.

METHODS

A cross-sectional survey was conducted between June 2017 and April 2018 in three Chinese provinces, investigating 9526 parents with children aged 0-13 years old. Data from 1944 parents who self-medicated their children and 2478 respondents whose children sought care were analyzed.

RESULTS

Skills for antibiotic identification were found to be a moderator for the association between skills for antibiotic use and two inappropriate behaviors. Compared with parents with low levels of both skills for antibiotic identification and use, those mastering both skills at either medium (OR = 0.48, 95% CI [0.26-0.88]) or high (OR = 0.15, 95% CI [0.07-0.34]) level were less likely to self-medicate their children with antibiotics. Parents with a medium level of skills for antibiotic identification and high level of skills for antibiotic use (OR = 0.18, 95% CI [0.08-0.44]) and those with a high level of both skills (OR = 0.15, 95% CI [0.05-0.47]) were less likely to ask doctors for antibiotics when seeking care.

CONCLUSION

Parents' high level of skills for antibiotic identification is revealed to promote inappropriate antibiotic use when parents master a low level of skills for antibiotic use. Conversely, based on excellent skills for antibiotic use, better skill for antibiotic identification is associated with a greater reduction in inappropriate behaviors. We recommend future health education to strengthen skills for antibiotic identification along with guidance on antibiotic use.

Effect of a low-cost instruction card for automated external defibrillator operation in lay rescuers: a randomized simulation study

BACKGROUND

To evaluate whether a simplified self-instruction card can help potential rescue providers use automated external defibrillators (AEDs) more accurately and quickly.

METHODS

From June 1, 2018, to November 30, 2019, a prospective longitudinal randomized controlled simulation study was conducted among 165 laypeople (18-65 years old) without prior AED training. A self-instruction card was designed to illuminate key AED operation procedures. Subjects were randomly divided into the card (n=83) and control (n=82) groups with age stratification. They were then individually evaluated in the same simulated scenario to use AED with (card group) or without the self-instruction card (control group) at baseline, post-training, and at the 3-month follow-up.

RESULTS

At baseline, the card group reached a significantly higher proportion of successful defibrillation (31.1% vs. 15.9%, P=0.03), fully baring the chest (88.9% vs. 63.4%, P<0.001), correct electrode placement (32.5% vs. 17.1%, P=0.03), and resuming cardiopulmonary resuscitation (CPR) (72.3% vs. 9.8%, P<0.001). At post-training and follow-up, there were no significant differences in key behaviors, except for resuming CPR. Time to shock and time to resume CPR were shorter in the card group, while time to power-on AED was not different in each phase of tests. In the 55-65 years group, the card group achieved more skill improvements over the control group compared to the other age groups.

CONCLUSION

The self-instruction card could serve as a direction for first-time AED users and as a reminder for trained subjects. This could be a practical, cost-effective way to improve the AED skills of potential rescue providers among different age groups, including seniors.

Effects of climbing- and resistance-training on climbing-specific performance: a systematic review and meta-analysis

The objective of this systematic review and meta-analysis was to examine the effects of climbing and climbing-and-resistance-training on climbing performance, and strength and endurance tests. We systematically searched three databases (SPORTDiscus, SCOPUS, and PubMed) for records published until January 2021. The search was limited to randomized-controlled trials using active climbers and measuring climbing performance or performance in climbing-specific tests. Data from the meta-analysis are presented as standardized difference in mean (SDM) with 95% confidence intervals (95% CI). Eleven studies are included in the systematic review and five studies compared training to a control group and could be meta-analyzed. The overall meta-analysis displayed an improvement in climbing-related test performance following climbing-specific resistance training compared to only climbing (SDM = 0.57, 95%CI = 0.24-0.91). Further analyses revealed that finger strength (SDM = 0.41, 95%CI 0.03-0.80), rate of force development (SDM = 0.91, 95%CI = 0.21-1.61), and forearm endurance (SDM = 1.23, 95%CI = 0.69-1.77) were improved by resistance-training of the finger flexors compared to climbing training. The systematic review showed that climbing performance may be improved by specific resistance-training or interval-style bouldering. However, resistance-training of the finger flexors showed no improvements in strength or endurance in climbing-specific tests. The available evidence suggests that resistance-training may be more effective than just climbing-training for improving performance outcomes. Importantly, interventional studies including climbers is limited and more research is needed to confirm these findings.

Pacing Behaviour Development and Acquisition: A Systematic Review

BACKGROUND

The goal-directed decision-making process of effort distribution (i.e. pacing) allows individuals to efficiently use energy resources as well as to manage the impact of fatigue on performance during exercise. Given the shared characteristics between pacing behaviour and other skilled behaviour, it was hypothesized that pacing behaviour would adhere to the same processes associated with skill acquisition and development.

METHODS

PubMed, Web of Science and PsycINFO databases between January 1995 and January 2022 were searched for articles relating to the pacing behaviour of individuals (1) younger than 18 years of age, or (2) repeatedly performing the same exercise task, or (3) with different levels of experience.

RESULTS

The search resulted in 64 articles reporting on the effect of age (n = 33), repeated task exposure (n = 29) or differing levels of experience (n = 13) on pacing behaviour. Empirical evidence identifies the development of pacing behaviour starts during childhood (~ 10 years old) and continues throughout adolescence. This development is characterized by an increasingly better fit to the task demands, encompassing the task characteristics (e.g. duration) and environment factors (e.g. opponents). Gaining task experience leads to an increased capability to attain a predetermined pace and results in pacing behaviour that better fits task demands.

CONCLUSIONS

Similar to skilled behaviour, physical maturation and cognitive development likely drive the development of pacing behaviour. Pacing behaviour follows established processes of skill acquisition, as repeated task execution improves the match between stimuli (e.g. task demands and afferent signals) and actions (i.e. continuing, increasing or decreasing the exerted effort) with the resulting exercise task performance. Furthermore, with increased task experience attentional capacity is freed for secondary tasks (e.g. incorporating opponents) and the goal selection is changed from achieving task completion to optimizing task performance. As the development and acquisition of pacing resemble that of other skills, established concepts in the literature (e.g. intervention-induced variability and augmented feedback) could enrich pacing research and be the basis for practical applications in physical education, healthcare, and sports.

Effectiveness of peer teaching in health professions education: A systematic review and meta-analysis

BACKGROUND

The reform in health professions education requires the focus to shift from fact memorization to exploring, analyzing, assimilating, and synthesizing information to promote active and collaborative learning. Peer teaching is one of the educational strategies.

AIMS

This review aimed to explore and synthesize quantitative evidence to determine the overall effect of peer teaching in enhancing students' theoretical knowledge and practical skills (e.g., procedural skills and resuscitation) in health professions education.

METHODS

PubMed, ScienceDirect, CINAHL, ERIC, ProQuest, reference lists of relevant studies, and reviews were searched till November 2021. Results were pooled using random-effects meta-analysis or narrative synthesis.

RESULTS

A total of 44 RCTs were included. This review showed a significant effect of peer teaching on procedural skills improvement and a comparable effect on theoretical knowledge and resuscitation skills acquisition compared to the conventional teaching method. Near-peer teaching seemed to be the most effective method for skill improvement. Subgroup analysis showed no significant differences between peer teaching and conventional teaching groups (e.g., expert/faculty teaching, self-study or lectures).

CONCLUSIONS

Peer teaching seems to be a promising teaching and learning strategy in health professions education, positively affecting theoretical knowledge and procedural skills. Future research should explore the effect of peer teaching in developing countries to provide a comprehensive picture of peer teaching.

Which Model Is Better to Teach How to Perform Tube Thoracostomy: Synthetic, Cadaver, or Animal?

INTRODUCTION

The lack of standardized skill training reported by medical students in performing tube thoracostomies may be associated with higher complications. The ideal training model is yet to be determined. This study sought to evaluate three different models.

METHODS

Between 2015 and 2017, 204 last-year medical students of Universidade de São Paulo with no prior training in tube thoracostomy were randomized into three groups: cadaver, pig, and synthetic models. All groups performed 1-d tube thoracostomy hands-on training and a 40-min theoretical class. The knowledge acquisition was measured by a comparison between a theoretical test before and 3 wk after the class, and the skills improvement was evaluated by a comparison between the skills test on the same day of the hands-on training and another after 24 wk (the retention skill test). A questionnaire was submitted to evaluate their satisfaction rate and self-reported confidence, as per a Likert scale.

RESULTS

The theoretical post-test score was higher compared to the pretest score in all groups (P < 0.001). The retention skills test in the cadaver and synthetic groups decreased compared to the skills test (P = 0.01 and P = 0.007, respectively). There was no difference between the groups either in the theoretical test or in the skills test. Student satisfaction was higher in the cadaver and pig groups. The confidence perception increased in all groups after the training.

CONCLUSIONS

The models used for tube thoracostomy training appear to have a similar impact on skills retention, knowledge acquisition, and confidence. Although the satisfaction rate is lower for the synthetic model, it has no biological risk or ethical issues and is more feasible.

Expanding Rehabilitation Options for Dysphagia: Skill-Based Swallowing Training

Over the past four decades, our understanding of swallowing neural control has expanded dramatically. However, until recently, advances in rehabilitation approaches for dysphagia have not kept pace, with a persistent focussing on strengthening peripheral muscle. This approach is no doubt very appropriate for some if not many of our patients. But what if the dysphagia is not due to muscles weakness? The purpose of this clinical manuscript is to reflect on where we have been, where we are now and perhaps where we need to go in terms of our understanding of swallowing motor control and rehabilitation of motor control impairments. This compilation is presented to clinicians in the hope that suggesting approaches "outside the box" will inspire clinicians to focus their attention "inside the box" to ultimately improve rehabilitation and long-term outcomes for patients with dysphagia.

"Not everyone can do this": childcare context and the practice of skill in emotional labor

Scholarship remains divided about whether emotional labor is 'skilled'. Interrogating gendered skill constructs that render emotions in work invisible, I examine two organizational contexts in the Early Childhood Education and Care (ECEC) sector: family and center-based care. I draw from 43 interviews, primarily with Latina and White women workers, reflecting feminized and racialized workplaces. I also draw from ethnographic and observational data. Challenging the particular devaluation of family-based care, findings reveal that the practice of skill in emotional labor is organizationally shaped across less and more institutionalized forms of ECEC. Examining worker critiques of professionalization norms and credential-based skill metrics, autonomy is also identified as a pre-requisite for embodied, tacit and discretionary skills in the emotional labor of ECEC.

Joining with the Conversation: Research as a Sustainable Practice in the Sport Sciences

What would it mean to consider research in the sport sciences as a sustainable practice? Taking a step back, in such a context, what would sustainability even mean? The time is ripe to address such questions, and what we lay out here are our initial thoughts on this most contemporary of issues. We start by exploring what is meant by the term ‘sustainability’. Rather than following mainstream thinking—the harnessing of earthly resources commodified and exploited as ‘renewables’—we situate it in the sport sciences as a continuing response-ability to the experiences of others. This view is rooted in ‘commoning’—an intransitive verb in which people conjoin varied experiences through correspondence. What makes this sustainable, is its ongoing open-endedness; meaning, it carries on as people (co)respond to one another. Central to this idea is a perceptual system attuned to the ebbs and flows of what or who one is corresponding with. Though, the current modus operandi of research in the sport sciences is located, not on the skilled perception of the scientist corresponding with the coming-into-being of phenomena, but on an unsustainable model of recognition that views phenomena as ‘objects of analysis’, fixed and final in form, waiting to be known about by means of reduction, fragmentation and classification. For research in the sport sciences to become a sustainable practice, we propose a scholarship that prioritises direct observation and participation with what holds our attention, corresponding within its natural ecology of relations, embedding the phenomenon itself. This re-conceptualisation of science views research as a response-able scholarship grounded in conversation. Like inquiring about the well-being of loved ones, what sustains such a scholarship is curiosity, care and hope—a curiosity about which captivates us, a care that sees us respond to what we observe, and a hope of carrying the correspondence on, together.

A Proposed Framework to Describe Movement Variability within Sporting Tasks: A Scoping Review

Movement variability is defined as the normal variations in motor performance across multiple repetitions of a task. However, the term "movement variability" can mean different things depending on context, and when used by itself does not capture the specifics of what has been investigated. Within sport, complex movements are performed repeatedly under a variety of different constraints (e.g. different situations, presence of defenders, time pressure). Movement variability has implications for sport performance and injury risk management. Given the importance of movement variability, it is important to understand the terms used to measure and describe it. This broad term of "movement variability" does not specify the different types of movement variability that are currently being assessed in the sporting literature. We conducted a scoping review (1) to assess the current terms and definitions used to describe movement variability within sporting tasks and (2) to utilise the results of the review for a proposed framework that distinguishes and defines the different types of movement variability within sporting tasks. To be considered eligible, sources must have assessed a sporting movement or skill and had at least one quantifiable measure of movement variability. A total of 43 peer-reviewed journal article sources were included in the scoping review. A total of 280 terms relating to movement variability terminology were extracted using a data-charting form jointly developed by two reviewers. One source out of 43 (2%) supplied definitions for all types of movement variability discussed. Moreover, 169 of 280 terms (60%) were undefined in the source material. Our proposed theoretical framework explains three types of movement variability: strategic, execution, and outcome. Strategic variability describes the different approaches or methods of movement used to complete a task. Execution variability describes the intentional and unintentional adjustments of the body between repetitions within the same strategy. Outcome variability describes the differences in the result or product of a movement. These types emerged from broader frameworks in motor control and were adapted to fit the movement variability needs in sports literature. By providing specific terms with explicit definitions, our proposed framework can ensure like-to-like comparisons of previous terms used in the literature. The practical goal of this framework is to aid athletes, coaches, and support staff to gain a better understanding of how the different types of movement variability within sporting tasks contribute to performance. The framework may allow training methods to be tailored to optimise the specific aspects of movement variability that contribute to success. This review was retrospectively registered using the Open Science Framework (OSF) Registries ( https://osf.io/q73fd ).

Entrustable professional activities versus competencies and skills: Exploring why different concepts are often conflated

Despite explanations in the literature, a returning question in the use of entrustable professional activities (EPAs) is how to distinguish them from competencies and skills. In this article, we attempt to analyze the causes of the frequent confusion and conflation of EPAs with competencies and skills, and argue why the distinction is important for education, qualification and patient safety. 'Tracheotomy', 'lumbar puncture', 'interprofessional collaboration' for example are colloquially called 'skills', but its is a person's ability to perform these activities that is the actual skill; the EPA is simply the activity itself. We identify two possible causes for the confusion. One is a tendency to frame all educational objectives as EPAs. Many objectives of medical training can be conceptualized as EPAs, if 'the ability to do X' is the corresponding competency; but that does not work for all. We offer ways to deal with objectives of training that are not usefully conceptualized as EPAs. A more fundamental cause relates to entrustment decisions. The permission to contribute to health care reflects entrustment. Entrustment decisions are the links or pivots between a person's readiness for the task and the actual task execution. However, if entrustment decisions do not lead to increased autonomy in the practice of health care, but only serve to decide upon the advancement to a next stage of training, EPAs can become the tick boxes learners feel they need to collect to 'pass'. Gradually, then, EPAs can loose their original meaning of units of practice for which one becomes qualified.

A comparison of treatment signatures of high and low performing physical therapists for patients with lower back pain: analysis of spine care from a physical therapy outcomes registry

INTRODUCTION

Lower back pain (LBP) is the most common orthopedic complaint in the United States. Physical therapy is recommended as a conservative, non-pharmacological intervention for LBP. While it is thought that skill level and effectiveness of physical therapists differ, there is little understanding regarding characteristics that distinguish high and low performing physical therapists. The purpose of this study was to compare differences in care delivery, termed treatment signatures, between high and low performing physical therapists previously differentiated by a risk-adjusted performance measure.

METHODS

Using previously published methodology, 1,240 physical therapists were classified as "outperforming", "meeting expectations", or "underperforming" relative to predicted change in Modified Low Back Pain Disability Questionnaire (MDQ) across patients receiving care for LBP. Patients were divided into quartiles of baseline disability per initial MDQ. Two-way analyses of variance were used to compare billed (1) active, exercise-based units per visit (UPV), (2) manual therapy UPV, (3) modality UPV, and (4) the combination of active and manual therapy UPV (broadly termed skilled UPV) by performance cohort and baseline patient disability quartile among physical therapists deemed "outperforming" and "underperforming". Tukey's post hoc tests established mean differences with 95% confidence intervals.

RESULTS

Physical therapists that "outperformed" (n=120; 17,404 patients) used more active UPV (mean difference (diff) = 0.1, p<.001), manual therapy UPV (mean diff = 0.2, p<.001), and skilled UPV (mean diff = 0.3, p<.001), and less modality UPV (mean diff = 0.1, P < 0.001) than those that "underperformed" (n=139; 21,800 patients). Tukey's post hoc tests showed that while differences in care were negligible in patients with low baseline disability, the highest performing PT cohort delivered skilled (0.4 UPV), active (0.2 UPV), and manual therapy (0.2 UPV) UPV at a significantly higher mean rate in patients with the highest baseline disability.

CONCLUSIONS

Clinically effective physical therapists incorporated a treatment signature that included a consistent blend of skilled active and manual therapy interventions that was distinct from lower performing physical therapists. While group mean differences were relatively small, a consistent pattern emerged in which high performing physical therapists maintained a high level of skilled, one-on-one interventions across their entire caseload-while their lower performing counterparts significantly decreased use of the same interventions as baseline disability increased. These differences highlighted a treatment signature that was associated with clinically important improvements for patients with greater baseline disability. Future guideline recommendations should consider the importance of baseline disability and the consistent application of skilled active and manual therapy interventions.

Associations between bio-motor ability, endocrine markers and hand-specific anthropometrics in elite female futsal players: a pilot study

BACKGROUND

The second-to-fourth digit ratio (2D:4D) has been calculated for individual athletes and sports, but it has not been investigated in futsal performance. Therefore, the aim of this study was to investigate any relationships between 2D:4D of the dominant and non-dominant hands and physical capacity performances, selected functional variables and hormone concentrations in elite female futsal players.

METHODS

Twenty-four elite female futsal players were measured for 2D:4D in the dominant (2D:4D_D) and non-dominant (2D:4D_ND) hand. The futsal specific performance test (FSPT), hand-grip strength (HGS) and aerobic power were also assessed. In addition, selected circulatory hormones were measured (estradiol, cortisol, growth hormone and insulin like growth factor-1). Pearson's correlation test was used to identify correlational relationships.

RESULTS

Total test-time and performance time (total time + penalty time) for the FSPT showed a significant correlation with 2D:4D_D (r = 0.53, p = 0.005 and r = 0.55, p = 0.003, respectively). HGS_ND also displayed a significant correlation with the 2D:4D_D (r = 0.59, p = 0.002). Aerobic power and time spent running on the treadmill also showed a significant relationship with 2D:4D_ND (both, r = 0.54, p = 0.006). Cortisol showed a significant correlation with 2D:4D_D (- 0.58, p = 0.003) and 2D:4D_ND(- 0.52, p = 0.008).

CONCLUSIONS

The measurement of 2D:4D ratio could be an important factor in determining potential performance attributes and talent identification of elite female futsal players. Further studies are needed in this area to further examine the results presented here.

How does curve sprint evolve across different age categories in soccer players?

Research has shown that soccer players regularly execute curved sprints during matches. The purpose of this study was to determine the age-related effects on curve sprint (CS) performance to both sides, asymmetry, and association with linear sprint (LS). Eighty-four soccer players (aged 16.1 ± 1.6 categorized in U15, U17, and U20) were recruited, who performed CS and LS tests. One-way analysis of variance (ANOVA) and effect size (ES) were used to compare CS performance between age categories, and relationships between physical performance measures were calculated using Pearson’s correlation coefficient. The main findings of this study were that: 1) there were significant differences in the “good” side CS among age groups (p < 0.001; ES from moderate to large), but not in the “weak” side CS, 2) curve asymmetry was significantly higher in U20 than U15 (p < 0.05; ES large) and U17 players (p < 0.05; ES moderate), and 3) relationships between CS and LS times decreased with age (from significant and very large [p < 0.001] to non-significant and smallmoderate [p > 0.05]). This study highlights the importance of assessing and training CS in different age categories, an action that becomes less correlated with LS as age increases, with the aim of mitigating the increase in asymmetries as a result of the specialization process, focusing interventions mainly on improving the CS “weak” side.

Mind, body, and shuttle: multidimensional benchmarks for talent identification in male youth badminton

The aim of the study was to identify benchmarks for anthropometric, physical performance, motor coordination, and psychological characteristics by comparing youth badminton players of different levels through the use of a multifactorial test battery. Sixty-one male participants aged 12-18 years were divided into three groups: elite (N = 10), sub-elite (N = 24), and novice (N = 27). Standard test batteries for anthropometry (including measures to estimate biological maturity), physical performance, and motor coordination were applied, as well as the modified PCDEQ2 questionnaire for psychological characteristics of youth athletes (Hill, 2016). Multivariate analyses of covariance (MANCOVAs) with age and biological maturity as covariates were used to investigate differences between skill levels. A discriminant analysis was used to reveal to what extent participants could be correctly assigned to their skill group. Significant differences were found in physical performance (explosive power, flexibility, speed, and endurance), BMI and motor coordination. In the psychological domain, perfectionism was found to be significantly different and elites scored highest. The discriminant analysis showed that 100% of the participants were correctly classified and 80.0% were correctly cross validated. These results significantly add to the previously limited youth players' reference values, and confirm the value of a generic, i.e. without sport-specific testing, multifactorial approach to talent identification in youth badminton.

Effect of ground technicity on cardio-respiratory and biomechanical parameters in uphill trail running

The goal of this study was to analyse the effects of ground technicity on cardio-respiratory and biomechanical responses during uphill running. Ten experienced male trail-runners ran ∼10.5 min at racing pace on two trails with different (high and low) a priori technicity levels. These two runs were replicated (same slope, velocity, and distance) indoor on a motor-driven treadmill. Oxygen uptake, minute ventilation (V̇_E), heart rate as well as step frequency and medio-lateral feet accelerations (i.e. objective indices of uneven terrain running patterns adjustments) were continuously measured throughout all sessions. Rating of perceived exertion (RPE) and perceived technicity were assessed at the end of each bout. Oxygen cost of running (O₂Cr) (+10.5%; p < 0.001), V̇_E (+21%; p < 0.004) and the range and variability of feet medio-lateral accelerations (+116% and +134%, respectively; p < 0.001), were significantly greater when running on trail compared to the treadmill, regardless of the a priori technicity level. Despite perceived technicity being lower on treadmill (p < 0.001), RPE was not different between trail and treadmill runs (p < 0.68). It is concluded that running uphill on a trail vs. a treadmill significantly elevates both O₂Cr and magnitude/variability of feet medio-lateral accelerations but no difference could be identified between trails of different a priori technicities. These results strengthen the need for trainers and race organisers to consider terrain technicity per se as a challenging cardio-respiratory and biomechanical component in uphill trail running.

Learning media based on augmented reality (AR) increased the skill of physical examination of the integumentary system of pregnant women in midwifery students

OBJECTIVE

This research was to analyze the correlation of AR-based Learning Media to improving the physical examination of the integumentary system of pregnant women in midwifery students.

METHOD

The research method used Quasi-experimental with Non-Equivalent Control Group Design. The sample of 92 students was selected by a purposive sample, divided into two intervention and control groups. The intervention group was 62 students, and the control group was 30 students. Data collection was performed using a checklist to assess the skill of the physical examination of the integumentary system of pregnant women. To test the differences of skill before and after treatment in control and intervention groups used the Mcnemar test, whereas to know the differences in skill from time to time Cochran test was used.

RESULT

The results showed differences in the measurement of skills improvement in the control and intervention groups before and after the intervention was given. A more significant increase in skills occurred in the intervention group with a p-value <0.001 contributing after 1week of giving a demonstration, and application-based (AR) skills increased by 66.1%. After two weeks it increased by 93.5%, and after two weeks it increased by 100%. So it could be concluded statistically that AR-based learning media was significant in improving the physical examination skills integumentary systems in pregnant women.

Acquisition of microvascular suturing techniques is feasible using objective measures of performance outside of the operating room

AIMS

The aim of this study was to determine the effectiveness of a microsurgical simulation course on a group of novice surgeons. The study also aimed to see whether a device to measure manual dexterity (Imperial College Surgical Assessment Device, ICSAD), a global rating scale and an end product assessment tool could be used to objectively measure performance.

METHODS

30 surgeons were recruited to take part and were evenly split into a novice, intermediate and expert group. The novice group took part in a one-week microsurgical course. The assessment of performance was done with the surgeon anastomosing a harvested rat aorta. They were assessed using ICSAD, which records number of hand movements, distance moved by hands and time. The assessment was also video recorded and were later watched by two assessors. The procedure performance was scored using a global rating scale and the final anastomosis was scored using an end product assessment tool. The novice surgeons took the assessment at the beginning and at the end of the course. The intermediate and expert group performed the assessment once to use as a comparison to the novice group.

RESULTS

By the end of the course the novices performed significantly better in all parameters in comparison to their pre course assessment. The novice group performed similarly to the expert group in their end of course assessment in four out of the five assessment parameters.

CONCLUSION

Simulation using objective measures of performance can be used to effectively to train a group of novice microsurgeons.

Children are suboptimal in adapting motor exploration to task dimensionality during motor learning

Motor learning in novel tasks requires exploration to find the appropriate coordination patterns to perform the task. Prior work has shown that compared to adults, children show limited exploration when learning a task that required using upper body movements to control a 2D cursor on a screen. Here, by changing the task dimensionality to 1D, we examined two competing hypotheses: whether children show limited exploration as a general strategy, or whether children are suboptimal in adapting their exploration to task dimensionality. Two groups of children (9- and 12-year olds), and one group of adults learned a virtual task that involved learning to control a cursor on the screen using movements of the upper body. Participants practiced the task for a single session with a total of 232 reaching movements. Results showed that 9-year olds show worse task performance relative to adults, as indicated by higher movement times and path lengths. Analysis of the coordination strategies indicated that both groups of children showed lower variance along the first principal component, suggesting that they had greater exploration than adults which was suboptimal for the 1D task. These results suggest that motor learning in children is characterized not by limited exploration per se, but by a limited adaptability in matching motor exploration to task dimensionality.

Effect of community-based education on undergraduate nursing students' skills: a systematic review

Background

Community-based education, as an effective approach to strengthen nurses’ skills in response to society’s problems and needs has increased in nursing education programs. The aim of this study was to review the effect of community-based education on nursing students’ skills.

Methods

For this systematic review, ProQuest, EMBASE, Scopus, PubMed/ MEDLINE, Cochran Library, Web of Science, CINAHL and Google Scholar were searched up to February 2021. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Seventeen studies were included in this systematic review. Inclusion criteria included articles published in English and were original articles.

Results

In all studies, undergraduate nursing students’ skills were improved by participation in a community-based education program. Community-based education enhances professional skills, communication skills, self-confidence, knowledge and awareness, and critical thinking skills and teamwork skills in undergraduate nursing students.

Conclusions

Community-based education should be used as an effective and practical method of training capable nurses to meet the changing needs of society, to improve nurses ‘skills and empower them to address problems in society.

The improvement of 10th students' mathematical communication skills through learning ellipse topics

Mathematical education in general, and mathematics education at high schools in particular, creates favorable conditions for students to develop essential and core competencies and assists students in improving their mathematical competence as a foundation for good learning. It also promotes necessary skills for society, in which mathematical communication skills are essential skills. The purpose of the research is to enhance students' mathematical communication skills while studying ellipse topics. In this study, 87 students in the tenth grade were tested to see if the teaching process for accelerating the development of mathematical communication skills related to ellipse topics was effective and possible. Students in the experimental class were instructed using a four-step learning model with the activities regarding the ACODESA method and mind map, whereas students in the control class were guided using the conventional way of instruction. A study design involving a pre-test, a treatment, and a post-test was used to determine the effectiveness of this type of teaching approach. Quantitative and qualitative analyses of the gathered data assessed the students' progress in mathematical language activities. The findings indicated that most students' mathematical communication skills regarding ellipse topics had improved significantly. The learners towards the above process also showed a positive attitude. In addition, the research findings have important implications and recommendations.

Continuum of Surgical Skill Acquisition for the Postgraduate Residents During COVID Pandemic: Role of Advanced Simulators in a Multipronged Modular Approach

Skill acquisition with required competencies as defined by the National Medical Commission for the postgraduate surgical residents can happen in a step-wise manner from novice or advanced beginner to competent levels. This requires well-defined program-specific objectives, teaching-learning and assessment methods as per the competency-based medical education curriculum. Various modalities of teaching for the residents are adapted during the COVID pandemic to maintain the continuum of learning. In this study, we have attempted to develop, implement, and evaluate the effectiveness of acquiring laparoscopic surgical skills using advanced simulators and with large live animal in a real-life situation by a modular training approach. This skill-based program was developed and implemented for final year General Surgery postgraduate residents of Yenepoya Medical College for training laparoscopic surgical competencies. The training was conducted at Advanced Simulation Centres of Yenepoya (Deemed to be University), Mangalore, Karnataka, India. Three training modules were prepared based on the competency-based medical education curriculum for incremental training with advanced simulators and large live animals in a real-life situation which included the sessions on briefing, scenarios, simulations, hands-on activities, debriefing, feedback, and assessment methods. Assessment after the modular training showed statistically significant improvement in their scores, and they scaled up their skill acquisition ladder after each module. The residents and faculty felt that integration from different specialties has increased their confidence levels and communication skills, exploring team dynamics with 1:1 mentorship to make them competent emphasizing the effectiveness of simulation-based training even during the pandemic.

TGMD-3 short version: Evidence of validity and associations with sex in Irish children

This study examined the internal structure and evidence of validity of the Test of Gross Motor Development 3^rd edition (TGMD-3) in primary school aged children. Participants (n = 1608, 47% girls, age range 5-11 years, mean age 9.2 ± 2.04) were recruited from Irish schools across twelve counties (56% rural, 44% urban). The TGMD-3 was used to measure FMS proficiency (Ulrich, 2020). A two-factor model (13 skills) was used and confirmatory indexes were calculated. The Bayesian criteria and the Composite Reliability were employed to evaluate alternative models. Relationships between the final model proposed with age, sex and BMI were calculated using a network analysis. Mplus 8.0 and Rstudio were used. A two-factor model (locomotion and object control) with adequate values (> 0.30) for the seven skills (gallop, hop, jump, two-hand strike, bounce, catch, overhand throw) presented excellent indexes. The skills with the highest indicator of strength centrality in the network were bounce and catch for both boys and girls and hop for boys and horizontal jump for girls. This study evidences the validity and reliability of the internal structure of the TGMD-3 and demonstrates that a short version of the TGMD-3, comprising seven skills is a valid measure of FMS in this population.

Constructing Expertise: Surmounting Performance Plateaus by Tasks, by Tools, and by Techniques

Acquiring expertise in a task is often thought of as an automatic process that follows inevitably with practice according to the log-log law (aka: power law) of learning. However, as Ericsson, Chase, and Faloon (1980) showed, this is not true for digit-span experts and, as we show, it is certainly not true for Tetris players at any level of expertise. Although some people may simply "twitch" faster than others, the limit to Tetris expertise is not raw keypress time but the techniques acquired by players that allow them to use the tools provided by the hardware and software to compensate for the game's relentlessly increasing drop speed. Unfortunately, these increases in drop speed between Tetris levels make performance plateaus very short and quickly followed by game death. Hence, a player's success at discovering, exploring, and practicing new techniques for the tasks of board preparation, board maintenance, optimal placement discovery, zoid rotation, lateral movement of zoids, and other tasks important to expertise in Tetris is limited. In this paper, we analyze data collected from 492 Tetris players to reveal the challenges they confronted while constructing expertise via the discovery of new techniques for gameplay at increasingly difficult levels of Tetris.

Evidence-based practice among Italian osteopaths: a national cross-sectional survey

BACKGROUND

While evidence-based practice (EBP) is widely accepted across healthcare professions, research investigating its implementation in manual therapy professions such as osteopathy is limited. The primary aim of this study was to investigate Italian osteopaths' attitudes, skills, and use of EBP. A secondary purpose was to understand the obstacles and enablers to EBP adoption in the Italian osteopathic context.

METHODS

A cross-sectional national survey was conducted (April to June 2020) among a sample of Italian osteopaths. Eligible participants were invited to complete the Italian-translated Evidence-Based practice Attitude and Utilization Survey (EBASE) anonymously online using various recruitment strategies, including email and social media campaigns. In addition to the three EBASE sub-scores (attitudes, skills and use), the demographic characteristics of the sample were considered.

RESULTS

A total of 473 osteopaths responded to the survey. The sample appeared to represent the Italian osteopathic profession. The majority of participants had a favorable attitude toward EBP. Eighty-eight percent of respondents agreed that EBP was necessary for osteopathy practice and that scientific literature and research findings were beneficial to their clinical scenario (95%). Perceived skill levels in EBP were rated as moderate, with the lowest scores for items relating to clinical research and systematic review conduct. Apart from reading/reviewing scientific literature and using online search engines to locate relevant research papers, participant engagement in all other EBP-related activities was generally low. Clinical practice was perceived to be based on a very small proportion of clinical research evidence. The primary obstacles to EBP implementation were a dearth of clinical evidence in osteopathy, and poor skills in applying research findings. The primary enablers of EBP adoption were access to full-text articles, internet connectivity at work, and access to online databases.

CONCLUSIONS

Italian osteopaths were largely supportive of evidence-based practice but lacked basic skills in EBP and rarely engaged in EBP activities. The updating of osteopathic training curriculum and professional formal regulation in Italy could provide a suitable framework to improve EBP skills and use.

Role-Play Assessment of Therapist Adherence and Skill in Implementation of Trauma-Focused Cognitive-Behavioral Therapy

Numerous efforts are underway to train clinicians in evidence-based practices. Unfortunately, the field has few practical measures of therapist adherence and skill with which to judge the success of these training and implementation efforts. One possible assessment method is using behavioral rehearsal, or role-play, as an analogue for therapist in-session behavior. The current study describes aspects of reliability, validity and utility of a behavioral role-play assessment developed to evaluate therapist adherence and skill in implementing Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT). TF-CBT role-play assessments were conducted with a sample of 43 therapists as part of a larger training study. The TF-CBT role-play assessments were independently coded for TF-CBT adherence and skill by a certified TF-CBT trainer and three clinical psychology doctoral students. Findings indicated good interrater reliability for the individual items (ICC: M = .71, SD = .15). Regarding utility, 67.19% (n = 43/64) of contacted therapists completed the role-play assessment, which took an average of 30 min (M = 31.42, SD = 5.65) to complete and 60 min (M = 62.84, SD = 11.31) to code. Therapists with a master's degree were more likely to complete the role-play assessment than those with other degrees but no other differences in demographic variables, practice characteristics, or TF-CBT knowledge or training were found between participants and nonparticipants. Role-play assessments may offer an alternative to observational coding for assessing therapist adherence and skill, particularly in contexts where session recordings are not feasible.

Single limb dynamics of jumping turns in dogs

Maneuverability is of paramount importance for many animals, e.g., in predator-prey interactions. Despite this fact, quadrupedal limb behavior in complicated maneuvers like simultaneous jumping and turning are not well studied. Twenty adult sport Border Collies were recorded while jumping over an obstacle and simultaneously turning. Kinetic and kinematic data were captured in synchrony using eight force plates and sixteen infrared cameras. These dogs were familiar with the task through regular participation in the dog sport agility. The experiments revealed that during landing, higher lateral forces acting in the forelimbs compared to hindlimbs. During landing, the outer limbs produced about twice the inner limbs' force in both vertical and lateral directions, showing their dominant contribution to turning. Advanced dogs showed significantly higher lateral impulse and stronger inner-outer limb asymmetry regarding lateral impulses than beginner dogs, leading to significantly stronger turning for advanced dogs. Somewhat unexpected, skill effects rarely explained global limb dynamics, indicating that landing a turn jump is a constrained motion. Constrained motions leave little space for individual techniques suggesting that the results can be generalized to quadrupedal turn jumps in other animals.

Efficacy of pedagogical framework in neonatal resuscitation skill learning in a resource-limited setting: a randomized controlled trial

BACKGROUND

The educational efficacy in neonatal resuscitation relies on the subject and teaching strategies. Therefore, it is imperative to test diverse educational methods if they are more instructive to engage students in active learning and practicing knowledge. Hence, the present study aims to investigate the efficacy of a pedagogical framework in neonatal resuscitation skill learning among nursing students in a resource-limited setting.

METHODS

A single-blind randomized controlled trial was conducted between October 2020 to March 2021. Sixty nursing students in the 3rd and 4th year of professional training were randomly allocated to the pedagogy and the traditional group. The pedagogy group learned via 6-step LSPPDM (Learn, See, Practice, Prove, Do, Maintain) pedagogy including lectures, video, clinical observation, skill sessions under supervision, and self-directed practice. The traditional group learned through 2-step (Learn, Practice) method that included lectures and skill sessions under supervision. The outcomes measured included technical and non-technical skills in neonatal resuscitation. The technical skill deals with steps such as stimulation, ventilation, oxygenation, intubation, chest compression, medications, and reporting. Non-technical skills refer to teamwork skills that focus on the interaction between leader and helper. Both skills were measured through previously published validated tools two times before and after the intervention by blinded assessors in a simulated delivery room.

RESULTS

Overall, the skill was significantly improved in both groups after intervention. Yet, the results showed that the mean difference of technical skill score in the pedagogy group (24.3 ± 3.5) was significantly higher (p <  0.001) compared to the traditional group (16.2 ± 2.4). Likewise, the mean difference of non-technical skill score in the pedagogy (36.9 ± 1.9) was highly significant (p <  0.001) compared to the traditional group (31.2 ± 1.7).

CONCLUSIONS

The LSPPDM pedagogy was found more effective in enhancing technical and non-technical skills in neonatal resuscitation compared to the traditional method. The results of this study support the efficacy of the 6-step LSPPDM pedagogy in the education of nursing students regarding neonatal resuscitation in a resource-limited setting.

TRIAL REGISTRATION

Prospectively registered at ClinicalTrials.gov ( NCT04748341 ).

Aptitude and attitude: predictors of performance during and after basic laparoscopic skills training

Background

Manual dexterity and visual-spatial ability are considered key to the development of superior laparoscopic skills. Nevertheless, these abilities do not reliably explain all the variance found in the technical performance of surgical trainees. Consequently, we must look beyond these abilities to improve our understanding of laparoscopic skills and to better identify/develop surgical potential earlier on.

Purpose

To assess the individual and collective impact of physical, cognitive, visual, and psychological variables on performance during and after basic simulation-based laparoscopic skills training.

Method

Thirty-four medical students (laparoscopic novices) completed a proficiency-based laparoscopic skills training program (using either a 2D or 3D viewing mode). This was followed by one testing session, a follow-up testing session with new (yet similar) tasks, and a series of physical, cognitive, visual, and psychological measures.

Results

The statistical models that best predicted variance in training performance metrics included four variables: viewingmode (2D vs 3D), psychologicalflexibility, perceivedtaskdemands, and manualdexterity (bimanual). In subsequent testing, a model that included viewingmode and manualdexterity (assembly) best predicted performance on the pre-practiced tasks. However, for a highly novel, spatially complex laparoscopic task, performance was best predicted by a model that comprised viewingmode, visual-spatialability, and perceivedtaskdemands. At follow-up, manualdexterity (assembly) alone was the best predictor of performance on new (yet similar) tasks.

Conclusion

By focussing exclusively on physical/cognitive abilities, we may overlook other important predictors of surgical performance (e.g. psychological variables). The present findings suggest that laparoscopic performance may be more accurately explained through the combined effects of physical, cognitive, visual, and psychological variables. Further, the results suggest that the predictors may change with both task demands and the development of the trainee. This study highlights the key role of psychological skills in overcoming initial training challenges, with far-reaching implications for practice.

"Learning by Design": What Sports Coaches can Learn from Video Game Designs

There have been multiple calls made in the sport science literature for the promotion of interdisciplinarity to progress some of sports’ most prevailing challenges. Designing practice environments that support learning represents one such challenge, particularly given contemporary perspectives of skill acquisition and motor learning calls for coaches to realign their role—progressing toward the designers of practice tasks that promote athlete-environment interactions. In doing so, performers learn through exploration, deepening a relationship with their performance environment as they solve problems based on changing and interacting constraints. This paper illustrates an interdisciplinary approach to the area of learning through sport practice by adapting established principles embedded in video game designs. Specifically, 13 principles common to good video game designs are described, with practical examples of each provided across different sports. Fundamentally, this paper aims to offer sports practitioners with an overview and application of key principles that could support learning by design. Beyond this, the ideas presented here should further illustrate the value of interdisciplinarity in sports research and practice.

Why market orientation matters for agriculture and fishery workers? Unravelling the association between households' occupational background and caloric deprivation in India

Background

Developmental policies in low- and middle-income countries pose immense potential within the agriculture sectors to escalate economic growth and development. Almost one-half of the workforces continue to be engaged in agriculture and allied activities with a relatively lower economic contribution than those employed in other sectors. Hence, realizing such potential however requires tremendous scaling up of skill development activities in the sector. Investing in skill development of workers engaged in agricultural and allied activities can potentially display notable value additions, income generation and therefore reductions in widespread deprivations in the form of food insecurity and undernutrition. Further with the direct link between nutrition and productivity, economic gains, it is further imperative to impart market exposure among subsistence and unskilled workers. This study therefore empirically investigates the association between households’ primary occupation and caloric deprivation in India. In particular, in a multivariate and multilevel framework, we identified how closely primary occupation of households explain the variation in caloric deprivation in India.

Methods

Drawing upon data from 68th round (2011–12) of nationally representative cross-sectional Household Consumer Expenditure Survey (HCES) of National Sample Survey (NSS), Government of India, we examined the association between occupational backgrounds of households and caloric deprivation (average caloric consumption as well as low calorie intake) among Indian households.

Results

Evidences show that agricultural and fishery labor households have lowest calorie intake (2086 kcal) across all the occupational groups. However, market oriented skilled agricultural and fishery workers’ (2261 kcal – rural, 2165 kcal - urban) have higher calorie intakes than those belonging to subsistence agricultural (2165 kcal – rural, 2149 kcal - urban). Further, the multilevel logistic regression estimates suggest that in rural areas, households engaged in skilled agricultural and fishery works have significantly (at 5% level) lower odds ratio (OR: 0.72, with 95% CI: 0.63; 0.82) of having insufficient calorie intake compared to the unskilled agricultural and fishery laborer households. Estimates from variance partitioning based on multilevel logistic regression models suggest that the households’ occupational group accounts for 7 to 14% of total variation in calorie consumption.

Conclusion

These insights when combined with the occupation-specific random-effects suggest that investing in skill development of agricultural and fishery workers may have immense potential to strengthen their nutritional status and to reduce deprivation levels.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10644-9.

Advanced Trauma Life Support/Advanced Trauma Care for Nurses: A systematic review concerning the knowledge and skills of emergency nurse related to trauma triage in a community

BACKGROUND

In the trauma triage procedure, nurses with good knowledge and skills can start initial treatment immediately pending doctors availability, and before a final diagnosis is made. The Advanced Trauma Life Support/ Advanced Trauma Care for Nurses is one of the most important trauma education programmes to enhance the knowledge and skills of emergency nurses. This systematic review of the literature attempts to investigate the implications of introducing an Advanced Trauma Life Support/Advanced Trauma Care for Nurses' knowledge and skills related to trauma triage.

METHODS

A systematic review was carried out using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The included sites and databases are Web of Science, Scopus, PubMed, ScienceDirect, Cochrane Library, and Bielefeld Academic Search Engine (BASE) from 1994 to 2019. The quality of the selected studies was evaluated using a standard quality rating tool (SQRT). The quality of the criteria for inclusion and exclusion was independently reviewed by three researchers.

RESULTS

This study evaluated 5266 records in the identification stage. In the included stage, only four studies were included in this review. In the standard quality assessment, none of the included studies were evaluated as being a strong study, none used an experimental design at three points in time (pre, post and follow-up), and all showed a moderate to high risk of bias. There is a lack of knowledge and skills related to trauma triage among emergency nurses in the included studies.

CONCLUSION

A lack of knowledge and skills concerning trauma triage among emergency nurses could potentially have an adverse effect on the outcomes of the patients in trauma cases.

Effectiveness of reflective learning in skill-based teaching among postgraduate anesthesia students: An outcome-based study using video annotation tool

BACKGROUND

Medical education all over the world is undergoing paradigm shift. Video recording of student's performance and self-annotation are emerging as valuable tools for self-directed learning among students. Study was conducted to find the effectiveness of video annotation tool in reflective learning. The learning outcome was to find whether the video annotation is helping in critical reflection and improving the perception of students on guideline compliance while learning the technique of epidural insertion.

METHODS

In phase 1; following pretest, the students were made to observe three epidural insertions and perform one epidural insertion. In phase 2; following posttest, two faculty members analyzed the depth of reflection using the Reflection Rubric. Students perception was recorded using the Reflective practice survey.

RESULTS

The average score of students after pretest was 76%. The posttest score was 84% (p value 0.003). In depth analysis using the reflection rubric we found 52.38% of the total reflections had a score of two, showing they were at introspection level only. 25.71% of reflections were having score of one, showing that they were just habitual answers. Only 21.9% of the total reflections had score of three; and none of them were critically reflecting. All the students (18/18) agreed that recording the session was meaningful.

CONCLUSION

The art of critical reflection is learnt by relentless effort. Yet it helps the students to reflect on the whole process introspecting and understanding what went wrong. Video annotation turns out to be a valuable tool in reflective learning.

Why Some Sports Bettors Think Gambling Addiction Prevented Them from Becoming Winners? A Qualitative Approach to Understanding the Role of Knowledge in Sports Betting Products

Sports betting products rely upon a balance between their knowledge and chance based structural characteristics. The emphasis by bookmakers on mastering the knowledge-based elements to become winners poses significant challenges for those seeking help for gambling disorder. Bettors find difficulties in integrating their preconceptions about the role of knowledge and skills in winning, into the new cognitive restructuring fostered by cognitive-behavioural therapy. Using a grounded theory approach, this study collected data from 43 Spanish sports bettors undergoing treatment for gambling disorder. The results suggest sports bettors neutralize some gambling-related cognitive distortions during CBT but retain others. Sports bettors try to eliminate them but encounter external validation to retain them, as well as internal incongruences to integrate them into a coherent understanding of how gambling works. The results are discussed with the aim of providing practical guidance as to how skill versus chance related persistent cognitions can be addressed in CBT.

Examining the representativeness of a virtual reality environment for simulation of tennis performance

There has been a growing interest in using virtual reality (VR) for training perceptual-cognitive skill in sport. For VR training to effectively simulate real-world tennis performance, it must recreate the contextual information and movement behaviours present in the real-world environment. It is therefore critical to assess the representativeness of VR prior to implementing skill training interventions. We constructed a VR tennis environment designed for training perceptual-cognitive skill, with the aim of assessing its representativeness and validating its use. Participants movement behaviours were compared when playing tennis in VR and real-world environments. When performing groundstrokes, participants frequently used the same stance in VR as they did in the real-world condition. Participants experienced a high sense of presence in VR, evident through the factors of spatial presence, engagement and ecological validity being high, with minimal negative effects found. We conclude that Tennis VR is sufficiently representative of real-world tennis. Our discussion focuses on the opportunity for training perceptual-cognitive skill and the potential for skill transfer.