Sample records for provide ongoing feedback

  1. Providing Students with Written Feedback on Their Assessment: A Collaborative Self-Study Exploring the Nexus of Research and Practice

    ERIC Educational Resources Information Center

    Pittaway, Sharon; Dowden, Tony

    2014-01-01

    This article is an account of a collaborative self-study of the process of providing written feedback on assessment to our teacher education students. Our five-year study grew out of concerns that written feedback might not always meet the learning needs of our students. The study was informed by on-going analysis of our reading of the relevant…

  2. Standardized Patients Provide a Reliable Assessment of Athletic Training Students' Clinical Skills

    ERIC Educational Resources Information Center

    Armstrong, Kirk J.; Jarriel, Amanda J.

    2016-01-01

    Context: Providing students reliable objective feedback regarding their clinical performance is of great value for ongoing clinical skill assessment. Since a standardized patient (SP) is trained to consistently portray the case, students can be assessed and receive immediate feedback within the same clinical encounter; however, no research, to our…

  3. Improving Clinical Feedback to Anesthesia Residents by Using an Optical Scanner and a Microcomputer.

    ERIC Educational Resources Information Center

    Albanese, Mark A.; And Others

    1989-01-01

    At the University of Iowa problems associated with managing evaluations of anesthesia residents led to a major backlog of unanalyzed evaluation forms. A system developed at the University that enables ongoing feedback to residents and provides a method to assess the clinical competence of residents is described. (Author/MLW)

  4. Curriculum-Based Measurement Performance Indicators: A Tool for Undergraduate Calculus Students to Inform and Direct Their Learning Behavior

    ERIC Educational Resources Information Center

    Sturges, Linda W.

    2010-01-01

    The present study investigated the extent to which providing students with individualized performance feedback informed and directed their learning behavior. Individualized performance feedback was delivered to students using curriculum-based measurement progress indicators, either as a visual representation of ongoing performance in the form of a…

  5. Feedback about Teaching in Higher Ed: Neglected Opportunities to Promote Change

    PubMed Central

    Evans, Mara; Brickman, Peggy

    2014-01-01

    Despite ongoing dissemination of evidence-based teaching strategies, science teaching at the university level is less than reformed. Most college biology instructors could benefit from more sustained support in implementing these strategies. One-time workshops raise awareness of evidence-based practices, but faculty members are more likely to make significant changes in their teaching practices when supported by coaching and feedback. Currently, most instructional feedback occurs via student evaluations, which typically lack specific feedback for improvement and focus on teacher-centered practices, or via drop-in classroom observations and peer evaluation by other instructors, which raise issues for promotion, tenure, and evaluation. The goals of this essay are to summarize the best practices for providing instructional feedback, recommend specific strategies for providing feedback, and suggest areas for further research. Missed opportunities for feedback in teaching are highlighted, and the sharing of instructional expertise is encouraged. PMID:26086652

  6. Implementing Audio Digital Feedback Loop Using the National Instruments RIO System

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Huang, G.; Byrd, J. M.

    2006-11-20

    Development of system for high precision RF distribution and laser synchronization at Berkeley Lab has been ongoing for several years. Successful operation of these systems requires multiple audio bandwidth feedback loops running at relatively high gains. Stable operation of the feedback loops requires careful design of the feedback transfer function. To allow for flexible and compact implementation, we have developed digital feedback loops on the National Instruments Reconfigurable Input/Output (RIO) platform. This platform uses an FPGA and multiple I/Os that can provide eight parallel channels running different filters. We present the design and preliminary experimental results of this system.

  7. An Adapting Auditory-motor Feedback Loop Can Contribute to Generating Vocal Repetition

    PubMed Central

    Brainard, Michael S.; Jin, Dezhe Z.

    2015-01-01

    Consecutive repetition of actions is common in behavioral sequences. Although integration of sensory feedback with internal motor programs is important for sequence generation, if and how feedback contributes to repetitive actions is poorly understood. Here we study how auditory feedback contributes to generating repetitive syllable sequences in songbirds. We propose that auditory signals provide positive feedback to ongoing motor commands, but this influence decays as feedback weakens from response adaptation during syllable repetitions. Computational models show that this mechanism explains repeat distributions observed in Bengalese finch song. We experimentally confirmed two predictions of this mechanism in Bengalese finches: removal of auditory feedback by deafening reduces syllable repetitions; and neural responses to auditory playback of repeated syllable sequences gradually adapt in sensory-motor nucleus HVC. Together, our results implicate a positive auditory-feedback loop with adaptation in generating repetitive vocalizations, and suggest sensory adaptation is important for feedback control of motor sequences. PMID:26448054

  8. In the loop: Practices of self-monitoring from accounts by trial participants

    PubMed Central

    Lynch, Rebecca; Cohn, Simon

    2015-01-01

    Self-monitoring, by which individuals record and appraise ongoing information about the status of their body in order to improve their health, has been a key element in the personal management of conditions such as diabetes, but it is now also increasingly used in relation to health-associated behaviours. The introduction of self-monitoring as an intervention to change behaviour is intended to provide feedback that can be used by individuals to both assess their status and provide ongoing support towards a goal that may be formally set or remains implicit. However, little attention has been paid to how individuals actually engage in the process or act upon the information they receive. This article addresses this by exploring how participants in a particular trial (‘Get Moving’) experienced the process and nature of feedback. Although the trial aimed to compare the potential efficacy of three different monitoring activities designed to encourage greater physical activity, participants did not present distinctly different accounts of each intervention and the specifics of the feedback provided. Instead, their accounts took the form of much more extended and personal narratives that included other people and features of the environment. We draw on these broader descriptions to problematise the notion of self-monitoring and conclude that self-monitoring is neither solely about ‘self’ nor is it exclusively about ‘monitoring’. We suggest that a more expansive social and material understanding of feedback can give insight into the ways information is made active and meaningful for individuals in their everyday contexts. PMID:26466601

  9. Designing K-2 Formative Assessment Tasks

    ERIC Educational Resources Information Center

    Reed, Kristen E.; Goldenberg, E. Paul

    2016-01-01

    Formative assessment is a process used by teachers and students during instruction that provides feedback to adjust ongoing teaching and learning to improve students' achievements of intended instructional outcomes. Formative assessment means assessment embedded in instruction. That definition was adopted in 2006 by the Council of Chief State…

  10. Evaluating Internal Model Strength and Performance of Myoelectric Prosthesis Control Strategies.

    PubMed

    Shehata, Ahmed W; Scheme, Erik J; Sensinger, Jonathon W

    2018-05-01

    On-going developments in myoelectric prosthesis control have provided prosthesis users with an assortment of control strategies that vary in reliability and performance. Many studies have focused on improving performance by providing feedback to the user but have overlooked the effect of this feedback on internal model development, which is key to improve long-term performance. In this paper, the strength of internal models developed for two commonly used myoelectric control strategies: raw control with raw feedback (using a regression-based approach) and filtered control with filtered feedback (using a classifier-based approach), were evaluated using two psychometric measures: trial-by-trial adaptation and just-noticeable difference. The performance of both strategies was also evaluated using Schmidt's style target acquisition task. Results obtained from 24 able-bodied subjects showed that although filtered control with filtered feedback had better short-term performance in path efficiency ( ), raw control with raw feedback resulted in stronger internal model development ( ), which may lead to better long-term performance. Despite inherent noise in the control signals of the regression controller, these findings suggest that rich feedback associated with regression control may be used to improve human understanding of the myoelectric control system.

  11. A Tale of Two Cultures: The Ones We Straddle

    ERIC Educational Resources Information Center

    Doolittle, Gini

    2003-01-01

    Findings from this six-year study point to the challenge of providing substantive and on-going feedback to students in a non-traditional leadership preparation program. More importantly, this paper describes, from an inside-out perspective, the struggles encountered as faculty attempted to remedy inconsistencies in the program and reconcile…

  12. Learner Perceptions of Online Peer Pronunciation Feedback through P-Check

    ERIC Educational Resources Information Center

    Yonesaka, Suzanne M.

    2017-01-01

    Receiving adequate pronunciation feedback is an ongoing challenge for L2 learners. Although instructors are the most important source of corrective pronunciation feedback (Szpyra, 2014; Timson, 2007), L2 learners can also benefit from peer pronunciation feedback (Lord, 2008; Kim & Yoon, 2014; Roccamo, 2015). This paper examines Japanese…

  13. Rapid Integration of Artificial Sensory Feedback during Operant Conditioning of Motor Cortex Neurons.

    PubMed

    Prsa, Mario; Galiñanes, Gregorio L; Huber, Daniel

    2017-02-22

    Neuronal motor commands, whether generating real or neuroprosthetic movements, are shaped by ongoing sensory feedback from the displacement being produced. Here we asked if cortical stimulation could provide artificial feedback during operant conditioning of cortical neurons. Simultaneous two-photon imaging and real-time optogenetic stimulation were used to train mice to activate a single neuron in motor cortex (M1), while continuous feedback of its activity level was provided by proportionally stimulating somatosensory cortex. This artificial signal was necessary to rapidly learn to increase the conditioned activity, detect correct performance, and maintain the learned behavior. Population imaging in M1 revealed that learning-related activity changes are observed in the conditioned cell only, which highlights the functional potential of individual neurons in the neocortex. Our findings demonstrate the capacity of animals to use an artificially induced cortical channel in a behaviorally relevant way and reveal the remarkable speed and specificity at which this can occur. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Barriers to using eHealth data for clinical performance feedback in Malawi: A case study.

    PubMed

    Landis-Lewis, Zach; Manjomo, Ronald; Gadabu, Oliver J; Kam, Matthew; Simwaka, Bertha N; Zickmund, Susan L; Chimbwandira, Frank; Douglas, Gerald P; Jacobson, Rebecca S

    2015-10-01

    Sub-optimal performance of healthcare providers in low-income countries is a critical and persistent global problem. The use of electronic health information technology (eHealth) in these settings is creating large-scale opportunities to automate performance measurement and provision of feedback to individual healthcare providers, to support clinical learning and behavior change. An electronic medical record system (EMR) deployed in 66 antiretroviral therapy clinics in Malawi collects data that supervisors use to provide quarterly, clinic-level performance feedback. Understanding barriers to provision of eHealth-based performance feedback for individual healthcare providers in this setting could present a relatively low-cost opportunity to significantly improve the quality of care. The aims of this study were to identify and describe barriers to using EMR data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers. We conducted a qualitative study using interviews, observations, and informant feedback in eight public hospitals in Malawi where an EMR system is used. We interviewed 32 healthcare providers and conducted seven hours of observation of system use. We identified four key barriers to the use of EMR data for clinical performance feedback: provider rotations, disruptions to care processes, user acceptance of eHealth, and performance indicator lifespan. Each of these factors varied across sites and affected the quality of EMR data that could be used for the purpose of generating performance feedback for individual healthcare providers. Using routinely collected eHealth data to generate individualized performance feedback shows potential at large-scale for improving clinical performance in low-resource settings. However, technology used for this purpose must accommodate ongoing changes in barriers to eHealth data use. Understanding the clinical setting as a complex adaptive system (CAS) may enable designers of technology to effectively model change processes to mitigate these barriers. Copyright © 2015. Published by Elsevier Ireland Ltd.

  15. Barriers to using eHealth data for clinical performance feedback in Malawi: A case study

    PubMed Central

    Landis-Lewis, Zach; Manjomo, Ronald; Gadabu, Oliver J; Kam, Matthew; Simwaka, Bertha N; Zickmund, Susan L; Chimbwandira, Frank; Douglas, Gerald P; Jacobson, Rebecca S

    2016-01-01

    Introduction Sub-optimal performance of healthcare providers in low-income countries is a critical and persistent global problem. The use of electronic health information technology (eHealth) in these settings is creating large-scale opportunities to automate performance measurement and provision of feedback to individual healthcare providers, to support clinical learning and behavior change. An electronic medical record system (EMR) deployed in 66 antiretroviral therapy clinics in Malawi collects data that supervisors use to provide quarterly, clinic-level performance feedback. Understanding barriers to provision of eHealth-based performance feedback for individual healthcare providers in this setting could present a relatively low-cost opportunity to significantly improve the quality of care. Objective The aims of this study were to identify and describe barriers to using EMR data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers. Methods We conducted a qualitative study using interviews, observations, and informant feedback in eight public hospitals in Malawi where an EMR is used. We interviewed 32 healthcare providers and conducted seven hours of observation of system use. Results We identified four key barriers to the use of EMR data for clinical performance feedback: provider rotations, disruptions to care processes, user acceptance of eHealth, and performance indicator lifespan. Each of these factors varied across sites and affected the quality of EMR data that could be used for the purpose of generating performance feedback for individual healthcare providers. Conclusion Using routinely collected eHealth data to generate individualized performance feedback shows potential at large-scale for improving clinical performance in low-resource settings. However, technology used for this purpose must accommodate ongoing changes in barriers to eHealth data use. Understanding the clinical setting as a complex adaptive system (CAS) may enable designers of technology to effectively model change processes to mitigate these barriers. PMID:26238704

  16. Playing Games with Formative Assessment

    ERIC Educational Resources Information Center

    Cassie, Jonathan

    2018-01-01

    Games can be great tools to engage reluctant learners and provide ongoing feedback to educators about how their lessons are "sticking." Cassie discusses how to use gamified formative assessments to measure different kinds of skills and looks at the different ways teachers can use games in the classroom--from out-of-the-box board games to…

  17. Fostering the Intelligent Novice: Learning from Errors with Metacognitive Tutoring

    ERIC Educational Resources Information Center

    Mathan, Santosh A.; Koedinger, Kenneth R.

    2005-01-01

    This article explores 2 important aspects of metacognition: (a) how students monitor their ongoing performance to detect and correct errors and (b) how students reflect on those errors to learn from them. Although many instructional theories have advocated providing students with immediate feedback on errors, some researchers have argued that…

  18. Pilot Guidelines for Improving Instructional Materials Through the Process of Learner Verification and Revision.

    ERIC Educational Resources Information Center

    Educational Products Information Exchange Inst., Stony Brook, NY.

    Learner Verification and Revision (LVR) Process of Instructional Materials is an ongoing effort for the improvement of instructional materials based on systematic feedback from learners who have used the materials. This evaluation gives publishers a method of identifying instructional strengths and weaknesses of a product and provides an…

  19. Educator Effectiveness in Colorado: The Connection between Evaluation and Professional Learning

    ERIC Educational Resources Information Center

    O'Brien, Colleen

    2014-01-01

    Purpose: The purpose of this study was to understand how schools and districts plan professional learning that provides the ongoing feedback and support needed to improve teacher performance under the new Colorado Educator Effectiveness Law. The study focused on the professional learning that follows a teacher's rating on the new educator…

  20. The Effect of Oral Feedback on Perceived Classroom Community in Undergraduate Students

    ERIC Educational Resources Information Center

    Boyles, Jennifer L.

    2017-01-01

    The ongoing trend in research regarding feedback has been to explore quantitative assessment. Garnering support more recently is qualitative narrative feedback in support of formative assessment. This type of feedback offers insight into expectations as well as offer additional knowledge gained. It enables students to improve their performance…

  1. Feedback about Teaching in Higher Ed: Neglected Opportunities to Promote Change.

    PubMed

    Gormally, Cara; Evans, Mara; Brickman, Peggy

    2014-01-01

    Despite ongoing dissemination of evidence-based teaching strategies, science teaching at the university level is less than reformed. Most college biology instructors could benefit from more sustained support in implementing these strategies. One-time workshops raise awareness of evidence-based practices, but faculty members are more likely to make significant changes in their teaching practices when supported by coaching and feedback. Currently, most instructional feedback occurs via student evaluations, which typically lack specific feedback for improvement and focus on teacher-centered practices, or via drop-in classroom observations and peer evaluation by other instructors, which raise issues for promotion, tenure, and evaluation. The goals of this essay are to summarize the best practices for providing instructional feedback, recommend specific strategies for providing feedback, and suggest areas for further research. Missed opportunities for feedback in teaching are highlighted, and the sharing of instructional expertise is encouraged. © 2014 M. Evans et al. CBE—Life Sciences Education © 2014 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  2. Operating room metrics score card-creating a prototype for individualized feedback.

    PubMed

    Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Urman, Richard D

    2014-11-01

    The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers.

  3. An Evaluative Report on the Current Status of Parapsychology

    DTIC Science & Technology

    1986-05-01

    mentation" (Stanford, 1979). The ganzfeld procedure eliminates patterned stimulation in the visual h and auditory modes. Visual isolation is provided by...distracting external stimulation . The most popular of such techniques is the ganzfeld, a procedure in which the subject looks through halves of ping...powerful statistical analyses. Ongoing analog or digital feedback can be provided to subjects in innumerable ways in either the visual or auditory mode

  4. "It's Just Not the Culture": A Qualitative Study Exploring Residents' Perceptions of the Impact of Institutional Culture on Feedback.

    PubMed

    Ramani, Subha; Post, Sarah E; Könings, Karen; Mann, Karen; Katz, Joel T; van der Vleuten, Cees

    2017-01-01

    Phenomenon: Competency-based medical education requires ongoing performance-based feedback for professional growth. In several studies, medical trainees report that the quality of faculty feedback is inadequate. Sociocultural barriers to feedback exchanges are further amplified in graduate and postgraduate medical education settings, where trainees serve as frontline providers of patient care. Factors that affect institutional feedback culture, enhance feedback seeking, acceptance, and bidirectional feedback warrant further exploration in these settings. Using a constructivist grounded theory approach, we sought to examine residents' perspectives on institutional factors that affect the quality of feedback, factors that influence receptivity to feedback, and quality and impact of faculty feedback. Four focus group discussions were conducted, with two investigators present at each. One facilitated the discussion, and the other observed the interactions and took field notes. We audiotaped and transcribed the discussions, and performed a thematic analysis. Measures to ensure rigor included thick descriptions, independent coding by two investigators, and attention to reflexivity. We identified five key themes, dominated by resident perceptions regarding the influence of institutional feedback culture. The theme labels are taken from direct participant quotes: (a) the cultural norm lacks clear expectations and messages around feedback, (b) the prevailing culture of niceness does not facilitate honest feedback, (c) bidirectional feedback is not part of the culture, (d) faculty-resident relationships impact credibility and receptivity to feedback, and (e) there is a need to establish a culture of longitudinal professional growth. Insights: Institutional culture could play a key role in influencing the quality, credibility, and acceptability of feedback. A polite culture promotes a positive learning environment but can be a barrier to honest feedback. Feedback initiatives focusing solely on techniques of feedback giving may not enhance meaningful feedback. Further research on factors that promote feedback seeking, receptivity to constructive feedback, and bidirectional feedback would provide valuable insights.

  5. The Analysis of the Blogs Created in a Blended Course through the Reflective Thinking Perspective

    ERIC Educational Resources Information Center

    Dos, Bulent; Demir, Servet

    2013-01-01

    Blogs have evolved from simple online diaries to communication tools with the capacity to engage people in collaboration, knowledge sharing, reflection and debate. Blog archives can be a source of information about student learning, providing a basis for ongoing feedback and redesign of learning activities. Previous studies show that blogs can…

  6. The medical educator, the discourse analyst, and the phonetician: a collaborative feedback methodology for clinical communication.

    PubMed

    Woodward-Kron, Robyn; Stevens, Mary; Flynn, Eleanor

    2011-05-01

    Frameworks for clinical communication assist educators in making explicit the principles of good communication and providing feedback to medical trainees. However, existing frameworks rarely take into account the roles of culture and language in communication, which can be important for international medical graduates (IMGs) whose first language is not English. This article describes the collaboration by a medical educator, a discourse analyst, and a phonetician to develop a communication and language feedback methodology to assist IMG trainees at a Victorian hospital in Australia with developing their doctor-patient communication skills. The Communication and Language Feedback (CaLF) methodology incorporates a written tool and video recording of role-plays of doctor-patient interactions in a classroom setting or in an objective structured clinical examination (OSCE) practice session with a simulated patient. IMG trainees receive verbal feedback from their hospital-based medical clinical educator, the simulated patient, and linguists. The CaLF tool was informed by a model of language in context, observation of IMG communication training, and process evaluation by IMG participants during January to August 2009. The authors provided participants with a feedback package containing their practice video (which included verbal feedback) and the completed CaLF tool.The CaLF methodology provides a tool for medical educators and language practitioners to work collaboratively with IMGs to enhance communication and language skills. The ongoing interdisciplinary collaboration also provides much-needed applied research opportunities in intercultural health communication, an area the authors believe cannot be adequately addressed from the perspective of one discipline alone. Copyright © by the Association of American medical Colleges.

  7. Data for Improvement and Clinical Excellence: a report of an interrupted time series trial of feedback in home care.

    PubMed

    Fraser, Kimberly D; Sales, Anne E; Baylon, Melba Andrea B; Schalm, Corinne; Miklavcic, John J

    2017-05-18

    There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits. A 10-month audit with feedback intervention study was conducted with care providers in seven home care offices in Alberta, Canada, which involved delivery of four quarterly feedback reports consisting of data derived from the Resident Assessment Instrument - Home Care (RAI-HC). The primary evaluation employed an interrupted time series design using segmented regression analysis to assess the effects of feedback reporting on the four quality indicators: pain, falls, delirium, and hospitalization. Changes in level and trend of the quality indicators were measured before, during, and after the implementation of feedback reports. Pressure ulcer reporting was analyzed as a comparator condition not included in the feedback report. Care providers were surveyed on responses to feedback reporting which informed a process evaluation. At initiation of feedback report implementation, the percentage of clients reporting pain and falls significantly increased. Though the percentage of clients reporting pain and falls tended to increase and reporting of delirium and hospital visits tended to decrease relative to the pre-intervention period, there was no significant effect of feedback reporting on quality indicators during the 10-month intervention. The percentage of clients reporting falls, delirium, and hospital visits significantly increased in the 6-month period following feedback reporting relative to the intervention period. About 50% of the care providers that read and understand the feedback reports found the reports useful to make changes to the way clients are cared for. Routinely collected data used over time for feedback is feasible in home care settings. A high proportion of care providers find feedback reports useful for informing how they care for clients. Since reporting on the frequency of quality indicators increased in the post-intervention period, this study suggests that ongoing use of audit with feedback to enhance health outcomes in home care may promote improved reporting on standardized instruments.

  8. Opposing and following responses in sensorimotor speech control: Why responses go both ways.

    PubMed

    Franken, Matthias K; Acheson, Daniel J; McQueen, James M; Hagoort, Peter; Eisner, Frank

    2018-06-04

    When talking, speakers continuously monitor and use the auditory feedback of their own voice to control and inform speech production processes. When speakers are provided with auditory feedback that is perturbed in real time, most of them compensate for this by opposing the feedback perturbation. But some responses follow the perturbation. In the present study, we investigated whether the state of the speech production system at perturbation onset may determine what type of response (opposing or following) is made. The results suggest that whether a perturbation-related response is opposing or following depends on ongoing fluctuations of the production system: The system initially responds by doing the opposite of what it was doing. This effect and the nontrivial proportion of following responses suggest that current production models are inadequate: They need to account for why responses to unexpected sensory feedback depend on the production system's state at the time of perturbation.

  9. The Data-to-Action Framework: A Rapid Program Improvement Process.

    PubMed

    Zakocs, Ronda; Hill, Jessica A; Brown, Pamela; Wheaton, Jocelyn; Freire, Kimberley E

    2015-08-01

    Although health education programs may benefit from quality improvement methods, scant resources exist to help practitioners apply these methods for program improvement. The purpose of this article is to describe the Data-to-Action framework, a process that guides practitioners through rapid-feedback cycles in order to generate actionable data to improve implementation of ongoing programs. The framework was designed while implementing DELTA PREP, a 3-year project aimed at building the primary prevention capacities of statewide domestic violence coalitions. The authors describe the framework's main steps and provide a case example of a rapid-feedback cycle and several examples of rapid-feedback memos produced during the project period. The authors also discuss implications for health education evaluation and practice. © 2015 Society for Public Health Education.

  10. Separable Neural Mechanisms Contribute to Feedback Processing in a Rule-Learning Task

    ERIC Educational Resources Information Center

    Zanolie, K.; Van Leijenhorst, L.; Rombouts, S. A. R. B.; Crone, E. A.

    2008-01-01

    To adjust performance appropriately to environmental demands, it is important to monitor ongoing action and process performance feedback for possible errors. In this study, we used fMRI to test whether medial prefrontal cortex (PFC)/anterior cingulate cortex (ACC) and dorsolateral (DL) PFC have different roles in feedback processing. Twenty adults…

  11. Web-based mammography audit feedback.

    PubMed

    Geller, Berta M; Ichikawa, Laura; Miglioretti, Diana L; Eastman, David

    2012-06-01

    Interpreting screening mammography accurately is challenging and requires ongoing education to maintain and improve interpretative skills. Recognizing this, many countries with organized breast screening programs have developed audit and feedback systems using national performance data to help radiologists assess and improve their skills. We developed and tested an interactive Website to provide screening and diagnostic mammography audit feedback with comparisons to national and regional benchmarks. Radiologists who participate in three Breast Cancer Surveillance Consortium registries in the United States were invited during 2009 and 2010 to use a Website that provides tabular and graphical displays of mammography audit reports with comparisons to national and regional performance measures. We collected data about the use and perceptions of the Website. Thirty-five of 111 invited radiologists used the Website from one to five times in a year. The most popular measure was sensitivity for both screening and diagnostic mammography, whereas a table with all measures was the most visited page. Of the 13 radiologists who completed the postuse survey, all found the Website easy to use and navigate, 11 found the benchmarks useful, and nine reported that they intended to improve a specific outcome measure that year. An interactive Website to provide customized mammography audit feedback reports to radiologists has the potential to be a powerful tool in improving interpretive performance. The conceptual framework of customized audit feedback reports can also be generalized to other imaging tests.

  12. Optogenetic feedback control of neural activity

    PubMed Central

    Newman, Jonathan P; Fong, Ming-fai; Millard, Daniel C; Whitmire, Clarissa J; Stanley, Garrett B; Potter, Steve M

    2015-01-01

    Optogenetic techniques enable precise excitation and inhibition of firing in specified neuronal populations and artifact-free recording of firing activity. Several studies have suggested that optical stimulation provides the precision and dynamic range requisite for closed-loop neuronal control, but no approach yet permits feedback control of neuronal firing. Here we present the ‘optoclamp’, a feedback control technology that provides continuous, real-time adjustments of bidirectional optical stimulation in order to lock spiking activity at specified targets over timescales ranging from seconds to days. We demonstrate how this system can be used to decouple neuronal firing levels from ongoing changes in network excitability due to multi-hour periods of glutamatergic or GABAergic neurotransmission blockade in vitro as well as impinging vibrissal sensory drive in vivo. This technology enables continuous, precise optical control of firing in neuronal populations in order to disentangle causally related variables of circuit activation in a physiologically and ethologically relevant manner. DOI: http://dx.doi.org/10.7554/eLife.07192.001 PMID:26140329

  13. An Automated Individual Feedback and Marking System: An Empirical Study

    ERIC Educational Resources Information Center

    Barker, Trevor

    2011-01-01

    The recent National Students Survey showed that feedback to students was an ongoing problem in Higher Education. This paper reports on the extension of our past research into the provision of automated feedback for objective testing. In the research presented here, the system has been further developed for marking practical and essay questions and…

  14. Selective and divided attention modulates auditory-vocal integration in the processing of pitch feedback errors.

    PubMed

    Liu, Ying; Hu, Huijing; Jones, Jeffery A; Guo, Zhiqiang; Li, Weifeng; Chen, Xi; Liu, Peng; Liu, Hanjun

    2015-08-01

    Speakers rapidly adjust their ongoing vocal productions to compensate for errors they hear in their auditory feedback. It is currently unclear what role attention plays in these vocal compensations. This event-related potential (ERP) study examined the influence of selective and divided attention on the vocal and cortical responses to pitch errors heard in auditory feedback regarding ongoing vocalisations. During the production of a sustained vowel, participants briefly heard their vocal pitch shifted up two semitones while they actively attended to auditory or visual events (selective attention), or both auditory and visual events (divided attention), or were not told to attend to either modality (control condition). The behavioral results showed that attending to the pitch perturbations elicited larger vocal compensations than attending to the visual stimuli. Moreover, ERPs were likewise sensitive to the attentional manipulations: P2 responses to pitch perturbations were larger when participants attended to the auditory stimuli compared to when they attended to the visual stimuli, and compared to when they were not explicitly told to attend to either the visual or auditory stimuli. By contrast, dividing attention between the auditory and visual modalities caused suppressed P2 responses relative to all the other conditions and caused enhanced N1 responses relative to the control condition. These findings provide strong evidence for the influence of attention on the mechanisms underlying the auditory-vocal integration in the processing of pitch feedback errors. In addition, selective attention and divided attention appear to modulate the neurobehavioral processing of pitch feedback errors in different ways. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  15. Task clarification, performance feedback, and social praise: Procedures for improving the customer service of bank tellers

    PubMed Central

    Crowell, Charles R.; Anderson, D. Chris; Abel, Dawn M.; Sergio, Joseph P.

    1988-01-01

    Customer service for bank tellers was defined in terms of 11 verbal behavior categories. An audio-recording system was used to track the occurrence of behaviors in these categories for six retail banking tellers. Three behavior management interventions (task clarification, performance feedback, and social praise), applied in sequence, were designed to improve overall teller performance with regard to the behavioral categories targeted. Clarification was accomplished by providing clear delineation of the various target categories, with specific examples of the behaviors in each. Feedback entailed presentation of ongoing verbal and visual information regarding teller performance. Praise consisted of verbal recognition of teller performance by branch managers. Results showed that clarification effects emerged quickly, producing an overall increase in desired behaviors of 12% over baseline. Feedback and praise effects occurred more gradually, resulting in overall increases of 6% and 7%, respectively. A suspension of all procedures led to a decline in overall performance, whereas reinstatement of feedback and praise was again accompanied by performance improvement. These findings extend the generality of behavior management applications and help to distinguish between possible antecedent and consequent effects of performance feedback. PMID:16795713

  16. Tensions in informed self-assessment: how the desire for feedback and reticence to collect and use it can conflict.

    PubMed

    Mann, Karen; van der Vleuten, Cees; Eva, Kevin; Armson, Heather; Chesluk, Ben; Dornan, Timothy; Holmboe, Eric; Lockyer, Jocelyn; Loney, Elaine; Sargeant, Joan

    2011-09-01

    Informed self-assessment describes the set of processes through which individuals use external and internal data to generate an appraisal of their own abilities. The purpose of this project was to explore the tensions described by learners and professionals when informing their self-assessments of clinical performance. This 2008 qualitative study was guided by principles of grounded theory. Eight programs in five countries across undergraduate, postgraduate, and continuing medical education were purposively sampled. Seventeen focus groups were held (134 participants). Detailed analyses were conducted iteratively to understand themes and relationships. Participants experienced multiple tensions in informed self-assessment. Three categories of tensions emerged: within people (e.g., wanting feedback, yet fearing disconfirming feedback), between people (e.g., providing genuine feedback yet wanting to preserve relationships), and in the learning/practice environment (e.g., engaging in authentic self-assessment activities versus "playing the evaluation game"). Tensions were ongoing, contextual, and dynamic; they prevailed across participant groups, infusing all components of informed self-assessment. They also were present in varied contexts and at all levels of learners and practicing physicians. Multiple tensions, requiring ongoing negotiation and renegotiation, are inherent in informed self-assessment. Tensions are both intraindividual and interindividual and they are culturally situated, reflecting both professional and institutional influences. Social learning theories (social cognitive theory) and sociocultural theories of learning (situated learning and communities of practice) may inform our understanding and interpretation of the study findings. The findings suggest that educational interventions should be directed at individual, collective, and institutional cultural levels. Implications for practice are presented.

  17. Do Those Who Benefit the Most Need it the Least? A Four-Year Experiment in Enquiry-Based Feedback

    ERIC Educational Resources Information Center

    Adcroft, Andy; Willis, Robert

    2013-01-01

    The aim of this paper is to report on an ongoing experiment in an enquiry-based approach to feedback. Over the course of four years, almost 1800 students have studied a final-year undergraduate module involving a mid-term assignment and end of module examination. Feedback on the assignment is delivered through a process which involves the…

  18. Practical Approaches for Assessment of Daily and Post-discharge Room Disinfection in Healthcare Facilities.

    PubMed

    Deshpande, Abhishek; Donskey, Curtis J

    2017-09-01

    Cleaning and disinfection in healthcare facilities is essential to ensure patient safety. This review examines practical strategies used to assess and improve the effectiveness of daily and post-discharge manual cleaning in healthcare facilities. Effective implementation of cleaning interventions requires objective monitoring of staff performance with regular feedback on performance. Use of fluorescent markers to assess thoroughness of cleaning and measurement of residual ATP can provide rapid and objective feedback to personnel and have been associated with improved cleaning. Direct observation of cleaning and interviews with front-line staff are useful to identify variations and deficiencies in practice that may not be detected by other methods. Although not recommended for routine monitoring, cultures can be helpful for outbreak investigations. Monitoring and feedback can be effective in improving cleaning and disinfection in healthcare facilities. Ongoing commitment within institutions is needed to sustain successful cleaning and disinfection programs.

  19. Sensorimotor learning in children and adults: Exposure to frequency-altered auditory feedback during speech production.

    PubMed

    Scheerer, N E; Jacobson, D S; Jones, J A

    2016-02-09

    Auditory feedback plays an important role in the acquisition of fluent speech; however, this role may change once speech is acquired and individuals no longer experience persistent developmental changes to the brain and vocal tract. For this reason, we investigated whether the role of auditory feedback in sensorimotor learning differs across children and adult speakers. Participants produced vocalizations while they heard their vocal pitch predictably or unpredictably shifted downward one semitone. The participants' vocal pitches were measured at the beginning of each vocalization, before auditory feedback was available, to assess the extent to which the deviant auditory feedback modified subsequent speech motor commands. Sensorimotor learning was observed in both children and adults, with participants' initial vocal pitch increasing following trials where they were exposed to predictable, but not unpredictable, frequency-altered feedback. Participants' vocal pitch was also measured across each vocalization, to index the extent to which the deviant auditory feedback was used to modify ongoing vocalizations. While both children and adults were found to increase their vocal pitch following predictable and unpredictable changes to their auditory feedback, adults produced larger compensatory responses. The results of the current study demonstrate that both children and adults rapidly integrate information derived from their auditory feedback to modify subsequent speech motor commands. However, these results also demonstrate that children and adults differ in their ability to use auditory feedback to generate compensatory vocal responses during ongoing vocalization. Since vocal variability also differed across the children and adult groups, these results also suggest that compensatory vocal responses to frequency-altered feedback manipulations initiated at vocalization onset may be modulated by vocal variability. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.

  20. BSV Gateway Description

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Deshpande, Alina

    Los Alamos National Laboratory (LANL) is part of that worldwide team and has been developing state of the art information systems to aid the global health community. For instance, in 2014 LANL announced the release of the LANL Biosurveillance (BSV) Gateway. The site provides information about ongoing biosurveillance research projects and capabilities at LANL, and provides access to a host of LANL-developed biosurveillance tools and resources. We are seeking feedback on this gateway and would like to ask interested folk to offer comments and suggestions after they have perused the BSV website.

  1. The Management Development Needs of Front-Line Managers: Voices from the Field.

    ERIC Educational Resources Information Center

    Longenecker, Clinton O.; Neubert, Mitchell

    2003-01-01

    A survey of 524 managers identified key practices to improve performance in a changing environment: clarifying roles, goals, and expectations; ongoing performance evaluation, feedback, and coaching; mentoring; challenging assignments; formal career planning; customer contact; cross-training; and 360-degree feedback. (Contains 31 references.) (SK)

  2. A Workshop Report on Wheat Genome Sequencing

    PubMed Central

    Gill, Bikram S.; Appels, Rudi; Botha-Oberholster, Anna-Maria; Buell, C. Robin; Bennetzen, Jeffrey L.; Chalhoub, Boulos; Chumley, Forrest; Dvořák, Jan; Iwanaga, Masaru; Keller, Beat; Li, Wanlong; McCombie, W. Richard; Ogihara, Yasunari; Quetier, Francis; Sasaki, Takuji

    2004-01-01

    Sponsored by the National Science Foundation and the U.S. Department of Agriculture, a wheat genome sequencing workshop was held November 10–11, 2003, in Washington, DC. It brought together 63 scientists of diverse research interests and institutions, including 45 from the United States and 18 from a dozen foreign countries (see list of participants at http://www.ksu.edu/igrow). The objectives of the workshop were to discuss the status of wheat genomics, obtain feedback from ongoing genome sequencing projects, and develop strategies for sequencing the wheat genome. The purpose of this report is to convey the information discussed at the workshop and provide the basis for an ongoing dialogue, bringing forth comments and suggestions from the genetics community. PMID:15514080

  3. Global change modeling for Northern Eurasia: a review and strategies to move forward

    NASA Astrophysics Data System (ADS)

    Monier, E.; Kicklighter, D. W.; Sokolov, A. P.; Zhuang, Q.; Sokolik, I. N.; Lawford, R. G.; Kappas, M.; Paltsev, S.; Groisman, P. Y.

    2017-12-01

    Northern Eurasia is made up of a complex and diverse set of physical, ecological, climatic and human systems, which provide important ecosystem services including the storage of substantial stocks of carbon in its terrestrial ecosystems. At the same time, the region has experienced dramatic climate change, natural disturbances and changes in land management practices over the past century. For these reasons, Northern Eurasia is both a critical region to understand and a complex system with substantial challenges for the modeling community. This review is designed to highlight the state of past and ongoing efforts of the research community to understand and model these environmental, socioeconomic, and climatic changes. We further aim to provide perspectives on the future direction of global change modeling to improve our understanding of the role of Northern Eurasia in the coupled human-Earth system. Modeling efforts have shown that environmental and socioeconomic changes in Northern Eurasia can have major impacts on biodiversity, ecosystems services, environmental sustainability, and the carbon cycle of the region, and beyond. These impacts have the potential to feedback onto and alter the global Earth system. We find that past and ongoing studies have largely focused on specific components of Earth system dynamics and have not systematically examined their feedbacks to the global Earth system and to society. We identify the crucial role of Earth system models in advancing our understanding of feedbacks within the region and with the global system. We further argue for the need for integrated assessment models (IAMs), a suite of models that couple human activity models to Earth system models, which are key to address many emerging issues that require a representation of the coupled human-Earth system.

  4. A review of and perspectives on global change modeling for Northern Eurasia

    NASA Astrophysics Data System (ADS)

    Monier, Erwan; Kicklighter, David W.; Sokolov, Andrei P.; Zhuang, Qianlai; Sokolik, Irina N.; Lawford, Richard; Kappas, Martin; Paltsev, Sergey V.; Groisman, Pavel Ya

    2017-08-01

    Northern Eurasia is made up of a complex and diverse set of physical, ecological, climatic and human systems, which provide important ecosystem services including the storage of substantial stocks of carbon in its terrestrial ecosystems. At the same time, the region has experienced dramatic climate change, natural disturbances and changes in land management practices over the past century. For these reasons, Northern Eurasia is both a critical region to understand and a complex system with substantial challenges for the modeling community. This review is designed to highlight the state of past and ongoing efforts of the research community to understand and model these environmental, socioeconomic, and climatic changes. We further aim to provide perspectives on the future direction of global change modeling to improve our understanding of the role of Northern Eurasia in the coupled human-Earth system. Modeling efforts have shown that environmental and socioeconomic changes in Northern Eurasia can have major impacts on biodiversity, ecosystems services, environmental sustainability, and the carbon cycle of the region, and beyond. These impacts have the potential to feedback onto and alter the global Earth system. We find that past and ongoing studies have largely focused on specific components of Earth system dynamics and have not systematically examined their feedbacks to the global Earth system and to society. We identify the crucial role of Earth system models in advancing our understanding of feedbacks within the region and with the global system. We further argue for the need for integrated assessment models (IAMs), a suite of models that couple human activity models to Earth system models, which are key to address many emerging issues that require a representation of the coupled human-Earth system.

  5. Stellar Feedback Up and Close

    NASA Astrophysics Data System (ADS)

    Gadotti, Dimitri; Timer Team

    2017-07-01

    We report the serendipitous discovery of ongoing stellar feedback in the star-bursting nuclear ring of a nearby spiral galaxy, as part of the TIMER survey with MUSE. Combining MUSE and ALMA data we show bubbles of ionised gas expanding from the ring and shocking with the cold ISM. We demonstrate how much energy is being released into the ISM corresponding to the star formation observed, how fast the heated ISM is expanding from the centre, and provide a physical description of the shocks happening at the interface between the heated and cold phases of the ISM. Further, we quantitatively show how the exchange of energy between the two phases impacts the dynamics of the cold ISM. Finally, applying a model to the spatially-resolved spectral properties of this system, we find that about 60% of the energy input into the ISM is produced via the direct transfer of momentum from photons scattering onto dust grains, and 27% produced by mass loss in supernova explosions. The remaining energy input is produced via photoionisation heating ( 12%) and stellar winds ( 1%). These analyses provide invaluable measurements against which our theoretical understanding of stellar feedback can be compared, particularly state-of-the-art simulations that aim at reproducing star formation and stellar feedback in galaxies.

  6. Micro-Feedback Training:Learning the art of effective feedback

    PubMed Central

    Baseer, Najma; Mahboob, Usman; Degnan, James

    2017-01-01

    Multiple attributes are expected of postgraduate research supervisors. Provision of timely and effective face-to-face feedback is one such skill that carries enormous significance in supervisee’s professional development. Feedback allows the supervisees to improve upon their performances. Unfortunately, both supervisors and supervisees have contrasting approaches towards the ongoing feedback practices. This incongruence is attributed, in part, to a lack of structured pedagogic training among the medical professionals. A standardized schema is therefore required to acquire and harmonize this pedagogical skill. One such systemized way is a training method called microteaching. Microteaching has long been used to enhance and incorporate old and new undergraduate teaching skills, respectively. Here we propose a similar structured approach of micro-feedback to inculcate effective feedback skills among postgraduate research supervisors using feedback-based scenarios, simulated students, standardized checklists and audiovisual aids. Thus, micro-feedback exercise may prove to be quite promising in improving feedback practices of postgraduate research supervisors. PMID:29492091

  7. A bilateral cortical network responds to pitch perturbations in speech feedback

    PubMed Central

    Kort, Naomi S.; Nagarajan, Srikantan S.; Houde, John F.

    2014-01-01

    Auditory feedback is used to monitor and correct for errors in speech production, and one of the clearest demonstrations of this is the pitch perturbation reflex. During ongoing phonation, speakers respond rapidly to shifts of the pitch of their auditory feedback, altering their pitch production to oppose the direction of the applied pitch shift. In this study, we examine the timing of activity within a network of brain regions thought to be involved in mediating this behavior. To isolate auditory feedback processing relevant for motor control of speech, we used magnetoencephalography (MEG) to compare neural responses to speech onset and to transient (400ms) pitch feedback perturbations during speaking with responses to identical acoustic stimuli during passive listening. We found overlapping, but distinct bilateral cortical networks involved in monitoring speech onset and feedback alterations in ongoing speech. Responses to speech onset during speaking were suppressed in bilateral auditory and left ventral supramarginal gyrus/posterior superior temporal sulcus (vSMG/pSTS). In contrast, during pitch perturbations, activity was enhanced in bilateral vSMG/pSTS, bilateral premotor cortex, right primary auditory cortex, and left higher order auditory cortex. We also found speaking-induced delays in responses to both unaltered and altered speech in bilateral primary and secondary auditory regions, the left vSMG/pSTS and right premotor cortex. The network dynamics reveal the cortical processing involved in both detecting the speech error and updating the motor plan to create the new pitch output. These results implicate vSMG/pSTS as critical in both monitoring auditory feedback and initiating rapid compensation to feedback errors. PMID:24076223

  8. Distributed task-specific processing of somatosensory feedback for voluntary motor control

    PubMed Central

    Omrani, Mohsen; Murnaghan, Chantelle D; Pruszynski, J Andrew; Scott, Stephen H

    2016-01-01

    Corrective responses to limb disturbances are surprisingly complex, but the neural basis of these goal-directed responses is poorly understood. Here we show that somatosensory feedback is transmitted to many sensory and motor cortical regions within 25 ms of a mechanical disturbance applied to the monkey’s arm. When limb feedback was salient to an ongoing motor action (task engagement), neurons in parietal area 5 immediately (~25 ms) increased their response to limb disturbances, whereas neurons in other regions did not alter their response until 15 to 40 ms later. In contrast, initiation of a motor action elicited by a limb disturbance (target selection) altered neural responses in primary motor cortex ~65 ms after the limb disturbance, and then in dorsal premotor cortex, with no effect in parietal regions until 150 ms post-perturbation. Our findings highlight broad parietofrontal circuits that provide the neural substrate for goal-directed corrections, an essential aspect of highly skilled motor behaviors. DOI: http://dx.doi.org/10.7554/eLife.13141.001 PMID:27077949

  9. Student laboratory reports: an approach to improving feedback and quality

    NASA Astrophysics Data System (ADS)

    Ellingsen, Pål Gunnar; Støvneng, Jon Andreas

    2018-05-01

    We present an ongoing effort in improving the quality of laboratory reports written by first and second year physics students. The effort involves a new approach where students are given the opportunity to submit reports at intermediate deadlines, receive feedback, and then resubmit for the final deadline. In combination with a differential grading system, instead of pass/fail, the improved feedback results in higher quality reports. Improvement in the quality of the reports is visible through the grade statistics.

  10. Improving product introduction through effective design reviews.

    PubMed

    Pelnik, Tammy M

    2003-01-01

    The design review process is a part of the manufacturer's due diligence in developing a safe and effective product. Design review provides early and on-going independent feedback to developers. By adopting a proactive review process, design improvements can be pursued at an optimum time in the product development effort, i.e., when it will cost less to implement changes and when these changes may have the greatest impact. Effective implementation of the design review requirement will lead to better medical products and improved product introduction results.

  11. Feedforward and Feedback Motor Control Abnormalities Implicate Cerebellar Dysfunctions in Autism Spectrum Disorder

    PubMed Central

    Mohanty, Suman; Greene, Rachel K.; Cook, Edwin H.; Vaillancourt, David E.; Sweeney, John A.

    2015-01-01

    Sensorimotor abnormalities are common in autism spectrum disorder (ASD) and among the earliest manifestations of the disorder. They have been studied far less than the social-communication and cognitive deficits that define ASD, but a mechanistic understanding of sensorimotor abnormalities in ASD may provide key insights into the neural underpinnings of the disorder. In this human study, we examined rapid, precision grip force contractions to determine whether feedforward mechanisms supporting initial motor output before sensory feedback can be processed are disrupted in ASD. Sustained force contractions also were examined to determine whether reactive adjustments to ongoing motor behavior based on visual feedback are altered. Sustained force was studied across multiple force levels and visual gains to assess motor and visuomotor mechanisms, respectively. Primary force contractions of individuals with ASD showed greater peak rate of force increases and large transient overshoots. Individuals with ASD also showed increased sustained force variability that scaled with force level and was more severe when visual gain was highly amplified or highly degraded. When sustaining a constant force level, their reactive adjustments were more periodic than controls, and they showed increased reliance on slower feedback mechanisms. Feedforward and feedback mechanism alterations each were associated with more severe social-communication impairments in ASD. These findings implicate anterior cerebellar circuits involved in feedforward motor control and posterior cerebellar circuits involved in transforming visual feedback into precise motor adjustments in ASD. PMID:25653359

  12. Feedback in clinical education: untying the Gordian knot.

    PubMed

    Weinstein, Debra F

    2015-05-01

    Feedback is essential to clinical education, especially in the era of competencies, milestones, and entrustable professional activities. It is, however, an area where medical educators often fall short. Although educational leaders and faculty supervisors provide feedback in a variety of clinical settings, surveys show important gaps in medical student and resident satisfaction with the feedback received, suggesting lost opportunities to identify performance problems as well as to help each learner reach his or her greatest potential.In this issue of Academic Medicine, Telio and colleagues extend the empirically validated concept of a "therapeutic alliance" to propose the "educational alliance" as a framework for enhancing feedback in medical education. They highlight the importance of source credibility, which depends on the teacher-learner relationship and alignment of values, the teacher's understanding of the learner's role and goals, the teacher's direct observation of the learner, and the learner's perception of the teacher's good intentions. The author of this Commentary suggests that the educational alliance framework should prompt medical educators to reconsider feedback and explore opportunities for optimizing it. Most medical schools and graduate medical education programs are not designed in a way that supports the education alliance model, but the Commentary author offers suggestions for cultivating educational alliances, including rethinking supervisor selection criteria. Such interventions should be combined with ongoing faculty development and efforts to improve coaching and mentoring for students, residents, and fellows. Untying the Gordian knot of effective feedback will require innovative approaches, exchange of successful strategies, and continued research.

  13. Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans.

    PubMed

    Roughead, Elizabeth E; Kalisch Ellett, Lisa M; Ramsay, Emmae N; Pratt, Nicole L; Barratt, John D; LeBlanc, Vanessa T; Ryan, Philip; Peck, Robert; Killer, Graeme; Gilbert, Andrew L

    2013-12-12

    The Australian Government Department of Veterans' Affairs (DVA) funds an ongoing health promotion based program to improve use of medicines and related health services, which implements interventions that include audit and feedback in the form of patient-specific feedback generated from administrative claims records. We aimed to determine changes in medicine use as a result of the program. The program provides targeted patient-specific feedback to medical practitioners. The feedback is supported with educational material developed by a clinical panel, subject to peer review and overseen by a national editorial committee. Veterans who meet target criteria also receive educational brochures. The program is supported by a national call centre and ongoing national consultation. Segmented regression analyses (interrupted time series) were undertaken to assess changes in medication use in targeted veterans pre and post each intervention. 12 interventions were included; three to increase medicine use, seven which aimed to reduce use, and two which had combination of messages to change use. All programs that aimed to increase medicine use were effective, with relative effect sizes at the time of the intervention ranging from 1% to 8%. Mixed results were seen with programs aiming to reduce inappropriate medicine use. Highly specific programs were effective, with relative effect sizes at the time of the intervention of 10% decline in use of NSAIDs in high risk groups and 14% decline in use of antipsychotics in dementia. Interventions targeting combinations of medicines, including medicine interactions and potentially inappropriate medicines in the elderly did not change practice significantly. Interventions with combinations of messages targeting multiple components of practice had an impact on one component, but not all components targeted. The Veterans' MATES program showed positive practice change over time, with interventions increasing use of appropriate medicines where under-use was evident and reduced use of inappropriate medicines when single medicines were targeted. Combinations of messages were less effective, suggesting specific messages focusing on single medicines are required to maximise effect. The program provides a model that could be replicated in other settings.

  14. Adolescents' Perspectives on Personalized E-Feedback in the Context of Health Risk Behavior Screening for Primary Care: Qualitative Study.

    PubMed

    Zieve, Garret G; Richardson, Laura P; Katzman, Katherine; Spielvogle, Heather; Whitehouse, Sandy; McCarty, Carolyn A

    2017-07-20

    Electronic health screening tools for primary care present an opportunity to go beyond data collection to provide education and feedback to adolescents in order to motivate behavior change. However, there is limited research to guide feedback message development. The aim of this study was to explore youth perceptions of and preferences for receiving personalized feedback for multiple health risk behaviors and reinforcement for health promoting behaviors from an electronic health screening tool for primary care settings, using qualitative methodology. In total, 31 adolescents aged 13-18 years completed the screening tool, received the electronic feedback, and subsequently participated in individual, semistructured, qualitative interviews lasting approximately 60 min. Participants were queried about their overall impressions of the tool, perceptions regarding various types of feedback messages, and additional features that would help motivate health behavior change. Using thematic analysis, interview transcripts were coded to identify common themes expressed across participants. Overall, the tool was well-received by participants who perceived it as a way to enhance-but not replace-their interactions with providers. They appreciated receiving nonjudgmental feedback from the tool and responded positively to information regarding the consequences of behaviors, comparisons with peer norms and health guidelines, tips for behavior change, and reinforcement of healthy choices. A small but noteworthy minority of participants dismissed the peer norms as not real or relevant and national guidelines as not valid or reasonable. When prompted for possible adaptations to the tool, adolescents expressed interest in receiving follow-up information, setting health-related goals, tracking their behaviors over time, and communicating with providers electronically between appointments. Adolescents in this qualitative study desired feedback that validates their healthy behavior choices and supports them as independent decision makers by neutrally presenting health information, facilitating goal setting, and offering ongoing technological supports. ©Garret G Zieve, Laura P Richardson, Katherine Katzman, Heather Spielvogle, Sandy Whitehouse, Carolyn A McCarty. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.07.2017.

  15. Feedback and feedforward locomotor adaptations to ankle-foot load in people with incomplete spinal cord injury.

    PubMed

    Gordon, Keith E; Wu, Ming; Kahn, Jennifer H; Schmit, Brian D

    2010-09-01

    Humans with spinal cord injury (SCI) modulate locomotor output in response to limb load. Understanding the neural control mechanisms responsible for locomotor adaptation could provide a framework for selecting effective interventions. We quantified feedback and feedforward locomotor adaptations to limb load modulations in people with incomplete SCI. While subjects airstepped (stepping performed with kinematic assistance and 100% bodyweight support), a powered-orthosis created a dorisflexor torque during the "stance phase" of select steps producing highly controlled ankle-load perturbations. When given repetitive, stance phase ankle-load, the increase in hip extension work, 0.27 J/kg above baseline (no ankle-load airstepping), was greater than the response to ankle-load applied during a single step, 0.14 J/kg (P = 0.029). This finding suggests that, at the hip, subjects produced both feedforward and feedback locomotor modulations. We estimate that, at the hip, the locomotor response to repetitive ankle-load was modulated almost equally by ongoing feedback and feedforward adaptations. The majority of subjects also showed after-effects in hip kinetic patterns that lasted 3 min in response to repetitive loading, providing additional evidence of feedforward locomotor adaptations. The magnitude of the after-effect was proportional to the response to repetitive ankle-foot load (R(2) = 0.92). In contrast, increases in soleus EMG amplitude were not different during repetitive and single-step ankle-load exposure, suggesting that ankle locomotor modulations were predominately feedback-based. Although subjects made both feedback and feedforward locomotor adaptations to changes in ankle-load, between-subject variations suggest that walking function may be related to the ability to make feedforward adaptations.

  16. Reinventing the Wheel: One Program's Approach to Redesign of Didactic Courses.

    PubMed

    Hudak, Nicholas M; Scott, Victoria; Spear, Sherrie B; Hills, Karen J

    2015-12-01

    Curriculum and course redesign are expected and intentional efforts in health professions education. For physician assistant (PA) education, ongoing program self-assessment is a required accreditation standard and may guide deliberate changes within curriculum. The purpose of this article is to describe one PA program’s approach to the redesign of 4 courses into 3 courses that span the entire didactic phase. Significant lessons learned include the importance of planning ahead, identifying key players, documenting the process as part of ongoing self-assessment, competency mapping, and being prepared to make real-time modifications and changes based on course evaluations and faculty feedback. Our approach and guiding principles to the successful redesign of the didactic courses may provide both established and new PA educational programs with useful methods to apply in their own unique curricula.

  17. "Why Are These Underlined?" Depth of Processing and Type of Written Corrective Feedback in L2 Spanish Compositions

    ERIC Educational Resources Information Center

    Caras, Allison Marie

    2017-01-01

    There is an ongoing debate as to whether written corrective feedback (WCF) is effective for the improvement of adult second language (L2) writers' accuracy. Ever since Truscott (1996, 1999) began arguing against grammar correction in L2 writing courses, researchers have challenged his position (i.e. below). Although most of these studies show WCF…

  18. Team Objective Structured Bedside Assessment (TOSBA) as formative assessment in undergraduate Obstetrics and Gynaecology: a cohort study.

    PubMed

    Deane, Richard P; Joyce, Pauline; Murphy, Deirdre J

    2015-10-09

    Team Objective Structured Bedside Assessment (TOSBA) is a learning approach in which a team of medical students undertake a set of structured clinical tasks with real patients in order to reach a diagnosis and formulate a management plan and receive immediate feedback on their performance from a facilitator. TOSBA was introduced as formative assessment to an 8-week undergraduate teaching programme in Obstetrics and Gynaecology (O&G) in 2013/14. Each student completed 5 TOSBA sessions during the rotation. The aim of the study was to evaluate TOSBA as a teaching method to provide formative assessment for medical students during their clinical rotation. The research questions were: Does TOSBA improve clinical, communication and/or reasoning skills? Does TOSBA provide quality feedback? A prospective cohort study was conducted over a full academic year (2013/14). The study used 2 methods to evaluate TOSBA as a teaching method to provide formative assessment: (1) an online survey of TOSBA at the end of the rotation and (2) a comparison of the student performance in TOSBA with their performance in the final summative examination. During the 2013/14 academic year, 157 students completed the O&G programme and the final summative examination . Each student completed the required 5 TOSBA tasks. The response rate to the student survey was 68 % (n = 107/157). Students reported that TOSBA was a beneficial learning experience with a positive impact on clinical, communication and reasoning skills. Students rated the quality of feedback provided by TOSBA as high. Students identified the observation of the performance and feedback of other students within their TOSBA team as key features. High achieving students performed well in both TOSBA and summative assessments. The majority of students who performed poorly in TOSBA subsequently passed the summative assessments (n = 20/21, 95 %). Conversely, the majority of students who failed the summative assessments had satisfactory scores in TOSBA (n = 6/7, 86 %). TOSBA has a positive impact on the clinical, communication and reasoning skills of medical students through the provision of high-quality feedback. The use of structured pre-defined tasks, the observation of the performance and feedback of other students and the use of real patients are key elements of TOSBA. Avoiding student complacency and providing accurate feedback from TOSBA are on-going challenges.

  19. Evaluation of a medication order writing standards policy in a regional health authority.

    PubMed

    Raymond, Colette B; Sproll, Barbara; Coates, Jan; Woloschuk, Donna M M

    2013-09-01

    The Winnipeg Regional Health Authority (WRHA) implemented a medication order writing standards (MOWS) policy (including banned abbreviations) to improve patient safety. Widespread educational campaigns and direct prescriber feedback were implemented. We audited orders within the WRHA from 2005 to 2009 and surveyed all WRHA staff in 2011 about the policy and suggestions for improving education and compliance. Overall, orders containing banned abbreviations, acronyms or symbols numbered 2261/8565 (26.4%) preimplementation. After WRHA-wide didactic education, the proportion declined to 1358/5461 (24.9%) (p = 0.043) and then, with targeted prescriber feedback, to 1186/6198 (19.1%) (p < 0.0001). A survey of 723 employees showed frequent violations of the MOWS, despite widespread knowledge of the policy. Respondents supported ongoing efforts to enforce the policy within the WRHA. Nonprescribers were significantly more likely than prescribers to agree with statements regarding enhancing compliance by defining prescriber/transcriber responsibilities and placing sanctions on noncompliant prescribers. Education, raising general awareness and targeted feedback to prescribers alone are insufficient to ensure compliance with MOWS policies. WRHA staff supported ongoing communication, improved tools such as compliant preprinted orders and reporting and feedback about medication incidents. A surprising number of respondents supported placing sanctions on noncompliant prescribers. Serial audits and targeted interventions such as direct prescriber feedback improve prescription quality in inpatient hospital settings. Education plus direct prescriber feedback had a greater impact than education alone on improving compliance with a MOWS policy. Future efforts at the WRHA to improve compliance will require an expanded focus on incentives, resources and development of action plans that involve all affected staff, not just prescribers. Plans include continued advertising, MOWS summaries in all charts, all-staff education, reminders and exploration of sustainable interventions for targeted feedback for prescribers.

  20. Feedforward and feedback motor control abnormalities implicate cerebellar dysfunctions in autism spectrum disorder.

    PubMed

    Mosconi, Matthew W; Mohanty, Suman; Greene, Rachel K; Cook, Edwin H; Vaillancourt, David E; Sweeney, John A

    2015-02-04

    Sensorimotor abnormalities are common in autism spectrum disorder (ASD) and among the earliest manifestations of the disorder. They have been studied far less than the social-communication and cognitive deficits that define ASD, but a mechanistic understanding of sensorimotor abnormalities in ASD may provide key insights into the neural underpinnings of the disorder. In this human study, we examined rapid, precision grip force contractions to determine whether feedforward mechanisms supporting initial motor output before sensory feedback can be processed are disrupted in ASD. Sustained force contractions also were examined to determine whether reactive adjustments to ongoing motor behavior based on visual feedback are altered. Sustained force was studied across multiple force levels and visual gains to assess motor and visuomotor mechanisms, respectively. Primary force contractions of individuals with ASD showed greater peak rate of force increases and large transient overshoots. Individuals with ASD also showed increased sustained force variability that scaled with force level and was more severe when visual gain was highly amplified or highly degraded. When sustaining a constant force level, their reactive adjustments were more periodic than controls, and they showed increased reliance on slower feedback mechanisms. Feedforward and feedback mechanism alterations each were associated with more severe social-communication impairments in ASD. These findings implicate anterior cerebellar circuits involved in feedforward motor control and posterior cerebellar circuits involved in transforming visual feedback into precise motor adjustments in ASD. Copyright © 2015 the authors 0270-6474/15/352015-11$15.00/0.

  1. Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

    PubMed

    Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

    2016-01-01

    Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  2. Conducting effective performance appraisals.

    PubMed

    2001-01-01

    According to experts, performance appraisals rate just below firing someone as the least favorite thing managers do. Many factors contribute to this view--one is that current systems do a poor job of evaluating performance and in fact often impede both evaluation and performance. When used as part of an ongoing supportive process of goal setting and feedback, performance appraisals can enhance performance and morale. One alternative to traditional employee evaluation methods is full-circle or 360-degree feedback. Contained in this issue are practical suggestions for preparing employees for performance appraisals which, when followed daily, encourage employees to put their best feet forward as part of their regular routine. Also included is a template specific to assessing the performance of clinical laboratory technologists . Additionally, numerous resources are provided to help you refine appraisal systems to fit your needs. Full-circle feedback is proving to be a boon to managers. It relieves them from being the exclusive "heavies" in evaluating performance, integrates appraisal input from several sources, and incorporates increasing employee skills, competencies, and satisfaction, thus improving productivity of people and processes. And aren't integration and continuous improvement what the laboratory is all about?

  3. Three Hundred Sixty Degree Feedback: program implementation in a local health department.

    PubMed

    Swain, Geoffrey R; Schubot, David B; Thomas, Virginia; Baker, Bevan K; Foldy, Seth L; Greaves, William W; Monteagudo, Maria

    2004-01-01

    Three Hundred Sixty Degree Feedback systems, while popular in business, have been less commonly implemented in local public health agencies. At the same time, they are effective methods of improving employee morale, work performance, organizational culture, and attainment of desired organizational outcomes. These systems can be purchased "off-the-shelf," or custom applications can be developed for a better fit with unique organizational needs. We describe the City of Milwaukee Health Department's successful experience customizing and implementing a 360-degree feedback system in the context of its ongoing total quality improvement efforts.

  4. Comfort Care Rounds: a staff capacity-building initiative in long-term care homes.

    PubMed

    Wickson-Griffiths, Abigail; Kaasalainen, Sharon; Brazil, Kevin; McAiney, Carrie; Crawshaw, Diane; Turner, Mickey; Kelley, Mary Lou

    2015-01-01

    This article reports a pilot evaluation of Comfort Care Rounds (CCRs)--a strategy for addressing long-term care home staff's palliative and end-of-life care educational and support needs. Using a qualitative descriptive design, semistructured individual and focus group interviews were conducted to understand staff members' perspectives and feedback on the implementation and application of CCRs. Study participants identified that effective advertising, interest, and assigning staff to attend CCRs facilitated their participation. The key barriers to their attendance included difficulty in balancing heavy workloads and scheduling logistics. Interprofessional team member representation was sought but was not consistent. Study participants recognized the benefits of attending; however, they provided feedback on how the scheduling, content, and focus could be improved. Overall, study participants found CCRs to be beneficial to their palliative and end-of-life care knowledge, practice, and confidence. However, they identified barriers and recommendations, which warrant ongoing evaluation. Copyright 2015, SLACK Incorporated.

  5. Advanced Instrumentation, Information, and Control Systems Technologies Pathway: FY 2016 External Review

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Thomas, Kenneth David; Hallbert, Bruce Perry

    2016-11-01

    This report describes an External Review conducted by the LWRS Program Advanced Instrumentation, Information, and Control (II&C) Systems Technologies Pathway to solicit feedback on the topics and results of the ongoing II&C research program. This review was held in conjunction with the Nuclear Energy Institute (NEI) Digital I&C Working Group meeting that was held at Idaho National Laboratory (INL) on August 9-10, 2016. Given the opportunity to visit INL and see the pathway research projects, NEI agreed that the Working Group would serve as the External Review panel for the purpose of obtaining expert input on the value and timingmore » of the research projects. This consisted of demonstrations in the Human Systems Simulation Laboratory followed by presentations on the II&C research program in general as well as the five technology development areas. Following the meeting, the presentations were sent to each of the attendees so they could review them in more detail and refer to them in completing the feedback form. Follow-up activities were conducted with the attendees following the meeting to obtain the completed feedback forms. A total of 13 forms were returned. The feedback forms were reviewed by the pathway to compile the data and comments received, which are documented in the report. In all, the feedback provided by the External Review participants is taken to be a strong endorsement of the types of projects being conducted by the pathway, the value they hold for the nuclear plants, and the general timing of need. The feedback aligns well with the priorities, levels of efforts allocated for the research projects, and project schedules. The feedback also represents realistic observations on the practicality of some aspects of implementing these technologies. In some cases, the participants provided thoughtful challenges to certain assumptions in the formulation of the technologies or in deployment plans. These deserve further review and revision of plans if warranted. The pathway will take all of the feedback and address the open issues that have been identified by the participants. This includes 11 actionable items for follow up by the II&C Pathway.« less

  6. Panarchy use in environmental science for risk and resilience planning

    USGS Publications Warehouse

    Angeler, David G.; Allen, Craig R.; Garmestani, Ahjond S.; Gunderson, Lance H.; Linkov, Igor

    2016-01-01

    Environmental sciences have an important role in informing sustainable management of built environments by providing insights about the drivers and potentially negative impacts of global environmental change. Here, we discuss panarchy theory, a multi-scale hierarchical concept that accounts for the dynamism of complex socio-ecological systems, especially for those systems with strong cross-scale feedbacks. The idea of panarchy underlies much of system resilience, focusing on how systems respond to known and unknown threats. Panarchy theory can provide a framework for qualitative and quantitative research and application in the environmental sciences, which can in turn inform the ongoing efforts in socio-technical resilience thinking and adaptive and transformative approaches to management.

  7. The development of an acute care case manager orientation.

    PubMed

    Strzelecki, S; Brobst, R

    1997-01-01

    The authors describe the development of an inpatient acute care case manager orientation in a community hospital. Benner's application of the Dreyfus model of skill acquisition provides the basis for the orientation program. The candidates for the case manager position were expert clinicians. Because of the role change it was projected that they would function as advanced beginners. It was also predicted that, as the case managers progressed within the role, the educational process would need to be adapted to facilitate progression of skills to the proficient level. Feedback from participants reinforced that the model supported the case manager in the role transition. In addition, the model provided a predictive framework for ongoing educational activities.

  8. Contextual cuing contributes to the independent modification of multiple internal models for vocal control

    PubMed Central

    Keough, Dwayne

    2011-01-01

    Research on the control of visually guided limb movements indicates that the brain learns and continuously updates an internal model that maps the relationship between motor commands and sensory feedback. A growing body of work suggests that an internal model that relates motor commands to sensory feedback also supports vocal control. There is evidence from arm-reaching studies that shows that when provided with a contextual cue, the motor system can acquire multiple internal models, which allows an animal to adapt to different perturbations in diverse contexts. In this study we show that trained singers can rapidly acquire multiple internal models regarding voice fundamental frequency (F0). These models accommodate different perturbations to ongoing auditory feedback. Participants heard three musical notes and reproduced each one in succession. The musical targets could serve as a contextual cue to indicate which direction (up or down) feedback would be altered on each trial; however, participants were not explicitly instructed to use this strategy. When participants were gradually exposed to altered feedback adaptation was observed immediately following vocal onset. Aftereffects were target specific and did not influence vocal productions on subsequent trials. When target notes were no longer a contextual cue, adaptation occurred during altered feedback trials and evidence for trial-by-trial adaptation was found. These findings indicate that the brain is exceptionally sensitive to the deviations between auditory feedback and the predicted consequence of a motor command during vocalization. Moreover, these results indicate that, with contextual cues, the vocal control system may maintain multiple internal models that are capable of independent modification during different tasks or environments. PMID:21346208

  9. Implementation of an electronic health record-based care management system to improve tobacco treatment.

    PubMed

    Kruse, Gina R; Kelley, Jennifer H K; Linder, Jeffrey A; Park, Elyse R; Rigotti, Nancy A

    2012-12-01

    Tobacco treatment is underused in primary care. We designed a Tobacco Care Management system to increase the delivery of treatment and reduce the burden on primary care providers (PCPs). A one-click functionality added to the electronic health record (EHR) allowed PCPs to refer smokers to a centralized tobacco treatment coordinator (TTC) who called smokers, provided brief counseling, connected them to ongoing treatment and gave feedback to PCPs. To study the system's feasibility and acceptability among PCPs, and its utilization by smokers. Using a mixed methods design, we documented system utilization quantitatively from February 1, 2010 to July 31, 2011, and conducted two focus groups with PCPs in June 2011. Thirty-six PCPs and 2,894 smokers from two community health centers in Massachusetts. Quantitative: One-click referral utilization by PCPs, proportion of smokers referred and connected to treatment. Qualitative: PCPs' reasons for use, barriers to use, and experiences with feedback. Twenty-nine PCPs (81 %) used the functionality more than once, generating 466 referrals for 15 % of known smokers seen during the study. The TTC reached 260 (56 %) of the referrals and connected 135 (29 %) to additional treatment. The director of one center sent PCPs monthly feedback about their utilization compared to peers. These PCPs referred a greater proportion of their known smokers (18 % vs. 9 %, p<0.0001) and reported that monthly feedback motivated referrals. PCPs attending focus groups (n=24) appreciated the system's simplicity, access to updated resources, and time-efficient way to address smoking, and wanted more feedback about cessation outcomes. They collectively supported the system's continuation. A novel EHR-based Tobacco Care Management system was adopted by PCPs, especially those receiving performance feedback, and connected one-third of referred smokers to treatment. The model has the potential to improve the delivery and outcomes of evidence-based tobacco treatment in primary care.

  10. Functional imaging of cortical feedback projections to the olfactory bulb

    PubMed Central

    Rothermel, Markus; Wachowiak, Matt

    2014-01-01

    Processing of sensory information is substantially shaped by centrifugal, or feedback, projections from higher cortical areas, yet the functional properties of these projections are poorly characterized. Here, we used genetically-encoded calcium sensors (GCaMPs) to functionally image activation of centrifugal projections targeting the olfactory bulb (OB). The OB receives massive centrifugal input from cortical areas but there has been as yet no characterization of their activity in vivo. We focused on projections to the OB from the anterior olfactory nucleus (AON), a major source of cortical feedback to the OB. We expressed GCaMP selectively in AON projection neurons using a mouse line expressing Cre recombinase (Cre) in these neurons and Cre-dependent viral vectors injected into AON, allowing us to image GCaMP fluorescence signals from their axon terminals in the OB. Electrical stimulation of AON evoked large fluorescence signals that could be imaged from the dorsal OB surface in vivo. Surprisingly, odorants also evoked large signals that were transient and coupled to odorant inhalation both in the anesthetized and awake mouse, suggesting that feedback from AON to the OB is rapid and robust across different brain states. The strength of AON feedback signals increased during wakefulness, suggesting a state-dependent modulation of cortical feedback to the OB. Two-photon GCaMP imaging revealed that different odorants activated different subsets of centrifugal AON axons and could elicit both excitation and suppression in different axons, indicating a surprising richness in the representation of odor information by cortical feedback to the OB. Finally, we found that activating neuromodulatory centers such as basal forebrain drove AON inputs to the OB independent of odorant stimulation. Our results point to the AON as a multifunctional cortical area that provides ongoing feedback to the OB and also serves as a descending relay for other neuromodulatory systems. PMID:25071454

  11. Phase-change lines, scale breaks, and trend lines using Excel 2013.

    PubMed

    Deochand, Neil; Costello, Mack S; Fuqua, R Wayne

    2015-01-01

    The development of graphing skills for behavior analysts is an ongoing process. Specialized graphing software is often expensive, is not widely disseminated, and may require specific training. Dixon et al. (2009) provided an updated task analysis for graph making in the widely used platform Excel 2007. Vanselow and Bourret (2012) provided online tutorials that outline some alternate methods also using Office 2007. This article serves as an update to those task analyses and includes some alternative and underutilized methods in Excel 2013. To examine the utility of our recommendations, 12 psychology graduate students were presented with the task analyses, and the experimenters evaluated their performance and noted feedback. The task analyses were rated favorably. © Society for the Experimental Analysis of Behavior.

  12. Influence of Vibrotactile Feedback on Controlling Tilt Motion After Spaceflight

    NASA Technical Reports Server (NTRS)

    Wood, S. J.; Rupert, A. H.; Vanya, R. D.; Esteves, J. T.; Clement, G.

    2011-01-01

    We hypothesize that adaptive changes in how inertial cues from the vestibular system are integrated with other sensory information leads to perceptual disturbances and impaired manual control following transitions between gravity environments. The primary goals of this ongoing post-flight investigation are to quantify decrements in manual control of tilt motion following short-duration spaceflight and to evaluate vibrotactile feedback of tilt as a sensorimotor countermeasure. METHODS. Data is currently being collected on 9 astronaut subjects during 3 preflight sessions and during the first 8 days after Shuttle landings. Variable radius centrifugation (216 deg/s, <20 cm radius) in a darkened room is utilized to elicit otolith reflexes in the lateral plane without concordant canal or visual cues. A Tilt-Translation Sled (TTS) is capable of synchronizing pitch tilt with fore-aft translation to align the resultant gravitoinertial vector with the longitudinal body axis, thereby eliciting canal reflexes without concordant otolith or visual cues. A simple 4 tactor system was implemented to provide feedback when tilt position exceeded predetermined levels in either device. Closed-loop nulling tasks are performed during random tilt steps or sum-of-sines (TTS only) with and without vibrotactile feedback of chair position. RESULTS. On landing day the manual control performance without vibrotactile feedback was reduced by >30% based on the gain or the amount of tilt disturbance successfully nulled. Manual control performance tended to return to baseline levels within 1-2 days following landing. Root-mean-square position error and tilt velocity were significantly reduced with vibrotactile feedback. CONCLUSIONS. These preliminary results are consistent with our hypothesis that adaptive changes in vestibular processing corresponds to reduced manual control performance following G-transitions. A simple vibrotactile prosthesis improves the ability to null out tilt motion within a limited range of motion disturbances.

  13. Simultaneous feedback control of plasma rotation and stored energy on NSTX-U using neoclassical toroidal viscosity and neutral beam injection

    NASA Astrophysics Data System (ADS)

    Goumiri, I. R.; Rowley, C. W.; Sabbagh, S. A.; Gates, D. A.; Boyer, M. D.; Gerhardt, S. P.; Kolemen, E.; Menard, J. E.

    2017-05-01

    A model-based feedback system is presented enabling the simultaneous control of the stored energy through βn and the toroidal rotation profile of the plasma in National Spherical Torus eXperiment Upgrade device. Actuation is obtained using the momentum from six injected neutral beams and the neoclassical toroidal viscosity generated by applying three-dimensional magnetic fields. Based on a model of the momentum diffusion and torque balance, a feedback controller is designed and tested in closed-loop simulations using TRANSP, a time dependent transport analysis code, in predictive mode. Promising results for the ongoing experimental implementation of controllers are obtained.

  14. Simultaneous feedback control of plasma rotation and stored energy on NSTX-U using neoclassical toroidal viscosity and neutral beam injection

    PubMed Central

    Goumiri, I. R.; Sabbagh, S. A.; Boyer, M. D.; Gerhardt, S. P.; Kolemen, E.; Menard, J. E.

    2017-01-01

    A model-based feedback system is presented enabling the simultaneous control of the stored energy through βn and the toroidal rotation profile of the plasma in National Spherical Torus eXperiment Upgrade device. Actuation is obtained using the momentum from six injected neutral beams and the neoclassical toroidal viscosity generated by applying three-dimensional magnetic fields. Based on a model of the momentum diffusion and torque balance, a feedback controller is designed and tested in closed-loop simulations using TRANSP, a time dependent transport analysis code, in predictive mode. Promising results for the ongoing experimental implementation of controllers are obtained. PMID:28435207

  15. Simultaneous feedback control of plasma rotation and stored energy on NSTX-U using neoclassical toroidal viscosity and neutral beam injection

    DOE PAGES

    Goumiri, I. R.; Rowley, C. W.; Sabbagh, S. A.; ...

    2017-02-23

    In this study, a model-based feedback system is presented enabling the simultaneous control of the stored energy through β n and the toroidal rotation profile of the plasma in National Spherical Torus eXperiment Upgrade device. Actuation is obtained using the momentum from six injected neutral beams and the neoclassical toroidal viscosity generated by applying three-dimensional magnetic fields. Based on a model of the momentum diffusion and torque balance, a feedback controller is designed and tested in closed-loop simulations using TRANSP, a time dependent transport analysis code, in predictive mode. Promising results for the ongoing experimental implementation of controllers are obtained.

  16. A Neural Model for Language and Speech.

    ERIC Educational Resources Information Center

    Buckingham, Hugh W., Jr.; Hollien, Harry

    1978-01-01

    A neural model in the form of a servo-mechanism is developed to account for certain aspects of language and speech in the human nervous system. Emphasis is placed on encoding processes as well as on-going feedback during production. (SW)

  17. A study of science leadership and science standards in exemplary standards-based science programs

    NASA Astrophysics Data System (ADS)

    Carpenter, Wendy Renae

    The purpose for conducting this qualitative study was to explore best practices of exemplary standards-based science programs and instructional leadership practices in a charter high school and in a traditional high school. The focus of this study included how twelve participants aligned practices to National Science Education Standards to describe their science programs and science instructional practices. This study used a multi-site case study qualitative design. Data were obtained through a review of literature, interviews, observations, review of educational documents, and researcher's notes collected in a field log. The methodology used was a multi-site case study because of the potential, through cross analysis, for providing greater explanation of the findings in the study (Merriam, 1988). This study discovered six characteristics about the two high school's science programs that enhance the literature found in the National Science Education Standards; (a) Culture of expectations for learning-In exemplary science programs teachers are familiar with a wide range of curricula. They have the ability to examine critically and select activities to use with their students to promote the understanding of science; (b) Culture of varied experiences-In exemplary science programs students are provided different paths to learning, which help students, take in information and make sense of concepts and skills that are set forth by the standards; (c) Culture of continuous feedback-In exemplary science programs teachers and students work together to engage students in ongoing assessments of their work and that of others as prescribed in the standards; (d) Culture of Observations-In exemplary science programs students, teachers, and principals reflect on classroom instructional practices; teachers receive ongoing evaluations about their teaching and apply feedback towards improving practices as outlined in the standards; (e) Culture of continuous learning-In exemplary science programs teachers value continuous personal development, teachers are provided on-going science professional development opportunities to improve instructional practices, teachers reflect and share professional practices, and teachers establish professional learning communities within their classrooms; and (f) Culture of shared leadership-In exemplary science programs instructional leadership purposes and values are consistently shared among all stakeholders which are outlined in the standards. These results are potentially useful for understanding exemplary standards-based science programs and science instructional leadership practices as a model for science programs trying to improve science education so that all students can have a true scientific learning experience.

  18. Physical Origins of Gas Motions in Galaxy Cluster Cores: Interpreting Hitomi Observations of the Perseus Cluster

    NASA Astrophysics Data System (ADS)

    Lau, Erwin T.; Gaspari, Massimo; Nagai, Daisuke; Coppi, Paolo

    2017-11-01

    The Hitomi X-ray satellite has provided the first direct measurements of the plasma velocity dispersion in a galaxy cluster. It finds a relatively “quiescent” gas with a line-of-sight velocity dispersion {σ }v,{los}≃ 160 {km} {{{s}}}-1, at 30-60 kpc from the cluster center. This is surprising given the presence of jets and X-ray cavities that indicates on-going activity and feedback from the active galactic nucleus (AGN) at the cluster center. Using a set of mock Hitomi observations generated from a suite of state-of-the-art cosmological cluster simulations, and an isolated but higher resolution simulation of gas physics in the cluster core, including the effects of cooling and AGN feedback, we examine the likelihood of Hitomi detecting a cluster with the observed velocities. As long as the Perseus has not experienced a major merger in the last few gigayears, and AGN feedback is operating in a “‘gentle” mode, we reproduce the level of gas motions observed by Hitomi. The frequent mechanical AGN feedback generates net line-of-sight velocity dispersions ˜ 100{--}200 {km} {{{s}}}-1, bracketing the values measured in the Perseus core. The large-scale velocity shear observed across the core, on the other hand, is generated mainly by cosmic accretion such as mergers. We discuss the implications of these results for AGN feedback physics and cluster cosmology and progress that needs to be made in both simulations and observations, including a Hitomi re-flight and calorimeter-based instruments with higher spatial resolution.

  19. Extreme ultraviolet diagnostic upgrades for kink mode control on the HBT-EP tokamak

    NASA Astrophysics Data System (ADS)

    Levesque, J. P.; Brooks, J. W.; Desanto, S.; Mauel, M. E.; Navratil, G. A.; Page, J. W.; Hansen, C. J.; Delgado-Aparicio, L.

    2016-10-01

    Optical diagnostics can provide non-invasive measurements of tokamak equilibria and the internal characteristics of MHD mode activity. We present research plans and ongoing progress on upgrading extreme ultraviolet (EUV) diagnostics in the HBT-EP tokamak. Four sets of 16 poloidal views will allow tomographic reconstruction of plasma emissivity and internal kink mode structure. Emission characteristics of naturally-occurring m/n = 2/1, 3/2, and 3/1 tearing and kink modes will be compared with expectations from a synthetic diagnostic. Coupling between internal and external modes leading up to disruptions is studied. The internal plasma response to external magnetic perturbations is investigated, and compared with magnetic response measurements. Correlation between internal emissivity and external magnetic measurements provides a global picture of long-wavelength MHD instabilities. Measurements are input to HBT-EP's GPU-based feedback system, allowing active feedback for kink modes using only optical sensors and both magnetic and edge current actuators. A separate two-color, 16-chord tangential system will be installed next year to allow reconstruction of temperature profiles and their fluctuations versus time. Supported by U.S. DOE Grant DE-FG02-86ER53222.

  20. Fostering learners' interaction with content: A learner-centered mobile device interface

    NASA Astrophysics Data System (ADS)

    Abdous, M.

    2015-12-01

    With the ever-increasing omnipresence of mobile devices in student life, leveraging smart devices to foster students' interaction with course content is critical. Following a learner-centered design iterative approach, we designed a mobile interface that may enable learners to access and interact with online course content efficiently and intuitively. Our design process leveraged recent technologies, such as bootstrap, Google's Material Design, HTML5, and JavaScript to design an intuitive, efficient, and portable mobile interface with a variety of built-in features, including context sensitive bookmarking, searching, progress tracking, captioning, and transcript display. The mobile interface also offers students the ability to ask context-related questions and to complete self-checks as they watch audio/video presentations. Our design process involved ongoing iterative feedback from learners, allowing us to refine and tweak the interface to provide learners with a unified experience across platforms and devices. The innovative combination of technologies built around well-structured and well-designed content seems to provide an effective learning experience to mobile learners. Early feedback indicates a high level of satisfaction with the interface's efficiency, intuitiveness, and robustness from both students and faculty.

  1. On deciphering the book of nature: human communication in psychotherapy.

    PubMed

    Goodheart, W B

    1992-10-01

    The tools of contemporary applied mathematics reveal important hidden regularities amidst the ongoing interactive feedback phenomena occurring in interactional or dynamical systems in nature where everything affects everything else. Badalamenti and Langs investigate each therapy session as a continuous sequential emergence of interrelated communicative events (or communicative states) which meet the criteria of a dynamical system. Applying mathematical modeling the authors demonstrate how otherwise hidden regularities occurring between patients and therapists become accessible to us that are unavailable to our unaided powers of observation, intuition, and thought. This is a systems or population investigation of clinical interaction that begins in a qualitative or domain mode, but which opens immediately toward statistical and formal modes of discussion. It can lead to statements of properties and laws that meet the criteria of scientific dialogue and validity. It provides the clinician with guidelines for making interpretations and for assessing their immediate subsequent effect. It is distinguished from the essentialist approach at the foundation of traditional clinical thought which provides no access to such feedback phenomena and their properties. Communicative Psychoanalysts have adopted the systems perspective and are evolving a clinical language and treatment based upon its principles and discoveries.

  2. A sustainable development of a city electrical grid via a non-contractual Demand-Side Management

    NASA Astrophysics Data System (ADS)

    Samoylenko, Vladislav O.; Pazderin, Andrew V.

    2017-06-01

    An increasing energy consumption of large cities as well as an extreme high density of city electrical loads leads to the necessity to search for an alternative approaches to city grid development. The ongoing implementation of the energy accounting tariffs with differentiated rates depending upon the market conditions and changing in a short-term perspective, provide the possibility to use it as a financial incentive base of a Demand-Side Management (DSM). Modern hi-technology energy metering and accounting systems with a large number of functions and consumer feedback are supposed to be the good means of DSM. Existing systems of Smart Metering (SM) billing usually provide general information about consumption curve, bills and compared data, but not the advanced statistics about the correspondence of financial and electric parameters. Also, consumer feedback is usually not fully used. So, the efforts to combine the market principle, Smart Metering and a consumer feedback for an active non-contractual load control are essential. The paper presents the rating-based multi-purpose system of mathematical statistics and algorithms of DSM efficiency estimation useful for both the consumers and the energy companies. The estimation is performed by SM Data processing systems. The system is aimed for load peak shaving and load curve smoothing. It is focused primarily on a retail market support. The system contributes to the energy efficiency and a distribution process improvement by the manual management or by the automated Smart Appliances interaction.

  3. Feasibility Testing and Refinement of a Supportive Educational Intervention for Carers of Patients with High-Grade Glioma - a Pilot Study.

    PubMed

    Halkett, Georgia K B; Lobb, Elizabeth A; Miller, Lisa; Shaw, Thérèse; Moorin, Rachael; Long, Anne; King, Anne; Clarke, Jenny; Fewster, Stephanie; Nowak, Anna K

    2017-02-11

    The aim of this pilot study was to test the feasibility and acceptability of a family carer intervention for carers of patients with high-grade glioma (HGG). The intervention consisted of: (1) an initial telephone assessment of carer needs; (2) a personalised tabbed resource file; (3) nurse-led home visit; and (4) ongoing telephone support. Two consumer representatives reviewed the intervention resources. The intervention was then piloted with participants who were the primary carer for patients undergoing treatment for HGG in Western Australia. Two consumers provided feedback on the resource, and 10 carers participated in the pilot. Positive feedback was received about the resource manual and intervention. Suggestions were also made for changes which were implemented into the trial. The surveys were shortened based on feedback. Participants identified a large range of issues during nursing assessments which would not otherwise be identified or addressed for carers receiving routine care. As a result of providing the intervention, the nurse was able to make referrals to address needs that were identified. This pilot study enabled us to refine and test the Care-IS intervention and test the feasibility and acceptability of proposed survey instruments. We were also able to estimate recruitment and retention and the overall study timeline required for the randomised controlled trial we are now conducting. It has also demonstrated the role of the nurse who delivered the intervention and allowed us to refine communication and referral pathways.

  4. Evaluation of a performance appraisal framework for radiation therapists in planning and simulation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Becker, Jillian, E-mail: jillian.becker@health.qld.gov.au; Bridge, Pete; Brown, Elizabeth

    2015-06-15

    Constantly evolving technology and techniques within radiation therapy require practitioners to maintain a continuous approach to professional development and training. Systems of performance appraisal and adoption of regular feedback mechanisms are vital to support this development yet frequently lack structure and rely on informal peer support. A Radiation Therapy Performance Appraisal Framework (RT-PAF) for radiation therapists in planning and simulation was developed to define expectations of practice and promote a supportive and objective culture of performance and skills appraisal. Evaluation of the framework was conducted via an anonymous online survey tool. Nine peer reviewers and fourteen recipients provided feedback onmore » its effectiveness and the challenges and limitations of the approach. Findings from the evaluation were positive and suggested that both groups gained benefit from and expressed a strong interest in embedding the approach more routinely. Respondents identified common challenges related to the limited ability to implement suggested development strategies; this was strongly associated with time and rostering issues. This framework successfully defined expectations for practice and provided a fair and objective feedback process that focussed on skills development. It empowered staff to maintain their skills and reach their professional potential. Management support, particularly in regard to provision of protected time was highlighted as critical to the framework's ongoing success. The demonstrated benefits arising in terms of staff satisfaction and development highlight the importance of this commitment to the modern radiation therapy workforce.« less

  5. The Multiple Component Alternative for Gifted Education.

    ERIC Educational Resources Information Center

    Swassing, Ray

    1984-01-01

    The Multiple Component Model (MCM) of gifted education includes instruction which may overlap in literature, history, art, enrichment, languages, science, physics, math, music, and dance. The model rests on multifactored identification and requires systematic development and selection of components with ongoing feedback and evaluation. (CL)

  6. A Staff-Training Program to Increase Spontaneous Vocal Requests in Children With Autism

    PubMed Central

    Karp, Rebecca

    2013-01-01

    This study evaluated a staff-training and feedback program to increase (a) staff use of naturalistic language training techniques, and (b) child production of spontaneous vocal requests in a school setting for young children with autism. Training was conducted in integrated preschool centers and in an art group. The results revealed that the training and feedback procedure was successful in increasing staff use of naturalistic language training techniques. Further, these increased strategies were associated with corresponding increases in spontaneous vocal requests for all children during embedded training and ongoing feedback conditions. In addition, probes collected by an unobtrusive observer revealed durability of child requesting when staff feedback was discontinued. Social validity measures from front-line staff regarding the intervention revealed positive ratings. The results are discussed in relation to the continued search for effective service-delivery systems to improve communication for children with autism in the public school setting. PMID:27999635

  7. Real World Evidence: A Quantitative and Qualitative Glance at Participant Feedback from a Free-Response Survey Investigating Experiences of a Structured Exercise Intervention for Men with Prostate Cancer.

    PubMed

    Fox, L; Cahill, F; Burgess, C; Peat, N; Rudman, S; Kinsella, J; Cahill, D; George, G; Santaolalla, A; Van Hemelrijck, M

    2017-01-01

    To explore patient experiences of a structured exercise intervention for men with prostate cancer (PCa). 41 men with either localised or advanced PCa who had been referred for a structured exercise programme by their physician and then subsequently consented to a telephone survey. Participants underwent a 10-week supervised exercise programme within a large cancer centre hospital consisting of 8 sessions. They then completed a short multiple choice telephone survey, elaborating on their responses where appropriate. Views expressed by participants were analysed using an affinity diagram and common themes were identified. Feedback from our telephone surveys was consistently positive and suggests that the structured exercise intervention provides exercise confidence, motivation to exercise, and social support and promotes positive health behaviour change in the context of exercise. Individual differences arose amongst participants in their perceived utility of the intervention, with 73.3% expressing a preference for structured exercise classes and 19.5% expressing a preference for exercising independently. Design of a structured exercise intervention for patients with PCa should embrace the positive aspects outlined here but consider patients' individual differences. Ongoing feedback from patients should be utilised alongside traditional study designs to inform intervention design in this area.

  8. Simultaneous Compliance and Corrosion Control: Myth versus Reality

    EPA Science Inventory

    a segment examining “nuts and bolts” examples of corrosion control strategies that have been implemented and which requiredmodifications when “things did not go according to plan”. The process of an ongoing review of data and feedback gathered on a continuousbasis in “real time” ...

  9. Classroom Observation Practice in Career Schools: A Multiple Case Study

    ERIC Educational Resources Information Center

    Withers, Marya G.

    2017-01-01

    Post-secondary career school educational leaders are charged with formulating sufficient, ongoing, and effective faculty development programming to ensure the delivery of quality education in their unique trade-expert led institutions. Classroom observations, which include substantive feedback exchanges from trained personnel are well documented…

  10. Computer vs. Workbook Instruction in Second Language Acquisition.

    ERIC Educational Resources Information Center

    Nagata, Noriko

    1996-01-01

    Compares the effectiveness of Nihongo-CALI (Japanese Computer Assisted Language Instruction) with non-CALI workbook instruction. Findings reveal that given the same grammar notes and exercises, ongoing intelligent computer feedback is more effective than simple workbook answer sheets for developing learners' grammatical skill in producing Japanese…

  11. A Re-Unification of Two Competing Models for Document Retrieval.

    ERIC Educational Resources Information Center

    Bodoff, David

    1999-01-01

    Examines query-oriented versus document-oriented information retrieval and feedback learning. Highlights include a reunification of the two approaches for probabilistic document retrieval and for vector space model (VSM) retrieval; learning in VSM and in probabilistic models; multi-dimensional scaling; and ongoing field studies. (LRW)

  12. Using Classroom Competitions to Prepare Students for the Competitive Business World

    ERIC Educational Resources Information Center

    Gibson, Fay Y.; Kincade, Doris H.; Frasier, Pamela Y.

    2013-01-01

    This paper describes how a university, collaborating with industry, integrated research with active learning (e.g., collaboration in teams and competitions) for fashion majors. The redesigned introductory course uses two strategies: team competitions and a genius bar to guide students, give ongoing feedback, and judge final competitions. Active…

  13. The Role of Teachers' Guided Reflection in Effecting Positive Program Change.

    ERIC Educational Resources Information Center

    Vogt, Lynn Allington; Au, Kathryn H. P.

    1995-01-01

    Examines the evolution of teacher support and development in the Kamehameha Elementary Education Program (KEEP) and Rough Rock Community School collaboration. Ongoing teacher development featured regular classroom observation and feedback with mentors and peers and self-reflection through videotaping and journal writing. (two references) (MDM)

  14. Focus on Learning: Reflective Learners & Feedback

    ERIC Educational Resources Information Center

    Bard, Rose

    2014-01-01

    Reflecting simply put is the act of thinking about something while seeking a deeper level of understanding. Reflective practice is applying this thinking systematically by making questions, collecting data, and analysing it in order, not to prove something, but to comprehend and act upon reality. It is also an ongoing process that involves…

  15. Enhanced Primary Care Treatment of Behavioral Disorders With ECHO Case-Based Learning.

    PubMed

    Komaromy, Miriam; Bartlett, Judy; Manis, Kathryn; Arora, Sanjeev

    2017-09-01

    The Extension for Community Healthcare Outcomes (ECHO) model offers a way for primary care providers to develop expertise in addressing behavioral health issues of primary care patients. It provides an alternative to traditional continuing medical education (CME) for ongoing training and support for health care providers. ECHO uses videoconferencing to connect multiple primary care teams simultaneously with academic specialists and builds capacity via mentorship and case-based learning. ECHO aims to expand access to care by developing capacity to treat common, complex conditions in underserved areas. Participants in an integrated addictions and psychiatry teleECHO program reported that when they presented a patient case, the feedback they received was highly valuable and led them to change their care plans more than 75% of the time. ECHO is an effective model for teaching primary care teams about behavioral health and may be more effective than traditional CME approaches.

  16. West Nile Virus: Using Adapted Primary Literature in Mathematical Biology to Teach Scientific and Mathematical Reasoning in High School

    NASA Astrophysics Data System (ADS)

    Norris, Stephen P.; Macnab, John S.; Wonham, Marjorie; de Vries, Gerda

    2009-05-01

    This paper promotes the use of adapted primary literature as a curriculum and instruction innovation for use in high school. Adapted primary literature is useful for promoting an understanding of scientific and mathematical reasoning and argument and for introducing modern science into the schools. We describe a prototype adapted from a published article on a mathematical model of the spread of the West Nile virus in North America. The prototype is available as a web-based resource that includes supplemental pedagogical units. Preliminary feedback from use of the prototype in two classrooms is described and a sketch of an ongoing formal evaluation is provided.

  17. Using social media for support and feedback by mental health service users: thematic analysis of a twitter conversation.

    PubMed

    Shepherd, Andrew; Sanders, Caroline; Doyle, Michael; Shaw, Jenny

    2015-02-19

    Internet based social media websites represent a growing space for interpersonal interaction. Research has been conducted in relation to the potential role of social media in the support of individuals with physical health conditions. However, limited research exists exploring such utilisation by individuals with experience of mental health problems. It could be proposed that access to wider support networks and knowledge could be beneficial for all users, although this positive interpretation has been challenged. The present study focusses on a specific discussion as a case study to assess the role of the website www.twitter.com as a medium for interpersonal communication by individuals with experience of mental disorder and possible source of feedback to mental health service providers. An electronic search was performed to identify material contributing to an online conversation entitled #dearmentalhealthprofessionals. Output from the search strategy was combined in such a way that repeated material was eliminated and all individual material anonymised. The remaining textual material was reviewed and combined in a thematic analysis to identify common themes of discussion. 515 unique communications were identified relating to the specified conversation. The majority of the material related to four overarching thematic headings: The impact of diagnosis on personal identity and as a facilitator for accessing care; Balance of power between professional and service user; Therapeutic relationship and developing professional communication; and Support provision through medication, crisis planning, service provision and the wider society. Remaining material was identified as being direct expression of thanks, self-referential in its content relating to the on-going conversation or providing a link to external resources and further discussion. The present study demonstrates the utility of online social media as both a discursive space in which individuals with experience of mental disorder may share information and develop understanding, and a medium of feedback to mental health service providers. Further research is required to establish potential individual benefit from the utilisation of such networks, its suitability as a means of service provision feedback and the potential role for, and user acceptability of, mental health service providers operating within the space.

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goumiri, I. R.; Rowley, C. W.; Sabbagh, S. A.

    In this study, a model-based feedback system is presented enabling the simultaneous control of the stored energy through β n and the toroidal rotation profile of the plasma in National Spherical Torus eXperiment Upgrade device. Actuation is obtained using the momentum from six injected neutral beams and the neoclassical toroidal viscosity generated by applying three-dimensional magnetic fields. Based on a model of the momentum diffusion and torque balance, a feedback controller is designed and tested in closed-loop simulations using TRANSP, a time dependent transport analysis code, in predictive mode. Promising results for the ongoing experimental implementation of controllers are obtained.

  19. An Optimization of Manufacturing Systems using a Feedback Control Scheduling Model

    NASA Astrophysics Data System (ADS)

    Ikome, John M.; Kanakana, Grace M.

    2018-03-01

    In complex production system that involves multiple process, unplanned disruption often turn to make the entire production system vulnerable to a number of problems which leads to customer’s dissatisfaction. However, this problem has been an ongoing problem that requires a research and methods to streamline the entire process or develop a model that will address it, in contrast to this, we have developed a feedback scheduling model that can minimize some of this problem and after a number of experiment, it shows that some of this problems can be eliminated if the correct remedial actions are implemented on time.

  20. Knowing and acting in the clinical workplace: trainees' perspectives on modelling and feedback.

    PubMed

    Stegeman, J H; Schoten, E J; Terpstra, O T

    2013-10-01

    In this article we discuss clinical workplace learning using a dual approach: a theoretical one and an empirical one. Drawing on the philosophical work of Aristotle, Polanyi and Schön we posit that the 'knowing and acting' underpinning day-to-day medical practice is personal and embraces by nature a tacit dimension. Consequently, imparting and acquiring this knowledge type necessitates personal interaction between trainer and trainee. The tacit dimension particularly influences modelling and feedback. In our empirical exploration we explore these educational routes in two disparate disciplines: surgery and paediatrics. We use a longitudinal design with in-depth interviewing. Our conclusion on modelling is: modelling is a dynamic and fragmented process reflecting discipline bound characteristics and working styles. On feedback it is: 'feedback' serves as vehicle for three distinctive forms of commenting on performance, each holding a specific power of expression for learning. We propose to view clinical workplace learning as: an interactive master-apprenticeship model encompassing modelling and feedback as natural educational routes. We conceptualise modelling and feedback as 'function' of interaction (developing grounded theory). Modelling function and feedback function may serve to study these routes as didactical components of ongoing interaction between trainer and trainee rather than an educator-driven series of unrelated events.

  1. Mediated interruptions of anaesthesia providers using predictions of workload from anaesthesia information management system data.

    PubMed

    Epstein, R H; Dexter, F

    2012-09-01

    Perioperative interruptions generated electronically from anaesthesia information management systems (AIMS) can provide useful feedback, but may adversely affect task performance if distractions occur at inopportune moments. Ideally such interruptions would occur only at times when their impact would be minimal. In this study of AIMS data, we evaluated the times of comments, drugs, fluids and periodic assessments (e.g. electrocardiogram diagnosis and train-of-four) to develop recommendations for the timing of interruptions during the intraoperative period. The 39,707 cases studied were divided into intervals between: 1) enter operating room; 2) induction; 3) intubation; 4) surgical incision; and 5) end surgery. Five-minute intervals of no documentation were determined for each case. The offsets from the start of each interval when >50% of ongoing cases had completed initial documentation were calculated (MIN50). The primary endpoint for each interval was the percentage of all cases still ongoing at MIN50. Results were that the intervals from entering the operating room to induction and from induction to intubation were unsuitable for interruptions confirming prior observational studies of anaesthesia workload. At least 13 minutes after surgical incision was the most suitable time for interruptions with 92% of cases still ongoing. Timing was minimally affected by the type of anaesthesia, surgical facility, surgical service, prone positioning or scheduled case duration. The implication of our results is that for mediated interruptions, waiting at least 13 minutes after the start of surgery is appropriate. Although we used AIMS data, operating room information system data is also suitable.

  2. Core principles of assessment in competency-based medical education.

    PubMed

    Lockyer, Jocelyn; Carraccio, Carol; Chan, Ming-Ka; Hart, Danielle; Smee, Sydney; Touchie, Claire; Holmboe, Eric S; Frank, Jason R

    2017-06-01

    The meaningful assessment of competence is critical for the implementation of effective competency-based medical education (CBME). Timely ongoing assessments are needed along with comprehensive periodic reviews to ensure that trainees continue to progress. New approaches are needed to optimize the use of multiple assessors and assessments; to synthesize the data collected from multiple assessors and multiple types of assessments; to develop faculty competence in assessment; and to ensure that relationships between the givers and receivers of feedback are appropriate. This paper describes the core principles of assessment for learning and assessment of learning. It addresses several ways to ensure the effectiveness of assessment programs, including using the right combination of assessment methods and conducting careful assessor selection and training. It provides a reconceptualization of the role of psychometrics and articulates the importance of a group process in determining trainees' progress. In addition, it notes that, to reach its potential as a driver in trainee development, quality care, and patient safety, CBME requires effective information management and documentation as well as ongoing consideration of ways to improve the assessment system.

  3. Closed-loop control of a core free rolled EAP actuator

    NASA Astrophysics Data System (ADS)

    Sarban, Rahimullah; Oubaek, Jakob; Jones, Richard W.

    2009-03-01

    Tubular dielectric electro-active polymer actuators, also referred as tubular InLastors, have many possible applications. One of the most obvious is as a positioning push-type device. This work examines the feedback closed-loop control of a core-free tubular InLastor fabricated from sheets of PolyPowerTM, an EAP material developed by Danfoss PolyPower A/S, which uses a silicone elastomer in conjunction with smart compliant electrode technology. This is part of an ongoing study to develop a precision positioning feedback control system for this device. Initially proportional and integral (PI) control is considered to provide position control of the tubular InLastor. Control of the tubular Inlastors require more than conventional control, used for linear actuators, because the InLastors display highly nonlinear static voltage-strain and voltage-force characteristics as well as dynamic hysteresis and time-dependent strain behavior. In an attempt to overcome the nonlinear static voltage-strain characteristics of the Inlastors and for improving the dynamic performance of the controlled device, a gain scheduling algorithm is then integrated into the PI controlled system.

  4. Runtime visualization of the human arterial tree.

    PubMed

    Insley, Joseph A; Papka, Michael E; Dong, Suchuan; Karniadakis, George; Karonis, Nicholas T

    2007-01-01

    Large-scale simulation codes typically execute for extended periods of time and often on distributed computational resources. Because these simulations can run for hours, or even days, scientists like to get feedback about the state of the computation and the validity of its results as it runs. It is also important that these capabilities be made available with little impact on the performance and stability of the simulation. Visualizing and exploring data in the early stages of the simulation can help scientists identify problems early, potentially avoiding a situation where a simulation runs for several days, only to discover that an error with an input parameter caused both time and resources to be wasted. We describe an application that aids in the monitoring and analysis of a simulation of the human arterial tree. The application provides researchers with high-level feedback about the state of the ongoing simulation and enables them to investigate particular areas of interest in greater detail. The application also offers monitoring information about the amount of data produced and data transfer performance among the various components of the application.

  5. Brain-computer interface users speak up: the Virtual Users' Forum at the 2013 International Brain-Computer Interface Meeting.

    PubMed

    Peters, Betts; Bieker, Gregory; Heckman, Susan M; Huggins, Jane E; Wolf, Catherine; Zeitlin, Debra; Fried-Oken, Melanie

    2015-03-01

    More than 300 researchers gathered at the 2013 International Brain-Computer Interface (BCI) Meeting to discuss current practice and future goals for BCI research and development. The authors organized the Virtual Users' Forum at the meeting to provide the BCI community with feedback from users. We report on the Virtual Users' Forum, including initial results from ongoing research being conducted by 2 BCI groups. Online surveys and in-person interviews were used to solicit feedback from people with disabilities who are expert and novice BCI users. For the Virtual Users' Forum, their responses were organized into 4 major themes: current (non-BCI) communication methods, experiences with BCI research, challenges of current BCIs, and future BCI developments. Two authors with severe disabilities gave presentations during the Virtual Users' Forum, and their comments are integrated with the other results. While participants' hopes for BCIs of the future remain high, their comments about available systems mirror those made by consumers about conventional assistive technology. They reflect concerns about reliability (eg, typing accuracy/speed), utility (eg, applications and the desire for real-time interactions), ease of use (eg, portability and system setup), and support (eg, technical support and caregiver training). People with disabilities, as target users of BCI systems, can provide valuable feedback and input on the development of BCI as an assistive technology. To this end, participatory action research should be considered as a valuable methodology for future BCI research. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Effects of biotic feedback and harvest management on boreal forest fire activity under climate change.

    PubMed

    Krawchuk, Meg A; Cumming, Steve G

    2011-01-01

    Predictions of future fire activity over Canada's boreal forests have primarily been generated from climate data following assumptions that direct effects of weather will stand alone in contributing to changes in burning. However, this assumption needs explicit testing. First, areas recently burned can be less likely to burn again in the near term, and this endogenous regulation suggests the potential for self-limiting, negative biotic feedback to regional climate-driven increases in fire. Second, forest harvest is ongoing, and resulting changes in vegetation structure have been shown to affect fire activity. Consequently, we tested the assumption that fire activity will be driven by changes in fire weather without regulation by biotic feedback or regional harvest-driven changes in vegetation structure in the mixedwood boreal forest of Alberta, Canada, using a simulation experiment that includes the interaction of fire, stand dynamics, climate change, and clear cut harvest management. We found that climate change projected with fire weather indices calculated from the Canadian Regional Climate Model increased fire activity, as expected, and our simulations established evidence that the magnitude of regional increase in fire was sufficient to generate negative feedback to subsequent fire activity. We illustrate a 39% (1.39-fold) increase in fire initiation and 47% (1.47-fold) increase in area burned when climate and stand dynamics were included in simulations, yet 48% (1.48-fold) and 61% (1.61-fold) increases, respectively, when climate was considered alone. Thus, although biotic feedbacks reduced burned area estimates in important ways, they were secondary to the direct effect of climate on fire. We then show that ongoing harvest management in this region changed landscape composition in a way that led to reduced fire activity, even in the context of climate change. Although forest harvesting resulted in decreased regional fire activity when compared to unharvested conditions, forest composition and age structure was shifted substantially, illustrating a trade-off between management goals to minimize fire and conservation goals to emulate natural disturbance.

  7. A literature review for large-scale health information system project planning, implementation and evaluation.

    PubMed

    Sligo, Judith; Gauld, Robin; Roberts, Vaughan; Villa, Luis

    2017-01-01

    Information technology is perceived as a potential panacea for healthcare organisations to manage pressure to improve services in the face of increased demand. However, the implementation and evaluation of health information systems (HIS) is plagued with problems and implementation shortcomings and failures are rife. HIS implementation is complex and relies on organisational, structural, technological, and human factors to be successful. It also requires reflective, nuanced, multidimensional evaluation to provide ongoing feedback to ensure success. This article provides a comprehensive review of the literature about evaluating and implementing HIS, detailing the challenges and recommendations for both evaluators and healthcare organisations. The factors that inhibit or promote successful HIS implementation are identified and effective evaluation strategies are described with the goal of informing teams evaluating complex HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Electrical stimulation of rhesus monkey nucleus reticularis gigantocellularis. II. Effects on metrics and kinematics of ongoing gaze shifts to visual targets.

    PubMed

    Freedman, Edward G; Quessy, Stephan

    2004-06-01

    Saccade kinematics are altered by ongoing head movements. The hypothesis that a head movement command signal, proportional to head velocity, transiently reduces the gain of the saccadic burst generator (Freedman 2001, Biol Cybern 84:453-462) can account for this observation. Using electrical stimulation of the rhesus monkey nucleus reticularis gigantocellularis (NRG) to alter the head contribution to ongoing gaze shifts, two critical predictions of this gaze control hypothesis were tested. First, this hypothesis predicts that activation of the head command pathway will cause a transient reduction in the gain of the saccadic burst generator. This should alter saccade kinematics by initially reducing velocity without altering saccade amplitude. Second, because this hypothesis does not assume that gaze amplitude is controlled via feedback, the added head contribution (produced by NRG stimulation on the side ipsilateral to the direction of an ongoing gaze shift) should lead to hypermetric gaze shifts. At every stimulation site tested, saccade kinematics were systematically altered in a way that was consistent with transient reduction of the gain of the saccadic burst generator. In addition, gaze shifts produced during NRG stimulation were hypermetric compared with control movements. For example, when targets were briefly flashed 30 degrees from an initial fixation location, gaze shifts during NRG stimulation were on average 140% larger than control movements. These data are consistent with the predictions of the tested hypothesis, and may be problematic for gaze control models that rely on feedback control of gaze amplitude, as well as for models that do not posit an interaction between head commands and the saccade burst generator.

  9. The Role of Feedback in the Assimilation of Information in Prediction Markets

    ERIC Educational Resources Information Center

    Jolly, Richard Donald

    2011-01-01

    Leveraging the knowledge of an organization is an ongoing challenge that has given rise to the field of knowledge management. Yet, despite spending enormous sums of organizational resources on Information Technology (IT) systems, executives recognize there is much more knowledge to harvest. Prediction markets are emerging as one tool to help…

  10. Integrating Research Proposals into a Field Seminar: Feedback from Students

    ERIC Educational Resources Information Center

    Kvarfordt, Connie L.; Carter, Irene; Park, Wansoo; Yun, Sung Hyun

    2014-01-01

    Teaching research to social work students continues to be the topic of an ongoing dialog within the profession. The literature suggests that some form of a "real-world" or "hands-on" learning opportunity has many benefits for teaching a subject that students often are reluctant to engage in. Using online survey methods,…

  11. 77 FR 17493 - Agency Information Collection Activities: Proposed Collection; Comment Request; DOI Generic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-26

    ... Don Bieniewicz at DOI via email at [email protected]ios.doi.gov or via facsimile (202) 208-4867. FOR... yield quantitative results that can be generalized to the population of study. This feedback will... operations might improve delivery of products or services. These collections will allow for ongoing...

  12. Reading Comprehension Exercises Online: The Effects of Feedback, Proficiency and Interaction

    ERIC Educational Resources Information Center

    Murphy, Philip

    2007-01-01

    This paper describes an ongoing project to create an online version of a reading programme, a custom-designed English language proficiency course at a university in Japan. Following an interactionist view of second language acquisition, it was hypothesised that comprehension of a reading passage could be enhanced by online materials promoting…

  13. Norms and Goals of Appraisal of German Teachers for Students with Learning Disabilities

    ERIC Educational Resources Information Center

    Wilbert, Jurgen; Grunke, Matthias

    2010-01-01

    Although there is an ongoing debate about which achievement feedback is most useful, the majority of researchers agree that social comparisons and a focus on competition are inappropriate for students with learning disabilities and otherwise academically-challenged students. They are highly at-risk to be unfavorably influenced by inappropriate…

  14. Feedback about Teaching in Higher Ed: Neglected Opportunities to Promote Change

    ERIC Educational Resources Information Center

    Gormally, Cara; Evans, Mara; Brickman, Peggy

    2014-01-01

    Despite ongoing dissemination of evidence-based teaching strategies, science teaching at the university level is less than reformed. Most college biology instructors could benefit from more sustained support in implementing these strategies. One-time workshops raise awareness of evidence-based practices, but faculty members are more likely to make…

  15. Aspects of body self-calibration

    NASA Technical Reports Server (NTRS)

    Lackner, J. R.; DiZio, P. A.

    2000-01-01

    The representation of body orientation and configuration is dependent on multiple sources of afferent and efferent information about ongoing and intended patterns of movement and posture. Under normal terrestrial conditions, we feel virtually weightless and we do not perceive the actual forces associated with movement and support of our body. It is during exposure to unusual forces and patterns of sensory feedback during locomotion that computations and mechanisms underlying the ongoing calibration of our body dimensions and movements are revealed. This review discusses the normal mechanisms of our position sense and calibration of our kinaesthetic, visual and auditory sensory systems, and then explores the adaptations that take place to transient Coriolis forces generated during passive body rotation. The latter are very rapid adaptations that allow body movements to become accurate again, even in the absence of visual feedback. Muscle spindle activity interpreted in relation to motor commands and internally modeled reafference is an important component in permitting this adaptation. During voluntary rotary movements of the body, the central nervous system automatically compensates for the Coriolis forces generated by limb movements. This allows accurate control to be maintained without our perceiving the forces generated.

  16. System Dynamics

    NASA Astrophysics Data System (ADS)

    Morecroft, John

    System dynamics is an approach for thinking about and simulating situations and organisations of all kinds and sizes by visualising how the elements fit together, interact and change over time. This chapter, written by John Morecroft, describes modern system dynamics which retains the fundamentals developed in the 1950s by Jay W. Forrester of the MIT Sloan School of Management. It looks at feedback loops and time delays that affect system behaviour in a non-linear way, and illustrates how dynamic behaviour depends upon feedback loop structures. It also recognises improvements as part of the ongoing process of managing a situation in order to achieve goals. Significantly it recognises the importance of context, and practitioner skills. Feedback systems thinking views problems and solutions as being intertwined. The main concepts and tools: feedback structure and behaviour, causal loop diagrams, dynamics, are practically illustrated in a wide variety of contexts from a hot water shower through to a symphony orchestra and the practical application of the approach is described through several real examples of its use for strategic planning and evaluation.

  17. Evaluating and giving feedback to mentors: new evidence-based approaches.

    PubMed

    Anderson, Lauren; Silet, Karin; Fleming, Michael

    2012-02-01

    A comprehensive mentoring program includes a variety of components. One of the most important is the ongoing assessment of and feedback to mentors. Scholars need strong active mentors who have the expertise, disposition, motivation, skills, and the ability to accept feedback and to adjust their mentoring style. Assessing the effectiveness of a given mentor is no easy task. Variability in learning needs and academic goals among scholars makes it difficult to develop a single evaluation instrument or a standardized procedure for evaluating mentors. Scholars, mentors, and program leaders are often reluctant to conduct formal evaluations, as there are no commonly accepted measures. The process of giving feedback is often difficult and there is limited empirical data on efficacy. This article presents a new and innovative six-component approach to mentor evaluation that includes the assessment of mentee training and empowerment, peer learning and mentor training, scholar advocacy, mentee-mentor expectations, mentor self-reflection, and mentee evaluation of their mentor. © 2012 Wiley Periodicals, Inc.

  18. Real World Evidence: A Quantitative and Qualitative Glance at Participant Feedback from a Free-Response Survey Investigating Experiences of a Structured Exercise Intervention for Men with Prostate Cancer

    PubMed Central

    Cahill, F.; Burgess, C.; Peat, N.; Rudman, S.; Kinsella, J.; Cahill, D.; George, G.; Santaolalla, A.; Van Hemelrijck, M.

    2017-01-01

    Aim To explore patient experiences of a structured exercise intervention for men with prostate cancer (PCa). Sample 41 men with either localised or advanced PCa who had been referred for a structured exercise programme by their physician and then subsequently consented to a telephone survey. Method Participants underwent a 10-week supervised exercise programme within a large cancer centre hospital consisting of 8 sessions. They then completed a short multiple choice telephone survey, elaborating on their responses where appropriate. Views expressed by participants were analysed using an affinity diagram and common themes were identified. Results Feedback from our telephone surveys was consistently positive and suggests that the structured exercise intervention provides exercise confidence, motivation to exercise, and social support and promotes positive health behaviour change in the context of exercise. Individual differences arose amongst participants in their perceived utility of the intervention, with 73.3% expressing a preference for structured exercise classes and 19.5% expressing a preference for exercising independently. Conclusion Design of a structured exercise intervention for patients with PCa should embrace the positive aspects outlined here but consider patients' individual differences. Ongoing feedback from patients should be utilised alongside traditional study designs to inform intervention design in this area. PMID:28758113

  19. Effects of performance feedback and coaching on the problem-solving process: Improving the integrity of implementation and enhancing student outcomes

    NASA Astrophysics Data System (ADS)

    Lundahl, Allison A.

    Schools implementing Response to Intervention (RtI) procedures frequently engage in team problem-solving processes to address the needs of students who require intensive and individualized services. Because the effectiveness of the problem-solving process will impact the overall success of RtI systems, the present study was designed to learn more about how to strengthen the integrity of the problem-solving process. Research suggests that school districts must ensure high quality training and ongoing support to enhance the effectiveness, acceptability, and sustainability of the problem-solving process within an RtI model; however, there is a dearth of research examining the effectiveness of methods to provide this training and support. Consequently, this study investigated the effects of performance feedback and coaching strategies on the integrity with which teams of educators conducted the problem-solving process in schools. In addition, the relationships between problem-solving integrity, teacher acceptability, and student outcomes were examined. Results suggested that the performance feedback increased problem-solving procedural integrity across two of the three participating schools. Conclusions about the effectiveness of the (a) coaching intervention and (b) interventions implemented in the third school were inconclusive. Regression analyses indicated that the integrity with which the teams conducted the problem-solving process was a significant predictor of student outcomes. However, the relationship between problem-solving procedural integrity and teacher acceptability was not statistically significant.

  20. Pediatric Emergency Medicine (PEM) fellowship: essentials of a three-year academic curriculum. Three-Year Academic Subcommittee of the PEM Fellowship Committee of the Section of Emergency Medicine, American Academy of Pediatrics.

    PubMed

    Shaw, K N; Schunk, J; Ledwith, C; Lockhart, G

    1997-02-01

    This committee of fellowship directors has proposed guidelines for an academic curriculum for training fellows in PEM. The curriculum should be modified to each unique program, but is based on current expectation of the American Board of Pediatrics and the ACGME for graduate education. This is the first PEM academic curriculum document in publication. Ongoing refinement and adaptation based on feedback from fellows and directors is essential to provide the best fellowship experience to our trainees. The proposed curriculum is also subject to further change as more details are given for ACGME approval of the fellowship programs.

  1. Perceived image quality for autostereoscopic holograms in healthcare training

    NASA Astrophysics Data System (ADS)

    Goldiez, Brian; Abich, Julian; Carter, Austin; Hackett, Matthew

    2017-03-01

    The current state of dynamic light field holography requires further empirical investigation to ultimately advance this developing technology. This paper describes a user-centered design approach for gaining insight into the features most important to clinical personnel using emerging dynamic holographic displays. The approach describes the generation of a high quality holographic model of a simulated traumatic amputation above the knee using 3D scanning. Using that model, a set of static holographic prints will be created varying in color or monochrome, contrast ratio, and polygon density. Leveraging methods from image quality research, the goal for this paper is to describe an experimental approach wherein participants are asked to provide feedback regarding the elements previously mentioned in order to guide the ongoing evolution of holographic displays.

  2. Overview of past, ongoing and future efforts of the integrated modeling of global change for Northern Eurasia

    NASA Astrophysics Data System (ADS)

    Monier, Erwan; Kicklighter, David; Sokolov, Andrei; Zhuang, Qianlai; Melillo, Jerry; Reilly, John

    2016-04-01

    Northern Eurasia is both a major player in the global carbon budget (it includes roughly 70% of the Earth's boreal forest and more than two-thirds of the Earth's permafrost) and a region that has experienced dramatic climate change (increase in temperature, growing season length, floods and droughts) over the past century. Northern Eurasia has also undergone significant land-use change, both driven by human activity (including deforestation, expansion of agricultural lands and urbanization) and natural disturbances (such as wildfires and insect outbreaks). These large environmental and socioeconomic impacts have major implications for the carbon cycle in the region. Northern Eurasia is made up of a diverse set of ecosystems that range from tundra to forests, with significant areas of croplands and pastures as well as deserts, with major urban areas. As such, it represents a complex system with substantial challenges for the modeling community. In this presentation, we provide an overview of past, ongoing and possible future efforts of the integrated modeling of global change for Northern Eurasia. We review the variety of existing modeling approaches to investigate specific components of Earth system dynamics in the region. While there are a limited number of studies that try to integrate various aspects of the Earth system (through scale, teleconnections or processes), we point out that there are few systematic analyses of the various feedbacks within the Earth system (between components, regions or scale). As a result, there is a lack of knowledge of the relative importance of such feedbacks, and it is unclear how policy relevant current studies are that fail to account for these feedbacks. We review the role of Earth system models, and their advantages/limitations compared to detailed single component models. We further introduce the human activity system (global trade, economic models, demographic model and so on), the need for coupled human/earth system models and Integrated Assessment Models (IAMs), a suite of models that couple human activity models to Earth System Models. Finally, we conclude the presentation with examples of emerging issues that require a representation of the coupled human/earth system models.

  3. The effect of feedback-assisted reduction in heart rate reactivity on videogame performance.

    PubMed

    Larkin, K T; Manuck, S B; Kasprowicz, A L

    1990-12-01

    In 67 male volunteers, we examined the reduction of cardiovascular responsivity to a psychomotor challenge (videogame) achieved by use of heart rate (HR) feedback and effects of these procedures on concomitant behavioral performance. Each subject participated in a pretraining assessment of his cardiovascular responses to the videogame, a training condition, and a posttraining assessment identical to the initial evaluation. During training, subjects were assigned to one of four conditions: (a) a habituation control group receiving no instructions to alter HR (HC); (b) an instructions-only control group receiving instructions to maintain a low or unchanged HR during videogame presentations (IC); (c) a feedback group receiving instructions to reduce HR using ongoing HR feedback (FB-); or (d) a feedback group receiving instructions to lower HR and given HR feedback plus a score contingency in which total game score was jointly determined by subjects' game performance and success at HR control (FB+). Subjects receiving feedback (FB+, FB-) exhibited greater reductions in HR response to the videogame in the posttraining assessment than control (HC, IC) subjects; FB+ subjects showed greater HR reductions than subjects in any other group. FB+ and FB- subjects showed a lower SBP at posttraining relative to the two control groups, but no reduction in task-induced blood pressure reactivity. There were no group differences in videogame performance, either before or following training.

  4. STAR CLUSTER FORMATION WITH STELLAR FEEDBACK AND LARGE-SCALE INFLOW

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Matzner, Christopher D.; Jumper, Peter H., E-mail: matzner@astro.utoronto.ca

    2015-12-10

    During star cluster formation, ongoing mass accretion is resisted by stellar feedback in the form of protostellar outflows from the low-mass stars and photo-ionization and radiation pressure feedback from the massive stars. We model the evolution of cluster-forming regions during a phase in which both accretion and feedback are present and use these models to investigate how star cluster formation might terminate. Protostellar outflows are the strongest form of feedback in low-mass regions, but these cannot stop cluster formation if matter continues to flow in. In more massive clusters, radiation pressure and photo-ionization rapidly clear the cluster-forming gas when itsmore » column density is too small. We assess the rates of dynamical mass ejection and of evaporation, while accounting for the important effect of dust opacity on photo-ionization. Our models are consistent with the census of protostellar outflows in NGC 1333 and Serpens South and with the dust temperatures observed in regions of massive star formation. Comparing observations of massive cluster-forming regions against our model parameter space, and against our expectations for accretion-driven evolution, we infer that massive-star feedback is a likely cause of gas disruption in regions with velocity dispersions less than a few kilometers per second, but that more massive and more turbulent regions are too strongly bound for stellar feedback to be disruptive.« less

  5. The Astronomical Forcing of Climate Change: Forcings and Feedbacks

    NASA Astrophysics Data System (ADS)

    Erb, M. P.; Broccoli, A. J.; Clement, A. C.

    2010-12-01

    Understanding the role that orbital forcing played in driving climate change over the Pleistocene has been a matter of ongoing research. While it is undeniable that variations in Earth’s orbit result in changes in the seasonal and latitudinal distribution of insolation, the specifics of how this forcing leads to the climate changes seen in the paleo record are not fully understood. To research this further, climate simulations have been conducted with the GFDL CM2.1, a coupled atmosphere-ocean GCM. Two simulations represent the extremes of obliquity during the past 600 kyr and four others show key times in the precessional cycle. All non-orbital variables are set to preindustrial levels to isolate the effects of astronomical forcing alone. It is expected that feedbacks should play a large role in dictating climate change, so to investigate this, the so-called “kernel method” is used to calculate the lapse rate, water vapor, albedo, and cloud feedbacks. Preliminary results of these experiments confirm that feedbacks are important in explaining the nature and, in places, even the sign of climate response to orbital forcing. In the case of low obliquity, for instance, a combination of climate feedbacks lead to global cooling in spite of zero global-average top of atmosphere insolation change. Feedbacks will be analyzed in the obliquity and precession experiments so that the role of feedbacks in contributing to climate change may be better understood.

  6. [Real-time feedback systems for improvement of resuscitation quality].

    PubMed

    Lukas, R P; Van Aken, H; Engel, P; Bohn, A

    2011-07-01

    The quality of chest compression is a determinant of survival after cardiac arrest. Therefore, the European Resuscitation Council (ERC) 2010 guidelines on resuscitation strongly focus on compression quality. Despite its impact on survival, observational studies have shown that chest compression quality is not reached by professional rescue teams. Real-time feedback devices for resuscitation are able to measure chest compression during an ongoing resuscitation attempt through a sternal sensor equipped with a motion and pressure detection system. In addition to the electrocardiograph (ECG) ventilation can be detected by transthoracic impedance monitoring. In cases of quality deviation, such as shallow chest compression depth or hyperventilation, feedback systems produce visual or acoustic alarms. Rescuers can thereby be supported and guided to the requested quality in chest compression and ventilation. Feedback technology is currently available both as a so-called stand-alone device and as an integrated feature in a monitor/defibrillator unit. Multiple studies have demonstrated sustainable enhancement in the education of resuscitation due to the use of real-time feedback technology. There is evidence that real-time feedback for resuscitation combined with training and debriefing strategies can improve both resuscitation quality and patient survival. Chest compression quality is an independent predictor for survival in resuscitation and should therefore be measured and documented in further clinical multicenter trials.

  7. Tapping Technology's Potential: Shrinking Budgets, Looming Standards, and a Dizzying Array of Innovations Are Changing the Professional Learning Landscape

    ERIC Educational Resources Information Center

    Killion, Joellen

    2013-01-01

    As the call for professional learning that incorporates ongoing feedback and support increases and resources to address that need decline, more states, districts, schools, and individuals are turning to technology. Technology creates significant opportunities for more focused professional learning, especially when it is effectively integrated into…

  8. Evaluative Inquiry: Using Evaluation To Promote Student Success.

    ERIC Educational Resources Information Center

    Parsons, Beverly A.

    There is plentiful discussion about the importance of accountability, but much needs to be done to translate it into a manageable and credible system of ongoing feedback. In this book, evaluative inquiry is used in a way that balances attention between the investigation process and its purpose. The book is divided into three parts. Following an…

  9. Uniting Technology and Pedagogy: The Evolution of an Online Teaching Certification Course

    ERIC Educational Resources Information Center

    Riedinger, Bonnie; Rosenberg, Paul

    2006-01-01

    Like all learners, new online instructors need hands-on experience, feedback, and ongoing support to become comfortable and proficient in the virtual classroom. It is unrealistic to expect even the most self-motivated, creatively pedagogical, and technically inclined instructor to fly solo after just a few hours of training. With the authors'…

  10. Impact of Recasts on the Accuracy in EFL Learners' Writing

    ERIC Educational Resources Information Center

    Degteva, Olga

    2011-01-01

    Since the famous Truscott's "The case against grammar correction in L2 writing class" (1996) there has been an ongoing debate in SLA research about the value of corrective feedback and its different forms. A growing number of empirical research is now investigating the question, and although more and more evidence is obtained against Truscott's…

  11. Variations in Chinese Parental Perceptions of Early Childhood Education Quality

    ERIC Educational Resources Information Center

    Hu, Bi Ying; Zhou, Yisu; Li, Kejian

    2017-01-01

    As consumers of Early Childhood Education and Care (ECEC), Chinese parents play a crucial role in the ongoing process of monitoring, evaluating, and improving the quality of ECEC in China. This study used questionnaires to solicit parental feedback on the importance of, and their quality ratings for, aspects of ECEC. The researchers used a random…

  12. More harmful climate change impacts in polluted forests – a review

    Treesearch

    E Paoletti; NE Grulke; A Bytnerowicz

    2009-01-01

    Forests are facing significant pressures from climate change and air pollution. Air pollution is the main driver of the ongoing climate change. Current knowledge suggests that climate change may become more harmful to pollution-affected forests, although the magnitude of these feedbacks is still to be determined. At present, the air pollutants of most concern to...

  13. Teaching through 10,000 Earthquakes: Constructive Practice for Instructors in a Post-Disaster Environment

    ERIC Educational Resources Information Center

    Wright, Sarah; Wordsworth, Russell

    2013-01-01

    The authors describe their experiences of teaching through a series of major earthquakes and the lessons learned regarding sustaining teaching and learning through an ongoing natural disaster. Student feedback data from across the university is analyzed to generate a model of constructive practice for instructors responding to a crisis. The…

  14. Computer-Assisted, Counselor-Delivered Smoking Cessation Counseling for Community College Students: Intervention Approach and Sample Characteristics

    ERIC Educational Resources Information Center

    Prokhorov, Alexander V.; Fouladi, Rachel T.; de Moor, Carl; Warneke, Carla L.; Luca, Mario; Jones, Mary Mullin; Rosenblum, Carol; Emmons, Karen M.; Hudmon, Karen Suchanek; Yost, Tracey E.; Gritz, Ellen R.

    2007-01-01

    This report presents the experimental approach and baseline findings from "Look at Your Health," an ongoing study to develop and evaluate a computer-assisted, counselor-delivered smoking cessation program for community college students. It describes the expert system software program used for data collection and for provision of tailored feedback,…

  15. Effects of Communities of Reflecting Peers on Student-Teacher Development--Including In-Depth Case Studies

    ERIC Educational Resources Information Center

    Fund, Zvia

    2010-01-01

    Despite continuing interest in teacher reflection and an extensive body of research on peer assessment, the interaction between these areas has not been sufficiently investigated. This study on reflection and peer feedback is part of an ongoing action research addressing the design and pedagogical model of a theoretically oriented teacher training…

  16. The Effects of Self-Monitoring and Performance Feedback on the Treatment Integrity of Behavior Intervention Plan Implementation and Generalization

    ERIC Educational Resources Information Center

    Mouzakitis, Angela; Codding, Robin S.; Tryon, Georgiana

    2015-01-01

    Accurate implementation of individualized behavior intervention plans (BIPs) is a critical aspect of evidence-based practice. Research demonstrates that neither training nor consultation is sufficient to improve and maintain high rates of treatment integrity (TI). Therefore, evaluation of ongoing support strategies is needed. The purpose of this…

  17. The Anatomy of Program Design for an On-Line Business Management Course

    ERIC Educational Resources Information Center

    Barger, Bonita

    2008-01-01

    How does one design an on-line course to bridge theory and practice? How can the feedback of on-going stakeholder (student and administration) be incorporated into the design process to enhance quality? This paper presents the theoretical underpinning of designing an on-line management course recognized as best practice for a "well organized…

  18. Application of vibrotactile feedback of body motion to improve rehabilitation in individuals with imbalance

    PubMed Central

    Wall, Conrad

    2010-01-01

    Background and Purpose Balance rehabilitation and vestibular/balance prostheses are both emerging fields that have a potential for synergistic interaction. This paper reviews vibrotactile prosthetic devices that have been developed to date and ongoing work related to the application of vibrotactile feedback for enhanced postural control. A vibrotactile feedback device developed in the author’s laboratory is described. Methods Twelve subjects with vestibular hypofunction were tested on a platform that moved randomly in a plane, while receiving vibrotactile feedback in the anterio-posterior direction. The feedback allowed subjects to significantly decrease their anterio-posterior body tilt, but did not change mediolateral tilt. A tandem walking task using subjects with vestibulopathies demonstrated a reduction in their medio-lateral sway due to vibrotactile feedback of medio-lateral body tilt, after controlling for the effects of task learning. The findings from two additional experiments conducted in the laboratories of collaborating physical therapists are summarized. Results The Dynamic Gait Index scores in community-dwelling elderly individuals who were prone-to-fall were significantly improved with the use of medio-lateral body tilt feedback. Discussion and Conclusions While more work is needed, these results suggest that vibrotactile tilt feedback of subjects’ body motion can be used effectively by physical therapists for balance rehabilitation. A preliminary description of the 3rd generation device that has been reduced from a vest format to a belt format is described to demonstrate the progressive evolution from research to clinical application. PMID:20588096

  19. Teleconsultation in school settings: linking classroom teachers and behavior analysts through web-based technology.

    PubMed

    Frieder, Jessica E; Peterson, Stephanie M; Woodward, Judy; Crane, Jaelee; Garner, Marlane

    2009-01-01

    This paper describes a technically driven, collaborative approach to assessing the function of problem behavior using web-based technology. A case example is provided to illustrate the process used in this pilot project. A school team conducted a functional analysis with a child who demonstrated challenging behaviors in a preschool setting. Behavior analysts at a university setting provided the school team with initial workshop trainings, on-site visits, e-mail and phone communication, as well as live web-based feedback on functional analysis sessions. The school personnel implemented the functional analysis with high fidelity and scored the data reliably. Outcomes of the project suggest that there is great potential for collaboration via the use of web-based technologies for ongoing assessment and development of effective interventions. However, an empirical evaluation of this model should be conducted before wide-scale adoption is recommended.

  20. Clinical supervision of psychotherapy: essential ethics issues for supervisors and supervisees.

    PubMed

    Barnett, Jeffrey E; Molzon, Corey H

    2014-11-01

    Clinical supervision is an essential aspect of every mental health professional's training. The importance of ensuring that supervision is provided competently, ethically, and legally is explained. The elements of the ethical practice of supervision are described and explained. Specific issues addressed include informed consent and the supervision contract, supervisor and supervisee competence, attention to issues of diversity and multicultural competence, boundaries and multiple relationships in the supervision relationship, documentation and record keeping by both supervisor and supervisee, evaluation and feedback, self-care and the ongoing promotion of wellness, emergency coverage, and the ending of the supervision relationship. Additionally, the role of clinical supervisor as mentor, professional role model, and gatekeeper for the profession are discussed. Specific recommendations are provided for ethically and effectively conducting the supervision relationship and for addressing commonly arising dilemmas that supervisors and supervisees may confront. © 2014 Wiley Periodicals, Inc.

  1. First downscattered neutron images from Inertial Confinement Fusion experiments at the National Ignition Facility

    NASA Astrophysics Data System (ADS)

    Guler, Nevzat; Aragonez, Robert J.; Archuleta, Thomas N.; Batha, Steven H.; Clark, David D.; Clark, Deborah J.; Danly, Chris R.; Day, Robert D.; Fatherley, Valerie E.; Finch, Joshua P.; Gallegos, Robert A.; Garcia, Felix P.; Grim, Gary; Hsu, Albert H.; Jaramillo, Steven A.; Loomis, Eric N.; Mares, Danielle; Martinson, Drew D.; Merrill, Frank E.; Morgan, George L.; Munson, Carter; Murphy, Thomas J.; Oertel, John A.; Polk, Paul J.; Schmidt, Derek W.; Tregillis, Ian L.; Valdez, Adelaida C.; Volegov, Petr L.; Wang, Tai-Sen F.; Wilde, Carl H.; Wilke, Mark D.; Wilson, Douglas C.; Atkinson, Dennis P.; Bower, Dan E.; Drury, Owen B.; Dzenitis, John M.; Felker, Brian; Fittinghoff, David N.; Frank, Matthias; Liddick, Sean N.; Moran, Michael J.; Roberson, George P.; Weiss, Paul; Buckles, Robert A.; Cradick, Jerry R.; Kaufman, Morris I.; Lutz, Steve S.; Malone, Robert M.; Traille, Albert

    2013-11-01

    Inertial Confinement Fusion experiments at the National Ignition Facility (NIF) are designed to understand and test the basic principles of self-sustaining fusion reactions by laser driven compression of deuterium-tritium (DT) filled cryogenic plastic (CH) capsules. The experimental campaign is ongoing to tune the implosions and characterize the burning plasma conditions. Nuclear diagnostics play an important role in measuring the characteristics of these burning plasmas, providing feedback to improve the implosion dynamics. The Neutron Imaging (NI) diagnostic provides information on the distribution of the central fusion reaction region and the surrounding DT fuel by collecting images at two different energy bands for primary (13-15 MeV) and downscattered (10-12 MeV) neutrons. From these distributions, the final shape and size of the compressed capsule can be estimated and the symmetry of the compression can be inferred. The first downscattered neutron images from imploding ICF capsules are shown in this paper.

  2. Enhancing pediatric residents’ scholar role: the development of a Scholarly Activity Guidance and Evaluation program

    PubMed Central

    Pound, Catherine M.; Moreau, Katherine A.; Ward, Natalie; Eady, Kaylee; Writer, Hilary

    2015-01-01

    Background Research training is essential to the development of well-rounded physicians. Although many pediatric residency programs require residents to complete a research project, it is often challenging to integrate research training into educational programs. Objective We aimed to develop an innovative research program for pediatric residents, called the Scholarly Activity Guidance and Evaluation (SAGE) program. Methods We developed a competency-based program which establishes benchmarks for pediatric residents, while providing ongoing academic mentorship. Results Feedback from residents and their research supervisors about the SAGE program has been positive. Preliminary evaluation data have shown that all final-year residents have met or exceeded program expectations. Conclusions By providing residents with this supportive environment, we hope to influence their academic career paths, increase their research productivity, promote evidence-based practice, and ultimately, positively impact health outcomes. PMID:26059213

  3. Panarchy use in environmental science for risk and resilience ...

    EPA Pesticide Factsheets

    Environmental sciences have an important role in informing sustainable management of built environments by providing insights about the drivers and potentially negative impacts of global environmental change. Here, we discuss panarchy theory, a multi-scale hierarchical concept that accounts for the dynamism of complex socio-ecological systems, especially for those systems with strong cross-scale feedbacks. The idea of panarchy underlies much of system resilience, focusing on how systems respond to known and unknown threats. Panarchy theory can provide a framework for qualitative and quantitative research and application in the environmental sciences, which can in turn inform the ongoing efforts in socio-technical resilience thinking and adaptive and transformative approaches to management. The environmental sciences strive for understanding, mitigating and reversing the negative impacts of global environmental change, including chemical pollution, to maintain sustainability options for the future, and therefore play an important role for informing management.

  4. The changing seasonal climate in the Arctic.

    PubMed

    Bintanja, R; van der Linden, E C

    2013-01-01

    Ongoing and projected greenhouse warming clearly manifests itself in the Arctic regions, which warm faster than any other part of the world. One of the key features of amplified Arctic warming concerns Arctic winter warming (AWW), which exceeds summer warming by at least a factor of 4. Here we use observation-driven reanalyses and state-of-the-art climate models in a variety of standardised climate change simulations to show that AWW is strongly linked to winter sea ice retreat through the associated release of surplus ocean heat gained in summer through the ice-albedo feedback (~25%), and to infrared radiation feedbacks (~75%). Arctic summer warming is surprisingly modest, even after summer sea ice has completely disappeared. Quantifying the seasonally varying changes in Arctic temperature and sea ice and the associated feedbacks helps to more accurately quantify the likelihood of Arctic's climate changes, and to assess their impact on local ecosystems and socio-economic activities.

  5. The changing seasonal climate in the Arctic

    PubMed Central

    Bintanja, R.; van der Linden, E. C.

    2013-01-01

    Ongoing and projected greenhouse warming clearly manifests itself in the Arctic regions, which warm faster than any other part of the world. One of the key features of amplified Arctic warming concerns Arctic winter warming (AWW), which exceeds summer warming by at least a factor of 4. Here we use observation-driven reanalyses and state-of-the-art climate models in a variety of standardised climate change simulations to show that AWW is strongly linked to winter sea ice retreat through the associated release of surplus ocean heat gained in summer through the ice-albedo feedback (~25%), and to infrared radiation feedbacks (~75%). Arctic summer warming is surprisingly modest, even after summer sea ice has completely disappeared. Quantifying the seasonally varying changes in Arctic temperature and sea ice and the associated feedbacks helps to more accurately quantify the likelihood of Arctic's climate changes, and to assess their impact on local ecosystems and socio-economic activities. PMID:23532038

  6. Developing and assessing the acceptability of an epilepsy first aid training intervention for patients who visit UK emergency departments: A multi-method study of patients and professionals.

    PubMed

    Snape, Darlene A; Morgan, Myfanwy; Ridsdale, Leone; Goodacre, Steve; Marson, Anthony G; Noble, Adam J

    2017-03-01

    Epilepsy affects around 1% of the UK population; 40% of whom experience two or more seizures annually. However, most Emergency Department (ED) visits by people with epilepsy (PWE) are clinically unnecessary. Evidence highlights that with correct training, seizures can be safely managed by patients and their families within the community. Arguably therefore, PWE who frequently visit the ED might benefit from a self-management intervention that improves their own and their families' confidence and ability in managing seizures. Currently, no such intervention is available for PWE attending the ED. A collaborative approach (patients, carers, health professionals) was adopted to develop a patient-focused, self-management intervention. An existing group-based seizure management course, offered by the Epilepsy Society, was adapted. Collaborative feedback was sought via a base-line document review, one-to-one semi-structured interviews, and focus group discussions. The applied framework provided a systematic approach from development through to implementation. Participant feedback overall was extremely positive. People with epilepsy who visit the ED reported a positive view of epilepsy seizure first aid training and associated educational materials. Their feedback was then used to develop the optimized intervention presented here. Strengths and perceived barriers to successful implementation and participation, as well as the practical and psychosocial benefits, were identified. We describe the developed intervention together with the process followed. This description, while being project-specific, provides a useful template to assist in the development of interventions more generally. Ongoing evaluation will determine the effects of the training intervention on participants' behavior. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Are health care provider organizations ready to tackle diagnostic error? A survey of Leapfrog-participating hospitals.

    PubMed

    Newman-Toker, David E; Austin, J Matthew; Derk, Jordan; Danforth, Melissa; Graber, Mark L

    2017-06-27

    A 2015 National Academy of Medicine report on improving diagnosis in health care made recommendations for direct action by hospitals and health systems. Little is known about how health care provider organizations are addressing diagnostic safety/quality. This study is an anonymous online survey of safety professionals from US hospitals and health systems in July-August 2016. The survey was sent to those attending a Leapfrog Group webinar on misdiagnosis (n=188). The instrument was focused on knowledge, attitudes, and capability to address diagnostic errors at the institutional level. Overall, 61 (32%) responded, including community hospitals (42%), integrated health networks (25%), and academic centers (21%). Awareness was high, but commitment and capability were low (31% of leaders understand the problem; 28% have sufficient safety resources; and 25% have made diagnosis a top institutional safety priority). Ongoing efforts to improve diagnostic safety were sparse and mostly included root cause analysis and peer review feedback around diagnostic errors. The top three barriers to addressing diagnostic error were lack of awareness of the problem, lack of measures of diagnostic accuracy and error, and lack of feedback on diagnostic performance. The top two tools viewed as critically important for locally tackling the problem were routine feedback on diagnostic performance and culture change to emphasize diagnostic safety. Although hospitals and health systems appear to be aware of diagnostic errors as a major safety imperative, most organizations (even those that appear to be making a strong commitment to patient safety) are not yet doing much to improve diagnosis. Going forward, efforts to activate health care organizations will be essential to improving diagnostic safety.

  8. Next-generation audit and feedback for inpatient quality improvement using electronic health record data: a cluster randomised controlled trial.

    PubMed

    Patel, Sajan; Rajkomar, Alvin; Harrison, James D; Prasad, Priya A; Valencia, Victoria; Ranji, Sumant R; Mourad, Michelle

    2018-03-05

    Audit and feedback improves clinical care by highlighting the gap between current and ideal practice. We combined best practices of audit and feedback with continuously generated electronic health record data to improve performance on quality metrics in an inpatient setting. We conducted a cluster randomised control trial comparing intensive audit and feedback with usual audit and feedback from February 2016 to June 2016. The study subjects were internal medicine teams on the teaching service at an urban tertiary care hospital. Teams in the intensive feedback arm received access to a daily-updated team-based data dashboard as well as weekly inperson review of performance data ('STAT rounds'). The usual feedback arm received ongoing twice-monthly emails with graphical depictions of team performance on selected quality metrics. The primary outcome was performance on a composite discharge metric (Discharge Mix Index, 'DMI'). A washout period occurred at the end of the trial (from May through June 2016) during which STAT rounds were removed from the intensive feedback arm. A total of 40 medicine teams participated in the trial. During the intervention period, the primary outcome of completion of the DMI was achieved on 79.3% (426/537) of patients in the intervention group compared with 63.2% (326/516) in the control group (P<0.0001). During the washout period, there was no significant difference in performance between the intensive and usual feedback groups. Intensive audit and feedback using timely data and STAT rounds significantly increased performance on a composite discharge metric compared with usual feedback. With the cessation of STAT rounds, performance between the intensive and usual feedback groups did not differ significantly, highlighting the importance of feedback delivery on effecting change. The trial was registered with ClinicalTrials.gov (NCT02593253). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Examining the teaching roles and experiences of non-physician health care providers in family medicine education: a qualitative study.

    PubMed

    Beber, Serena; Antao, Viola; Telner, Deanna; Krueger, Paul; Peranson, Judith; Meaney, Christopher; Meindl, Maria; Webster, Fiona

    2015-02-13

    Primary Care reform in Canada and globally has encouraged the development of interprofessional primary care initiatives. This has led to significant involvement of non-physician Health Care Providers (NPHCPs) in the teaching of medical trainees. The objective of this study was to understand the experiences, supports and challenges facing non-physician health care providers in Family Medicine education. Four focus groups were conducted using a semi-structured interview guide with twenty one NPHCPs involved in teaching at the University of Toronto, Department of Family & Community Medicine. The focus groups were transcribed and analyzed for recurrent themes. The multi-disciplinary research team held several meetings to discuss themes. NPHCPs were highly involved in Family Medicine education, formally and informally. NPHCPs felt valued as teachers, but this often did not occur until after learners understood their educator role through increased time and exposure. NPHCPs expressed a lack of advance information of learner knowledge level and expectations, and missed opportunities to give feedback or receive teaching evaluations. Adequate preparation time, teaching space and financial compensation were important to NPHCPs, yet were often lacking. There was low awareness but high interest in faculty status and professional development opportunities. Sharing learner goals and objectives and offering NPHCPs feedback and evaluation would help to formalize NPHCP roles and optimize their capacity for cross-professional teaching. Preparation time and dedicated space for teaching are also necessary. NPHCPs should be encouraged to pursue faculty appointments and to access ongoing Professional Development opportunities.

  10. Quasar feedback revealed by giant molecular outflows

    NASA Astrophysics Data System (ADS)

    Feruglio, C.; Maiolino, R.; Piconcelli, E.; Menci, N.; Aussel, H.; Lamastra, A.; Fiore, F.

    2010-07-01

    In the standard scenario for galaxy evolution young star-forming galaxies transform into red bulge-dominated spheroids, where star formation has been quenched. To explain this transformation, a strong negative feedback generated by accretion onto a central super-massive black hole is often invoked. The depletion of gas resulting from quasar-driven outflows should eventually stop star-formation across the host galaxy and lead the black hole to “suicide” by starvation. Direct observational evidence for a major quasar feedback onto the host galaxy is still missing, because outflows previously observed in quasars are generally associated with the ionized component of the gas, which only accounts for a minor fraction of the total gas content, and typically occurrs in the central regions. We used the IRAM PdB Interferometer to observe the CO(1-0) transition in Mrk 231, the closest quasar known. Thanks to the wide band we detected broad wings of the CO line, with velocities of up to 750 km s-1 and spatially resolved on the kpc scale. These broad CO wings trace a giant molecular outflow of about 700 M_⊙/year, far larger than the ongoing star-formation rate (~200 M_⊙/year) observed in the host galaxy. This wind will totally expel the cold gas reservoir in Mrk 231 in about 107 yrs, therefore halting the star-formation activity on the same timescale. The inferred kinetic energy in the molecular outflow is ~1.2 × 1044 erg/s, corresponding to a few percent of the AGN bolometric luminosity, which is very close to the fraction expected by models ascribing quasar feedback to highly supersonic shocks generated by radiatively accelerated nuclear winds. Instead, the contribution by the SNe associated with the starburst fall short by several orders of magnitude to account for the kinetic energy observed in the outflow. The direct observational evidence for quasar feedback reported here provides solid support to the scenarios ascribing the observed properties of local massive galaxies to quasar-induced large-scale winds.

  11. Using Technological Advances to Improve Surgery Curriculum: Experience With a Mobile Application.

    PubMed

    Green, Courtney A; Kim, Edward H; O'Sullivan, Patricia S; Chern, Hueylan

    2018-01-31

    Our previous home-video basic surgical skills curriculum required substantial faculty time and resources, and was limited by delayed feedback and technical difficulties. Consequently, we integrated that curriculum with a mobile application platform. Our purpose is to describe this application and learner satisfaction. The mobile platform incorporates a patented pedagogical design based on Ericsson's deliberate practice and Bandura's social learning theory. Instructors built step-wise skills modules. During the challenge phase, learners watched a video of surgical tasks completed by experts and uploaded a video of themselves performing the same task. In the Peer Review phase, they used a grading rubric to provide feedback. In the Recap stage, learners received individual feedback and could review their own videos. Two groups of learners, graduating medical students and matriculating surgical residents, participated in this independent learning platform, along with 2 to 4 laboratory sessions, and completed a survey about their experience. Survey responses were summarized descriptively and comments analyzed using content analysis. Fifty learners submitted videos of assigned tasks and completed peer reviews. Learners reported positive experiences specifically for the Peer Review Stage, structured home practice, ease of mobile access to submit and review videos, and ongoing immediate feedback. Over half of the learners reported spending at least 10 to 30 minute practicing skills before recording their videos and over 80% rerecorded at least 2 times before submission. Content analysis revealed learners engaged with the educational concepts designed into the platform. Learners easily used and were satisfied with a mobile-technology teaching platform that maintained the fundamental content, educational theories, and organizational structure of our previously effective surgical skills curriculum. Prior challenges were directly addressed through the mobile application's ease of use, support of deliberate practice, and improved timeliness of feedback. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Schema-based learning of adaptable and flexible prey-catching in anurans I. The basic architecture.

    PubMed

    Corbacho, Fernando; Nishikawa, Kiisa C; Weerasuriya, Ananda; Liaw, Jim-Shih; Arbib, Michael A

    2005-12-01

    A motor action often involves the coordination of several motor synergies and requires flexible adjustment of the ongoing execution based on feedback signals. To elucidate the neural mechanisms underlying the construction and selection of motor synergies, we study prey-capture in anurans. Experimental data demonstrate the intricate interaction between different motor synergies, including the interplay of their afferent feedback signals (Weerasuriya 1991; Anderson and Nishikawa 1996). Such data provide insights for the general issues concerning two-way information flow between sensory centers, motor circuits and periphery in motor coordination. We show how different afferent feedback signals about the status of the different components of the motor apparatus play a critical role in motor control as well as in learning. This paper, along with its companion paper, extend the model by Liaw et al. (1994) by integrating a number of different motor pattern generators, different types of afferent feedback, as well as the corresponding control structure within an adaptive framework we call Schema-Based Learning. We develop a model of the different MPGs involved in prey-catching as a vehicle to investigate the following questions: What are the characteristic features of the activity of a single muscle? How can these features be controlled by the premotor circuit? What are the strategies employed to generate and synchronize motor synergies? What is the role of afferent feedback in shaping the activity of a MPG? How can several MPGs share the same underlying circuitry and yet give rise to different motor patterns under different input conditions? In the companion paper we also extend the model by incorporating learning components that give rise to more flexible, adaptable and robust behaviors. To show these aspects we incorporate studies on experiments on lesions and the learning processes that allow the animal to recover its proper functioning.

  13. Automation and apps for clinical dental biomechanics.

    PubMed

    Adams, Bruce W

    2016-09-01

    The aim of this research summary is to introduce the current and ongoing work using smartphone video, tracking markers to measure musculoskeletal disorders of cranial and mandibular origin, and the potential significance of the technology to doctors and therapists. The MPA™ biomechanical measuring apps are in beta trials with various doctors and therapists. The technique requires substantial image processing and statistical analysis, best suited to server-side processing. A smartphone environment has enabled a virtual laboratory, which provides automated generation of graphics and in some cases automated interpretation. The system enables highly accurate real-time biomechanics studies using only a smartphone and tracking markers. Despite the technical challenges in setting up and testing of the virtual environment and with interpretation of clinical relevance, the trials have enabled a demonstration of real-time biomechanics studies. The technology has prompted a lot of discussion about the relevance of rapid assessment tools in clinical practice. It seems that a prior bias against motion tracking and its relevance is very strong with occlusion related use cases, yet there has been a general agreement about the use case for cranial movement tracking in managing complex issues related to the head, neck, and TMJ. Measurement of cranial and mandibular functions using a smartphone video as the input have been investigated. Ongoing research will depend upon doctors and therapists to provide feedback as to which uses are considered clinically relevant.

  14. Applying health information technology and team-based care to residency education.

    PubMed

    Brown, Kristy K; Master-Hunter, Tara A; Cooke, James M; Wimsatt, Leslie A; Green, Lee A

    2011-01-01

    Training physicians capable of practicing within the Patient-centered Medical Home (PCMH) is an emerging area of scholarly inquiry within residency education. This study describes an effort to integrate PCMH principles into teaching practices within a university-based residency setting and evaluates the effect on clinical performance. Using participant feedback and clinical data extracted from an electronic clinical quality management system, we retrospectively examined performance outcomes at two family medicine residency clinics over a 7-year period. Instructional approaches were identified and clinical performance patterns analyzed. Alumni ratings of the practice-based curriculum increased following institution of the PCMH model. Clinical performance outcomes indicated improvements in the delivery of clinical care to patients. Implementation of instructional methodologies posed some challenges to residency faculty, particularly in development of consistent scheduling of individualized feedback sessions. Residents required the greatest support and guidance in managing point-of-care clinical reminders during patient encounters. Teaching practices that take into consideration the integration of team-based care and use of electronic health technologies can successfully be used to deliver residency education in the context of the PCMH model. Ongoing assessment provides important information to residency directors and faculty in support of improving the quality of clinical instruction.

  15. An ongoing six-year innovative osteoporosis disease management program: challenges and success in an IPA physician group environment.

    PubMed

    Woo, Ann; Hittell, Jodi; Beardsley, Carrie; Noh, Charles; Stoukides, Cheryl A; Kaul, Alan F

    2004-01-01

    The goal of this ongoing comprehensive osteoporosis disease management initiative is to provide the adult primary care physicians' (PCPs) offices with a program enabling them to systematically identify and manage their population for osteoporosis. For over six years, Hill Physicians Medical Group (Hill Physicians) has implemented multiple strategies to develop a best practice for identifying and treating members who were candidates for osteoporosis therapy. Numerous tools were used to support this disease management effort, including: evidence-based clinical practice guidelines, patient education sessions, the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire tool, member specific reports for PCPs, targeted member mailings, office-based Peripheral Instantaneous X-ray Imaging (PIXI) test and counseling, dual x-ray absorptiometry (DEXA) scan guidelines, and web-based Electronic Simple Calculated Osteoporosis Risk Estimation (eSCORE) questionnaire tools. Hill Physicians tabulated results for patients who completed 2649 SCORE tests, screened 978 patients with PIXI tests, and identified 338 osteopenic and 124 osteoporotic patients. The preliminary results of this unique six-year ongoing educational initiative are slow but promising. New physician offices express interest in participating and those offices that have participated in the program continue to screen for osteoporosis. Hill Physicians' message is consistent and is communicated to the physicians repeatedly in different ways in accordance with the principles of educational outreach. Physicians who have conducted the program have positive feedback from their patients and office staff and have begun to communicate their experience to their peers.

  16. From Cheerleader to Coach: The Developmental Progression of Bedside Teachers in Giving Feedback to Early Learners.

    PubMed

    Wenrich, Marjorie D; Jackson, Molly Blackley; Maestas, Ramoncita R; Wolfhagen, Ineke H A P; Scherpbier, Albert J J

    2015-11-01

    Medical students learn clinical skills at the bedside from teaching clinicians, who often learn to teach by teaching. Little is known about the process of becoming an effective clinical teacher. Understanding how teaching skills and approaches change with experience may help tailor faculty development for new teachers. Focusing on giving feedback to early learners, the authors asked: What is the developmental progression of clinician-teachers as they learn to give clinical skills feedback to medical students? This qualitative study included longitudinal interviews with clinician-teachers over five years in a new clinical skills teaching program for preclinical medical students. Techniques derived from grounded theory were used for initial analyses. The current study focused on one theme identified in initial analyses: giving feedback to students. Transcript passages were organized by interview year, coded, and discussed in year clusters; thematic codes were compared and emergent codes developed. Themes related to giving feedback demonstrated a dyadic structure: characteristic of less experienced teachers versus characteristic of experienced teachers. Seven dominant dyadic themes emerged, including teacher as cheerleader versus coach, concern about student fragility versus understanding resilience, and focus on creating a safe environment versus challenging students within a safe environment. With consistent teaching, clinical teachers demonstrated progress in giving feedback to students in multiple areas, including understanding students' developmental trajectory and needs, developing tools and strategies, and adopting a dynamic, challenging, inclusive team approach. Ongoing teaching opportunities with targeted faculty development may help improve clinician-teachers' feedback skills and approaches.

  17. Ensemble reconstruction constraints on the global carbon cycle sensitivity to climate.

    PubMed

    Frank, David C; Esper, Jan; Raible, Christoph C; Büntgen, Ulf; Trouet, Valerie; Stocker, Benjamin; Joos, Fortunat

    2010-01-28

    The processes controlling the carbon flux and carbon storage of the atmosphere, ocean and terrestrial biosphere are temperature sensitive and are likely to provide a positive feedback leading to amplified anthropogenic warming. Owing to this feedback, at timescales ranging from interannual to the 20-100-kyr cycles of Earth's orbital variations, warming of the climate system causes a net release of CO(2) into the atmosphere; this in turn amplifies warming. But the magnitude of the climate sensitivity of the global carbon cycle (termed gamma), and thus of its positive feedback strength, is under debate, giving rise to large uncertainties in global warming projections. Here we quantify the median gamma as 7.7 p.p.m.v. CO(2) per degrees C warming, with a likely range of 1.7-21.4 p.p.m.v. CO(2) per degrees C. Sensitivity experiments exclude significant influence of pre-industrial land-use change on these estimates. Our results, based on the coupling of a probabilistic approach with an ensemble of proxy-based temperature reconstructions and pre-industrial CO(2) data from three ice cores, provide robust constraints for gamma on the policy-relevant multi-decadal to centennial timescales. By using an ensemble of >200,000 members, quantification of gamma is not only improved, but also likelihoods can be assigned, thereby providing a benchmark for future model simulations. Although uncertainties do not at present allow exclusion of gamma calculated from any of ten coupled carbon-climate models, we find that gamma is about twice as likely to fall in the lowermost than in the uppermost quartile of their range. Our results are incompatibly lower (P < 0.05) than recent pre-industrial empirical estimates of approximately 40 p.p.m.v. CO(2) per degrees C (refs 6, 7), and correspondingly suggest approximately 80% less potential amplification of ongoing global warming.

  18. Adaptation of handwriting size under distorted visual feedback in patients with Parkinson's disease and elderly and young controls

    PubMed Central

    Teulings, H; Contreras-Vidal, J; Stelmach, G; Adler, C

    2002-01-01

    Objective: The ability to use visual feedback to control handwriting size was compared in patients with Parkinson's disease (PD), elderly people, and young adults to better understand factors playing a part in parkinsonian micrographia. Methods: The participants wrote sequences of eight cursive l loops with visual target sizes of 0.5 and 2 cm on a flat panel display digitiser which both recorded and displayed the pen movements. In the pre-exposure and postexposure conditions, the display digitiser showed the actual pen trace in real time and real size. In the distortion exposure conditions, the gain of the vertical dimension of the visual feedback was either reduced to 70% or enlarged to 140%. Results: The young controls showed a gradual visuomotor adaptation that compensated for the visual feedback distortions during the exposure conditions. They also showed significant after effects during the postexposure conditions. The elderly controls marginally corrected for the size distortions and showed small after effects. The patients with PD, however, showed no trial by trial adaptations or after effects but instead, a progressive amplification of the distortion effect in each individual trial. Conclusion: The young controls used visual feedback to update their visuomotor map. The elderly controls seemed to make little use of visual feedback. The patients with Parkinson's disease rely on the visual feedback of previous or of ongoing strokes to programme subsequent strokes. This recursive feedback may play a part in the progressive reductions in handwriting size found in parkinsonian micrographia. PMID:11861687

  19. A theory of how active behavior stabilises neural activity: Neural gain modulation by closed-loop environmental feedback

    PubMed Central

    2018-01-01

    During active behaviours like running, swimming, whisking or sniffing, motor actions shape sensory input and sensory percepts guide future motor commands. Ongoing cycles of sensory and motor processing constitute a closed-loop feedback system which is central to motor control and, it has been argued, for perceptual processes. This closed-loop feedback is mediated by brainwide neural circuits but how the presence of feedback signals impacts on the dynamics and function of neurons is not well understood. Here we present a simple theory suggesting that closed-loop feedback between the brain/body/environment can modulate neural gain and, consequently, change endogenous neural fluctuations and responses to sensory input. We support this theory with modeling and data analysis in two vertebrate systems. First, in a model of rodent whisking we show that negative feedback mediated by whisking vibrissa can suppress coherent neural fluctuations and neural responses to sensory input in the barrel cortex. We argue this suppression provides an appealing account of a brain state transition (a marked change in global brain activity) coincident with the onset of whisking in rodents. Moreover, this mechanism suggests a novel signal detection mechanism that selectively accentuates active, rather than passive, whisker touch signals. This mechanism is consistent with a predictive coding strategy that is sensitive to the consequences of motor actions rather than the difference between the predicted and actual sensory input. We further support the theory by re-analysing previously published two-photon data recorded in zebrafish larvae performing closed-loop optomotor behaviour in a virtual swim simulator. We show, as predicted by this theory, that the degree to which each cell contributes in linking sensory and motor signals well explains how much its neural fluctuations are suppressed by closed-loop optomotor behaviour. More generally we argue that our results demonstrate the dependence of neural fluctuations, across the brain, on closed-loop brain/body/environment interactions strongly supporting the idea that brain function cannot be fully understood through open-loop approaches alone. PMID:29342146

  20. A theory of how active behavior stabilises neural activity: Neural gain modulation by closed-loop environmental feedback.

    PubMed

    Buckley, Christopher L; Toyoizumi, Taro

    2018-01-01

    During active behaviours like running, swimming, whisking or sniffing, motor actions shape sensory input and sensory percepts guide future motor commands. Ongoing cycles of sensory and motor processing constitute a closed-loop feedback system which is central to motor control and, it has been argued, for perceptual processes. This closed-loop feedback is mediated by brainwide neural circuits but how the presence of feedback signals impacts on the dynamics and function of neurons is not well understood. Here we present a simple theory suggesting that closed-loop feedback between the brain/body/environment can modulate neural gain and, consequently, change endogenous neural fluctuations and responses to sensory input. We support this theory with modeling and data analysis in two vertebrate systems. First, in a model of rodent whisking we show that negative feedback mediated by whisking vibrissa can suppress coherent neural fluctuations and neural responses to sensory input in the barrel cortex. We argue this suppression provides an appealing account of a brain state transition (a marked change in global brain activity) coincident with the onset of whisking in rodents. Moreover, this mechanism suggests a novel signal detection mechanism that selectively accentuates active, rather than passive, whisker touch signals. This mechanism is consistent with a predictive coding strategy that is sensitive to the consequences of motor actions rather than the difference between the predicted and actual sensory input. We further support the theory by re-analysing previously published two-photon data recorded in zebrafish larvae performing closed-loop optomotor behaviour in a virtual swim simulator. We show, as predicted by this theory, that the degree to which each cell contributes in linking sensory and motor signals well explains how much its neural fluctuations are suppressed by closed-loop optomotor behaviour. More generally we argue that our results demonstrate the dependence of neural fluctuations, across the brain, on closed-loop brain/body/environment interactions strongly supporting the idea that brain function cannot be fully understood through open-loop approaches alone.

  1. Feedback on prescribing errors to junior doctors: exploring views, problems and preferred methods.

    PubMed

    Bertels, Jeroen; Almoudaris, Alex M; Cortoos, Pieter-Jan; Jacklin, Ann; Franklin, Bryony Dean

    2013-06-01

    Prescribing errors are common in hospital inpatients. However, the literature suggests that doctors are often unaware of their errors as they are not always informed of them. It has been suggested that providing more feedback to prescribers may reduce subsequent error rates. Only few studies have investigated the views of prescribers towards receiving such feedback, or the views of hospital pharmacists as potential feedback providers. Our aim was to explore the views of junior doctors and hospital pharmacists regarding feedback on individual doctors' prescribing errors. Objectives were to determine how feedback was currently provided and any associated problems, to explore views on other approaches to feedback, and to make recommendations for designing suitable feedback systems. A large London NHS hospital trust. To explore views on current and possible feedback mechanisms, self-administered questionnaires were given to all junior doctors and pharmacists, combining both 5-point Likert scale statements and open-ended questions. Agreement scores for statements regarding perceived prescribing error rates, opinions on feedback, barriers to feedback, and preferences for future practice. Response rates were 49% (37/75) for junior doctors and 57% (57/100) for pharmacists. In general, doctors did not feel threatened by feedback on their prescribing errors. They felt that feedback currently provided was constructive but often irregular and insufficient. Most pharmacists provided feedback in various ways; however some did not or were inconsistent. They were willing to provide more feedback, but did not feel it was always effective or feasible due to barriers such as communication problems and time constraints. Both professional groups preferred individual feedback with additional regular generic feedback on common or serious errors. Feedback on prescribing errors was valued and acceptable to both professional groups. From the results, several suggested methods of providing feedback on prescribing errors emerged. Addressing barriers such as the identification of individual prescribers would facilitate feedback in practice. Research investigating whether or not feedback reduces the subsequent error rate is now needed.

  2. Vocal responses to unanticipated perturbations in voice loudness feedback: an automatic mechanism for stabilizing voice amplitude.

    PubMed

    Bauer, Jay J; Mittal, Jay; Larson, Charles R; Hain, Timothy C

    2006-04-01

    The present study tested whether subjects respond to unanticipated short perturbations in voice loudness feedback with compensatory responses in voice amplitude. The role of stimulus magnitude (+/- 1,3 vs 6 dB SPL), stimulus direction (up vs down), and the ongoing voice amplitude level (normal vs soft) were compared across compensations. Subjects responded to perturbations in voice loudness feedback with a compensatory change in voice amplitude 76% of the time. Mean latency of amplitude compensation was 157 ms. Mean response magnitudes were smallest for 1-dB stimulus perturbations (0.75 dB) and greatest for 6-dB conditions (0.98 dB). However, expressed as gain, responses for 1-dB perturbations were largest and almost approached 1.0. Response magnitudes were larger for the soft voice amplitude condition compared to the normal voice amplitude condition. A mathematical model of the audio-vocal system captured the main features of the compensations. Previous research has demonstrated that subjects can respond to an unanticipated perturbation in voice pitch feedback with an automatic compensatory response in voice fundamental frequency. Data from the present study suggest that voice loudness feedback can be used in a similar manner to monitor and stabilize voice amplitude around a desired loudness level.

  3. A feedback system in residency to evaluate CanMEDS roles and provide high-quality feedback: Exploring its application.

    PubMed

    Renting, Nienke; Gans, Rijk O B; Borleffs, Jan C C; Van Der Wal, Martha A; Jaarsma, A Debbie C; Cohen-Schotanus, Janke

    2016-07-01

    Residents benefit from regular, high quality feedback on all CanMEDS roles during their training. However, feedback mostly concerns Medical Expert, leaving the other roles behind. A feedback system was developed to guide supervisors in providing feedback on CanMEDS roles. We analyzed whether feedback was provided on the intended roles and explored differences in quality of written feedback. In the feedback system, CanMEDS roles were assigned to five authentic situations: Patient Encounter, Morning Report, On-call, CAT, and Oral Presentation. Quality of feedback was operationalized as specificity and inclusion of strengths and improvement points. Differences in specificity between roles were tested with Mann-Whitney U tests with a Bonferroni correction (α = 0.003). Supervisors (n = 126) provided residents (n = 120) with feedback (591 times). Feedback was provided on the intended roles, most frequently on Scholar (78%) and Communicator (71%); least on Manager (47%), and Collaborator (56%). Strengths (78%) were mentioned more frequently than improvement points (52%), which were lacking in 40% of the feedback on Manager, Professional, and Collaborator. Feedback on Scholar was more frequently (p = 0.000) and on Reflective Professional was less frequently (p = 0.003) specific. Assigning roles to authentic situations guides supervisors in providing feedback on different CanMEDS roles. We recommend additional supervisor training on how to observe and evaluate the roles.

  4. Effects of Peer-Assessed Feedback, Goal Setting and a Group Contingency on Performance and Learning by 10-12-Year-Old Academy Soccer Players

    ERIC Educational Resources Information Center

    Holt, Josh E.; Kinchin, Gary; Clarke, Gill

    2012-01-01

    Background: Coaches developing young talent in team sports must maximise practice and learning of essential game skills and accurately and continuously assess the performance and potential of each player. Relative age effects highlight an erroneous process of initial and on-going player assessment, based largely on subjective opinions of game…

  5. Identifying Mentors' Observations for Providing Feedback

    ERIC Educational Resources Information Center

    Hudson, Peter

    2016-01-01

    Mentors' feedback can assist preservice teachers' development; yet feedback tends to be variable from one mentor to the next. What do mentors observe for providing feedback? In this study, 24 mentors observed a final-year preservice teacher through a professionally video-recorded lesson and provided written notes for feedback. They observed the…

  6. Development and pilot testing of an intervention to promote care engagement and adherence among HIV-positive Kenyan MSM.

    PubMed

    Graham, Susan M; Micheni, Murugi; Kombo, Bernadette; Van Der Elst, Elisabeth M; Mugo, Peter M; Kivaya, Esther; Aunon, Frances; Kutner, Bryan; Sanders, Eduard J; Simoni, Jane M

    2015-12-01

    In many African settings, MSM are a stigmatized group whose access to and engagement in HIV care may be challenging. Our aim was to design a targeted, culturally appropriate intervention to promote care engagement and antiretroviral therapy (ART) adherence for MSM in coastal Kenya, and describe intervention safety, feasibility, and acceptability based upon a small pilot study. Based on qualitative work including in-depth interviews with HIV-positive MSM and focus groups with providers, we developed a tailored intervention and conducted a pilot test to refine intervention materials and procedures. The Shikamana intervention combines modified Next-Step Counseling by trained providers, support from a trained peer navigator, and tailored use of SMS messaging, phone calls, and discrete pill carriers. Providers, including counselors and clinicians, work together with peer navigators as a case management team. Forty HIV-positive MSM aged 19-51 participated in intervention development and testing. Six counselors, three clinical officers, and four MSM peers were trained in intervention procedures. Of 10 ART-naïve participants who enrolled in the pilot, eight completed follow-up with no adverse events reported. One participant was lost to follow-up after 2 months and another failed to initiate ART despite ongoing counseling. No adverse events were reported. Staff feedback and exit interviews rated the intervention as feasible and acceptable. This adherence support intervention tailored for Kenyan MSM was well tolerated, feasible, and acceptable in the pilot phase. A randomized controlled trial of a scaled-up programme to estimate intervention efficacy is ongoing.

  7. Feedback in clinical education, part I: Characteristics of feedback provided by approved clinical instructors.

    PubMed

    Nottingham, Sara; Henning, Jolene

    2014-01-01

    Providing students with feedback is an important component of athletic training clinical education; however, little information is known about the feedback that Approved Clinical Instructors (ACIs; now known as preceptors) currently provide to athletic training students (ATSs). To characterize the feedback provided by ACIs to ATSs during clinical education experiences. Qualitative study. One National Collegiate Athletic Association Division I athletic training facility and 1 outpatient rehabilitation clinic that were clinical sites for 1 entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. A total of 4 ACIs with various experience levels and 4 second-year ATSs. Extensive field observations were audio recorded, transcribed, and integrated with field notes for analysis. The constant comparative approach of open, axial, and selective coding was used to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. The ACIs gave 88 feedback statements in 45 hours and 10 minutes of observation. Characteristics of feedback categories included purpose, timing, specificity, content, form, and privacy. Feedback that ACIs provided included several components that made each feedback exchange unique. The ACIs in our study provided feedback that is supported by the literature, suggesting that ACIs are using current recommendations for providing feedback. Feedback needs to be investigated across multiple athletic training education programs to gain more understanding of certain areas of feedback, including frequency, privacy, and form.

  8. The Accuracy of Computer-Assisted Feedback and Students' Responses to It

    ERIC Educational Resources Information Center

    Lavolette, Elizabeth; Polio, Charlene; Kahng, Jimin

    2015-01-01

    Various researchers in second language acquisition have argued for the effectiveness of immediate rather than delayed feedback. In writing, truly immediate feedback is impractical, but computer-assisted feedback provides a quick way of providing feedback that also reduces the teacher's workload. We explored the accuracy of feedback from…

  9. Cortical excitability correlates with the event-related desynchronization during brain-computer interface control

    NASA Astrophysics Data System (ADS)

    Daly, Ian; Blanchard, Caroline; Holmes, Nicholas P.

    2018-04-01

    Objective. Brain-computer interfaces (BCIs) based on motor control have been suggested as tools for stroke rehabilitation. Some initial successes have been achieved with this approach, however the mechanism by which they work is not yet fully understood. One possible part of this mechanism is a, previously suggested, relationship between the strength of the event-related desynchronization (ERD), a neural correlate of motor imagination and execution, and corticospinal excitability. Additionally, a key component of BCIs used in neurorehabilitation is the provision of visual feedback to positively reinforce attempts at motor control. However, the ability of visual feedback of the ERD to modulate the activity in the motor system has not been fully explored. Approach. We investigate these relationships via transcranial magnetic stimulation delivered at different moments in the ongoing ERD related to hand contraction and relaxation during BCI control of a visual feedback bar. Main results. We identify a significant relationship between ERD strength and corticospinal excitability, and find that our visual feedback does not affect corticospinal excitability. Significance. Our results imply that efforts to promote functional recovery in stroke by targeting increases in corticospinal excitability may be aided by accounting for the time course of the ERD.

  10. The Effects of Source, Revision Possibility, and Amount of Feedback on Marketing Students' Impressions of Feedback on an Assignment

    ERIC Educational Resources Information Center

    Ackerman, David S.; Dommeyer, Curt J.; Gross, Barbara L.

    2017-01-01

    This study examines how three factors affect students' reactions to critical feedback on an assignment--amount of feedback (none vs. low amount vs. high amount), source of feedback (instructor-provided feedback vs. peer-provided feedback), and the situational context of the feedback (revision of paper is or is not possible). An incomplete 3 × 2 ×…

  11. Planned and ongoing projects (pop) database: development and results.

    PubMed

    Wild, Claudia; Erdös, Judit; Warmuth, Marisa; Hinterreiter, Gerda; Krämer, Peter; Chalon, Patrice

    2014-11-01

    The aim of this study was to present the development, structure and results of a database on planned and ongoing health technology assessment (HTA) projects (POP Database) in Europe. The POP Database (POP DB) was set up in an iterative process from a basic Excel sheet to a multifunctional electronic online database. The functionalities, such as the search terminology, the procedures to fill and update the database, the access rules to enter the database, as well as the maintenance roles, were defined in a multistep participatory feedback loop with EUnetHTA Partners. The POP Database has become an online database that hosts not only the titles and MeSH categorizations, but also some basic information on status and contact details about the listed projects of EUnetHTA Partners. Currently, it stores more than 1,200 planned, ongoing or recently published projects of forty-three EUnetHTA Partners from twenty-four countries. Because the POP Database aims to facilitate collaboration, it also provides a matching system to assist in identifying similar projects. Overall, more than 10 percent of the projects in the database are identical both in terms of pathology (indication or disease) and technology (drug, medical device, intervention). In addition, approximately 30 percent of the projects are similar, meaning that they have at least some overlap in content. Although the POP DB is successful concerning regular updates of most national HTA agencies within EUnetHTA, little is known about its actual effects on collaborations in Europe. Moreover, many non-nationally nominated HTA producing agencies neither have access to the POP DB nor can share their projects.

  12. Systematic Braiding of Two Evidence-Based Parent Training Programs: Qualitative Results from the Pilot Phase

    PubMed Central

    Guastaferro, Kate; Miller, Katy; Shanley Chatham, Jenelle R.; Whitaker, Daniel J.; McGilly, Kate; Lutzker, John R.

    2017-01-01

    An effective approach in early intervention for children and families, including child maltreatment prevention, is home-based services. Though several evidence-based programs exist, they are often grouped together, despite having different foci. This paper describes an ongoing cluster randomized trial systematically braiding two evidence-based home-based models, SafeCare® and Parents as Teachers (PAT)®, to better meet the needs of families at-risk. We describe the methodology for braiding model implementation and curriculum, specifically focusing on how structured qualitative feedback from pilot families and providers was used to create the braided curriculum and implementation. Systematic braiding of two models at the implementation and curriculum levels is a mechanism that has the potential to meet the more comprehensive needs of families at-risk for maltreatment. PMID:27870760

  13. A five-year self-sustainability analysis of nurse-administered HIV rapid testing in Veterans Affairs primary care.

    PubMed

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-10-01

    In 2008, nurse-administered HIV oral rapid testing (RT) was introduced at the Veterans Affairs Primary Care Clinic in Downtown Los Angeles. Analysis at five years revealed variable yet increasing rates of HIV RT at that facility despite the fact that no post-launch support was provided by the implementation team. Qualitative interviews among stakeholders conducted at five years revealed the pre-existing implementation practices endemic to this clinic that facilitated this unprecedented success (e.g. history of positive quality improvement implementations, leadership support, clinician involvement at each step of the process to facilitate empowerment, ownership and feasible customisation of the implementation, cohesive communication among clinicians and leadership, training, efficient supply pathway, progressive performance feedback and ongoing encouragement). © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Using online learning in a traditional face-to-face environment.

    PubMed

    Kozlowski, Dawn

    2002-01-01

    A model for designing online learning was developed and implemented in a Registered Nurse-to-Bachelor of Science in Nursing course using online and face-to-face methodologies. The combination of online and face-to-face learning modalities may help the student who is a novice Internet explorer or seasoned Web navigator by offering technological support as well as providing constant in-person feedback regarding course requirements. The face-to-face component facilitates a sense of community and peer support that sometimes is lacking in an entirely online course. During the 2 semesters this model was used, students expressed satisfaction with having the course facilitator/professor physically available for consultation and advisement. Evaluation of this online/on-site course is ongoing and uses computer-administered qualitative questionnaires, a facilitator-moderated focus group, and Likert-type course evaluations.

  15. Star Formation in the Eagle Nebula

    NASA Astrophysics Data System (ADS)

    Oliveira, J. M.

    2008-12-01

    M16 (the Eagle Nebula) is a striking star forming region, with a complex morphology of gas and dust sculpted by the massive stars in NGC 6611. Detailed studies of the famous ``elephant trunks'' dramatically increased our understanding of the massive star feedback into the parent molecular cloud. A rich young stellar population (2-3 Myr) has been identified, from massive O-stars down to substellar masses. Deep into the remnant molecular material, embedded protostars, Herbig-Haro objects and maser sources bear evidence of ongoing star formation in the nebula, possibly triggered by the massive cluster members. M 16 is a excellent template for the study of star formation under the hostile environment created by massive O-stars. This review aims at providing an observational overview not only of the young stellar population but also of the gas remnant of the star formation process.

  16. Empowering Lay-Counsellors with Technology: Masivukeni, a Standardized Multimedia Counselling Support Tool to Deliver ART Counselling.

    PubMed

    Gouse, H; Robbins, R N; Mellins, C A; Kingon, A; Rowe, J; Henry, M; Remien, R H; Pearson, A; Victor, F; Joska, J A

    2018-05-19

    Lay-counsellors in resource-limited settings convey critical HIV- and ART-information, and face challenges including limited training and variable application of counselling. This study explored lay-counsellors and Department of Health (DoH) perspectives on the utility of a multimedia adherence counselling program. Masivukeni, an mHealth application that provides scaffolding for delivering standardized ART counselling was used in a 3-year randomized control trail at two primary health care clinics in Cape Town, South Africa. In this programmatic and descriptive narrative report, we describe the application; lay-counsellors' response to open-ended questions regarding their experience with using Masivukeni; and perspectives of the City of Cape Town and Western Cape Government DoH, obtained through ongoing engagements and feedback sessions. Counsellors reported Masivukeni empowered them to provide high quality counselling. DoH indicated strong support for a future implementation study assessing feasibility for larger scale roll-out. Masivukeni has potential as a counselling tool in resource-limited settings.

  17. The embodiment of authentic leadership.

    PubMed

    Waite, Roberta; McKinney, Nicole; Smith-Glasgow, Mary Ellen; Meloy, Faye A

    2014-01-01

    Development of student leadership capacity and efficacy is critical to the nursing profession, and vital to this process is a strong foundation in critical thinking that includes a depth of understanding of self (i.e., authentic leadership development). This article will (a) present a theoretical overview of authentic leadership as compared with other popular leadership theories, (b) provide an overview of development/implementation of an authentic leadership course, the first in a series of six one-credit courses as an integral component of the Macy Undergraduate Leadership Fellows Program for upper-level nursing students, and (c) discuss related implications for nursing education. Findings from an investigator-developed quantitative pre-post survey and qualitative evaluation questions are provided. Student feedback regarding the comprehensive nature of the course was extremely positive and affirmed the value of introspection associated with authentic leadership in ongoing personal and professional development. Critical pedagogy and action-oriented learning strategies also proved beneficial to student engagement. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Feedback Providing Improvement Strategies and Reflection on Feedback Use: Effects on Students' Writing Motivation, Process, and Performance

    ERIC Educational Resources Information Center

    Duijnhouwer, Hendrien; Prins, Frans J.; Stokking, Karel M.

    2012-01-01

    This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students' writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the control feedback condition (n = 41) received…

  19. Feedback in a clinical setting: A way forward to enhance student's learning through constructive feedback.

    PubMed

    Sultan, Amber Shamim; Mateen Khan, Muhammad Arif

    2017-07-01

    Feedback is considered as a dynamic process in which information about the observed performance is used to promote the desirable behaviour and correct the negative ones. The importance of feedback is widely acknowledged, but still there seems to be inconsistency in the amount, type and timing of feedback received from the clinical faculty. No significant effort has been put forward from the educator end to empower the learners with the skills of receiving and using the feedback effectively. Some institutions conduct faculty development workshops and courses to facilitate the clinicians on how best to deliver constructive feedback to the learners. Despite of all these struggles learners are not fully satisfied with the quality of feedback received from their busy clinicians. The aim of this paper is to highlight what actually feedback is, type and structure of feedback, the essential components of a constructive feedback, benefits of providing feedback, barriers affecting the provision of timely feedback and different models used for providing feedback. The ultimate purpose of this paper is to provide sufficient information to the clinical directors that there is a need to establish a robust system for giving feedback to learners and to inform all the clinical educators with the skills required to provide constructive feedback to their learners. For the literature review, we had used the key words glossary as: Feedback, constructive feedback, barriers to feedback, principles of constructive feedback, Models of feedback, reflection, self-assessment and clinical practice etc. The data bases for the search include: Cardiff University library catalogue, Pub Med, Google Scholar, Web of Knowledge and Science direct.

  20. Feedback in Clinical Education, Part I: Characteristics of Feedback Provided by Approved Clinical Instructors

    PubMed Central

    Nottingham, Sara; Henning, Jolene

    2014-01-01

    Context Providing students with feedback is an important component of athletic training clinical education; however, little information is known about the feedback that Approved Clinical Instructors (ACIs; now known as preceptors) currently provide to athletic training students (ATSs). Objective To characterize the feedback provided by ACIs to ATSs during clinical education experiences. Design Qualitative study. Setting One National Collegiate Athletic Association Division I athletic training facility and 1 outpatient rehabilitation clinic that were clinical sites for 1 entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants A total of 4 ACIs with various experience levels and 4 second-year ATSs. Data Collection and Analysis Extensive field observations were audio recorded, transcribed, and integrated with field notes for analysis. The constant comparative approach of open, axial, and selective coding was used to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Results The ACIs gave 88 feedback statements in 45 hours and 10 minutes of observation. Characteristics of feedback categories included purpose, timing, specificity, content, form, and privacy. Conclusions Feedback that ACIs provided included several components that made each feedback exchange unique. The ACIs in our study provided feedback that is supported by the literature, suggesting that ACIs are using current recommendations for providing feedback. Feedback needs to be investigated across multiple athletic training education programs to gain more understanding of certain areas of feedback, including frequency, privacy, and form. PMID:24143902

  1. A patient centered care plan in the EHR: improving collaboration and engagement.

    PubMed

    Chunchu, Kavitha; Mauksch, Larry; Charles, Carol; Ross, Valerie; Pauwels, Judith

    2012-09-01

    Patients attempting to manage their chronic conditions require ongoing support in changing and adopting self-management behaviors. However, patient values, health goals, and action plans are not well represented in the electronic health record (EHR) impeding the ability of the team (MA and providers) to provide respectful, ongoing self-management support. We evaluated whether a team approach to using an EHR based patient centered care plan (PCCP) improved collaborative self-management planning. An experimental, prospective cohort study was conducted in a family medicine residency clinic. The experimental group included 7 physicians and a medical assistant who received 2 hr of PCCP training. The control group consisted of 7 physicians and a medical assistant. EHR charts were analyzed for evidence of 8 behavior change elements. Follow-up interviews with experimental group patients and physicians and the medical assistant assessed their experiences. We found that PCCP charts had more documented behavior change elements than control charts in all 8 domains (p < .001). Experimental group physicians valued the PCCP model and suggested ways to improve its use. Patient feedback demonstrated support for the model. A PCCP can help team members to engage patients with chronic illnesses in goal setting and action planning to support self-management. An EHR design that stores patient values, health goals, and action plans may strengthen continuity and quality of care between patients and primary care team members. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  2. Hierarchical decision processes that operate over distinct timescales underlie choice and changes in strategy

    PubMed Central

    Purcell, Braden A.; Kiani, Roozbeh

    2016-01-01

    Decision-making in a natural environment depends on a hierarchy of interacting decision processes. A high-level strategy guides ongoing choices, and the outcomes of those choices determine whether or not the strategy should change. When the right decision strategy is uncertain, as in most natural settings, feedback becomes ambiguous because negative outcomes may be due to limited information or bad strategy. Disambiguating the cause of feedback requires active inference and is key to updating the strategy. We hypothesize that the expected accuracy of a choice plays a crucial rule in this inference, and setting the strategy depends on integration of outcome and expectations across choices. We test this hypothesis with a task in which subjects report the net direction of random dot kinematograms with varying difficulty while the correct stimulus−response association undergoes invisible and unpredictable switches every few trials. We show that subjects treat negative feedback as evidence for a switch but weigh it with their expected accuracy. Subjects accumulate switch evidence (in units of log-likelihood ratio) across trials and update their response strategy when accumulated evidence reaches a bound. A computational framework based on these principles quantitatively explains all aspects of the behavior, providing a plausible neural mechanism for the implementation of hierarchical multiscale decision processes. We suggest that a similar neural computation—bounded accumulation of evidence—underlies both the choice and switches in the strategy that govern the choice, and that expected accuracy of a choice represents a key link between the levels of the decision-making hierarchy. PMID:27432960

  3. Hierarchical decision processes that operate over distinct timescales underlie choice and changes in strategy.

    PubMed

    Purcell, Braden A; Kiani, Roozbeh

    2016-08-02

    Decision-making in a natural environment depends on a hierarchy of interacting decision processes. A high-level strategy guides ongoing choices, and the outcomes of those choices determine whether or not the strategy should change. When the right decision strategy is uncertain, as in most natural settings, feedback becomes ambiguous because negative outcomes may be due to limited information or bad strategy. Disambiguating the cause of feedback requires active inference and is key to updating the strategy. We hypothesize that the expected accuracy of a choice plays a crucial rule in this inference, and setting the strategy depends on integration of outcome and expectations across choices. We test this hypothesis with a task in which subjects report the net direction of random dot kinematograms with varying difficulty while the correct stimulus-response association undergoes invisible and unpredictable switches every few trials. We show that subjects treat negative feedback as evidence for a switch but weigh it with their expected accuracy. Subjects accumulate switch evidence (in units of log-likelihood ratio) across trials and update their response strategy when accumulated evidence reaches a bound. A computational framework based on these principles quantitatively explains all aspects of the behavior, providing a plausible neural mechanism for the implementation of hierarchical multiscale decision processes. We suggest that a similar neural computation-bounded accumulation of evidence-underlies both the choice and switches in the strategy that govern the choice, and that expected accuracy of a choice represents a key link between the levels of the decision-making hierarchy.

  4. Developing a coaching mechanism for practicing surgeons.

    PubMed

    Stefanidis, Dimitrios; Anderson-Montoya, Brittany; Higgins, Robert V; Pimentel, Manuel E; Rowland, Patrick; Scarborough, Madison O; Higgins, Danelle

    2016-09-01

    While performance feedback and assessment are hallmarks of surgical training, they abruptly cease after training is completed. In their absence, performance may stagnate and poor habits persist. Our aim was to develop a coaching mechanism for practicing surgeons with feedback provision based on objective performance assessment. Technical and nontechnical intraoperative video recordings from laparoscopic or robotic cholecystectomies, colectomies, and hysterectomies were assessed by a blinded surgeon and a human factors expert, respectively. Aspects of performance in need of improvement were noted, and a coaching session was developed for feedback provision to participating surgeons. This 4-hour coaching session consisted of a didactic lecture with video review and hands-on practice using procedural and mannequin-based simulation. Thirty-two practicing surgeons (18 general; 14 gynecologists) from 6 different hospitals were assessed, and 9 of them participated in coaching. Technical aspects identified for performance improvement included suboptimal trocar placement, inadequate critical view achievement during laparoscopic cholecystectomies, poor visualization of the operating field, bimanual dexterity, and dissection techniques, while nontechnical aspects included inappropriate handling of distractions and interruptions, poor ergonomic positioning and situational awareness, and inadequate mitigation of delays. Most surgeons appropriately accomplished some of the objectives of the distraction scenario, but none was able to achieve expert levels on Fundamentals of Laparoscopy tasks. Participants perceived the coaching sessions as highly valuable. Our study identified several technical and nontechnical skill sets of practicing surgeons in need of improvement and provided support for the implementation of coaching programs for surgeons on an ongoing basis. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Designing Caregiver-Implemented Shared-Reading Interventions to Overcome Implementation Barriers

    PubMed Central

    Logan, Jessica R.; Damschroder, Laura

    2015-01-01

    Purpose This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. Methods A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Results Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. Conclusions A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders. PMID:26262941

  6. Designing Caregiver-Implemented Shared-Reading Interventions to Overcome Implementation Barriers.

    PubMed

    Justice, Laura M; Logan, Jessica R; Damschroder, Laura

    2015-12-01

    This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders.

  7. Putting program evaluation into practice: enhancing the Girls Just Wanna Have Fun program.

    PubMed

    Bean, Corliss N; Kendellen, Kelsey; Halsall, Tanya; Forneris, Tanya

    2015-04-01

    In recent years there has been a call for increased community physical activity and sport programs for female youth that are deliberately structured to foster positive developmental outcomes. In addition, researchers have recognized the need to empirically evaluate such programs to ensure that youth are provided with optimal opportunities to thrive. This study represents a utilization-focused evaluation of Girls Just Wanna Have Fun, a female-only physical activity-based life skills community program. A utilization-focused evaluation is particularly important when the evaluation is to help stakeholders utilize the findings in practice. The purpose of this study was twofold: (a) to gain an understanding of the ongoing successes and challenges after year two of program implementation and (b) to examine how the adaptations made based on feedback from the first year evaluation were perceived as impacting the program. From interviews with youth participants and program leaders, three main themes with eight sub-themes emerged. The main themes were: (a) applying lessons learned can make a significant difference, (b) continually implementing successful strategies, and (c) ongoing challenges. Overall, this evaluation represents an important step in understanding how to improve program delivery to better meet the needs of the participants in community-based programming. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Developing a shared understanding of the Upper Mississippi River: the foundation of an ecological resilience assessment

    USGS Publications Warehouse

    Bouska, Kristen; Houser, Jeff N.; De Jager, Nathan R.; Hendrickson, Jon S.

    2018-01-01

    The Upper Mississippi River System (UMRS) is a large and complex floodplain river ecosystem that spans the jurisdictions of multiple state and federal agencies. In support of ongoing ecosystem restoration and management by this broad partnership, we are undertaking a resilience assessment of the UMRS. We describe the UMRS in the context of an ecological resilience assessment. Our description articulates the temporal and spatial extent of our assessment of the UMRS, the relevant historical context, the valued services provided by the system, and the fundamental controlling variables that determine its structure and function. An important objective of developing the system description was to determine the simplest, adequate conceptual understanding of the UMRS. We conceptualize a simplified UMRS as three interconnected subsystems: lotic channels, lentic off-channel areas, and floodplains. By identifying controlling variables within each subsystem, we have developed a shared understanding of the basic structure and function of the UMRS, which will serve as the basis for ongoing quantitative evaluations of factors that likely contribute to the resilience of the UMRS. As we undertake the subsequent elements of a resilience assessment, we anticipate our improved understanding of interactions, feedbacks, and critical thresholds will assist natural resource managers to better recognize the system’s ability to adapt to existing and new stresses.

  9. Exploring the Reality of Using Patient Experience Data to Provide Resident Feedback: A Qualitative Study of Attending Physician Perspectives

    PubMed Central

    Campbell, Steffanie; Goltz, Heather Honoré; Njue, Sarah; Dang, Bich Ngoc

    2016-01-01

    Introduction: Little is known about the attitudes of faculty and residents toward the use of patient experience data as a tool for providing resident feedback. The purpose of this study was to explore the attitudes of teaching faculty surrounding patient experience data and how those attitudes may influence the feedback given to trainees. Methods: From July 2013 to August 2013, we conducted in-depth, face-to-face, semistructured interviews with 9 attending physicians who precept residents in internal medicine at 2 continuity clinics (75% of eligible attendings). Interviews were coded using conventional content analysis. Results: Content analysis identified six potential barriers in using patient experience survey data to provide feedback to residents: 1) perceived inability of residents to learn or to incorporate feedback, 2) punitive nature of feedback, 3) lack of training in the delivery of actionable feedback, 4) lack of timeliness in the delivery of feedback, 5) unclear benefit of patient experience survey data as a tool for providing resident feedback, and 6) lack of individualized feedback. Conclusion: Programs may want to conduct an internal review on how patient experience data is incorporated into the resident feedback process and how, if at all, their faculty are trained to provide such feedback. PMID:27400180

  10. Exploring the Reality of Using Patient Experience Data to Provide Resident Feedback: A Qualitative Study of Attending Physician Perspectives.

    PubMed

    Campbell, Steffanie; Goltz, Heather Honoré; Njue, Sarah; Dang, Bich Ngoc

    2016-01-01

    Little is known about the attitudes of faculty and residents toward the use of patient experience data as a tool for providing resident feedback. The purpose of this study was to explore the attitudes of teaching faculty surrounding patient experience data and how those attitudes may influence the feedback given to trainees. From July 2013 to August 2013, we conducted in-depth, face-to-face, semistructured interviews with 9 attending physicians who precept residents in internal medicine at 2 continuity clinics (75% of eligible attendings). Interviews were coded using conventional content analysis. Content analysis identified six potential barriers in using patient experience survey data to provide feedback to residents: 1) perceived inability of residents to learn or to incorporate feedback, 2) punitive nature of feedback, 3) lack of training in the delivery of actionable feedback, 4) lack of timeliness in the delivery of feedback, 5) unclear benefit of patient experience survey data as a tool for providing resident feedback, and 6) lack of individualized feedback. Programs may want to conduct an internal review on how patient experience data is incorporated into the resident feedback process and how, if at all, their faculty are trained to provide such feedback.

  11. Progress on thermobrachytherapy surface applicator for superficial tissue disease

    NASA Astrophysics Data System (ADS)

    Arunachalam, Kavitha; Craciunescu, Oana I.; Maccarini, Paolo F.; Schlorff, Jaime L.; Markowitz, Edward; Stauffer, Paul R.

    2009-02-01

    This work reports the ongoing development of a combination applicator for simultaneous heating of superficial tissue disease using a 915 MHz DCC (dual concentric conductor) array and High Dose Rate (HDR) brachytherapy delivered via an integrated conformal catheter array. The progress includes engineering design changes in the waterbolus, DCC configurations and fabrication techniques of the conformal multilayer applicator. The dosimetric impact of the thin copper DCC array is also assessed. Steady state fluid dynamics of the new waterbolus bag indicates nearly uniform flow with less than 1°C variation across a large (19×32cm) bolus. Thermometry data of the torso phantom acquired with computer controlled movement of fiberoptic temperature probes inside thermal mapping catheters indicate feasibility of real time feedback control for the DCC array. MR (magnetic resonance) scans of a torso phantom indicate that the waterbolus thickness across the treatment area is controlled by the pressure applied by the surrounding inflatable airbladder and applicator securing straps. The attenuation coefficient of the DCC array was measured as 3+/- 0.001% and 2.95+/-0.03 % using an ion chamber and OneDose dosimeters respectively. The performance of the combination applicator on patient phantoms provides valuable feedback to optimize the applicator prior use in the patient clinic.

  12. Fiber optic tracheal detection device

    NASA Astrophysics Data System (ADS)

    Souhan, Brian E.; Nawn, Corinne D.; Shmel, Richard; Watts, Krista L.; Ingold, Kirk A.

    2017-02-01

    Poorly performed airway management procedures can lead to a wide variety of adverse events, such as laryngeal trauma, stenosis, cardiac arrest, hypoxemia, or death as in the case of failed airway management or intubation of the esophagus. Current methods for confirming tracheal placement, such as auscultation, direct visualization or capnography, may be subjective, compromised due to clinical presentation or require additional specialized equipment that is not always readily available during the procedure. Consequently, there exists a need for a non-visual detection mechanism for confirming successful airway placement that can give the provider rapid feedback during the procedure. Based upon our previously presented work characterizing the reflectance spectra of tracheal and esophageal tissue, we developed a fiber-optic prototype to detect the unique spectral characteristics of tracheal tissue. Device performance was tested by its ability to differentiate ex vivo samples of tracheal and esophageal tissue. Pig tissue samples were tested with the larynx, trachea and esophagus intact as well as excised and mounted on cork. The device positively detected tracheal tissue 18 out of 19 trials and 1 false positive out of 19 esophageal trials. Our proof of concept device shows great promise as a potential mechanism for rapid user feedback during airway management procedures to confirm tracheal placement. Ongoing studies will investigate device optimizations of the probe for more refined sensing and in vivo testing.

  13. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Campbell, J. E.; Berry, J. A.; Seibt, U.

    Growth in terrestrial gross primary production (GPP) may provide a feedback for climate change, but there is still strong disagreement on the extent to which biogeochemical processes may suppress this GPP growth at the ecosystem to continental scales. The consequent uncertainty in modeling of future carbon storage by the terrestrial biosphere constitutes one of the largest unknowns in global climate projections for the next century. Here we provide a global, measurement-based estimate of historical GPP growth using long-term atmospheric carbonyl sulfide (COS) records derived from ice core, firn, and ambient air samples. We interpret these records using a model thatmore » relates changes in the COS concentration to changes in its sources and sinks, the largest of which is proportional to GPP. The COS history was most consistent with simulations that assume a large historical GPP growth. Carbon-climate models that assume little to no GPP growth predicted trajectories of COS concentration over the anthropogenic era that differ from those observed. Continued COS monitoring may be useful for detecting ongoing changes in GPP while extending the ice core record to glacial cycles could provide further opportunities to evaluate earth system models.« less

  14. The Art of Giving Online Feedback

    ERIC Educational Resources Information Center

    Leibold, Nancyruth; Schwarz, Laura Marie

    2015-01-01

    The cultivation of providing online feedback that is positive, effective, and enhances the learning experience is a valuable educator skill. Acquisition of the art of providing feedback is through education, practice, and faculty development. This article provides information about the best practices for delivering online feedback to learners. An…

  15. The effectiveness of a Web-based personalized feedback and social norms alcohol intervention on United Kingdom university students: randomized controlled trial.

    PubMed

    Bewick, Bridgette M; West, Robert M; Barkham, Michael; Mulhern, Brendan; Marlow, Robert; Traviss, Gemma; Hill, Andrew J

    2013-07-24

    Alcohol consumption in the student population continues to be cause for concern. Building on the established evidence base for traditional brief interventions, interventions using the Internet as a mode of delivery are being developed. Published evidence of replication of initial findings and ongoing development and modification of Web-based personalized feedback interventions for student alcohol use is relatively rare. The current paper reports on the replication of the initial Unitcheck feasibility trial. To evaluate the effectiveness of Unitcheck, a Web-based intervention that provides instant personalized feedback on alcohol consumption. It was hypothesized that use of Unitcheck would be associated with a reduction in alcohol consumption. A randomized control trial with two arms (control=assessment only; intervention=fully automated personalized feedback delivered using a Web-based intervention). The intervention was available week 1 through to week 15. Students at a UK university who were completing a university-wide annual student union electronic survey were invited to participate in the current study. Participants (n=1618) were stratified by sex, age group, year of study, self-reported alcohol consumption, then randomly assigned to one of the two arms, and invited to participate in the current trial. Participants were not blind to allocation. In total, n=1478 (n=723 intervention, n=755 control) participants accepted the invitation. Of these, 70% were female, the age ranged from 17-50 years old, and 88% were white/white British. Data were collected electronically via two websites: one for each treatment arm. Participants completed assessments at weeks 1, 16, and 34. Assessment included CAGE, a 7-day retrospective drinking diary, and drinks consumed per drinking occasion. The regression model predicted a monitoring effect, with participants who completed assessments reducing alcohol consumption over the final week. Further reductions were predicted for those allocated to receive the intervention, and additional reductions were predicted as the number of visits to the intervention website increased. Unitcheck can reduce the amount of alcohol consumed, and the reduction can be sustained in the medium term (ie, 19 weeks after intervention was withdrawn). The findings suggest self-monitoring is an active ingredient to Web-based personalized feedback.

  16. Learning to See: Enhancing Student Learning through Videotaped Feedback

    ERIC Educational Resources Information Center

    Yakura, Elaine K.

    2009-01-01

    Feedback is crucial to developing skills, but meaningful feedback is difficult to provide. Classroom videotaping can provide effective feedback on student performance, but for video feedback to be most helpful, students must develop a type of "visual intelligence"--analytical skills that increase critical thinking and self-awareness. The author…

  17. Environmental cleaning and disinfection of patient areas.

    PubMed

    Doll, Michelle; Stevens, Michael; Bearman, Gonzalo

    2018-02-01

    The healthcare setting is predisposed to harbor potential pathogens, which in turn can pose a great risk to patients. Routine cleaning of the patient environment is critical to reduce the risk of hospital-acquired infections. While many approaches to environmental cleaning exist, manual cleaning supplemented with ongoing assessment and feedback may be the most feasible for healthcare facilities with limited resources. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  18. The Career Advancement for Registered Nurse Excellence Program.

    PubMed

    Fusilero, Jane; Lini, Linda; Prohaska, Priscilla; Szweda, Christine; Carney, Katie; Mion, Lorraine C

    2008-12-01

    Nurse administrators focus on factors that influence nurses' levels of satisfaction to reduce turnover and improve retention. One important determinant of nurses' satisfaction is the opportunity for professional development. On the basis of feedback from the nurses, a professional development program, Career Advancement for Registered Nurse Excellence, was instituted. The authors describe one approach to create opportunities to improve professional nurse development and the necessity for ongoing assessment of its impact on nurses' job satisfaction.

  19. Error correcting mechanisms during antisaccades: contribution of online control during primary saccades and offline control via secondary saccades.

    PubMed

    Bedi, Harleen; Goltz, Herbert C; Wong, Agnes M F; Chandrakumar, Manokaraananthan; Niechwiej-Szwedo, Ewa

    2013-01-01

    Errors in eye movements can be corrected during the ongoing saccade through in-flight modifications (i.e., online control), or by programming a secondary eye movement (i.e., offline control). In a reflexive saccade task, the oculomotor system can use extraretinal information (i.e., efference copy) online to correct errors in the primary saccade, and offline retinal information to generate a secondary corrective saccade. The purpose of this study was to examine the error correction mechanisms in the antisaccade task. The roles of extraretinal and retinal feedback in maintaining eye movement accuracy were investigated by presenting visual feedback at the spatial goal of the antisaccade. We found that online control for antisaccade is not affected by the presence of visual feedback; that is whether visual feedback is present or not, the duration of the deceleration interval was extended and significantly correlated with reduced antisaccade endpoint error. We postulate that the extended duration of deceleration is a feature of online control during volitional saccades to improve their endpoint accuracy. We found that secondary saccades were generated more frequently in the antisaccade task compared to the reflexive saccade task. Furthermore, we found evidence for a greater contribution from extraretinal sources of feedback in programming the secondary "corrective" saccades in the antisaccade task. Nonetheless, secondary saccades were more corrective for the remaining antisaccade amplitude error in the presence of visual feedback of the target. Taken together, our results reveal a distinctive online error control strategy through an extension of the deceleration interval in the antisaccade task. Target feedback does not improve online control, rather it improves the accuracy of secondary saccades in the antisaccade task.

  20. Error Correcting Mechanisms during Antisaccades: Contribution of Online Control during Primary Saccades and Offline Control via Secondary Saccades

    PubMed Central

    Bedi, Harleen; Goltz, Herbert C.; Wong, Agnes M. F.; Chandrakumar, Manokaraananthan; Niechwiej-Szwedo, Ewa

    2013-01-01

    Errors in eye movements can be corrected during the ongoing saccade through in-flight modifications (i.e., online control), or by programming a secondary eye movement (i.e., offline control). In a reflexive saccade task, the oculomotor system can use extraretinal information (i.e., efference copy) online to correct errors in the primary saccade, and offline retinal information to generate a secondary corrective saccade. The purpose of this study was to examine the error correction mechanisms in the antisaccade task. The roles of extraretinal and retinal feedback in maintaining eye movement accuracy were investigated by presenting visual feedback at the spatial goal of the antisaccade. We found that online control for antisaccade is not affected by the presence of visual feedback; that is whether visual feedback is present or not, the duration of the deceleration interval was extended and significantly correlated with reduced antisaccade endpoint error. We postulate that the extended duration of deceleration is a feature of online control during volitional saccades to improve their endpoint accuracy. We found that secondary saccades were generated more frequently in the antisaccade task compared to the reflexive saccade task. Furthermore, we found evidence for a greater contribution from extraretinal sources of feedback in programming the secondary “corrective” saccades in the antisaccade task. Nonetheless, secondary saccades were more corrective for the remaining antisaccade amplitude error in the presence of visual feedback of the target. Taken together, our results reveal a distinctive online error control strategy through an extension of the deceleration interval in the antisaccade task. Target feedback does not improve online control, rather it improves the accuracy of secondary saccades in the antisaccade task. PMID:23936308

  1. Automatic and controlled processing in the corticocerebellar system.

    PubMed

    Ramnani, Narender

    2014-01-01

    During learning, performance changes often involve a transition from controlled processing in which performance is flexible and responsive to ongoing error feedback, but effortful and slow, to a state in which processing becomes swift and automatic. In this state, performance is unencumbered by the requirement to process feedback, but its insensitivity to feedback reduces its flexibility. Many properties of automatic processing are similar to those that one would expect of forward models, and many have suggested that these may be instantiated in cerebellar circuitry. Since hierarchically organized frontal lobe areas can both send and receive commands, I discuss the possibility that they can act both as controllers and controlled objects and that their behaviors can be independently modeled by forward models in cerebellar circuits. Since areas of the prefrontal cortex contribute to this hierarchically organized system and send outputs to the cerebellar cortex, I suggest that the cerebellum is likely to contribute to the automation of cognitive skills, and to the formation of habitual behavior which is resistant to error feedback. An important prerequisite to these ideas is that cerebellar circuitry should have access to higher order error feedback that signals the success or failure of cognitive processing. I have discussed the pathways through which such feedback could arrive via the inferior olive and the dopamine system. Cerebellar outputs inhibit both the inferior olive and the dopamine system. It is possible that learned representations in the cerebellum use this as a mechanism to suppress the processing of feedback in other parts of the nervous system. Thus, cerebellar processes that control automatic performance may be completed without triggering the engagement of controlled processes by prefrontal mechanisms. © 2014 Elsevier B.V. All rights reserved.

  2. Development of a clinical pharmacy model within an Australian home nursing service using co-creation and participatory action research: the Visiting Pharmacist (ViP) study

    PubMed Central

    Lee, Cik Yin; Beanland, Christine; Goeman, Dianne P; Petrie, Neil; Petrie, Barbara; Vise, Felicity; Gray, June

    2017-01-01

    Objective To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. Design Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. Setting A large, non-profit home nursing service in Melbourne, Australia. Participants Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team. Data collection and analysis Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists’ reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists. Results The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges. Conclusions A collaborative, person-centred clinical pharmacy model that addressed the needs of clients, carers, nurses and other stakeholders was successfully developed. The model is likely to have applicability to home nursing services nationally and internationally. PMID:29102998

  3. Design strategies for dynamic closed-loop optogenetic neurocontrol in vivo

    NASA Astrophysics Data System (ADS)

    Bolus, M. F.; Willats, A. A.; Whitmire, C. J.; Rozell, C. J.; Stanley, G. B.

    2018-04-01

    Objective. Controlling neural activity enables the possibility of manipulating sensory perception, cognitive processes, and body movement, in addition to providing a powerful framework for functionally disentangling the neural circuits that underlie these complex phenomena. Over the last decade, optogenetic stimulation has become an increasingly important and powerful tool for understanding neural circuit function, owing to the ability to target specific cell types and bidirectionally modulate neural activity. To date, most stimulation has been provided in open-loop or in an on/off closed-loop fashion, where previously-determined stimulation is triggered by an event. Here, we describe and demonstrate a design approach for precise optogenetic control of neuronal firing rate modulation using feedback to guide stimulation continuously. Approach. Using the rodent somatosensory thalamus as an experimental testbed for realizing desired time-varying patterns of firing rate modulation, we utilized a moving average exponential filter to estimate firing rate online from single-unit spiking measured extracellularly. This estimate of instantaneous rate served as feedback for a proportional integral (PI) controller, which was designed during the experiment based on a linear-nonlinear Poisson (LNP) model of the neuronal response to light. Main results. The LNP model fit during the experiment enabled robust closed-loop control, resulting in good tracking of sinusoidal and non-sinusoidal targets, and rejection of unmeasured disturbances. Closed-loop control also enabled manipulation of trial-to-trial variability. Significance. Because neuroscientists are faced with the challenge of dissecting the functions of circuit components, the ability to maintain control of a region of interest in spite of changes in ongoing neural activity will be important for disambiguating function within networks. Closed-loop stimulation strategies are ideal for control that is robust to such changes, and the employment of continuous feedback to adjust stimulation in real-time can improve the quality of data collected using optogenetic manipulation.

  4. Formative Feedback in a Malaysian Primary School ESL Context

    ERIC Educational Resources Information Center

    Sardareh, Sedigheh Abbasnasab

    2016-01-01

    The idea of providing students with formative feedback is a crucial part of formative assessment. Teachers need to provide students with feedback that improves their learning. In other words, formative feedback should provide learners with information that help them bridge their learning gap. As formative assessment itself is a newly introduced…

  5. Frequent external-focus feedback enhances motor learning.

    PubMed

    Wulf, Gabriele; Chiviacowsky, Suzete; Schiller, Eduardo; Avila, Luciana Toaldo Gentilini

    2010-01-01

    The present study examined the hypothesis that feedback inducing an external focus of attention enhances motor learning if it is provided frequently (i.e., 100%) rather than less frequently. Children (10- to 12-year-olds) practiced a soccer throw-in task and were provided feedback about movement form. The feedback statements, provided either after every (100%) or every third (33%) practice trial, were similar in content but induced either an internal focus (body-movement related) or external focus (movement-effect related). The results demonstrated that learning of the movement form was enhanced by external-focus feedback after every trial (100%) relative to external-focus feedback after every third trial (33%) or internal-focus feedback (100%, 33%), as demonstrated by immediate and delayed transfer tests without feedback. There was no difference between the two internal-focus feedback groups. These findings indicate that the attentional focus induced by feedback is an important factor in determining the effectiveness of different feedback frequencies. We argue that the informational properties of feedback cannot sufficiently account for these and related findings, and suggest that the attentional role of feedback be given greater consideration in future studies.

  6. Combined Student Ratings and Self-Assessment Provide Useful Feedback for Clinical Teachers

    ERIC Educational Resources Information Center

    Stalmeijer, Renee E.; Dolmans, Diana H. J. M.; Wolfhagen, Ineke H. A. P.; Peters, Wim G.; van Coppenolle, Lieve; Scherpbier, Albert J. J. A.

    2010-01-01

    Many evaluation instruments have been developed to provide feedback to physicians on their clinical teaching but written feedback alone is not always effective. We explored whether feedback effectiveness improved when teachers' self-assessment was added to written feedback based on student ratings. 37 physicians (10 residents, 27 attending…

  7. Trajectory of the arctic as an integrated system

    USGS Publications Warehouse

    Hinzman, Larry; Deal, Clara; McGuire, Anthony David; Mernild, Sebastian H.; Polyakov, Igor V.; Walsh, John E.

    2013-01-01

    Although much remains to be learned about the Arctic and its component processes, many of the most urgent scientific, engineering, and social questions can only be approached through a broader system perspective. Here, we address interactions between components of the Arctic System and assess feedbacks and the extent to which feedbacks (1) are now underway in the Arctic; and (2) will shape the future trajectory of the Arctic system. We examine interdependent connections among atmospheric processes, oceanic processes, sea-ice dynamics, marine and terrestrial ecosystems, land surface stocks of carbon and water, glaciers and ice caps, and the Greenland ice sheet. Our emphasis on the interactions between components, both historical and anticipated, is targeted on the feedbacks, pathways, and processes that link these different components of the Arctic system. We present evidence that the physical components of the Arctic climate system are currently in extreme states, and that there is no indication that the system will deviate from this anomalous trajectory in the foreseeable future. The feedback for which the evidence of ongoing changes is most compelling is the surface albedo-temperature feedback, which is amplifying temperature changes over land (primarily in spring) and ocean (primarily in autumn-winter). Other feedbacks likely to emerge are those in which key processes include surface fluxes of trace gases, changes in the distribution of vegetation, changes in surface soil moisture, changes in atmospheric water vapor arising from higher temperatures and greater areas of open ocean, impacts of Arctic freshwater fluxes on the meridional overturning circulation of the ocean, and changes in Arctic clouds resulting from changes in water vapor content.

  8. Trajectory of the Arctic as an integrated system.

    PubMed

    Hinzman, Larry D; Deal, Clara J; McGuire, A David; Mernild, Sebastian H; Polyakov, Igor V; Walsh, John E

    2013-12-01

    Although much remains to be learned about the Arctic and its component processes, many of the most urgent scientific, engineering, and social questions can only be approached through a broader system perspective. Here, we address interactions between components of the Arctic system and assess feedbacks and the extent to which feedbacks (1) are now underway in the Arctic and (2) will shape the future trajectory of the Arctic system. We examine interdependent connections among atmospheric processes, oceanic processes, sea-ice dynamics, marine and terrestrial ecosystems, land surface stocks of carbon and water, glaciers and ice caps, and the Greenland ice sheet. Our emphasis on the interactions between components, both historical and anticipated, is targeted on the feedbacks, pathways, and processes that link these different components of the Arctic system. We present evidence that the physical components of the Arctic climate system are currently in extreme states, and that there is no indication that the system will deviate from this anomalous trajectory in the foreseeable future. The feedback for which the evidence of ongoing changes is most compelling is the surface albedo-temperature feedback, which is amplifying temperature changes over land (primarily in spring) and ocean (primarily in autumn-winter). Other feedbacks likely to emerge are those in which key processes include surface fluxes of trace gases, changes in the distribution of vegetation, changes in surface soil moisture, changes in atmospheric water vapor arising from higher temperatures and greater areas of open ocean, impacts of Arctic freshwater fluxes on the meridional overturning circulation of the ocean, and changes in Arctic clouds resulting from changes in water vapor content.

  9. Computer-supported feedback message tailoring: theory-informed adaptation of clinical audit and feedback for learning and behavior change.

    PubMed

    Landis-Lewis, Zach; Brehaut, Jamie C; Hochheiser, Harry; Douglas, Gerald P; Jacobson, Rebecca S

    2015-01-21

    Evidence shows that clinical audit and feedback can significantly improve compliance with desired practice, but it is unclear when and how it is effective. Audit and feedback is likely to be more effective when feedback messages can influence barriers to behavior change, but barriers to change differ across individual health-care providers, stemming from differences in providers' individual characteristics. The purpose of this article is to invite debate and direct research attention towards a novel audit and feedback component that could enable interventions to adapt to barriers to behavior change for individual health-care providers: computer-supported tailoring of feedback messages. We argue that, by leveraging available clinical data, theory-informed knowledge about behavior change, and the knowledge of clinical supervisors or peers who deliver feedback messages, a software application that supports feedback message tailoring could improve feedback message relevance for barriers to behavior change, thereby increasing the effectiveness of audit and feedback interventions. We describe a prototype system that supports the provision of tailored feedback messages by generating a menu of graphical and textual messages with associated descriptions of targeted barriers to behavior change. Supervisors could use the menu to select messages based on their awareness of each feedback recipient's specific barriers to behavior change. We anticipate that such a system, if designed appropriately, could guide supervisors towards giving more effective feedback for health-care providers. A foundation of evidence and knowledge in related health research domains supports the development of feedback message tailoring systems for clinical audit and feedback. Creating and evaluating computer-supported feedback tailoring tools is a promising approach to improving the effectiveness of clinical audit and feedback.

  10. How we give personalised audio feedback after summative OSCEs.

    PubMed

    Harrison, Christopher J; Molyneux, Adrian J; Blackwell, Sara; Wass, Valerie J

    2015-04-01

    Students often receive little feedback after summative objective structured clinical examinations (OSCEs) to enable them to improve their performance. Electronic audio feedback has shown promise in other educational areas. We investigated the feasibility of electronic audio feedback in OSCEs. An electronic OSCE system was designed, comprising (1) an application for iPads allowing examiners to mark in the key consultation skill domains, provide "tick-box" feedback identifying strengths and difficulties, and record voice feedback; (2) a feedback website giving students the opportunity to view/listen in multiple ways to the feedback. Acceptability of the audio feedback was investigated, using focus groups with students and questionnaires with both examiners and students. 87 (95%) students accessed the examiners' audio comments; 83 (90%) found the comments useful and 63 (68%) reported changing the way they perform a skill as a result of the audio feedback. They valued its highly personalised, relevant nature and found it much more useful than written feedback. Eighty-nine per cent of examiners gave audio feedback to all students on their stations. Although many found the method easy, lack of time was a factor. Electronic audio feedback provides timely, personalised feedback to students after a summative OSCE provided enough time is allocated to the process.

  11. Coherent ongoing subthreshold state of a cortical neural network regulated by slow- and fast-spiking interneurons.

    PubMed

    Hoshino, Osamu

    2006-12-01

    Although details of cortical interneurons in anatomy and physiology have been well understood, little is known about how they contribute to ongoing spontaneous neuronal activity that could have a great impact on subsequent neuronal information processing. Simulating a cortical neural network model of an early sensory area, we investigated whether and how two distinct types of inhibitory interneurons, or fast-spiking interneurons with narrow axonal arbors and slow-spiking interneurons with wide axonal arbors, have a spatiotemporal influence on the ongoing activity of principal cells and subsequent cognitive information processing. In the model, dynamic cell assemblies, or population activation of principal cells, expressed information about specific sensory features. Within cell assemblies, fast-spiking interneurons give a feedback inhibitory effect on principal cells. Between cell assemblies, slow-spiking interneurons give a lateral inhibitory effect on principal cells. Here, we show that these interneurons keep the network at a subthreshold level for action potential generation under the ongoing state, by which the reaction time of principal cells to sensory stimulation could be accelerated. We suggest that the best timing of inhibition mediated by fast-spiking interneurons and slow-spiking interneurons allows the network to remain near threshold for rapid responses to input.

  12. Closed-Loop Task Difficulty Adaptation during Virtual Reality Reach-to-Grasp Training Assisted with an Exoskeleton for Stroke Rehabilitation

    PubMed Central

    Grimm, Florian; Naros, Georgios; Gharabaghi, Alireza

    2016-01-01

    Stroke patients with severe motor deficits of the upper extremity may practice rehabilitation exercises with the assistance of a multi-joint exoskeleton. Although this technology enables intensive task-oriented training, it may also lead to slacking when the assistance is too supportive. Preserving the engagement of the patients while providing “assistance-as-needed” during the exercises, therefore remains an ongoing challenge. We applied a commercially available seven degree-of-freedom arm exoskeleton to provide passive gravity compensation during task-oriented training in a virtual environment. During this 4-week pilot study, five severely affected chronic stroke patients performed reach-to-grasp exercises resembling activities of daily living. The subjects received virtual reality feedback from their three-dimensional movements. The level of difficulty for the exercise was adjusted by a performance-dependent real-time adaptation algorithm. The goal of this algorithm was the automated improvement of the range of motion. In the course of 20 training and feedback sessions, this unsupervised adaptive training concept led to a progressive increase of the virtual training space (p < 0.001) in accordance with the subjects' abilities. This learning curve was paralleled by a concurrent improvement of real world kinematic parameters, i.e., range of motion (p = 0.008), accuracy of movement (p = 0.01), and movement velocity (p < 0.001). Notably, these kinematic gains were paralleled by motor improvements such as increased elbow movement (p = 0.001), grip force (p < 0.001), and upper extremity Fugl-Meyer-Assessment score from 14.3 ± 5 to 16.9 ± 6.1 (p = 0.026). Combining gravity-compensating assistance with adaptive closed-loop feedback in virtual reality provides customized rehabilitation environments for severely affected stroke patients. This approach may facilitate motor learning by progressively challenging the subject in accordance with the individual capacity for functional restoration. It might be necessary to apply concurrent restorative interventions to translate these improvements into relevant functional gains of severely motor impaired patients in activities of daily living. PMID:27895550

  13. Closed-Loop Task Difficulty Adaptation during Virtual Reality Reach-to-Grasp Training Assisted with an Exoskeleton for Stroke Rehabilitation.

    PubMed

    Grimm, Florian; Naros, Georgios; Gharabaghi, Alireza

    2016-01-01

    Stroke patients with severe motor deficits of the upper extremity may practice rehabilitation exercises with the assistance of a multi-joint exoskeleton. Although this technology enables intensive task-oriented training, it may also lead to slacking when the assistance is too supportive. Preserving the engagement of the patients while providing "assistance-as-needed" during the exercises, therefore remains an ongoing challenge. We applied a commercially available seven degree-of-freedom arm exoskeleton to provide passive gravity compensation during task-oriented training in a virtual environment. During this 4-week pilot study, five severely affected chronic stroke patients performed reach-to-grasp exercises resembling activities of daily living. The subjects received virtual reality feedback from their three-dimensional movements. The level of difficulty for the exercise was adjusted by a performance-dependent real-time adaptation algorithm. The goal of this algorithm was the automated improvement of the range of motion. In the course of 20 training and feedback sessions, this unsupervised adaptive training concept led to a progressive increase of the virtual training space ( p < 0.001) in accordance with the subjects' abilities. This learning curve was paralleled by a concurrent improvement of real world kinematic parameters, i.e., range of motion ( p = 0.008), accuracy of movement ( p = 0.01), and movement velocity ( p < 0.001). Notably, these kinematic gains were paralleled by motor improvements such as increased elbow movement ( p = 0.001), grip force ( p < 0.001), and upper extremity Fugl-Meyer-Assessment score from 14.3 ± 5 to 16.9 ± 6.1 ( p = 0.026). Combining gravity-compensating assistance with adaptive closed-loop feedback in virtual reality provides customized rehabilitation environments for severely affected stroke patients. This approach may facilitate motor learning by progressively challenging the subject in accordance with the individual capacity for functional restoration. It might be necessary to apply concurrent restorative interventions to translate these improvements into relevant functional gains of severely motor impaired patients in activities of daily living.

  14. Synergistic Effects on the Elderly People's Motor Control by Wearable Skin-Stretch Device Combined with Haptic Joystick

    PubMed Central

    Yoon, Han U.; Anil Kumar, Namita; Hur, Pilwon

    2017-01-01

    Cutaneous sensory feedback can be used to provide additional sensory cues to a person performing a motor task where vision is a dominant feedback signal. A haptic joystick has been widely used to guide a user by providing force feedback. However, the benefit of providing force feedback is still debatable due to performance dependency on factors such as the user's skill-level, task difficulty. Meanwhile, recent studies have shown the feasibility of improving a motor task performance by providing skin-stretch feedback. Therefore, a combination of two aforementioned feedback types is deemed to be promising to promote synergistic effects to consistently improve the person's motor performance. In this study, we aimed at identifying the effect of the combined haptic and skin-stretch feedbacks on the aged person's driving motor performance. For the experiment, 15 healthy elderly subjects (age 72.8 ± 6.6 years) were recruited and were instructed to drive a virtual power-wheelchair through four different courses with obstacles. Four augmented sensory feedback conditions were tested: no feedback, force feedback, skin-stretch feedback, and a combination of both force and skin-stretch feedbacks. While the haptic force was provided to the hand by the joystick, the skin-stretch was provided to the steering forearm by a custom-designed wearable skin-stretch device. We tested two hypotheses: (i) an elderly individual's motor control would benefit from receiving information about a desired trajectory from multiple sensory feedback sources, and (ii) the benefit does not depend on task difficulty. Various metrics related to skills and safety were used to evaluate the control performance. Repeated measure ANOVA was performed for those metrics with two factors: task scenario and the type of the augmented sensory feedback. The results revealed that elderly subjects' control performance significantly improved when the combined feedback of both haptic force and skin-stretch feedback was applied. The proposed approach suggest the feasibility to improve people's task performance by the synergistic effects of multiple augmented sensory feedback modalities. PMID:28690514

  15. Rationale, design and methods of the HEALTHY study physical education intervention component.

    PubMed

    McMurray, R G; Bassin, S; Jago, R; Bruecker, S; Moe, E L; Murray, T; Mazzuto, S L; Volpe, S L

    2009-08-01

    The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention integrated nutrition, physical education (PE) and behavior changes with a communications strategy of promotional and educational materials and activities. The PE intervention component was developed over a series of pilot studies to maximize student participation and the time (in minutes) spent in moderate-to-vigorous physical activity (MVPA), while meeting state-mandated PE guidelines. The goal of the PE intervention component was to achieve > or =150 min of MVPA in PE classes every 10 school days with the expectation that it would provide a direct effect on adiposity and insulin resistance, subsequently reducing the risk of type 2 diabetes in youth. The PE intervention component curriculum used standard lesson plans to provide a comprehensive approach to middle school PE. Equipment and PE teacher assistants were provided for each school. An expert in PE at each center trained the PE teachers and assistants, monitored delivery of the intervention and provided ongoing feedback and guidance.

  16. Rationale, design and methods of the HEALTHY study physical education intervention component

    PubMed Central

    McMurray, RG; Bassin, S; Jago, R; Bruecker, S; Moe, EL; Murray, T; Mazzuto, SL; Volpe, SL

    2009-01-01

    The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention integrated nutrition, physical education (PE) and behavior changes with a communications strategy of promotional and educational materials and activities. The PE intervention component was developed over a series of pilot studies to maximize student participation and the time (in minutes) spent in moderate-to-vigorous physical activity (MVPA), while meeting state-mandated PE guidelines. The goal of the PE intervention component was to achieve ≥150 min of MVPA in PE classes every 10 school days with the expectation that it would provide a direct effect on adiposity and insulin resistance, subsequently reducing the risk of type 2 diabetes in youth. The PE intervention component curriculum used standard lesson plans to provide a comprehensive approach to middle school PE. Equipment and PE teacher assistants were provided for each school. An expert in PE at each center trained the PE teachers and assistants, monitored delivery of the intervention and provided ongoing feedback and guidance. PMID:19623187

  17. An intergenerational reminiscence programme for older adults with early dementia and youth volunteers: values and challenges.

    PubMed

    Chung, Jenny C C

    2009-06-01

    To examine the values of a reminiscence programme, adopting an intergenerational approach, on older persons with early dementia and youth volunteers. A pre- and post- one group design was adopted. Forty-nine elderly participants with early dementia and 117 youth volunteers participated in the study. Each elderly participant was assigned to two youth participants. This dyad group participated in a 12-session reminiscence programme. The youth participants acted as facilitators to prompt the elderly participants to share and discuss past events and experiences, and to support them to fabricate a personalized life-story book. An occupational therapist provided ongoing support and monitoring. The elderly participants were evaluated by the Chinese version of Mini-mental State Examination, Quality of Life-Alzheimer's Disease (QoL-AD), and Chinese version of Geriatric Depression Scale (CGDS) before and after the programme. Dementia Quiz (DQ), Rosenberg Self-Esteem Scale and a 20-item feedback questionnaire on the programme were used to evaluate the youth participants. Significant pre- and postprogramme differences were found for QoL-AD (mean change = -1.91; 95% CI = -3.18, -0.64) and CGDS (mean change = 1.86; 95% CI = 0.92, 2.80) among the elderly participants, and for DQ (mean change = -1.14; 95% CI = -2.11, -0.17) among the youth participants. Volunteers also showed positive appreciation of older persons and opined that this community service provided them an opportunity to reflect on their relationship with elderly relatives. Some volunteers, however, commented the heavy workload of the reminiscence programme. The intergenerational reminiscence programme suggests mutually beneficial values for both groups of participants. Whilst it is feasible to involve trained volunteers in the implementation of dementia-related programmes, it is essential that they are adequately trained and that ongoing support and monitoring are provided.

  18. The AMCP Format for Formulary Submissions: Welcome to Version 4.0.

    PubMed

    2016-05-01

    Managed care pharmacists are increasingly presented with complex considerations related to prescription drug formulary management. As prescription drug spending soars, and new effective, but expensive drugs rush to the market, pharmacists and other health care decision makers must evaluate a myriad of important clinical and economic considerations in determining the relative value and, subsequently, the appropriate placement of a product within a formulary. The AMCP Format for Formulary Submissions, Version 4.0, is the next iteration of the Format, which was first released in 2000. Version 4.0, developed by pharmacists from health plan, manufacturer, and academic perspectives, provides updated recommendations on acquiring and evaluating clinical and economic evidence to inform formulary and medical policy decisions. It also includes new guidance related to emerging special topic considerations such as biosimilars, specialty pharmacy products, and companion diagnostic tests. Version 4.0 has been modified to improve the usability of the Format, with clarifying guidance related to logistical considerations such as a recommended time frame for implementation of Version 4.0, as well as dossier updates and ongoing communication between manufacturers and health care decision makers. The Format should be used as a framework for ongoing evidence-based dialogue between manufacturers and payers. The evolving health care landscape will require new levels of collaboration and communication among key stakeholders to successfully navigate the challenges of this new environment. The Format provides a framework to support these critical interactions related to product value by facilitating an evidence-based, transparent approach. This document was prepared by Jeff Lee, PharmD, FCCP, on behalf of the AMCP Format Executive Committee. Committee members reviewed and provided feedback on the final draft. No conflicts of interest, financial or otherwise, were reported.

  19. A Study of Policy for Providing Feedback to Students on College English

    ERIC Educational Resources Information Center

    Chen, Liping

    2009-01-01

    Feedback is central to the development of effective learning in college English. This article presents a study on feedback to students on college English. The purpose of providing feedback to the students is to help teachers and students to identify their strengths and weaknesses. The author offers different kinds of feedback in her teaching.…

  20. New Directions in Formative Feedback in Interactive Learning Environments

    ERIC Educational Resources Information Center

    Goldin, Ilya; Narciss, Susanne; Foltz, Peter; Bauer, Malcolm

    2017-01-01

    Formative feedback is well known as a key factor in influencing learning. Modern interactive learning environments provide a broad range of ways to provide feedback to students as well as new tools to understand feedback and its relation to various learning outcomes. This issue focuses on the role of formative feedback through a lens of how…

  1. Improved obstetric safety through programmatic collaboration.

    PubMed

    Goffman, Dena; Brodman, Michael; Friedman, Arnold J; Minkoff, Howard; Merkatz, Irwin R

    2014-01-01

    Healthcare safety and quality are critically important issues in obstetrics, and society, healthcare providers, patients and insurers share a common goal of working toward safer practice, and are continuously seeking strategies to facilitate improvements. To this end, 4 New York City voluntary hospitals with large maternity services initiated a unique collaborative quality improvement program. It was facilitated by their common risk management advisors, FOJP Service Corporation, and their professional liability insurer, Hospitals Insurance Company. Under the guidance of 4 obstetrics and gynecology departmental chairmen, consensus best practices for obstetrics were developed which included: implementation of evidence based protocols with audit and feedback; standardized educational interventions; mandatory electronic fetal monitoring training; and enhanced in-house physician coverage. Each institution developed unique safety related expertise (development of electronic documentation, team training, and simulation education), and experiences were shared across the collaborative. The collaborative group developed robust systems for audit of outcomes and documentation quality, as well as enforcement mechanisms. Ongoing feedback to providers served as a key component of the intervention. The liability carrier provided financial support for these patient safety innovations. As a result of the interventions, the overall AOI for our institutions decreased 42% from baseline (January-June 2008) to the most recently reviewed time period (July-December 2011) (10.7% vs 6.2%, p < 0.001). The Weighted Adverse Outcome Score (WAOS) also decreased during the same time period (3.9 vs 2.3, p = 0.001.) Given the improved outcomes noted, our unique program and the process by which it was developed are described in the hopes that others will recognize collaborative partnering with or without insurers as an opportunity to improve obstetric patient safety. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

  2. Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

    PubMed

    Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

    2013-10-01

    Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

  3. Satellite Observed Changes in the Arctic

    NASA Technical Reports Server (NTRS)

    Comiso, Josefino C.; Parkinson, Claire L.

    2004-01-01

    The Arctic is currently considered an area in transformation. Glaciers have been retreating, permafrost has been diminishing, snow covered areas have been decreasing, and sea ice and ice sheets have been thinning. This paper provides an overview of the unique role that satellite sensors have contributed in the detection of changes in the Arctic and demonstrates that many of the changes are not just local but a pan-Arctic phenomenon. Changes from the upper atmosphere to the surface are discussed and it is apparent that the magnitude of the trends tends to vary from region to region and from season to season. Previous reports of a warming Arctic and a retreating perennial ice cover have also been updated, and results show that changes are ongoing. Feedback effects that can lead to amplification of the signals and the role of satellite data in enhancing global circulation models are also discussed.

  4. Gender identity in disorders of sex development: review article.

    PubMed

    Yang, Jennifer H; Baskin, Laurence S; DiSandro, Michael

    2010-01-01

    Many concerns have been raised regarding the treatment and long-term outcome of infants born with complex genital anomalies. Debate among clinicians, psychologists, ethicists, and patient advocate groups regarding the optimal management of these individuals is ongoing. Although determining the most appropriate gender is a difficult task, this review will help clarify some of the issues at hand. A literature review which addresses the challenges of advising families about gender identity in infants and children with disorders of sex development. The evidence for endocrine effects on neurobiological development with regard to sexual behavior is compelling, although the existing outcome studies are largely anecdotal and somewhat contradictory. Gender assignment in infants born with a disorder of sex development remains only one of the many difficult decisions faced by both the treatment team and the family. Improved long-term follow-up of these patients will provide much needed feedback on previous and contemporary management. 2010 Elsevier Inc. All rights reserved.

  5. The Leadership Lab for Women: Advancing and Retaining Women in STEM through Professional Development.

    PubMed

    Van Oosten, Ellen B; Buse, Kathleen; Bilimoria, Diana

    2017-01-01

    Innovative professional development approaches are needed to address the ongoing lack of women leaders in science, technology, engineering, and math (STEM) careers. Developed from the research on women who persist in engineering and computing professions and essential elements of women's leadership development, the Leadership Lab for Women in STEM Program was launched in 2014. The Leadership Lab was created as a research-based leadership development program, offering 360-degree feedback, coaching, and practical strategies aimed at increasing the advancement and retention of women in the STEM professions. The goal is to provide women with knowledge, tools and a supportive learning environment to help them navigate, achieve, flourish, and catalyze organizational change in male-dominated and technology-driven organizations. This article describes the importance of creating unique development experiences for women in STEM fields, the genesis of the Leadership Lab, the design and content of the program, and the outcomes for the participants.

  6. Refining the structure and content of clinical genomic reports.

    PubMed

    Dorschner, Michael O; Amendola, Laura M; Shirts, Brian H; Kiedrowski, Lesli; Salama, Joseph; Gordon, Adam S; Fullerton, Stephanie M; Tarczy-Hornoch, Peter; Byers, Peter H; Jarvik, Gail P

    2014-03-01

    To effectively articulate the results of exome and genome sequencing we refined the structure and content of molecular test reports. To communicate results of a randomized control trial aimed at the evaluation of exome sequencing for clinical medicine, we developed a structured narrative report. With feedback from genetics and non-genetics professionals, we developed separate indication-specific and incidental findings reports. Standard test report elements were supplemented with research study-specific language, which highlighted the limitations of exome sequencing and provided detailed, structured results, and interpretations. The report format we developed to communicate research results can easily be transformed for clinical use by removal of research-specific statements and disclaimers. The development of clinical reports for exome sequencing has shown that accurate and open communication between the clinician and laboratory is ideally an ongoing process to address the increasing complexity of molecular genetic testing. © 2014 Wiley Periodicals, Inc.

  7. Reflective dialogue in clinical supervision: A pilot study involving collaborative review of supervision videos.

    PubMed

    Hill, Hamish R M; Crowe, Trevor P; Gonsalvez, Craig J

    2016-01-01

    To pilot an intervention involving reflective dialogue based on video recordings of clinical supervision. Fourteen participants (seven psychotherapists and their supervisors) completed a reflective practice protocol after viewing a video of their most recent supervision session, then shared their reflections in a second session. Thematic analysis of individual reflections and feedback resulted in the following dominant themes: (1) Increased discussion of supervisee anxiety and the tensions between autonomy and dependence; (2) intentions to alter supervisory roles and practice; (3) identification of and reflection on parallel process (defined as the dynamic transmission of relationship patterns between therapy and supervision); and (4) a range of perceived impacts including improvements in supervisory alliance. The results suggest that reflective dialogue based on supervision videos can play a useful role in psychotherapy supervision, including with relatively inexperienced supervisees. Suggestions are provided for the encouragement of ongoing reflective dialogue in routine supervision practice.

  8. Despite liability climate, clinicians predict an IUD comeback.

    PubMed

    1986-12-01

    Based on demand by clinicians, women, and and organizations like Planned Parenthood and the American Public Health Association, as well as ongoing work by researchers, it appears that the IUD will come back on the market in the U.S. Since one of the legal objections to IUDs was the claim that the tail may damage the cervical mucosa or provide a path for disease agents, some new IUDs have no tails. H.J. Tatum, developer of the copper Tatum-T IUD, is working on a tailless IUD with a magnetic core so that it can be located by electronic instruments for checkup or removal. The removal device is a pistol like instrument with sensors, grasping elements and feedback to a video screen. Although removal is a complex technical feat, it can be done within as little as 4 sec. with practice. Another approach to bring IUDs back is to smooth out liability litigation, possibly by government controls.

  9. The Sixth Omega Laser Facility Users Group Workshop

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Petrasso, R. D.

    A capacity gathering of over 100 researchers from 25 universities and laboratories met at the Laboratory for Laser Energetics (LLE) for the Sixth Omega Laser Facility Users Group (OLUG) workshop. The purpose of the 2.5-day workshop was to facilitate communications and exchanges among individual OMEGA users, and between users and the LLE management; to present ongoing and proposed research; to encourage research opportunities and collaborations that could be undertaken at the Omega Laser Facility and in a complementary fashion at other facilities [such as the National Ignition Facility (NIF) or the Laboratoire pour l’Utilisation des Lasers Intenses (LULI)]; to providemore » an opportunity for students, postdoctoral fellows, and young researchers to present their research in an informal setting; and to provide feedback from the users to LLE management about ways to improve and keep the facility and future experimental campaigns at the cutting edge.« less

  10. The Fifth Omega Laser Facility Users Group Workshop

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Petrasso, R. D.

    A capacity gathering of over 100 researchers from 25 universities and laboratories met at the Laboratory for Laser Energetics (LLE) for the Fifth Omega Laser Facility Users Group (OLUG) workshop. The purpose of the 2.5-day workshop was to facilitate communications and exchanges among individual Omega users and between users and the LLE management; to present ongoing and proposed research; to encourage research opportunities and collaborations that could be undertaken at the Omega Laser Facility and in a complementary fashion at other facilities [such as the National Ignition Facility (NIF) or the Laboratoire pour l’Utilisation des Lasers Intenses (LULI)]; to providemore » an opportunity for students, postdoctoral fellows, and young researchers to present their research in an informal setting; and to provide feedback to LLE management from the users about ways to improve the facility and future experimental campaigns.« less

  11. Refining the Structure and Content of Clinical Genomic Reports

    PubMed Central

    DORSCHNER, MICHAEL O.; AMENDOLA, LAURA M.; SHIRTS, BRIAN H.; KIEDROWSKI, LESLI; SALAMA, JOSEPH; GORDON, ADAM S.; FULLERTON, STEPHANIE M.; TARCZY-HORNOCH, PETER; BYERS, PETER H.; JARVIK, GAIL P.

    2014-01-01

    To effectively articulate the results of exome and genome sequencing we refined the structure and content of molecular test reports. To communicate results of a randomized control trial aimed at the evaluation of exome sequencing for clinical medicine, we developed a structured narrative report. With feedback from genetics and non-genetics professionals, we developed separate indication-specific and incidental findings reports. Standard test report elements were supplemented with research study-specific language, which highlighted the limitations of exome sequencing and provided detailed, structured results, and interpretations. The report format we developed to communicate research results can easily be transformed for clinical use by removal of research-specific statements and disclaimers. The development of clinical reports for exome sequencing has shown that accurate and open communication between the clinician and laboratory is ideally an ongoing process to address the increasing complexity of molecular genetic testing. PMID:24616401

  12. A one-year practice-based learning programme for new general practice nurses in Scotland: evaluation of the pilot.

    PubMed

    Wakeling, Judy; Ferguson, Julie; Kennedy, Susan

    2016-01-01

    This paper summarises the evaluation of a pilot programme introduced by NHS Education for Scotland to provide education and skills training for nurses new to general practice. The programme was developed through extensive consultation with existing general practice nurses and was educationally accredited by the Royal College of General Practitioners and the Royal College of Nursing in 2013. Twelve nurses embarked upon the programme 2012-2013 and nine completed it. The programme was extensively evaluated through questionnaires (with supervisors, practice staff and participants), analysis of programme documentation and interviews with participants. Based on the evaluation feedback, alterations have been made to subsequent deliveries of the programme. These include removing some topic areas and lengthening the programme by three months. The programme continues to be successfully delivered and evaluation is ongoing to ensure it continues to meet nurses' needs.

  13. Studying health information from a distance: refining an e-learning case study in the crucible of student evaluation.

    PubMed

    Booth, Andrew; Levy, Philippa; Bath, Peter A; Lacey, Terence; Sanderson, Mark; Diercks-O'Brien, Gabi

    2005-12-01

    To present a formative evaluation of the impact of a multimedia case study as a component of a masters course in health informatics delivered by distance learning. First and second year health informatics students undertaking four core modules of a masters programme at the University of Sheffield. Individual qualitative user surveys and interviews. Formative evaluation has played a significant role in refining the case study through its text-based, intermediate and CD-ROM based stages. Feedback from students has resulted in clarification of case study tasks, clearer definition of teaching roles and a revised approach to assessment. At the same time it has highlighted the importance of ongoing revision and maintenance in keeping the scenarios realistic and current. The multimedia case study has met many of its original aims in providing greater cohesion for core modules and encouraging greater levels of interaction and multidisciplinary collaboration.

  14. Testing Quick Response (QR) Codes as an Innovation to Improve Feedback Among Geographically-Separated Clerkship Sites.

    PubMed

    Snyder, Matthew J; Nguyen, Dana R; Womack, Jasmyne J; Bunt, Christopher W; Westerfield, Katie L; Bell, Adriane E; Ledford, Christy J W

    2018-03-01

    Collection of feedback regarding medical student clinical experiences for formative or summative purposes remains a challenge across clinical settings. The purpose of this study was to determine whether the use of a quick response (QR) code-linked online feedback form improves the frequency and efficiency of rater feedback. In 2016, we compared paper-based feedback forms, an online feedback form, and a QR code-linked online feedback form at 15 family medicine clerkship sites across the United States. Outcome measures included usability, number of feedback submissions per student, number of unique raters providing feedback, and timeliness of feedback provided to the clerkship director. The feedback method was significantly associated with usability, with QR code scoring the highest, and paper second. Accessing feedback via QR code was associated with the shortest time to prepare feedback. Across four rotations, separate repeated measures analyses of variance showed no effect of feedback system on the number of submissions per student or the number of unique raters. The results of this study demonstrate that preceptors in the family medicine clerkship rate QR code-linked feedback as a high usability platform. Additionally, this platform resulted in faster form completion than paper or online forms. An overarching finding of this study is that feedback forms must be portable and easily accessible. Potential implementation barriers and the social norm for providing feedback in this manner need to be considered.

  15. The effect of multimodal and enriched feedback on SMR-BCI performance.

    PubMed

    Sollfrank, T; Ramsay, A; Perdikis, S; Williamson, J; Murray-Smith, R; Leeb, R; Millán, J D R; Kübler, A

    2016-01-01

    This study investigated the effect of multimodal (visual and auditory) continuous feedback with information about the uncertainty of the input signal on motor imagery based BCI performance. A liquid floating through a visualization of a funnel (funnel feedback) provided enriched visual or enriched multimodal feedback. In a between subject design 30 healthy SMR-BCI naive participants were provided with either conventional bar feedback (CB), or visual funnel feedback (UF), or multimodal (visual and auditory) funnel feedback (MF). Subjects were required to imagine left and right hand movement and were trained to control the SMR based BCI for five sessions on separate days. Feedback accuracy varied largely between participants. The MF feedback lead to a significantly better performance in session 1 as compared to the CB feedback and could significantly enhance motivation and minimize frustration in BCI use across the five training sessions. The present study demonstrates that the BCI funnel feedback allows participants to modulate sensorimotor EEG rhythms. Participants were able to control the BCI with the funnel feedback with better performance during the initial session and less frustration compared to the CB feedback. The multimodal funnel feedback provides an alternative to the conventional cursorbar feedback for training subjects to modulate their sensorimotor rhythms. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Experience in action: Moderating care in web-based patient feedback.

    PubMed

    Ziewitz, Malte

    2017-02-01

    What does it take to mobilise experiences of care and make them useful for improving services? This article draws on ethnographic fieldwork with a UK-based patient feedback website to develop a critical perspective on patient experience as a contingent accomplishment and a focal point for eliciting, provoking, and respecifying relations of accountability. Following a single posting from the moderation room back to the author and into the wards and offices of the hospital, I show how moderators, carers, and clinical staff respond to and act upon a seemingly stable experience. Drawing on recent work in science studies and ethnomethodology, I suggest that the work of 'capturing the patient experience' is not so much a matter of accurate reporting or incontestable opining, but an exercise in testing versions of reality through the ongoing respecification of objects, audiences, and identities. Attending to the mundane practices of moderating accounts of care highlights the work of ordering alongside technologies of evaluation - the largely invisible labour that sustains the possibility of public patient feedback in the first place. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. “Homework Feedback Is…”: Elementary and Middle School Teachers’ Conceptions of Homework Feedback

    PubMed Central

    Cunha, Jennifer; Rosário, Pedro; Núñez, José Carlos; Nunes, Ana Rita; Moreira, Tânia; Nunes, Tânia

    2018-01-01

    This study explored mathematics teachers’ conceptions of the homework feedback focusing on four key aspects: definition, purpose, types, and perceived impact. Forty-seven teachers from elementary and middle schools participated in six focus groups. Data were analyzed using content analysis. To enhance the trustworthiness of findings, classroom observations were used for triangulation of data. Participants conceptualized homework feedback in three directions (i.e., teachers’ feedback provided to students, students’ feedback provided to teachers, and homework self-feedback), being teachers’ monitoring of students’ learning the purpose reported by most teachers. Participants also reported the types of homework feedback more frequently used in class (e.g., checking homework completion, checking homework on the board), and their perceived impact on students. Findings provide valuable information to deepen the understanding of the homework feedback process, which may help develop new avenues for future research. PMID:29467687

  18. "Homework Feedback Is…": Elementary and Middle School Teachers' Conceptions of Homework Feedback.

    PubMed

    Cunha, Jennifer; Rosário, Pedro; Núñez, José Carlos; Nunes, Ana Rita; Moreira, Tânia; Nunes, Tânia

    2018-01-01

    This study explored mathematics teachers' conceptions of the homework feedback focusing on four key aspects: definition, purpose, types, and perceived impact. Forty-seven teachers from elementary and middle schools participated in six focus groups. Data were analyzed using content analysis. To enhance the trustworthiness of findings, classroom observations were used for triangulation of data. Participants conceptualized homework feedback in three directions (i.e., teachers' feedback provided to students, students' feedback provided to teachers, and homework self-feedback), being teachers' monitoring of students' learning the purpose reported by most teachers. Participants also reported the types of homework feedback more frequently used in class (e.g., checking homework completion, checking homework on the board), and their perceived impact on students. Findings provide valuable information to deepen the understanding of the homework feedback process, which may help develop new avenues for future research.

  19. Using Automated Assessment Feedback to Enhance the Quality of Student Learning in Universities: A Case Study

    NASA Astrophysics Data System (ADS)

    Biggam, John

    There are many different ways of providing university students with feedback on their assessment performance, ranging from written checklists and handwritten commentaries to individual verbal feedback. Regardless of whether the feedback is summative or formative in nature, it is widely recognized that providing consistent, meaningful written feedback to students on assessment performance is not a simple task, particularly where a module is delivered by a team of staff. Typical student complaints about such feedback include: inconsistency of comment between lecturers; illegible handwriting; difficulty in relating feedback to assessment criteria; and vague remarks. For staff themselves, there is the problem that written comments, to be of any benefit to students, are immensely time-consuming. This paper illustrates, through a case study, the enormous benefits of Automated Assessment Feedback for staff and students. A clear strategy on how to develop an automated assessment feedback system, using the simplest of technologies, is provided.

  20. Operation of Reliability Analysis Center (FY88)

    DTIC Science & Technology

    1989-10-01

    4.1 Current Projects 16 4.2 Completed Projects 22 6.0 FINANCIAL SUMMARY FY󈨜 23 7.0 INFORMATION FROM IAC USERS 24 7.1 User Feedback on IAC Services...22 6.0 FINANCIAL SUMMARY FY󈨜 Operating expenditures for carrying out the Reliability Analysis Center’s on-going operational functions and satisfying...Because the RAC does n~ot stand to benefit from either a favorable or unfavorable appraisal of any contractors design, an unbiased analysis can result

  1. Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention.

    PubMed

    Fraser, Kimberly D; O'Rourke, Hannah M; Baylon, Melba Andrea B; Boström, Anne-Marie; Sales, Anne E

    2013-02-13

    Audit with feedback is a moderately effective approach for improving professional practice in other health care settings. Although unregulated caregivers give the majority of direct care in long-term care settings, little is known about how they understand and perceive feedback reports because unregulated providers have not been directly targeted to receive audit with feedback in quality improvement interventions in long-term care. The purpose of this paper is to describe unregulated care providers' perceptions of usefulness of a feedback report in four Canadian long-term care facilities. We delivered monthly feedback reports to unregulated care providers for 13 months in 2009-2010. The feedback reports described a unit's performance in relation to falls, depression, and pain as compared to eight other units in the study. Follow-up surveys captured participant perceptions of the feedback report. We conducted descriptive analyses of the variables related to participant perceptions and multivariable logistic regression to assess the association between perceived usefulness of the feedback report and a set of independent variables. The vast majority (80%) of unregulated care providers (n = 171) who responded said they understood the reports. Those who discussed the report with others and were interested in other forms of data were more likely to find the feedback report useful for making changes in resident care. This work suggests that unregulated care providers can understand and feel positively about using audit with feedback reports to make changes to resident care. Further research should explore ways to promote fuller engagement of unregulated care providers in decision-making to improve quality of care in long-term care settings.

  2. Real-time augmented feedback benefits robotic laparoscopic training.

    PubMed

    Judkins, Timothy N; Oleynikov, Dmitry; Stergiou, Nick

    2006-01-01

    Robotic laparoscopic surgery has revolutionized minimally invasive surgery for treatment of abdominal pathologies. However, current training techniques rely on subjective evaluation. There is a lack of research on the type of tasks that should be used for training. Robotic surgical systems also do not currently have the ability to provide feedback to the surgeon regarding success of performing tasks. We trained medical students on three laparoscopic tasks and provided real-time feedback of performance during training. We found that real-time feedback can benefit training if the feedback provides information that is not available through other means (grip force). Subjects that received grip force feedback applied less force when the feedback was removed. Other forms of feedback (speed and relative phase) did not aid or impede training. Secondly, a relatively short training period (10 trials for each task) significantly improved most objective measures of performance. We also showed that robotic surgical performance can be quantitatively measured and evaluated. Providing grip force feedback can make the surgeon more aware of the forces being applied to delicate tissue during surgery.

  3. Uncovering the spatially distant feedback loops of global trade: A network and input-output approach.

    PubMed

    Prell, Christina; Sun, Laixiang; Feng, Kuishuang; He, Jiaying; Hubacek, Klaus

    2017-05-15

    Land-use change is increasingly driven by global trade. The term "telecoupling" has been gaining ground as a means to describe how human actions in one part of the world can have spatially distant impacts on land and land-use in another. These interactions can, over time, create both direct and spatially distant feedback loops, in which human activity and land use mutually impact one another over great expanses. In this paper, we develop an analytical framework to clarify spatially distant feedbacks in the case of land use and global trade. We use an innovative mix of multi-regional input-output (MRIO) analysis and stochastic actor-oriented models (SAOMs) for analyzing the co-evolution of changes in trade network patterns with those of land use, as embodied in trade. Our results indicate that the formation of trade ties and changes in embodied land use mutually impact one another, and further, that these changes are linked to disparities in countries' wealth. Through identifying this feedback loop, our results support ongoing discussions about the unequal trade patterns between rich and poor countries that result in uneven distributions of negative environmental impacts. Finally, evidence for this feedback loop is present even when controlling for a number of underlying mechanisms, such as countries' land endowments, their geographical distance from one another, and a number of endogenous network tendencies. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit.

    PubMed

    Vratsistas-Curto, Angela; McCluskey, Annie; Schurr, Karl

    2017-01-01

    The audit-feedback cycle is a behaviour change intervention used to reduce evidence-practice gaps. In this study, repeat audits, feedback, education and training were used to change practice and increase compliance with Australian guideline recommendations for stroke rehabilitation. To increase the proportion of patients with stroke receiving best practice screening, assessment and treatment. A before-and-after study design was used. Data were collected from medical records (n=15 files per audit). Four audits were conducted between 2009 and 2013. Consecutive files of patients with stroke admitted to the stroke unit were selected and audited retrospectively. Staff behaviour change interventions included four cycles of audit feedback, and education to assist staff with change. The primary outcome measure was the proportion of eligible patients receiving best practice against target behaviours, based on audit data. Between the first and fourth audit (2009 and 2013), 20 of the 27 areas targeted (74%) met or exceeded the minimum target of 10% change. Practice areas that showed the most change included sensation screening (+75%) and rehabilitation (+100%); neglect screening (+92%) and assessment (100%). Some target behaviours showed a drop in compliance such as anxiety and depression screening (-27%) or little or no overall improvement such as patient education about stroke (6% change). Audit feedback and education increased the proportion of inpatients with stroke receiving best practice rehabilitation in some, but not all practice areas. An ongoing process of quality improvement is needed to help sustain these improvements.

  5. Flipped Learning, MOOCs and Learning Analytics: Lessons learnt from a Web Map Design course redesign

    NASA Astrophysics Data System (ADS)

    Treves, R.

    2013-12-01

    Five weeks content of a 12 week course in web map design were converted to 'flipped learning': Lecture sessions were replaced by online short video lectures and multiple choice questions to be completed outside class. Class time was taken up with activities and exercises linked to the online learning. Students use of the online content was carefully tracked and detailed student feedback gathered. The response from students was good, 90% of them completed all the out of class activities and their feedback was very positive. The format has the advantage of being easily repurposed as a MOOC or scaled up in other ways. Lessons learnt from the implementation of the materials and the analysis of the VLE logs will be discussed as will ongoing efforts to reuse the materials in a MOOC.

  6. Proceedings of the NASA First Wake Vortex Dynamic Spacing Workshop

    NASA Technical Reports Server (NTRS)

    Creduer, Leonard (Editor); Perry, R. Brad (Editor)

    1997-01-01

    A Government and Industry workshop on wake vortex dynamic spacing systems was conducted on May 13-15, 1997, at the NASA Langley Research Center. The purpose of the workshop was to disclose the status of ongoing NASA wake vortex R&D to the international community and to seek feedback on the direction of future work to assure an optimized research approach. Workshop sessions examined wake vortex characterization and physics, wake sensor technologies, aircraft/wake encounters, terminal area weather characterization and prediction, and wake vortex systems integration and implementation. A final workshop session surveyed the Government and Industry perspectives on the NASA research underway and related international wake vortex activities. This document contains the proceedings of the workshop including the presenters' slides, the discussion following each presentation, the wrap-up panel discussion, and the attendees' evaluation feedback.

  7. Delivering Faster Congestion Feedback with the Mark-Front Strategy

    NASA Technical Reports Server (NTRS)

    Liu, Chunlei; Jain, Raj

    2001-01-01

    Computer networks use congestion feedback from the routers and destinations to control the transmission load. Delivering timely congestion feedback is essential to the performance of networks. Reaction to the congestion can be more effective if faster feedback is provided. Current TCP/IP networks use timeout, duplicate Acknowledgement Packets (ACKs) and explicit congestion notification (ECN) to deliver the congestion feedback, each provides a faster feedback than the previous method. In this paper, we propose a markfront strategy that delivers an even faster congestion feedback. With analytical and simulation results, we show that mark-front strategy reduces buffer size requirement, improves link efficiency and provides better fairness among users. Keywords: Explicit Congestion Notification, mark-front, congestion control, buffer size requirement, fairness.

  8. Feedback to semi-professional counselors in treating child aggression.

    PubMed

    Shechtman, Zipora; Tutian, Rony

    2017-05-01

    To investigate the impact of outcome feedback provided to semi-professional counselors of children and adolescents at risk for aggressive behavior, following group treatment. Participants included 230 aggressive children and adolescents and 64 educators in a quasi-experimental design of 3 conditions: experimental group with feedback, experimental group without feedback, and control group (no treatment). The current study employed a feedback system based on self-report aggression scores measured after each session, provided to teachers, including an alert system and weekly follow-up group support. Outcomes were more favorable for the treatment children than the control group, but feedback had no impact on the results. Outcome feedback provided to group therapists does not have an effect on children and adolescents' reduction of aggression. Further research is needed to identify possible reasons for failure to show feedback effect.

  9. Improving the Acquisition of Basic Technical Surgical Skills with VR-Based Simulation Coupled with Computer-Based Video Instruction.

    PubMed

    Rojas, David; Kapralos, Bill; Dubrowski, Adam

    2016-01-01

    Next to practice, feedback is the most important variable in skill acquisition. Feedback can vary in content and the way that it is used for delivery. Health professions education research has extensively examined the different effects provided by the different feedback methodologies. In this paper we compared two different types of knowledge of performance (KP) feedback. The first type was video-based KP feedback while the second type consisted of computer generated KP feedback. Results of this study showed that computer generated performance feedback is more effective than video based performance feedback. The combination of the two feedback methodologies provides trainees with a better understanding.

  10. Building a virtual network in a community health research training program.

    PubMed

    Lau, F; Hayward, R

    2000-01-01

    To describe the experiences, lessons, and implications of building a virtual network as part of a two-year community health research training program in a Canadian province. An action research field study in which 25 health professionals from 17 health regions participated in a seven-week training course on health policy, management, economics, research methods, data analysis, and computer technology. The participants then returned to their regions to apply the knowledge in different community health research projects. Ongoing faculty consultations and support were provided as needed. Each participant was given a notebook computer with the necessary software, Internet access, and technical support for two years, to access information resources, engage in group problem solving, share ideas and knowledge, and collaborate on projects. Data collected over two years consisted of program documents, records of interviews with participants and staff, meeting notes, computer usage statistics, automated online surveys, computer conference postings, program Web site, and course feedback. The analysis consisted of detailed review and comparison of the data from different sources. NUD*IST was then used to validate earlier study findings. The ten key lessons are that role clarity, technology vision, implementation staging, protected time, just-in-time training, ongoing facilitation, work integration, participatory design, relationship building, and the demonstration of results are essential ingredients for building a successful network. This study provides a descriptive model of the processes involved in developing, in the community health setting, virtual networks that can be used as the basis for future research and as a practical guide for managers.

  11. Implementing the Patient-Centered Medical Home: Observation and Description of the National Demonstration Project

    PubMed Central

    Stewart, Elizabeth E.; Nutting, Paul A.; Crabtree, Benjamin F.; Stange, Kurt C.; Miller, William L.; Jaén, Carlos Roberto

    2010-01-01

    PURPOSE We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. METHODS An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). RESULTS The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. CONCLUSIONS The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning. PMID:20530392

  12. Comparison of combat and non-combat burns from ongoing U.S. military operations.

    PubMed

    Kauvar, David S; Cancio, Leopoldo C; Wolf, Steven E; Wade, Charles E; Holcomb, John B

    2006-05-15

    Military burns result from either combat or non-combat causes. We compared these etiologies from patients involved in ongoing conflicts to evaluate their impact and provide prevention recommendations. All military patients with significant burns treated at the United States Army Institute of Surgical Research from April 2003 to May 2005 were reviewed. Injuries were categorized as having resulted from combat or non-combat causes. Demographics, burn severity and pattern, mortality, and early outcomes were compared. There were 273 burn patients seen with 63% injured in combat. A high early rate of non-combat injuries was noted. Feedback on non-combat burn prevention was provided to the combat theater, and the incidence of non-combat burns decreased. Mean age and time from injury to admission did not differ. The majority of combat injuries resulted from explosive device detonation. Waste burning, ammunition handling, and gasoline caused most non-combat injuries. Combat casualties had more associated and inhalation injuries and greater full-thickness burn size; total body surface area burned was equivalent. The hands and the face were the most frequently burned body areas. Mortality was 5% in combat and 2% in non-combat patients. The majority of survivors in both groups returned to military duty. The disparity in full-thickness burn size and incidence of inhalation and associated injuries resulted from differing mechanisms of injury, with explosions and penetrating trauma more common in combat wounds. Despite the severity of combat burns, mortality was low and outcomes generally good. Non-combat burns are preventable and have decreased in incidence.

  13. Implementing the patient-centered medical home: observation and description of the national demonstration project.

    PubMed

    Stewart, Elizabeth E; Nutting, Paul A; Crabtree, Benjamin F; Stange, Kurt C; Miller, William L; Jaén, Carlos Roberto

    2010-01-01

    We provide an overall description of the National Demonstration Project (NDP) intervention to transform family practices into patient-centered medical homes. An independent evaluation team used multiple data sources and methods to describe the design and implementation of the NDP. These included direct observation of the implementation team and project meetings, site visits to practices, depth interviews with practice members and implementation team members, access to practice communications (eg, telephone calls, e-mails), and public domain materials (eg, the NDP Web site). The American Academy of Family Physicians created a new division called TransforMED, which launched the 24-month NDP in June 2006. From 337 family medicine practices completing an extensive online application, 36 were selected and randomized to a facilitated group, which received tailored, intensive assistance and services from TransforMED, or a self-directed group, which received very limited assistance. Three facilitators from diverse backgrounds in finance, practice management, and organizational psychology used multiple practice change strategies including site visits, e-mails, metrics, and learning sessions. The self-directed practices worked primarily on their own, but self-organized a retreat midway through the project. The intervention model for the project evolved to be consistent with the emerging national consensus principles of the patient-centered medical home. The independent evaluation team studied the NDP and provided ongoing feedback to inform the implementation process. The NDP illustrates that complex practice change interventions must combine flexibility in the intervention model, implementation strategy, and the evaluation, in order to maximize ongoing learning.

  14. Assessing the Impact of a Community-Based Health and Nutrition Education on the Management of Diarrhea in an Urban District, Cairo, Egypt

    PubMed Central

    Abdel-Aziz, Shaimaa B.; Mowafy, Maha A.; Galal, Yasmine S.

    2016-01-01

    Diarrhea is considered as a major cause of mortality in children aged less than five years old. This pre/post interventional study was designed to assess maternal knowledge about diarrhea and implement a community-based health and nutrition education messages. The study was held in Al-Darb Al-Ahamar (ADAA) district, Cairo, Egypt and targeted a random sample of 600 mothers having at least one child under-five years old and complained of at least one previous attack of diarrhea. The study was conducted in three phases. The pre-intervention phase included a base line survey for the mothers and training activities for the community health workers (CHWs). Intervention phase included health and nutrition education sessions; performance evaluation for the CHWs during providing the message. In phase three, the mothers had no instructions for 3 months then the post- intervention interview and feedback sessions were conducted. Results showed that knowledge of mothers about diarrhea (etiological factors and preventive measures) had improved significantly after the intervention. During observation CHWs’ scored 50% of the required tasks in education and communication skills. In the feedback sessions, all the mothers declared that nutrition education sessions were highly valuable, and asked for on-going support and training programs. The current study found that health and nutrition education sessions were successful in improving mothers’ knowledge regarding preventive measures and management of diarrhea. CHWs are effective health education providers especially in household based intervention. Thus, health services should support community based interventions to reinforce mothers’ knowledge and practices towards their sick children. PMID:26383210

  15. Intensive communication skills teaching for specialist training in palliative medicine: development and evaluation of an experiential workshop.

    PubMed

    Clayton, Josephine M; Adler, Jonathan L; O'Callaghan, Anne; Martin, Peter; Hynson, Jenny; Butow, Phyllis N; Laidsaar-Powell, Rebekah C; Arnold, Robert M; Tulsky, James A; Back, Anthony L

    2012-05-01

    The Australasian Chapter of the Palliative Medicine (AChPM) Curriculum Development Group identified communication as a core skill that trainees in palliative medicine need to acquire, and proposed the development of a communication skills workshop that should become a compulsory part of training to achieve accreditation as a palliative medicine specialist in Australia and New Zealand. This paper describes the development and subsequent evaluation of this module. A three-day communication workshop was developed in collaboration with expert communication skills facilitators from the United States and Australia. The teaching consists of: (1) brief plenary presentations providing an evidence-based framework for communication and a demonstration of suggested strategies; (2) small group experiential learning providing opportunities to practice communication skills with clinically relevant simulated patients, self-appraisal, constructive feedback, and reflective exercises; and (3) accompanying course-specific written material. Participants completed de-identified questionnaires before, after, and three months following completion of the workshop. Forty-one participants completed the training in two workshops held in 2008 and 2009. Participants said in their questionnaire responses that the training was useful, would be helpful for their communication with patients, and that they would recommend the training to others. Qualitative feedback was highly positive. Self-assessed confidence in communication skills significantly increased following the workshop (p<.001) and was sustained at three months (p<.001). The training is highly valued by participants and increases confidence in communication skills. Facilitator training and capacity planning will be critical for the ongoing success of the communication workshop.

  16. The results of a survey highlighting issues with feedback on medical training in the United Kingdom and how a Smartphone App could provide a solution.

    PubMed

    Gray, Thomas G; Hood, Gill; Farrell, Tom

    2015-11-06

    Feedback drives learning in medical education. Healthcare Supervision Logbook (HSL) is a Smartphone App developed at Sheffield Teaching Hospitals for providing feedback on medical training, from both a trainee's and a supervisor's perspective. In order to establish a mandate for the role of HSL in clinical practice, a large survey was carried out. Two surveys (one for doctors undertaking specialty training and a second for consultants supervising their training) were designed. The survey for doctors-in-training was distributed to all specialty trainees in the South and West localities of the Health Education Yorkshire and the Humber UK region. The survey for supervisors was distributed to all consultants involved in educational and clinical supervision of specialty trainees at Sheffield Teaching Hospitals. The results confirm that specialty trainees provide feedback on their training infrequently-66 % do so only annually. 96 % of the specialty trainees owned a Smartphone and 45 % said that they would be willing to use a Smartphone App to provide daily feedback on the clinical and educational supervision they receive. Consultant supervisors do not receive regular feedback on the educational and clinical supervision they provide to trainees-56 % said they never received such feedback and 33 % said it was only on an annual basis. 86 % of consultants surveyed owned a Smartphone and 41 % said they would be willing to use a Smartphone App to provide feedback on the performance of trainees they were supervising. Feedback on medical training is recorded by specialty trainees infrequently and consultants providing educational and clinical supervision often do not receive any feedback on their performance in this area. HSL is a simple, quick and efficient way to collect and collate feedback on medical training to improve this situation. Good support and education needs to be provided when implementing this new technology.

  17. The Effects of Feedback on Online Quizzes

    ERIC Educational Resources Information Center

    Butler, Melanie; Pyzdrowski, Laura; Goodykoontz, Adam; Walker, Vennessa

    2008-01-01

    Online homework is unable to provide the detailed feedback of paper and pencil assignments. However, immediate feedback is an advantage that online assessments provide. A research study was conducted that focused on the effects of immediate feedback; students in 5 sections of a Pre-calculus course were participants. Three sections were randomly…

  18. Exploring cultural differences in feedback processes and perceived instructiveness during clerkships: replicating a Dutch study in Indonesia.

    PubMed

    Suhoyo, Yoyo; van Hell, Elisabeth A; Prihatiningsih, Titi S; Kuks, Jan B M; Cohen-Schotanus, Janke

    2014-03-01

    Cultural differences between countries may entail differences in feedback processes. By replicating a Dutch study in Indonesia, we analysed whether differences in processes influenced the perceived instructiveness of feedback. Over a two-week period, Indonesian students (n = 215) recorded feedback moments during clerkships, noting who provided the feedback, whether the feedback was based on observations, who initiated the feedback, and its perceived instructiveness. Data were compared with the earlier Dutch study and analysed with χ(2) tests, t-tests and multilevel techniques. Cultural differences were explored using Hofstede's Model, with Indonesia and the Netherlands differing on "power distance" and "individualism." Perceived instructiveness of feedback did not differ significantly between both countries. However, significant differences were found in feedback provider, observation and initiative. Indonesian students perceived feedback as more instructive if provided by specialists and initiated jointly by the supervisor and student (βresidents = -0.201, p < 0.001 and βjoint = 0.193, p = 0.001). Dutch students appreciated feedback more when it was based on observation. We obtained empirical evidence that one model of feedback does not necessarily translate to another culture. Further research is necessary to unravel other possible influences of culture in implementing feedback procedures in different countries.

  19. Multisource feedback to graduate nurses: a multimethod study.

    PubMed

    McPhee, Samantha; Phillips, Nicole M; Ockerby, Cherene; Hutchinson, Alison M

    2017-11-01

    (1) To explore graduate nurses' perceptions of the influence of multisource feedback on their performance and (2) to explore perceptions of Clinical Nurse Educators involved in providing feedback regarding feasibility and benefit of the approach. Graduate registered nurses are expected to provide high-quality care for patients in demanding and unpredictable clinical environments. Receiving feedback is essential to their development. Performance appraisals are a common method used to provide feedback and typically involve a single source of feedback. Alternatively, multisource feedback allows the learner to gain insight into performance from a variety of perspectives. This study explores multisource feedback in an Australian setting within the graduate nurse context. Multimethod study. Eleven graduates were given structured performance feedback from four raters: Nurse Unit Manager, Clinical Nurse Educator, preceptor and a self-appraisal. Thirteen graduates received standard single-rater appraisals. Data regarding perceptions of feedback for both groups were obtained using a questionnaire. Semistructured interviews were conducted with nurses who received multisource feedback and the educators. In total, 94% (n = 15) of survey respondents perceived feedback was important during the graduate year. Four themes emerged from interviews: informal feedback, appropriateness of raters, elements of delivery and creating an appraisal process that is 'more real'. Multisource feedback was perceived as more beneficial compared to single-rater feedback. Educators saw value in multisource feedback; however, perceived barriers were engaging raters and collating feedback. Some evidence exists to indicate that feedback from multiple sources is valued by graduates. Further research in a larger sample and with more experienced nurses is required. Evidence resulting from this study indicates that multisource feedback is valued by both graduates and educators and informs graduates' development and transition into the role. Thus, a multisource approach to feedback for graduate nurses should be considered. © 2016 John Wiley & Sons Ltd.

  20. Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention

    PubMed Central

    2013-01-01

    Background Audit with feedback is a moderately effective approach for improving professional practice in other health care settings. Although unregulated caregivers give the majority of direct care in long-term care settings, little is known about how they understand and perceive feedback reports because unregulated providers have not been directly targeted to receive audit with feedback in quality improvement interventions in long-term care. The purpose of this paper is to describe unregulated care providers’ perceptions of usefulness of a feedback report in four Canadian long-term care facilities. Methods We delivered monthly feedback reports to unregulated care providers for 13 months in 2009–2010. The feedback reports described a unit’s performance in relation to falls, depression, and pain as compared to eight other units in the study. Follow-up surveys captured participant perceptions of the feedback report. We conducted descriptive analyses of the variables related to participant perceptions and multivariable logistic regression to assess the association between perceived usefulness of the feedback report and a set of independent variables. Results The vast majority (80%) of unregulated care providers (n = 171) who responded said they understood the reports. Those who discussed the report with others and were interested in other forms of data were more likely to find the feedback report useful for making changes in resident care. Conclusions This work suggests that unregulated care providers can understand and feel positively about using audit with feedback reports to make changes to resident care. Further research should explore ways to promote fuller engagement of unregulated care providers in decision-making to improve quality of care in long-term care settings. PMID:23402382

  1. A Prototype Exercise-Empowerment Mobile Video Game for Children With Cancer, and Its Usability Assessment: Developing Digital Empowerment Interventions for Pediatric Diseases.

    PubMed

    Bruggers, Carol S; Baranowski, Sabrina; Beseris, Mathew; Leonard, Rachel; Long, Derek; Schulte, Elizabeth; Shorter, Ashton; Stigner, Rowan; Mason, Clinton C; Bedrov, Alisa; Pascual, Ian; Bulaj, Grzegorz

    2018-01-01

    Medical advances continue to improve morbidity and mortality of serious pediatric diseases, including cancer, driving research addressing diminished physical and psychological quality of life in children with these chronic conditions. Empowerment enhances resilience and positively influences health, disease, and therapy understanding. We describe the development and usability assessment of a prototype Empower Stars! mobile video game grounded in behavioral and exercise theories with the purpose of coupling physical exercise with empowerment over disease in children with cancer. Academic faculty, health-care providers, and community video game developers collaborated in this project. The iPadAir was selected as a delivery platform for its accelerometer and gyroscope features facilitating exercise design. Unity multiplatform technology provided animation and audiovisual features for immediate player feedback. Javascript, C#, Photoshop, Flash, and SketchUp were used for coding, creating graphical assets, Sprite sheets, and printing files, respectively. 3D-printed handles and case backing were used to adapt the iPad for physical exercise. Game usability, engagement, and enjoyment were assessed via a multilevel study of children undergoing cancer chemotherapy, their parents, and pediatric cancer health-care providers. Feedback crucial for ongoing game development was analyzed. A prototype Empower Stars! mobile video game was developed for children 7-14 years old with cancer. Active, sedentary, educational, and empowerment-centered elements intermix for 20 min of exercise within a 30 min "one-day treatment" gameplay session involving superheroes, space exploration, metaphorical cancer challenges, life restoration on a barren planet, and innumerable star rewards. No player "dies." Usability assessment data analyses showed widespread enthusiasm for integrating exercise with empowerment over cancer and the game itself. Favorite elements included collecting star rewards and planet terraforming. Traveling in space and the Healthy Food Choice game were least liked. The need for improved gameplay instructions was expressed by all groups. The usability study provided essential feedback for converting the prototype into alpha version of Empower Stars! Adapting exercise empowerment-promoting video game technology to mobile platforms facilitates usability and widespread dissemination for children with cancer. We discuss broader therapeutic applicability in diverse chronic pediatric diseases, including obesity, asthma, cystic fibrosis, diabetes, and juvenile idiopathic arthritis.

  2. Trainees' Perceptions of Feedback: Validity Evidence for Two FEEDME (Feedback in Medical Education) Instruments.

    PubMed

    Bing-You, Robert; Ramesh, Saradha; Hayes, Victoria; Varaklis, Kalli; Ward, Denham; Blanco, Maria

    2018-01-01

    Construct: Medical educators consider feedback a core component of the educational process. Effective feedback allows learners to acquire new skills, knowledge, and attitudes. Learners' perceptions of feedback are an important aspect to assess with valid methods in order to improve the feedback skills of educators and the feedback culture. Although guidelines for delivering effective feedback have existed for several decades, medical students and residents often indicate that they receive little feedback. A recent scoping review on feedback in medical education did not reveal any validity evidence on instruments to assess learner's perceptions of feedback. The purpose of our study was to gather validity evidence on two novel FEEDME (Feedback in Medical Education) instruments to assess medical students' and residents' perceptions of the feedback that they receive. After the authors developed an initial instrument with 54 items, cognitive interviews with medical students and residents suggested that 2 separate instruments were needed, one focused on the feedback culture (FEEDME-Culture) and the other on the provider of feedback (FEEDME-Provider). A Delphi study with 17 medical education experts and faculty members assessed content validity. The response process was explored involving 31 medical students and residents at 2 academic institutions. Exploratory factor analysis and reliability analyses were performed on completed instruments. Two Delphi consultation rounds refined the wording of items and eliminated several items. Learners found both instruments easy and quick to answer; it took them less than 5 minutes to complete. Learners preferred an electronic format of the instruments over paper. Factor analysis revealed a two- and three-factor solution for the FEEDME-Culture and FEEDME-Provider instruments, respectively. Cronbach's alpha was greater than 0.80 for all factors. Items on both instruments were moderately to highly correlated (range, r = .3-.7). Our results provide preliminary validity evidence of 2 novel feedback instruments. After further validation of both FEEDME instruments, sharing the results of the FEEDME-Culture instrument with educational leaders and faculty may improve the culture of feedback on specific educational rotations and at the institutional level. The FEEDME-Provider instrument could be useful for faculty development targeting feedback skills. Additional research studies could assess whether both instruments may be used to help learners receive feedback and prompt reflective learning.

  3. Planning a graduate programme in public health nutrition for experienced nutrition professionals.

    PubMed

    Fox, Ann; Beyers, Joanne

    2011-08-01

    Public health renewal in Canada has highlighted the need for development and expansion of the public health nutrition workforce, particularly in northern and rural communities. The purpose of the present paper is to describe the planning of a more accessible graduate programme for experienced nutrition professionals. The planning effort was challenged by a short timeframe between programme approval and implementation and required intense collaboration with stakeholders and students. The programme planning model developed by The Health Communication Unit (THCU) at the Centre for Health Promotion was used to guide the process. This six-step model was familiar to key stakeholders and involved pre-planning, conducting a situational assessment, establishing goals and objectives, developing strategies and outcome indicators, and monitoring feedback. Resource constraints, short timelines and debates around distance education options presented challenges that were overcome by conducting a thorough needs assessment, creating an advisory committee, engaging key stakeholders in the planning process, and building on existing resources. Extensive involvement of the first cohort of students in ongoing planning and evaluation was particularly helpful in informing the evolution of the programme. The THCU planning model provided a useful framework for stakeholder collaboration and for planning and implementing the new graduate programme in public health nutrition. Preliminary data suggest that graduates are benefiting from their educational experiences through career enhancement opportunities. The evaluation strategies built into the programme design will be useful in informing ongoing programme development.

  4. Dynamic effective connectivity in cortically embedded systems of recurrently coupled synfire chains.

    PubMed

    Trengove, Chris; Diesmann, Markus; van Leeuwen, Cees

    2016-02-01

    As a candidate mechanism of neural representation, large numbers of synfire chains can efficiently be embedded in a balanced recurrent cortical network model. Here we study a model in which multiple synfire chains of variable strength are randomly coupled together to form a recurrent system. The system can be implemented both as a large-scale network of integrate-and-fire neurons and as a reduced model. The latter has binary-state pools as basic units but is otherwise isomorphic to the large-scale model, and provides an efficient tool for studying its behavior. Both the large-scale system and its reduced counterpart are able to sustain ongoing endogenous activity in the form of synfire waves, the proliferation of which is regulated by negative feedback caused by collateral noise. Within this equilibrium, diverse repertoires of ongoing activity are observed, including meta-stability and multiple steady states. These states arise in concert with an effective connectivity structure (ECS). The ECS admits a family of effective connectivity graphs (ECGs), parametrized by the mean global activity level. Of these graphs, the strongly connected components and their associated out-components account to a large extent for the observed steady states of the system. These results imply a notion of dynamic effective connectivity as governing neural computation with synfire chains, and related forms of cortical circuitry with complex topologies.

  5. A model study of warming-induced phosphorus-oxygen feedbacks in open-ocean oxygen minimum zones on millennial timescales

    NASA Astrophysics Data System (ADS)

    Niemeyer, Daniela; Kemena, Tronje P.; Meissner, Katrin J.; Oschlies, Andreas

    2017-05-01

    Observations indicate an expansion of oxygen minimum zones (OMZs) over the past 50 years, likely related to ongoing deoxygenation caused by reduced oxygen solubility, changes in stratification and circulation, and a potential acceleration of organic matter turnover in a warming climate. The overall area of ocean sediments that are in direct contact with low-oxygen bottom waters also increases with expanding OMZs. This leads to a release of phosphorus from ocean sediments. If anthropogenic carbon dioxide emissions continue unabated, higher temperatures will cause enhanced weathering on land, which, in turn, will increase the phosphorus and alkalinity fluxes into the ocean and therefore raise the ocean's phosphorus inventory even further. A higher availability of phosphorus enhances biological production, remineralisation and oxygen consumption, and might therefore lead to further expansions of OMZs, representing a positive feedback. A negative feedback arises from the enhanced productivity-induced drawdown of carbon and also increased uptake of CO2 due to weathering-induced alkalinity input. This feedback leads to a decrease in atmospheric CO2 and weathering rates. Here, we quantify these two competing feedbacks on millennial timescales for a high CO2 emission scenario. Using the University of Victoria (UVic) Earth System Climate Model of intermediate complexity, our model results suggest that the positive benthic phosphorus release feedback has only a minor impact on the size of OMZs in the next 1000 years. The increase in the marine phosphorus inventory under assumed business-as-usual global warming conditions originates, on millennial timescales, almost exclusively (> 80 %) from the input via terrestrial weathering and causes a 4- to 5-fold expansion of the suboxic water volume in the model.

  6. Social closeness and feedback modulate susceptibility to the framing effect

    PubMed Central

    Sip, Kamila E.; Smith, David V.; Porcelli, Anthony J.; Kar, Kohitij; Delgado, Mauricio R.

    2014-01-01

    Although, we often seek social feedback from others to help us make decisions, little is known about how social feedback affects decisions under risk, particularly from a close peer. We conducted two experiments using an established framing task to probe how decision making is modulated by social feedback valence (positive, negative) and the level of closeness with feedback provider (friend, confederate). Participants faced mathematically equivalent decisions framed as either an opportunity to keep (gain frame) or lose (loss frame) part of an initial endowment. Periodically, participants were provided with positive (e.g., “Nice!”) or negative (e.g., “Lame!”) feedback about their choices. Such feedback was provided by either a confederate (Experiment 1), or a gender-matched close friend (Experiment 2). As expected, the framing effect was observed in both experiments. Critically, an individual’s susceptibility to the framing effect was modulated by the valence of the social feedback, but only when the feedback provider was a close friend. This effect was reflected in the activation patterns of ventromedial prefrontal cortex and posterior cingulate cortex, regions involved in complex decision making. Taken together, these results highlight social closeness as an important factor in understanding the impact of social feedback on neural mechanisms of decision making. PMID:25074501

  7. Medical Students' Perspectives on Implementing Curriculum Change at One Institution.

    PubMed

    Yengo-Kahn, Aaron M; Baker, Courtney E; Lomis, And Kimberly D

    2017-04-01

    Training physicians to be effective practitioners throughout their careers begins in undergraduate medical education with particular focus on self-directed inquiry, professional and interprofessional development, and competency-based assessment. A select number of medical schools are restructuring their curricula by placing the student at the center of content delivery to enhance the learning experience. While this restructuring may benefit the adult learner, administrators often make assumptions about how students will perceive and respond to such innovative and unfamiliar educational concepts. This can create a disconnect between students and their curriculum. Administrative mindfulness of student experiences is needed to ensure successful implementation of curricular change, facilitate the transition from old to new modalities, and train competent physician graduates.Vanderbilt University School of Medicine (VUSM) recently completed a curriculum update, and student representatives have been essential participants in the transition, from the earliest stages in preplanning to rapid-cycle feedback as the curriculum runs. Two of the authors are members of VUSM's Student Curriculum Committee, which facilitates gathering and relaying student feedback to the administration. Drawing from their experiences, five specific considerations to address and manage when implementing student-centered curricular change are presented: (1) Communicate the rationale, (2) acknowledge anxiety, (3) adjust extracurricular leadership roles, (4) manage "The Bulge" of learners in the clinical environment, and (5) foster ongoing collaboration of students and administrators. For each consideration, examples and proposed solutions are provided.

  8. Developing a framework for assessing responsible conduct of research education programs.

    PubMed

    Olson, Lynne E

    2010-03-01

    Education in the responsible conduct of research (RCR) in the United States has evolved over the past decade from targeting trainees to including educational efforts aimed at faculty and staff. In addition RCR education has become more focused as federal agencies have moved to recommend specific content and to mandate education in certain areas. RCR education has therefore become a research-compliance issue necessitating the development of policies and the commitment of resources to develop or expand systems for educating faculty and staff and for assuring compliance. These changes implied the need to develop a program evaluation model that could be applied to institutional RCR education programs, which were expected to differ from traditional academic credit-bearing courses targeting trainees. Information gleaned from the examination of corporate compliance models was analyzed in order to create a program evaluation module that could be used to document and assess educational programs focused on teaching RCR. A programmed series of questions for each of the nine RCR content areas identified by the United States Office of Research Integrity was created based on a performance-monitoring evaluation model. The questions focus on educational goals, resources provided to support the educational efforts, educational content, content delivery, educational outcomes, compliance requirements and feedback. Answers collected in response to the questions could be used to both document and continually improve the quality of RCR educational programs through on-going formative assessment and feedback.

  9. Collaborative Peer Feedback

    ERIC Educational Resources Information Center

    Smith, David A.

    2017-01-01

    Feedback on assessed work is invaluable to student learning, but there is a limit to the amount of feedback an instructor may provide. Peer feedback increases the volume of feedback possible, but potentially reduces the quality of the feedback. This research proposes a model of collaborative peer feedback designed to increase quality of peer…

  10. Useful but Different: Resident Physician Perceptions of Interprofessional Feedback.

    PubMed

    Vesel, Travis P; O'Brien, Bridget C; Henry, Duncan M; van Schaik, Sandrijn M

    2016-01-01

    Phenomenon: Based on recently formulated interprofessional core competencies, physicians are expected to incorporate feedback from other healthcare professionals. Based on social identity theory, physicians likely differentiate between feedback from members of their own profession and others. The current study examined residents' experiences with, and perceptions of, interprofessional feedback. In 2013, Anesthesia, Obstetrics-Gynecology, Pediatrics, and Psychiatry residents completed a survey including questions about frequency of feedback from different professionals and its perceived value (5-point scale). The authors performed an analysis of variance to examine interactions between residency program and profession of feedback provider. They conducted follow-up interviews with a subset of residents to explore reasons for residents' survey ratings. Fifty-two percent (131/254) of residents completed the survey, and 15 participated in interviews. Eighty percent of residents reported receiving written feedback from physicians, 26% from nurses, and less than 10% from other professions. There was a significant interaction between residency program and feedback provider profession, F(21, 847) = 3.82, p < .001, and a significant main effect of feedback provider profession, F(7, 847) = 73.7, p < .001. On post hoc analyses, residents from all programs valued feedback from attending physicians higher than feedback from others, and anesthesia residents rated feedback from other professionals significantly lower than other residents. Ten major themes arose from qualitative data analysis, which revealed an overall positive attitude toward interprofessional feedback and clarified reasons behind residents' perceptions and identified barriers. Insights: Residents in our study reported limited exposure to interprofessional feedback and valued such feedback less than intraprofessional feedback. However, our data suggest opportunities exist for effective utilization of interprofessional feedback.

  11. Improving Professional Development by Examining Teachers' Identities, Beliefs, and Practices in Writing Feedback

    ERIC Educational Resources Information Center

    Reyes, Lisa Darlene

    2017-01-01

    The unpreparedness of some regular classroom teachers of English Language Learners (ELLS) to provide appropriate writing feedback and receive improved professional development to combat low student progress have resulted in researcher debate about how and why teachers provide feedback. Some teachers have become frustrated with writing feedback as…

  12. Regulated provider perceptions of feedback reports.

    PubMed

    O'Rourke, Hannah M; Fraser, Kimberly D; Boström, Anne-Marie; Baylon, Melba Andrea B; Sales, Anne E

    2013-11-01

    This paper reports on regulated (or licensed) care providers' understanding and perceptions of feedback reports in a sample of Canadian long-term care settings using a cross-sectional survey design. Audit with feedback quality improvement studies have seldom targeted front-line providers in long-term care to receive feedback information. Feedback reports were delivered to front-line regulated care providers in four long-term care facilities for 13 months in 2009-10. Providers completed a postfeedback survey. Most (78%) regulated care providers (n = 126) understood the reports and felt they provided useful information for making changes to resident care (64%). Perceptions of the report differed, depending on the role of the regulated care provider. In multivariable logistic regression, the regulated nurses' understanding of more than half the report was negatively associated with 'usefulness of information for changing resident care', and perceiving the report as generally useful had a positive association. Front-line regulated providers are an appropriate target for feedback reports in long-term care. Long-term care administrators should share unit-level information on care quality with unit-level managers and other professional front-line direct care providers. © 2013 John Wiley & Sons Ltd.

  13. The use of interactive computer vision and robot hand controllers for enhancing manufacturing safety

    NASA Technical Reports Server (NTRS)

    Marzwell, Neville I.; Jacobus, Charles J.; Peurach, Thomas M.; Mitchell, Brian T.

    1994-01-01

    Current available robotic systems provide limited support for CAD-based model-driven visualization, sensing algorithm development and integration, and automated graphical planning systems. This paper describes ongoing work which provides the functionality necessary to apply advanced robotics to automated manufacturing and assembly operations. An interface has been built which incorporates 6-DOF tactile manipulation, displays for three dimensional graphical models, and automated tracking functions which depend on automated machine vision. A set of tools for single and multiple focal plane sensor image processing and understanding has been demonstrated which utilizes object recognition models. The resulting tool will enable sensing and planning from computationally simple graphical objects. A synergistic interplay between human and operator vision is created from programmable feedback received from the controller. This approach can be used as the basis for implementing enhanced safety in automated robotics manufacturing, assembly, repair and inspection tasks in both ground and space applications. Thus, an interactive capability has been developed to match the modeled environment to the real task environment for safe and predictable task execution.

  14. The use of interactive computer vision and robot hand controllers for enhancing manufacturing safety

    NASA Astrophysics Data System (ADS)

    Marzwell, Neville I.; Jacobus, Charles J.; Peurach, Thomas M.; Mitchell, Brian T.

    1994-02-01

    Current available robotic systems provide limited support for CAD-based model-driven visualization, sensing algorithm development and integration, and automated graphical planning systems. This paper describes ongoing work which provides the functionality necessary to apply advanced robotics to automated manufacturing and assembly operations. An interface has been built which incorporates 6-DOF tactile manipulation, displays for three dimensional graphical models, and automated tracking functions which depend on automated machine vision. A set of tools for single and multiple focal plane sensor image processing and understanding has been demonstrated which utilizes object recognition models. The resulting tool will enable sensing and planning from computationally simple graphical objects. A synergistic interplay between human and operator vision is created from programmable feedback received from the controller. This approach can be used as the basis for implementing enhanced safety in automated robotics manufacturing, assembly, repair and inspection tasks in both ground and space applications. Thus, an interactive capability has been developed to match the modeled environment to the real task environment for safe and predictable task execution.

  15. ISS Training Best Practices and Lessons Learned

    NASA Technical Reports Server (NTRS)

    Barshi, Immanuel; Dempsey, Donna L.

    2017-01-01

    Training our crew members for long duration exploration-class missions (LDEM) will have to be qualitatively and quantitatively different from current training practices. However, there is much to be learned from the extensive experience NASA has gained in training crew members for missions on board the International Space Station (ISS). Furthermore, the operational experience on board the ISS provides valuable feedback concerning training effectiveness. Keeping in mind the vast differences between current ISS crew training and training for LDEM, the needs of future crew members, and the demands of future missions, this ongoing study seeks to document current training practices and lessons learned. The goal of the study is to provide input to the design of future crew training that takes as much advantage as possible of what has already been learned and avoids as much as possible past inefficiencies. Results from this study will be presented upon its completion. By researching established training principles, examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs.

  16. ISS Training Best Practices and Lessons Learned

    NASA Technical Reports Server (NTRS)

    Dempsey, Donna L.; Barshi, Immanuel

    2018-01-01

    Training our crew members for long-duration Deep Space Transport (DST) missions will have to be qualitatively and quantitatively different from current training practices. However, there is much to be learned from the extensive experience NASA has gained in training crew members for missions on board the International Space Station (ISS). Furthermore, the operational experience on board the ISS provides valuable feedback concerning training effectiveness. Keeping in mind the vast differences between current ISS crew training and training for DST missions, the needs of future crew members, and the demands of future missions, this ongoing study seeks to document current training practices and lessons learned. The goal of the study is to provide input to the design of future crew training that takes as much advantage as possible of what has already been learned and avoids as much as possible past inefficiencies. Results from this study will be presented upon its completion. By researching established training principles, examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs.

  17. Understanding feedback report uptake: process evaluation findings from a 13-month feedback intervention in long-term care settings.

    PubMed

    Sales, Anne E; Fraser, Kimberly; Baylon, Melba Andrea B; O'Rourke, Hannah M; Gao, Gloria; Bucknall, Tracey; Maisey, Suzanne

    2015-02-12

    Long-term care settings provide care to a large proportion of predominantly older, highly disabled adults across the United States and Canada. Managing and improving quality of care is challenging, in part because staffing is highly dependent on relatively non-professional health care aides and resources are limited. Feedback interventions in these settings are relatively rare, and there has been little published information about the process of feedback intervention. Our objectives were to describe the key components of uptake of the feedback reports, as well as other indicators of participant response to the intervention. We conducted this project in nine long-term care units in four facilities in Edmonton, Canada. We used mixed methods, including observations during a 13-month feedback report intervention with nine post-feedback survey cycles, to conduct a process evaluation of a feedback report intervention in these units. We included all facility-based direct care providers (staff) in the feedback report distribution and survey administration. We conducted descriptive analyses of the data from observations and surveys, presenting this in tabular and graphic form. We constructed a short scale to measure uptake of the feedback reports. Our analysis evaluated feedback report uptake by provider type over the 13 months of the intervention. We received a total of 1,080 survey responses over the period of the intervention, which varied by type of provider, facility, and survey month. Total number of reports distributed ranged from 103 in cycle 12 to 229 in cycle 3, although the method of delivery varied widely across the period, from 12% to 65% delivered directly to individuals and 15% to 84% left for later distribution. The key elements of feedback uptake, including receiving, reading, understanding, discussing, and reporting a perception that the reports were useful, varied by survey cycle and provider type, as well as by facility. Uptake, as we measured it, was consistently high overall, but varied widely by provider type and time period. We report detailed process data describing the aspects of uptake of a feedback report during an intensive, longitudinal feedback intervention in long-term care facilities. Uptake is a complex process for which we used multiple measures. We demonstrate the feasibility of conducting a complex longitudinal feedback intervention in relatively resource-poor long-term care facilities to a wider range of provider types than have been included in prior feedback interventions.

  18. Amount of kinematic feedback affects learning of speech motor skills.

    PubMed

    Ballard, Kirrie J; Smith, Heather D; Paramatmuni, Divija; McCabe, Patricia; Theodoros, Deborah G; Murdoch, Bruce E

    2012-01-01

    Knowledge of Performance (KP) feedback, such as biofeedback or kinematic feedback, is used to provide information on the nature and quality of movement responses for the purpose of guiding active learning or rehabilitation of motor skills. It has been proposed that KP feedback may interfere with long-term learning when provided throughout training. Here, twelve healthy English-speaking adults were trained to produce a trilled Russian [r] in words with KP kinematic feedback using electropalatography (EPG) and without KP (noKP). Five one-hour training sessions were provided over one week with testing pretraining and one day and one week posttraining. No group differences were found at pretraining or one day post training for production accuracy. A group by time interaction supported the hypothesis that providing kinematic feedback continually during skill acquisition interferes with retention.

  19. Teachers' Emotions and Test Feedback.

    ERIC Educational Resources Information Center

    Stough, Laura M.; Emmer, Edmund T.

    1998-01-01

    Investigates teachers thoughts about test-feedback sessions and their resulting emotions and strategies when delivering feedback to students. Explains that past experiences with feedback sessions, problem students, teachers beliefs about feedback processes, and their goals for providing feedback influence the teachers level of emotion; the…

  20. Designing Crowdcritique Systems for Formative Feedback

    ERIC Educational Resources Information Center

    Easterday, Matthew W.; Rees Lewis, Daniel; Gerber, Elizabeth M.

    2017-01-01

    Intelligent tutors based on expert systems often struggle to provide formative feedback on complex, ill-defined problems where answers are unknown. Hybrid crowdsourcing systems that combine the intelligence of multiple novices in face-to-face settings might provide an alternate approach for providing intelligent formative feedback. The purpose of…

  1. A Roadmap for caGrid, an Enterprise Grid Architecture for Biomedical Research

    PubMed Central

    Saltz, Joel; Hastings, Shannon; Langella, Stephen; Oster, Scott; Kurc, Tahsin; Payne, Philip; Ferreira, Renato; Plale, Beth; Goble, Carole; Ervin, David; Sharma, Ashish; Pan, Tony; Permar, Justin; Brezany, Peter; Siebenlist, Frank; Madduri, Ravi; Foster, Ian; Shanbhag, Krishnakant; Mead, Charlie; Hong, Neil Chue

    2012-01-01

    caGrid is a middleware system which combines the Grid computing, the service oriented architecture, and the model driven architecture paradigms to support development of interoperable data and analytical resources and federation of such resources in a Grid environment. The functionality provided by caGrid is an essential and integral component of the cancer Biomedical Informatics Grid (caBIG™) program. This program is established by the National Cancer Institute as a nationwide effort to develop enabling informatics technologies for collaborative, multi-institutional biomedical research with the overarching goal of accelerating translational cancer research. Although the main application domain for caGrid is cancer research, the infrastructure provides a generic framework that can be employed in other biomedical research and healthcare domains. The development of caGrid is an ongoing effort, adding new functionality and improvements based on feedback and use cases from the community. This paper provides an overview of potential future architecture and tooling directions and areas of improvement for caGrid and caGrid-like systems. This summary is based on discussions at a roadmap workshop held in February with participants from biomedical research, Grid computing, and high performance computing communities. PMID:18560123

  2. A roadmap for caGrid, an enterprise Grid architecture for biomedical research.

    PubMed

    Saltz, Joel; Hastings, Shannon; Langella, Stephen; Oster, Scott; Kurc, Tahsin; Payne, Philip; Ferreira, Renato; Plale, Beth; Goble, Carole; Ervin, David; Sharma, Ashish; Pan, Tony; Permar, Justin; Brezany, Peter; Siebenlist, Frank; Madduri, Ravi; Foster, Ian; Shanbhag, Krishnakant; Mead, Charlie; Chue Hong, Neil

    2008-01-01

    caGrid is a middleware system which combines the Grid computing, the service oriented architecture, and the model driven architecture paradigms to support development of interoperable data and analytical resources and federation of such resources in a Grid environment. The functionality provided by caGrid is an essential and integral component of the cancer Biomedical Informatics Grid (caBIG) program. This program is established by the National Cancer Institute as a nationwide effort to develop enabling informatics technologies for collaborative, multi-institutional biomedical research with the overarching goal of accelerating translational cancer research. Although the main application domain for caGrid is cancer research, the infrastructure provides a generic framework that can be employed in other biomedical research and healthcare domains. The development of caGrid is an ongoing effort, adding new functionality and improvements based on feedback and use cases from the community. This paper provides an overview of potential future architecture and tooling directions and areas of improvement for caGrid and caGrid-like systems. This summary is based on discussions at a roadmap workshop held in February with participants from biomedical research, Grid computing, and high performance computing communities.

  3. Enhanced Medical Rehabilitation: Effectiveness of a clinical training model.

    PubMed

    Bland, Marghuretta D; Birkenmeier, Rebecca L; Barco, Peggy; Lenard, Emily; Lang, Catherine E; Lenze, Eric J

    2016-10-14

    Patient engagement in medical rehabilitation can be greatly influenced by their provider during therapy sessions. We developed Enhanced Medical Rehabilitation (EMR), a set of provider skills grounded in theories of behavior change. EMR utilizes 18 motivational techniques focused on providing frequent feedback to patients on their effort and progress and linking these to patient goals. To examine the effectiveness of a clinical training protocol for clinicians to do EMR, as measured by clinician adherence. A physical therapist, physical therapist assistant, occupational therapist, and certified occupational therapist assistant were trained in EMR. Training consisted of five formal training sessions and individual and group coaching. Adherence to EMR techniques was measured during two phases: Pre-Training and Maintenance, with an a priori target of 90% adherence by clinicians to each EMR technique. With training and coaching, clinician adherence per therapeutic activity significantly improved in 13 out of 18 items (p < 0.05). The target of 90% adherence was not achieved for many items. Our training and coaching program successfully trained clinicians to promote patient engagement during therapeutic service delivery, although not typically to 90% or greater adherence. Ongoing coaching efforts were necessary to increase adherence.

  4. Partnerships for Quality project: closing the gap in care of children with ADHD.

    PubMed

    Lannon, Carole; Dolins, Judith; Lazorick, Suzanne; Crowe, Virginia Leigh Hamilton; Butts-Dion, Sue; Schoettker, Pamela J

    2007-12-01

    The Partnerships for Quality project was designed to close the gap between knowledge and care for children with attention deficit hyperactivity disorder by fostering a partnership between a major medical specialty society, a professional certifying body, a national family-based advocacy organization, and a child health improvement organization. Ten American Academy of Pediatrics chapters conducted training workshops for practicing pediatricians and their office teams. Assistance was provided in the form of feedback of data, ongoing communication via conference calls, and a listserve. Two national workshops were conducted to disseminate learnings and promote sustainability. Participation in the intervention resulted in greater involvement in quality improvement activities by practice teams and improved care outcomes. The training workshops facilitated collaboration among providers, parents, and the educational, mental health, and legal systems. The partnership structure used demonstrated what professional societies can do to support improvement at the local level and what component chapters need to do to support improvement at the practice level. The integration of quality improvement infrastructure and policy changes at the national and local levels suggest that the quality efforts are likely to be sustained, providing long-term improvement in care and outcomes for children and families.

  5. Testing with feedback improves recall of information in informed consent: A proof of concept study.

    PubMed

    Roberts, Katherine J; Revenson, Tracey A; Urken, Mark L; Fleszar, Sara; Cipollina, Rebecca; Rowe, Meghan E; Reis, Laura L Dos; Lepore, Stephen J

    2016-08-01

    This study investigates whether applying educational testing approaches to an informed consent video for a medical procedure can lead to greater recall of the information presented. Undergraduate students (n=120) were randomly assigned to watch a 20-min video on informed consent under one of three conditions: 1) tested using multiple-choice knowledge questions and provided with feedback on their answers after each 5-min segment; 2) tested with multiple choice knowledge questions but not provided feedback after each segment; or 3) watched the video without knowledge testing. Participants who were tested and provided feedback had significantly greater information recall compared to those who were tested but not provided feedback and to those not tested. The effect of condition was stronger for moderately difficult questions versus easy questions. Inserting knowledge tests and providing feedback about the responses at timed intervals in videos can be effective in improving recall of information. Providing informed consent information through a video not only standardizes the material, but using testing with feedback inserted within the video has the potential to increase recall and retention of this material. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Multiple-Try Feedback and Higher-Order Learning Outcomes

    ERIC Educational Resources Information Center

    Clariana, Roy B.; Koul, Ravinder

    2005-01-01

    Although feedback is an important component of computer-based instruction (CBI), the effects of feedback on higher-order learning outcomes are not well understood. Several meta-analyses provide two rules of thumb: any feedback is better than no feedback and feedback with more information is better than feedback with less information. …

  7. Medical student perspective: working toward specific and actionable clinical clerkship feedback.

    PubMed

    Moss, Haley A; Derman, Peter B; Clement, R Carter

    2012-01-01

    Feedback on the wards is an important component of medical student education. Medical schools have incorporated formalized feedback mechanisms such as clinical encounter cards and standardized patient encounters into clinical curricula. However, the system could be further improved as medical students frequently feel uncomfortable requesting feedback, and are often dissatisfied with the quality of the feedback they receive. This article explores the shortcomings of the existing medical student feedback system and examines the relevant literature in an effort to shed light on areas in which the system can be enhanced. The discussion focuses on resident-provided feedback but is broadly applicable to delivering feedback in general. A review of the organizational psychology and business administration literature on fostering effective feedback was performed. These insights were then applied to the setting of medical education. Providing effective feedback requires training and forethought. Feedback itself should be specific and actionable. Utilizing these strategies will help medical students and educators get the most out of existing feedback systems.

  8. Haptic seat for fuel economy feedback

    DOEpatents

    Bobbitt, III, John Thomas

    2016-08-30

    A process of providing driver fuel economy feedback is disclosed in which vehicle sensors provide for haptic feedback on fuel usage. Such sensors may include one or more of a speed sensors, global position satellite units, vehicle pitch/roll angle sensors, suspension displacement sensors, longitudinal accelerometer sensors, throttle position in sensors, steering angle sensors, break pressure sensors, and lateral accelerometer sensors. Sensors used singlely or collectively can provide enhanced feedback as to various environmental conditions and operating conditions such that a more accurate assessment of fuel economy information can be provided to the driver.

  9. The implementation of an AR (augmented reality) approach to support mammographic interpretation training: an initial feasibility study

    NASA Astrophysics Data System (ADS)

    Tang, Qiang; Chen, Yan; Gale, Alastair G.

    2017-03-01

    Appropriate feedback plays an important role in optimising mammographic interpretation training whilst also ensuring good interpretation performance. The traditional keyboard, mouse and workstation technical approach has a critical limitation in providing supplementary image-related information and providing complex feedback in real time. Augmented Reality (AR) provides a possible superior approach in this situation, as feedback can be provided directly overlaying the displayed mammographic images so making a generic approach which can also be vendor neutral. In this study, radiological feedback was dynamically remapped virtually into the real world, using perspective transformation, in order to provide a richer user experience in mammographic interpretation training. This is an initial attempt of an AR approach to dynamically superimpose pre-defined feedback information of a DICOM image on top of a radiologist's view, whilst the radiologist is examining images on a clinical workstation. The study demonstrates the feasibility of the approach, although there are limitations on interactive operations which are due to the hardware used. The results of this fully functional approach provide appropriate feedback/image correspondence in a simulated mammographic interpretation environment. Thus, it is argued that employing AR is a feasible way to provide rich feedback in the delivery of mammographic interpretation training.

  10. Recommendations for Clinical Decision Support Deployment: Synthesis of a Roundtable of Medical Directors of Information Systems

    PubMed Central

    Jenders, Robert A.; Osheroff, Jerome A.; Sittig, Dean F.; Pifer, Eric A.; Teich, Jonathan M

    2007-01-01

    Background: Ample evidence exists that clinical decision support (CDS) can improve clinician performance. Nevertheless, additional evidence demonstrates that clinicians still do not perform adequately in many instances. This suggests an ongoing need for implementation of CDS, in turn prompting development of a roadmap for national action regarding CDS. Objective: Develop practical advice to aid CDS implementation in order to improve clinician performance. Method: Structured group interview during a roundtable discussion by medical directors of information systems (N = 30), with subsequent review by participants and synthesis. Results: Participant consensus was that CDS should be comprehensive and should involve techniques such as order sets and facilitated documentation as well as alerts; should be subject to ongoing feedback; and should flow from and be governed by an organization’s clinical goals. Conclusion: A structured roundtable discussion of clinicians experienced in health information technology can yield practical, consensus advice for implementation of CDS. PMID:18693858

  11. Beyond Content, Deeper than Delivery: What Critique Feedback Reveals about Communication Expectations in Design Education

    ERIC Educational Resources Information Center

    Dannels, Deanna; Gaffney, Amy Housley; Martin, Kelly Norris

    2008-01-01

    In design education, the critique is a communication event in which students present their design and critics provide feedback. Presumably, the feedback gives the students information about their progress on the design. Yet critic feedback also serves a socializing function--providing students information about what it means to communicate well in…

  12. Getting Students to Read Instructor Feedback (and Maybe Actually Learn from It)

    ERIC Educational Resources Information Center

    Redd, Bibia R.; Kennette, Lynne N.

    2017-01-01

    Effective instructor feedback can be used to increase student learning, provided that students read and apply this feedback, which is not always the case. The current study investigates an approach which may encourage students to read and immediately apply instructor-provided feedback. This is done by giving students the opportunity to submit…

  13. Teachers' Accounts of Their Perceptions and Practices of Providing Written Feedback to Nursing Students on Their Assignments

    ERIC Educational Resources Information Center

    Iqbal, Sajid; Gul, Raisa; Lakhani, Arusa; Rizvi, Nusrat Fatima

    2014-01-01

    Written feedback can facilitate students' learning in several ways. However, the teachers' practices of written feedback may be affected by various factors. This study aimed to explore the nurse teachers' accounts of their perceptions and practices of providing written feedback. A descriptive exploratory design was employed in the study. A…

  14. Dynamical regimes due to technological change in a microeconomical model of production

    NASA Astrophysics Data System (ADS)

    Hamacher, K.

    2012-09-01

    We develop a microeconomical model to investigate the impact of technological change onto production decisions of suppliers—modeling an effective feedback mechanism of the market. An important property—the time horizon of production planning—is related to the Kolmogorov entropy of the one-dimensional maps describing price dynamics. We simulate this price dynamics in an ensemble representing the whole macroeconomy. We show how this model can be used to support ongoing research in economic growth and incorporate the obtained microeconomic findings into the discussion about appropriate macroeconomic quantities such as the production function—thus effectively underpinning macroeconomics with microeconomical dynamics. From there we can show that the model exhibits different dynamical regimes (suggesting "phase transitions") with respect to an order parameter. The non-linear feedback under technological change was found to be the crucial mechanism. The implications of the obtained regimes are finally discussed.

  15. Dynamical regimes due to technological change in a microeconomical model of production.

    PubMed

    Hamacher, K

    2012-09-01

    We develop a microeconomical model to investigate the impact of technological change onto production decisions of suppliers-modeling an effective feedback mechanism of the market. An important property-the time horizon of production planning-is related to the Kolmogorov entropy of the one-dimensional maps describing price dynamics. We simulate this price dynamics in an ensemble representing the whole macroeconomy. We show how this model can be used to support ongoing research in economic growth and incorporate the obtained microeconomic findings into the discussion about appropriate macroeconomic quantities such as the production function-thus effectively underpinning macroeconomics with microeconomical dynamics. From there we can show that the model exhibits different dynamical regimes (suggesting "phase transitions") with respect to an order parameter. The non-linear feedback under technological change was found to be the crucial mechanism. The implications of the obtained regimes are finally discussed.

  16. Feed-backs among inbreeding, inbreeding depression in sperm traits, and sperm competition can drive evolution of costly polyandry.

    PubMed

    Bocedi, Greta; Reid, Jane M

    2017-12-01

    Ongoing ambitions are to understand the evolution of costly polyandry and its consequences for species ecology and evolution. Emerging patterns could stem from feed-back dynamics between the evolving mating system and its genetic environment, defined by interactions among kin including inbreeding. However, such feed-backs are rarely considered in nonselfing systems. We use a genetically explicit model to demonstrate a mechanism by which inbreeding depression can select for polyandry to mitigate the negative consequences of mating with inbred males, rather than to avoid inbreeding, and to elucidate underlying feed-backs. Specifically, given inbreeding depression in sperm traits, costly polyandry evolved to ensure female fertility, without requiring explicit inbreeding avoidance. Resulting sperm competition caused evolution of sperm traits and further mitigated the negative effect of inbreeding depression on female fertility. The evolving mating system fed back to decrease population-wide homozygosity, and hence inbreeding. However, the net overall decrease was small due to compound effects on the variances in sex-specific reproductive success and paternity skew. Purging of deleterious mutations did not eliminate inbreeding depression in sperm traits or hence selection for polyandry. Overall, our model illustrates that polyandry evolution, both directly and through sperm competition, might facilitate evolutionary rescue for populations experiencing sudden increases in inbreeding. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

  17. The effect of haptic guidance and visual feedback on learning a complex tennis task.

    PubMed

    Marchal-Crespo, Laura; van Raai, Mark; Rauter, Georg; Wolf, Peter; Riener, Robert

    2013-11-01

    While haptic guidance can improve ongoing performance of a motor task, several studies have found that it ultimately impairs motor learning. However, some recent studies suggest that the haptic demonstration of optimal timing, rather than movement magnitude, enhances learning in subjects trained with haptic guidance. Timing of an action plays a crucial role in the proper accomplishment of many motor skills, such as hitting a moving object (discrete timing task) or learning a velocity profile (time-critical tracking task). The aim of the present study is to evaluate which feedback conditions-visual or haptic guidance-optimize learning of the discrete and continuous elements of a timing task. The experiment consisted in performing a fast tennis forehand stroke in a virtual environment. A tendon-based parallel robot connected to the end of a racket was used to apply haptic guidance during training. In two different experiments, we evaluated which feedback condition was more adequate for learning: (1) a time-dependent discrete task-learning to start a tennis stroke and (2) a tracking task-learning to follow a velocity profile. The effect that the task difficulty and subject's initial skill level have on the selection of the optimal training condition was further evaluated. Results showed that the training condition that maximizes learning of the discrete time-dependent motor task depends on the subjects' initial skill level. Haptic guidance was especially suitable for less-skilled subjects and in especially difficult discrete tasks, while visual feedback seems to benefit more skilled subjects. Additionally, haptic guidance seemed to promote learning in a time-critical tracking task, while visual feedback tended to deteriorate the performance independently of the task difficulty and subjects' initial skill level. Haptic guidance outperformed visual feedback, although additional studies are needed to further analyze the effect of other types of feedback visualization on motor learning of time-critical tasks.

  18. `INCLUDING' Partnerships to Build Authentic Research Into K-12 Science Education

    NASA Astrophysics Data System (ADS)

    Turrin, M.; Lev, E.; Newton, R.; Xu, C.

    2017-12-01

    Opportunities for authentic research experiences have been shown effective for recruiting and retaining students in STEM fields. Meaningful research experiences entail significant time in project design, modeling ethical practice, providing training, instruction, and ongoing guidance. We propose that in order to be sustainable, a new instructional paradigm is needed, one that shifts from being top-weighted in instruction to a distributed weight model. This model relies on partnerships where everyone has buy-in and reaps rewards, establishing broadened networks for support, and adjusting the mentoring model. We use our successful Secondary School Field Research Program as a model for this new paradigm. For over a decade this program has provided authentic geoscience field research for an expanding group of predominantly inner city high school youth from communities underrepresented in the sciences. The program has shifted the balance with returning participants now serving as undergraduate mentors for the high school student `researchers', providing much of the ongoing training, instruction, guidance and feedback needed. But in order to be sustainable and impactful we need to broaden our base. A recent NSF-INCLUDES pilot project has allowed us to expand this model, linking schools, informal education non-profits, other academic institutions, community partners and private funding agencies into geographically organized `clusters'. Starting with a tiered mentoring model with scientists as consultants, teachers as team members, undergraduates as team leaders and high school students as researchers, each cluster will customize its program to reflect the needs and strengths of the team. To be successful each organization must identify how the program fits their organizational goals, the resources they can contribute and what they need back. Widening the partnership base spreads institutional commitments for research scientists, research locations and lab space, meaningful projects and undergraduate mentors. Representatives from the clusters formed working groups to turn best practices in areas such as mentoring, recruitment, assessment and funding into a flexible structure for the clusters. These working groups will provide the outline to expand a successful authentic research program.

  19. Providing Formative Feedback From a Summative Computer-aided Assessment

    PubMed Central

    Sewell, Robert D. E.

    2007-01-01

    Objectives To examine the effectiveness of providing formative feedback for summative computer-aided assessment. Design Two groups of first-year undergraduate life science students in pharmacy and neuroscience who were studying an e-learning package in a common pharmacology module were presented with a computer-based summative assessment. A sheet with individualized feedback derived from each of the 5 results sections of the assessment was provided to each student. Students were asked via a questionnaire to evaluate the form and method of feedback. Assessment The students were able to reflect on their performance and use the feedback provided to guide their future study or revision. There was no significant difference between the responses from pharmacy and neuroscience students. Students' responses on the questionnaire indicated a generally positive reaction to this form of feedback. Conclusions Findings suggest that additional formative assessment conveyed by this style and method would be appreciated and valued by students. PMID:17533442

  20. Scenario and modelling uncertainty in global mean temperature change derived from emission driven Global Climate Models

    NASA Astrophysics Data System (ADS)

    Booth, B. B. B.; Bernie, D.; McNeall, D.; Hawkins, E.; Caesar, J.; Boulton, C.; Friedlingstein, P.; Sexton, D.

    2012-09-01

    We compare future changes in global mean temperature in response to different future scenarios which, for the first time, arise from emission driven rather than concentration driven perturbed parameter ensemble of a Global Climate Model (GCM). These new GCM simulations sample uncertainties in atmospheric feedbacks, land carbon cycle, ocean physics and aerosol sulphur cycle processes. We find broader ranges of projected temperature responses arising when considering emission rather than concentration driven simulations (with 10-90 percentile ranges of 1.7 K for the aggressive mitigation scenario up to 3.9 K for the high end business as usual scenario). A small minority of simulations resulting from combinations of strong atmospheric feedbacks and carbon cycle responses show temperature increases in excess of 9 degrees (RCP8.5) and even under aggressive mitigation (RCP2.6) temperatures in excess of 4 K. While the simulations point to much larger temperature ranges for emission driven experiments, they do not change existing expectations (based on previous concentration driven experiments) on the timescale that different sources of uncertainty are important. The new simulations sample a range of future atmospheric concentrations for each emission scenario. Both in case of SRES A1B and the Representative Concentration Pathways (RCPs), the concentration pathways used to drive GCM ensembles lies towards the lower end of our simulated distribution. This design decision (a legecy of previous assessments) is likely to lead concentration driven experiments to under-sample strong feedback responses in concentration driven projections. Our ensemble of emission driven simulations span the global temperature response of other multi-model frameworks except at the low end, where combinations of low climate sensitivity and low carbon cycle feedbacks lead to responses outside our ensemble range. The ensemble simulates a number of high end responses which lie above the CMIP5 carbon cycle range. These high end simulations can be linked to sampling a number of stronger carbon cycle feedbacks and to sampling climate sensitivities above 4.5 K. This latter aspect highlights the priority in identifying real world climate sensitivity constraints which, if achieved, would lead to reductions on the uppper bound of projected global mean temperature change. The ensembles of simulations presented here provides a framework to explore relationships between present day observables and future changes while the large spread of future projected changes, highlights the ongoing need for such work.

  1. Use of audit, feedback and education increased guideline implementation in a multidisciplinary stroke unit

    PubMed Central

    2017-01-01

    Background The audit-feedback cycle is a behaviour change intervention used to reduce evidence-practice gaps. In this study, repeat audits, feedback, education and training were used to change practice and increase compliance with Australian guideline recommendations for stroke rehabilitation. Objective To increase the proportion of patients with stroke receiving best practice screening, assessment and treatment. Methods A before-and-after study design was used. Data were collected from medical records (n=15 files per audit). Four audits were conducted between 2009 and 2013. Consecutive files of patients with stroke admitted to the stroke unit were selected and audited retrospectively. Staff behaviour change interventions included four cycles of audit feedback, and education to assist staff with change. The primary outcome measure was the proportion of eligible patients receiving best practice against target behaviours, based on audit data. Results Between the first and fourth audit (2009 and 2013), 20 of the 27 areas targeted (74%) met or exceeded the minimum target of 10% change. Practice areas that showed the most change included sensation screening (+75%) and rehabilitation (+100%); neglect screening (+92%) and assessment (100%). Some target behaviours showed a drop in compliance such as anxiety and depression screening (−27%) or little or no overall improvement such as patient education about stroke (6% change). Conclusions Audit feedback and education increased the proportion of inpatients with stroke receiving best practice rehabilitation in some, but not all practice areas. An ongoing process of quality improvement is needed to help sustain these improvements. PMID:29450304

  2. A design of hardware haptic interface for gastrointestinal endoscopy simulation.

    PubMed

    Gu, Yunjin; Lee, Doo Yong

    2011-01-01

    Gastrointestinal endoscopy simulations have been developed to train endoscopic procedures which require hundreds of practices to be competent in the skills. Even though realistic haptic feedback is important to provide realistic sensation to the user, most of previous simulations including commercialized simulation have mainly focused on providing realistic visual feedback. In this paper, we propose a novel design of portable haptic interface, which provides 2DOF force feedback, for the gastrointestinal endoscopy simulation. The haptic interface consists of translational and rotational force feedback mechanism which are completely decoupled, and gripping mechanism for controlling connection between the endoscope and the force feedback mechanism.

  3. Marking and Providing Feedback Face-to-Face: Staff and Student Perspectives

    ERIC Educational Resources Information Center

    Chalmers, Charlotte; Mowat, Elaine; Chapman, Maggie

    2018-01-01

    The setting, marking and providing feedback on assessments form an important part of a tutor's role. Studies into the use of feedback and how it is interpreted by students indicate a mismatch between what students are looking for and what tutors think they are giving. Tutors comment that students are more interested in the mark than the feedback,…

  4. On the Impact of Our Feedback: Students Choosing, and Using, to Learn

    ERIC Educational Resources Information Center

    Reyes, Reynaldo, III

    2013-01-01

    Do our students actually read and use the feedback we provide? If so, what purpose does it serve them? Although these should be concerns, if we provide the adequate tools and guidance on how to use our feedback, this question should not be a pedagogical burden. Ultimately, learning, thinking, and understanding are the products of good feedback to…

  5. A review of invasive and non-invasive sensory feedback in upper limb prostheses.

    PubMed

    Svensson, Pamela; Wijk, Ulrika; Björkman, Anders; Antfolk, Christian

    2017-06-01

    The constant challenge to restore sensory feedback in prosthetic hands has provided several research solutions, but virtually none has reached clinical fruition. A prosthetic hand with sensory feedback that closely imitates an intact hand and provides a natural feeling may induce the prosthetic hand to be included in the body image and also reinforces the control of the prosthesis. Areas covered: This review presents non-invasive sensory feedback systems such as mechanotactile, vibrotactile, electrotactile and combinational systems which combine the modalities; multi-haptic feedback. Invasive sensory feedback has been tried less, because of the inherent risk, but it has successfully shown to restore some afferent channels. In this review, invasive methods are also discussed, both extraneural and intraneural electrodes, such as cuff electrodes and transverse intrafascicular multichannel electrodes. The focus of the review is on non-invasive methods of providing sensory feedback to upper-limb amputees. Expert commentary: Invoking embodiment has shown to be of importance for the control of prosthesis and acceptance by the prosthetic wearers. It is a challenge to provide conscious feedback to cover the lost sensibility of a hand, not be overwhelming and confusing for the user, and to integrate technology within the constraint of a wearable prosthesis.

  6. Simple Versus Elaborate Feedback in a Nursing Science Course

    NASA Astrophysics Data System (ADS)

    Elder, Betty L.; Brooks, David W.

    2008-08-01

    Feedback techniques, including computer-assisted feedback, have had mixed results in improving student learning outcomes. This project addresses the effect of type of feedback, simple or elaborate, for both short-term comprehension and long-term outcomes. A sample of 75 graduate nursing students was given a total of ten examinations. Four examinations provided tutorials in which the students received one of two types of feedback, simple or elaborate. Five examinations provided tutorials with no feedback. A comprehensive final examination compared initial content and final scores. This study found no significant differences between the types of feedback the students received. The mean scores were significantly higher on the four examinations where the students received feedback than on the five examinations with no feedback on tutorials. The comparison between the individual examinations and the similar content portion of the final examination indicated a significant drop in each of the four examinations where feedback was given and a significant improvement in four of the five examinations where no feedback was given.

  7. A deforestation-induced tipping point for the South American monsoon system.

    PubMed

    Boers, Niklas; Marwan, Norbert; Barbosa, Henrique M J; Kurths, Jürgen

    2017-01-25

    The Amazon rainforest has been proposed as a tipping element of the earth system, with the possibility of a dieback of the entire ecosystem due to deforestation only of parts of the rainforest. Possible physical mechanisms behind such a transition are still subject to ongoing debates. Here, we use a specifically designed model to analyse the nonlinear couplings between the Amazon rainforest and the atmospheric moisture transport from the Atlantic to the South American continent. These couplings are associated with a westward cascade of precipitation and evapotranspiration across the Amazon. We investigate impacts of deforestation on the South American monsoonal circulation with particular focus on a previously neglected positive feedback related to condensational latent heating over the rainforest, which strongly enhances atmospheric moisture inflow from the Atlantic. Our results indicate the existence of a tipping point. In our model setup, crossing the tipping point causes precipitation reductions of up to 40% in non-deforested parts of the western Amazon and regions further downstream. The responsible mechanism is the breakdown of the aforementioned feedback, which occurs when deforestation reduces transpiration to a point where the available atmospheric moisture does not suffice anymore to release the latent heat needed to maintain the feedback.

  8. A deforestation-induced tipping point for the South American monsoon system

    PubMed Central

    Boers, Niklas; Marwan, Norbert; Barbosa, Henrique M. J.; Kurths, Jürgen

    2017-01-01

    The Amazon rainforest has been proposed as a tipping element of the earth system, with the possibility of a dieback of the entire ecosystem due to deforestation only of parts of the rainforest. Possible physical mechanisms behind such a transition are still subject to ongoing debates. Here, we use a specifically designed model to analyse the nonlinear couplings between the Amazon rainforest and the atmospheric moisture transport from the Atlantic to the South American continent. These couplings are associated with a westward cascade of precipitation and evapotranspiration across the Amazon. We investigate impacts of deforestation on the South American monsoonal circulation with particular focus on a previously neglected positive feedback related to condensational latent heating over the rainforest, which strongly enhances atmospheric moisture inflow from the Atlantic. Our results indicate the existence of a tipping point. In our model setup, crossing the tipping point causes precipitation reductions of up to 40% in non-deforested parts of the western Amazon and regions further downstream. The responsible mechanism is the breakdown of the aforementioned feedback, which occurs when deforestation reduces transpiration to a point where the available atmospheric moisture does not suffice anymore to release the latent heat needed to maintain the feedback. PMID:28120928

  9. Pulsatile desynchronizing delayed feedback for closed-loop deep brain stimulation

    PubMed Central

    Lysyansky, Borys; Rosenblum, Michael; Pikovsky, Arkady; Tass, Peter A.

    2017-01-01

    High-frequency (HF) deep brain stimulation (DBS) is the gold standard for the treatment of medically refractory movement disorders like Parkinson’s disease, essential tremor, and dystonia, with a significant potential for application to other neurological diseases. The standard setup of HF DBS utilizes an open-loop stimulation protocol, where a permanent HF electrical pulse train is administered to the brain target areas irrespectively of the ongoing neuronal dynamics. Recent experimental and clinical studies demonstrate that a closed-loop, adaptive DBS might be superior to the open-loop setup. We here combine the notion of the adaptive high-frequency stimulation approach, that aims at delivering stimulation adapted to the extent of appropriately detected biomarkers, with specifically desynchronizing stimulation protocols. To this end, we extend the delayed feedback stimulation methods, which are intrinsically closed-loop techniques and specifically designed to desynchronize abnormal neuronal synchronization, to pulsatile electrical brain stimulation. We show that permanent pulsatile high-frequency stimulation subjected to an amplitude modulation by linear or nonlinear delayed feedback methods can effectively and robustly desynchronize a STN-GPe network of model neurons and suggest this approach for desynchronizing closed-loop DBS. PMID:28273176

  10. A deforestation-induced tipping point for the South American monsoon system

    NASA Astrophysics Data System (ADS)

    Boers, Niklas; Marwan, Norbert; Barbosa, Henrique M. J.; Kurths, Jürgen

    2017-01-01

    The Amazon rainforest has been proposed as a tipping element of the earth system, with the possibility of a dieback of the entire ecosystem due to deforestation only of parts of the rainforest. Possible physical mechanisms behind such a transition are still subject to ongoing debates. Here, we use a specifically designed model to analyse the nonlinear couplings between the Amazon rainforest and the atmospheric moisture transport from the Atlantic to the South American continent. These couplings are associated with a westward cascade of precipitation and evapotranspiration across the Amazon. We investigate impacts of deforestation on the South American monsoonal circulation with particular focus on a previously neglected positive feedback related to condensational latent heating over the rainforest, which strongly enhances atmospheric moisture inflow from the Atlantic. Our results indicate the existence of a tipping point. In our model setup, crossing the tipping point causes precipitation reductions of up to 40% in non-deforested parts of the western Amazon and regions further downstream. The responsible mechanism is the breakdown of the aforementioned feedback, which occurs when deforestation reduces transpiration to a point where the available atmospheric moisture does not suffice anymore to release the latent heat needed to maintain the feedback.

  11. Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit.

    PubMed

    Swoboda, Sandra M; Earsing, Karen; Strauss, Kevin; Lane, Stephen; Lipsett, Pamela A

    2004-02-01

    To determine whether electronic monitoring of hand hygiene and voice prompts can improve hand hygiene and decrease nosocomial infection rates in a surgical intermediate care unit. Three-phase quasi-experimental design. Phase I was electronic monitoring and direct observation; phase II was electronic monitoring and computerized voice prompts for failure to perform hand hygiene on room exit; and phase III was electronic monitoring only. Nine-room, 14-bed intermediate care unit in a university, tertiary-care institution. All patient rooms, utility room, and staff lavatory were monitored electronically. All healthcare personnel including physicians, nurses, nursing support personnel, ancillary staff, all visitors and family members, and any other personnel interacting with patients on the intermediate care unit. All patients with an intermediate care unit length of stay >48 hrs were followed for nosocomial infection. Electronic monitoring during all phases, computerized voice prompts during phase II only. We evaluated a total of 283,488 electronically monitored entries into a patient room with 251,526 exits for 420 days (10,080 hrs and 3,549 patient days). Compared with phase I, hand hygiene compliance in patient rooms improved 37% during phase II (odds ratio, 1.38; 95% confidence interval, 1.04-1.83) and 41% in phase III (odds ratio, 1.41; 95% confidence interval, 1.07-1.84). When adjusting for patient admissions during each phase, point estimates of nosocomial infections decreased by 22% during phase II and 48% during phase III; when adjusting for patient days, the number of infections decreased by 10% during phase II and 40% during phase III. Although the overall rate of nosocomial infections significantly decreased when combining phases II and III, the association between nosocomial infection and individual phase was not significant. Electronic monitoring provided effective ongoing feedback about hand hygiene compliance. During both the voice prompt phase and post-intervention phase, hand hygiene compliance and nosocomial infection rates improved suggesting that ongoing monitoring and feedback had both a short-term and, perhaps, a longer-term effect.

  12. Sure I'm Sure: Prefrontal Oscillations Support Metacognitive Monitoring of Decision Making.

    PubMed

    Wokke, Martijn E; Cleeremans, Axel; Ridderinkhof, K Richard

    2017-01-25

    Successful decision making critically involves metacognitive processes such as monitoring and control of our decision process. Metacognition enables agents to modify ongoing behavior adaptively and determine what to do next in situations in which external feedback is not (immediately) available. Despite the importance of metacognition for many aspects of life, little is known about how our metacognitive system operates or about what kind of information is used for metacognitive (second-order) judgments. In particular, it remains an open question whether metacognitive judgments are based on the same information as first-order decisions. Here, we investigated the relationship between metacognitive performance and first-order task performance by recording EEG signals while participants were asked to make a "diagnosis" after seeing a sample of fictitious patient data (a complex pattern of colored moving dots of different sizes). To assess metacognitive performance, participants provided an estimate about the quality of their diagnosis on each trial. Results demonstrate that the information that contributes to first-order decisions differs from the information that supports metacognitive judgments. Further, time-frequency analyses of EEG signals reveal that metacognitive performance is associated specifically with prefrontal theta-band activity. Together, our findings are consistent with a hierarchical model of metacognition and suggest a crucial role for prefrontal oscillations in metacognitive performance. Monitoring and control of our decision process (metacognition) is a crucial aspect of adaptive decision making. Crucially, metacognitive skills enable us to adjust ongoing behavior and determine future decision making when immediate feedback is not available. In the present study, we constructed a "diagnosis task" that allowed us to assess in what way first-order task performance and metacognition are related to each other. Results demonstrate that the contribution of sensory evidence (size, color, and motion direction) differs between first- and second-order decision making. Further, our results indicate that metacognitive performance specifically is orchestrated by means of prefrontal theta oscillations. Together, our findings suggest a hierarchical model of metacognition. Copyright © 2017 the authors 0270-6474/17/370781-09$15.00/0.

  13. Immersive virtual reality used as a platform for perioperative training for surgical residents.

    PubMed

    Witzke, D B; Hoskins, J D; Mastrangelo, M J; Witzke, W O; Chu, U B; Pande, S; Park, A E

    2001-01-01

    Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

  14. A framework for predicting impacts on ecosystem services ...

    EPA Pesticide Factsheets

    Protection of ecosystem services is increasingly emphasized as a risk-assessment goal, but there are wide gaps between current ecological risk-assessment endpoints and potential effects on services provided by ecosystems. The authors present a framework that links common ecotoxicological endpoints to chemical impacts on populations and communities and the ecosystem services that they provide. This framework builds on considerable advances in mechanistic effects models designed to span multiple levels of biological organization and account for various types of biological interactions and feedbacks. For illustration, the authors introduce 2 case studies that employ well-developed and validated mechanistic effects models: the inSTREAM individual-based model for fish populations and the AQUATOX ecosystem model. They also show how dynamic energy budget theory can provide a common currency for interpreting organism-level toxicity. They suggest that a framework based on mechanistic models that predict impacts on ecosystem services resulting from chemical exposure, combined with economic valuation, can provide a useful approach for informing environmental management. The authors highlight the potential benefits of using this framework as well as the challenges that will need to be addressed in future work. The framework introduced here represents an ongoing initiative supported by the National Institute of Mathematical and Biological Synthesis (NIMBioS; http://www.nimbi

  15. The Nature of Feedback: How Different Types of Peer Feedback Affect Writing Performance

    ERIC Educational Resources Information Center

    Nelson, Melissa M.; Schunn, Christian D.

    2009-01-01

    Although providing feedback is commonly practiced in education, there is no general agreement regarding what type of feedback is most helpful and why it is helpful. This study examined the relationship between various types of feedback, potential internal mediators, and the likelihood of implementing feedback. Five main predictions were developed…

  16. Real-time feedback can improve infant manikin cardiopulmonary resuscitation by up to 79%--a randomised controlled trial.

    PubMed

    Martin, Philip; Theobald, Peter; Kemp, Alison; Maguire, Sabine; Maconochie, Ian; Jones, Michael

    2013-08-01

    European and Advanced Paediatric Life Support training courses. Sixty-nine certified CPR providers. CPR providers were randomly allocated to a 'no-feedback' or 'feedback' group, performing two-thumb and two-finger chest compressions on a "physiological", instrumented resuscitation manikin. Baseline data was recorded without feedback, before chest compressions were repeated with one group receiving feedback. Indices were calculated that defined chest compression quality, based upon comparison of the chest wall displacement to the targets of four, internationally recommended parameters: chest compression depth, release force, chest compression rate and compression duty cycle. Baseline data were consistent with other studies, with <1% of chest compressions performed by providers simultaneously achieving the target of the four internationally recommended parameters. During the 'experimental' phase, 34 CPR providers benefitted from the provision of 'real-time' feedback which, on analysis, coincided with a statistical improvement in compression rate, depth and duty cycle quality across both compression techniques (all measures: p<0.001). Feedback enabled providers to simultaneously achieve the four targets in 75% (two-finger) and 80% (two-thumb) of chest compressions. Real-time feedback produced a dramatic increase in the quality of chest compression (i.e. from <1% to 75-80%). If these results transfer to a clinical scenario this technology could, for the first time, support providers in consistently performing accurate chest compressions during infant CPR and thus potentially improving clinical outcomes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. ComPAIR: A New Online Tool Using Adaptive Comparative Judgement to Support Learning with Peer Feedback

    ERIC Educational Resources Information Center

    Potter, Tiffany; Englund, Letitia; Charbonneau, James; MacLean, Mark Thompson; Newell, Jonathan; Roll, Ido

    2017-01-01

    Peer feedback is a useful strategy in teaching and learning, but its effectiveness particularly in introductory courses can be limited by the relative newness of students to both the body of knowledge upon which they are being asked to provide feedback and the skill set involved in providing good feedback. This paper applies a novel approach to…

  18. A novel use of Twitter to provide feedback and evaluations.

    PubMed

    Desai, Bobby

    2014-04-01

    Inconsistencies in work schedules and faculty supervision are barriers to monthly emergency medicine (EM) resident doctor evaluations. Direct and contemporaneous feedback may be effective in providing specific details that determine a resident's evaluation. To determine whether Twitter, an easy to use application that is available on the Internet via smartphones and desktops, can provide direct and contemporaneous feedback that is easily accessible, and easy to store and refer back to. First- to third-year EM residents were administered a survey to assess their thoughts on the current monthly evaluation system. Subsequently, residents obtained a Twitter account and were instructed to follow a single general faculty Twitter account for ease of data collection. Following completion of an 8-week study period, a second survey was administered to assess resident thoughts on contemporaneous feedback and evaluations versus the traditional form. Of the 24 EM residents, 13 were available for study. A total of 220 'tweets' were provided by seven faculty members, with a mean of 11 tweets (range 8-17) per resident. The 13 residents received a total of eight formal evaluations from 19 faculty members. The second survey demonstrated that this method provided more detailed evaluations and increased the volume of feedback. Contemporaneous feedback and evaluation provides a greater volume of feedback that is more detailed than end-of-course evaluations. Twitter is an effective and easy means to provide this feedback. Limitations included the length of study time and the inability to have all of the EM residents involved in the study. © 2014 John Wiley & Sons Ltd.

  19. Using Turnitin to Provide Feedback on L2 Writers' Texts

    ERIC Educational Resources Information Center

    Kostka, Ilka; Maliborska, Veronika

    2016-01-01

    Second language (L2) writing instructors have varying tools at their disposal for providing feedback on students' writing, including ones that enable them to provide written and audio feedback in electronic form. One tool that has been underexplored is Turnitin, a widely used software program that matches electronic text to a wide range of…

  20. Contribution of sensory feedback to plantar flexor muscle activation during push-off in adults with cerebral palsy.

    PubMed

    Frisk, Rasmus F; Jensen, Peter; Kirk, Henrik; Bouyer, Laurent J; Lorentzen, Jakob; Nielsen, Jens B

    2017-12-01

    Exaggerated sensory activity has been assumed to contribute to functional impairment following lesion of the central motor pathway. However, recent studies have suggested that sensory contribution to muscle activity during gait is reduced in stroke patients and children with cerebral palsy (CP). We investigated whether this also occurs in CP adults and whether daily treadmill training is accompanied by alterations in sensory contribution to muscle activity. Seventeen adults with CP and 12 uninjured individuals participated. The participants walked on a treadmill while a robotized ankle-foot orthosis applied unload perturbations at the ankle, thereby removing sensory feedback naturally activated during push-off. Reduction of electromyographic (EMG) activity in the soleus muscle caused by unloads was compared and related to kinematics and ankle joint stiffness measurements. Similar measures were obtained after 6 wk of gait training. We found that sensory contribution to soleus EMG activation was reduced in CP adults compared with uninjured adults. The lowest contribution of sensory feedback was found in participants with lowest maximal gait speed. This was related to increased ankle plantar flexor stiffness. Six weeks of gait training did not alter the contribution of sensory feedback. We conclude that exaggerated sensory activity is unlikely to contribute to impaired gait in CP adults, because sensory contribution to muscle activity during gait was reduced compared with in uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait so that a larger part of plantar flexor muscle activity must be generated by descending motor commands. NEW & NOTEWORTHY Findings suggest that adults with cerebral palsy have less contribution of sensory feedback to ongoing soleus muscle activation during push-off than uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait, and/or sensory feedback is less integrated with central motor commands in the activation of spinal motor neurons. Consequently, muscle activation must to a larger extent rely on descending drive, which is already decreased because of the cerebral lesion. Copyright © 2017 the American Physiological Society.

  1. An expansion of glider observation strategies to systematically transmit and analyze preferred waypoints of underwater gliders

    NASA Astrophysics Data System (ADS)

    Smedstad, Lucy F.; Barron, Charlie N.; Bourg, Rachel N.; Brooking, Michael W.; Bryant, Danielle A.; Carr, Robert J.; Heaney, Kevin D.; Holmberg, Edward A.; Mask, Andrea C.; Mensi, Bryan L.

    2015-05-01

    The Glider Observation STrategies (GOST) system provides real-time assistance to ocean glider pilots by suggesting preferred ocean glider waypoints based on ocean forecasts and their uncertainties. Restrictions on waterspace, preferred operational areas, and other glider trajectories are also taken into account. Using existing operational regional Navy Coastal Ocean Model (RNCOM) output, demonstrations of glider waypoint calculation are ongoing in Navy operational areas. After the ocean forecast models and GOST components run at the Navy DoD Supercomputing Resource Center (Navy DSRC), GOST-suggested glider paths are transferred to the Glider Operations Center (GOC). The glider pilots at the GOC import this information into their Unmanned Systems Interface (USI), developed at the University of Washington, Applied Physics Laboratory (APL-UW) to evaluate the suggested glider paths, make adjustments, and update waypoints for the gliders. The waypoints being sent are visualized and analyzed using graphic capabilities to convey guidance uncertainty developed under a grant to the University of New Orleans (UNO) and added under the Environmental Measurements Path Planner (EMPath) system within GOST. USI forwards automatic messages from the gliders with recent glider location, speed, and depth to GOST for the next cycle. Over the course of these demonstrations, capabilities were added or modified including use of initial glider bearing, preferred path, refinement of glider turn frequency, correction of glider speed, and introduction of glider rendezvous locations. Automation has been added with help from the modeling group at the Naval Oceanographic Office (NAVOCEANO). GOST supports NAVOCEANO's ongoing efforts to direct and recover gliders, to safely navigate in changing ocean conditions, and to provide feedback to improve ocean model prediction.

  2. Development of a clinical pharmacy model within an Australian home nursing service using co-creation and participatory action research: the Visiting Pharmacist (ViP) study.

    PubMed

    Elliott, Rohan A; Lee, Cik Yin; Beanland, Christine; Goeman, Dianne P; Petrie, Neil; Petrie, Barbara; Vise, Felicity; Gray, June

    2017-11-03

    To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients. Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders. A large, non-profit home nursing service in Melbourne, Australia. Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team. Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists' reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists. The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges. A collaborative, person-centred clinical pharmacy model that addressed the needs of clients, carers, nurses and other stakeholders was successfully developed. The model is likely to have applicability to home nursing services nationally and internationally. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Applying systems theory to the evaluation of a whole school approach to violence prevention.

    PubMed

    Kearney, Sarah; Leung, Loksee; Joyce, Andrew; Ollis, Debbie; Green, Celia

    2016-02-01

    Issue addressed Our Watch led a complex 12-month evaluation of a whole school approach to Respectful Relationships Education (RRE) implemented in 19 schools. RRE is an emerging field aimed at preventing gender-based violence. This paper will illustrate how from an implementation science perspective, the evaluation was a critical element in the change process at both a school and policy level. Methods Using several conceptual approaches from systems science, the evaluation sought to examine how the multiple systems layers - student, teacher, school, community and government - interacted and influenced each other. A distinguishing feature of the evaluation included 'feedback loops'; that is, evaluation data was provided to participants as it became available. Evaluation tools included a combination of standardised surveys (with pre- and post-intervention data provided to schools via individualised reports), reflection tools, regular reflection interviews and summative focus groups. Results Data was shared during implementation with project staff, department staff and schools to support continuous improvement at these multiple systems levels. In complex settings, implementation can vary according to context; and the impact of evaluation processes, tools and findings differed across the schools. Interviews and focus groups conducted at the end of the project illustrated which of these methods were instrumental in motivating change and engaging stakeholders at both a school and departmental level and why. Conclusion The evaluation methods were a critical component of the pilot's approach, helping to shape implementation through data feedback loops and reflective practice for ongoing, responsive and continuous improvement. Future health promotion research on complex interventions needs to examine how the evaluation itself is influencing implementation. So what? The pilot has demonstrated that the evaluation, including feedback loops to inform project activity, were an asset to implementation. This has implications for other health promotion activities, where evaluation tools could be utilised to enhance, rather than simply measure, an intervention. The findings are relevant to a range of health promotion research activities because they demonstrate the importance of meta-evaluation techniques that seek to understand how the evaluation itself was influencing implementation and outcomes.

  4. Post discharge issues identified by a call-back program: identifying improvement opportunities.

    PubMed

    Ojeda, Patricia I; Kara, Areeba

    2017-12-01

    The period following discharge from the hospital is one of heightened vulnerability. Discharge instructions serve as a guide during this transition. Yet, clinicians receive little feedback on the quality of this document that ties into the patients' experience. We reviewed the issues voiced by discharged patients via a call-back program and compared them to the discharge instructions they had received. At our institution, patients receive an automated call forty-eight hours following discharge inquiring about progress. If indicated by the response to the call, they are directed to a nurse who assists with problem solving. We reviewed the nursing documentation of these encounters for a period of nine months. The issues voiced were grouped into five categories: communication, medications, durable medical equipment/therapies, follow up and new or ongoing symptoms. The discharge instructions given to each patient were reviewed. We retrieved data on the number of discharges from each specialty from the hospital over the same period. A total of 592 patients voiced 685 issues. The numbers of patients discharged from medical or surgical services identified as having issues via the call-back line paralleled the proportions discharged from medical and surgical services from the hospital during the same period. Nearly a quarter of the issues discussed had been addressed in the discharge instructions. The most common category of issues was related to communication deficits including missing or incomplete information which made it difficult for the patient to enact or understand the plan of care. Medication prescription related issues were the next most common. Resource barriers and questions surrounding medications were often unaddressed. Post discharge issues affect patients discharged from all services equally. Data from call back programs may provide actionable targets for improvement, identify the inpatient team's 'blind spots' and be used to provide feedback to clinicians.

  5. Adaptive Distributed Environment for Procedure Training (ADEPT)

    NASA Technical Reports Server (NTRS)

    Domeshek, Eric; Ong, James; Mohammed, John

    2013-01-01

    ADEPT (Adaptive Distributed Environment for Procedure Training) is designed to provide more effective, flexible, and portable training for NASA systems controllers. When creating a training scenario, an exercise author can specify a representative rationale structure using the graphical user interface, annotating the results with instructional texts where needed. The author's structure may distinguish between essential and optional parts of the rationale, and may also include "red herrings" - hypotheses that are essential to consider, until evidence and reasoning allow them to be ruled out. The system is built from pre-existing components, including Stottler Henke's SimVentive? instructional simulation authoring tool and runtime. To that, a capability was added to author and exploit explicit control decision rationale representations. ADEPT uses SimVentive's Scalable Vector Graphics (SVG)- based interactive graphic display capability as the basis of the tool for quickly noting aspects of decision rationale in graph form. The ADEPT prototype is built in Java, and will run on any computer using Windows, MacOS, or Linux. No special peripheral equipment is required. The software enables a style of student/ tutor interaction focused on the reasoning behind systems control behavior that better mimics proven Socratic human tutoring behaviors for highly cognitive skills. It supports fast, easy, and convenient authoring of such tutoring behaviors, allowing specification of detailed scenario-specific, but content-sensitive, high-quality tutor hints and feedback. The system places relatively light data-entry demands on the student to enable its rationale-centered discussions, and provides a support mechanism for fostering coherence in the student/ tutor dialog by including focusing, sequencing, and utterance tuning mechanisms intended to better fit tutor hints and feedback into the ongoing context.

  6. Perspectives of Chinese American smoker and nonsmoker household pairs about the creating smokefree living together program.

    PubMed

    Saw, Anne; Paterniti, Debora A; Fung, Lei-Chun; Tsoh, Janice Y; Tong, Elisa K

    2018-04-01

    Chinese men smoke at high rates, and this puts household members at risk for tobacco-related diseases. Culturally responsive interventions that provide education and support are needed to promote smokefree living and reduce smoke exposure, particularly for US immigrants who experience changes in smokefree social norms. This qualitative study examines perspectives of Chinese American smoker and nonsmoker household pairs in the Creating Smokefree Living Together program. Four focus groups were conducted with 30 Chinese American participants (15 smokers and 15 nonsmokers) who, in household pairs, completed smokefree education interventions of either brief or moderate intensity. Nearly three-quarters of the smokers continued to smoke after the intervention at the time of focus group participation. All smokers were male, and most household nonsmokers were female spouses. All participants had limited English proficiency. Focus group meetings were recorded, and the recordings were translated and transcribed. Transcripts and field notes were thematically analyzed. The following themes, shared by smokers and nonsmokers across interventions, were identified: 1) there was a preference for dyadic and group interventions because of the support offered, 2) increased knowledge of the health harms of smoke exposure within a pair improved the nonsmoker's support for smokefree living, 3) learning communication strategies improved household relationships and assertiveness for smokefree environments, 4) biochemical feedback was useful but had short-term effects, and 5) project magnets provided cues to action. Involving household partners is critical to smokefree interventions. Simple reminders at home appear to be more powerful than personal biochemical feedback of smoke exposure for sustaining motivation and engagement in ongoing behavioral changes within the household. Cancer 2018;124:1599-606. © 2018 American Cancer Society. © 2018 American Cancer Society.

  7. Multimodal US-gamma imaging using collaborative robotics for cancer staging biopsies.

    PubMed

    Esposito, Marco; Busam, Benjamin; Hennersperger, Christoph; Rackerseder, Julia; Navab, Nassir; Frisch, Benjamin

    2016-09-01

    The staging of female breast cancer requires detailed information about the level of cancer spread through the lymphatic system. Common practice to obtain this information for patients with early-stage cancer is sentinel lymph node (SLN) biopsy, where LNs are radioactively identified for surgical removal and subsequent histological analysis. Punch needle biopsy is a less invasive approach but suffers from the lack of combined anatomical and nuclear information. We present and evaluate a system that introduces live collaborative robotic 2D gamma imaging in addition to live 2D ultrasound to identify SLNs in the surrounding anatomy. The system consists of a robotic arm equipped with both a gamma camera and a stereoscopic tracking system that monitors the position of an ultrasound probe operated by the physician. The arm cooperatively places the gamma camera parallel to the ultrasound imaging plane to provide live multimodal visualization and guidance. We validate the system by evaluating the target registration errors between fused nuclear and US image data in a phantom consisting of two spheres, one of which is filled with radioactivity. Medical experts perform punch biopsies on agar-gelatine phantoms with complex configurations of hot and cold lesions to provide a qualitative and quantitative evaluation of the system. The average point registration error for the overlay is [Formula: see text] mm. The time of the entire procedure was reduced by 36 %, with 80v of the biopsies being successful. The users' feedback was very positive, and the system was deemed to be very intuitive, with handling similar to classic US-guided needle biopsy. We present and evaluate the first medical collaborative robotic imaging system. Feedback from potential users for SLN punch needle biopsy is encouraging. Ongoing work investigates the clinical feasibility with more complex and realistic phantoms.

  8. Development and implementation of a longitudinal students as teachers program: participant satisfaction and implications for medical student teaching and learning.

    PubMed

    Yeung, Celine; Friesen, Farah; Farr, Sarah; Law, Marcus; Albert, Lori

    2017-01-31

    Teaching is a key component of medical practice, but medical students receive little formal training to develop their teaching skills. A longitudinal Students as Teachers (SAT) program was created at the University of Toronto to provide medical students with opportunities to acquire an understanding of educational pedagogy and practice teaching early in their medical training. This program was 7-months in duration and consisted of monthly educational modules, practical teaching sessions, feedback, and reflective exercises. A mixed methods study design was used to evaluate initial outcomes of the SAT program by obtaining the perspectives of 18 second-year medical students. Participants filled out questionnaires at the beginning and end of the 7-month program to indicate their skill level and confidence in teaching. Differences between pre- and post-intervention scores were further explored in a group interview of 5 participants. Participants expressed a high degree of satisfaction with the SAT program structure and found the educational modules and practical teaching sessions to be particularly beneficial to their learning. Over the course of the program, there were significant increases in students' confidence in teaching, and self-perceived teaching capacity and communication skills. Furthermore, participants discussed improvements in their effectiveness as learners. Teaching is a skill that requires ongoing practice. Our results suggest that a longitudinal program consisting of theoretical modules, practical teaching sessions, feedback, and reflective exercises for medical students may improve teaching and communication skills, and equip them with improved learning strategies. This program also provides students with insight into the experience of teaching while holding other academic and clinical responsibilities.

  9. Multivariable control of the Space Shuttle Remote Manipulator System using linearization by state feedback. M.S. Thesis

    NASA Technical Reports Server (NTRS)

    Gettman, Chang-Ching LO

    1993-01-01

    This thesis develops and demonstrates an approach to nonlinear control system design using linearization by state feedback. The design provides improved transient response behavior allowing faster maneuvering of payloads by the SRMS. Modeling uncertainty is accounted for by using a second feedback loop designed around the feedback linearized dynamics. A classical feedback loop is developed to provide the easy implementation required for the relatively small on board computers. Feedback linearization also allows the use of higher bandwidth model based compensation in the outer loop, since it helps maintain stability in the presence of the nonlinearities typically neglected in model based designs.

  10. Providing Students with Formative Audio Feedback

    ERIC Educational Resources Information Center

    Brearley, Francis Q.; Cullen, W. Rod

    2012-01-01

    The provision of timely and constructive feedback is increasingly challenging for busy academics. Ensuring effective student engagement with feedback is equally difficult. Increasingly, studies have explored provision of audio recorded feedback to enhance effectiveness and engagement with feedback. Few, if any, of these focus on purely formative…

  11. Role of combined tactile and kinesthetic feedback in minimally invasive surgery.

    PubMed

    Lim, Soo-Chul; Lee, Hyung-Kew; Park, Joonah

    2014-10-18

    Haptic feedback is of critical importance in surgical tasks. However, conventional surgical robots do not provide haptic feedback to surgeons during surgery. Thus, in this study, a combined tactile and kinesthetic feedback system was developed to provide haptic feedback to surgeons during robotic surgery. To assess haptic feasibility, the effects of two types of haptic feedback were examined empirically - kinesthetic and tactile feedback - to measure object-pulling force with a telesurgery robotics system at two desired pulling forces (1 N and 2 N). Participants answered a set of questionnaires after experiments. The experimental results reveal reductions in force error (39.1% and 40.9%) when using haptic feedback during 1 N and 2 N pulling tasks. Moreover, survey analyses show the effectiveness of the haptic feedback during teleoperation. The combined tactile and kinesthetic feedback of the master device in robotic surgery improves the surgeon's ability to control the interaction force applied to the tissue. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  12. Motivation and intelligence drive auditory perceptual learning.

    PubMed

    Amitay, Sygal; Halliday, Lorna; Taylor, Jenny; Sohoglu, Ediz; Moore, David R

    2010-03-23

    Although feedback on performance is generally thought to promote perceptual learning, the role and necessity of feedback remain unclear. We investigated the effect of providing varying amounts of positive feedback while listeners attempted to discriminate between three identical tones on learning frequency discrimination. Using this novel procedure, the feedback was meaningless and random in relation to the listeners' responses, but the amount of feedback provided (or lack thereof) affected learning. We found that a group of listeners who received positive feedback on 10% of the trials improved their performance on the task (learned), while other groups provided either with excess (90%) or with no feedback did not learn. Superimposed on these group data, however, individual listeners showed other systematic changes of performance. In particular, those with lower non-verbal IQ who trained in the no feedback condition performed more poorly after training. This pattern of results cannot be accounted for by learning models that ascribe an external teacher role to feedback. We suggest, instead, that feedback is used to monitor performance on the task in relation to its perceived difficulty, and that listeners who learn without the benefit of feedback are adept at self-monitoring of performance, a trait that also supports better performance on non-verbal IQ tests. These results show that 'perceptual' learning is strongly influenced by top-down processes of motivation and intelligence.

  13. Effects of generic versus non-generic feedback on motor learning in children.

    PubMed

    Chiviacowsky, Suzete; Drews, Ricardo

    2014-01-01

    Non-generic feedback refers to a specific event and implies that performance is malleable, while generic feedback implies that task performance reflects an inherent ability. The present study examined the influences of generic versus non-generic feedback on motor performance and learning in 10-year-old children. In the first experiment, using soccer ball kicking at a target as a task, providing participants with generic feedback resulted in worse performance than providing non-generic feedback, after both groups received negative feedback. The second experiment measured more permanent effects. Results of a retention test, performed one day after practicing a throwing task, showed that participants who received non-generic feedback during practice outperformed the generic feedback group, after receiving a negative feedback statement. The findings demonstrate the importance of the wording of feedback. Even though different positive feedback statements may not have an immediate influence on performance, they can affect performance, and presumably individuals' motivation, when performance is (purportedly) poor. Feedback implying that performance is malleable, rather than due to an inherent ability, seems to have the potential to inoculate learners against setbacks--a situation frequently encountered in the context of motor performance and learning.

  14. Effects of Generic versus Non-Generic Feedback on Motor Learning in Children

    PubMed Central

    Chiviacowsky, Suzete; Drews, Ricardo

    2014-01-01

    Non-generic feedback refers to a specific event and implies that performance is malleable, while generic feedback implies that task performance reflects an inherent ability. The present study examined the influences of generic versus non-generic feedback on motor performance and learning in 10-year-old children. In the first experiment, using soccer ball kicking at a target as a task, providing participants with generic feedback resulted in worse performance than providing non-generic feedback, after both groups received negative feedback. The second experiment measured more permanent effects. Results of a retention test, performed one day after practicing a throwing task, showed that participants who received non-generic feedback during practice outperformed the generic feedback group, after receiving a negative feedback statement. The findings demonstrate the importance of the wording of feedback. Even though different positive feedback statements may not have an immediate influence on performance, they can affect performance, and presumably individuals' motivation, when performance is (purportedly) poor. Feedback implying that performance is malleable, rather than due to an inherent ability, seems to have the potential to inoculate learners against setbacks – a situation frequently encountered in the context of motor performance and learning. PMID:24523947

  15. The Impact of Incentivizing the Use of Feedback on Learning and Performance in Educational Videogames

    NASA Technical Reports Server (NTRS)

    Delacruz, Girlie C.

    2012-01-01

    Educational videogames can be designed to provide instructional feedback responsive to specific actions. However, existing research indicates that students tend to ignore the feedback provided. That is, students often use ineffective help-seeking strategies. Research on the topic of help-seeking in learning environments have primarily focused on the role of cognitive factors, the nature of the help, or issues of timing and frequency. There is a noticeable gap in understanding how to motivate the use provided feedback. This study examined the relation between incentivizing the use of feedback and providing an explanation of the game's scoring rules on math learning in a pre-algebra videogame. A randomized-control design was used, comparing learning outcomes of students who received the incentive with those who did not. Results indicated that students given the incentive to use feedback had significantly higher normalized change scores on math items (d = .53), with stronger effects for students with low academic intrinsic motivation (d = .88 - 1.17).

  16. Using Arrays of Microelectrodes Implanted in Residual Peripheral Nerves to Provide Dextrous Control of, and Modulated Sensory Feedback from, a Hand Prosthesis

    DTIC Science & Technology

    2015-10-01

    Modulated Sensory Feedback from, a Hand Prosthesis PRINCIPAL INVESTIGATOR: Bradley Greger, PhD CONTRACTING ORGANIZATION: Arizona State University...Residual Peripheral Nerves to Provide Dextrous Control of, and Modulated Sensory Feedback from, a Hand Prosthesis 5a. CONTRACT NUMBER 5b. GRANT...Peripheral Nerve Interface, Prosthetic Hand, Neural Prosthesis , Sensory Feedback, Micro-stimulation, Electrophysiology, Action Potentials, Micro

  17. Training Sessional Academic Staff to Provide Quality Feedback on University Students' Assessment: Lessons from a Faculty of Law Learning and Teaching Project

    ERIC Educational Resources Information Center

    Richards, Kelly; Bell, Tamara; Dwyer, Angela

    2017-01-01

    The quality of feedback provided to university students has long been recognised as the most important predictor of student learning and satisfaction. However, providing quality feedback to students is challenging in the current context, in which universities increasingly rely on casualised and inexperienced academic staff to assess undergraduate…

  18. A novel smart lighting clinical testbed.

    PubMed

    Gleason, Joseph D; Oishi, Meeko; Simkulet, Michelle; Tuzikas, Arunas; Brown, Lee K; Brueck, S R J; Karlicek, Robert F

    2017-07-01

    A real-time, feedback-capable, variable spectrum lighting system was recently installed at the University of New Mexico Hospital to facilitate biomedical research on the health impacts of lighting. The system consists of variable spectrum troffers, color sensors, occupancy sensors, and computing and communication infrastructure, and is the only such clinical facility in the US. The clinical environment posed special challenges for installation as well as for ongoing maintenance and operations. Pilot studies are currently underway to evaluate the effectiveness of the system to regulate circadian phase in subjects with delayed sleep-wake phase disorder.

  19. Analysis of the 323rd Flying Training Wing Using Organizational Development and the Action Research Model: A Communications Audit.

    DTIC Science & Technology

    1979-05-15

    United - -r’TA a~ y, Colorado Submitted in partial satisfaction of the requirements for the degree of MASTER OF ARTS in SPEECH COMMUNICATION V.r at...were developed, one by Fiedler and the other by Vroom , and finally the action research model proposed by French and Bell. All three have a different... Performance ," Org.anizational Behavior and Human Performance 3(1968): 143. 9 David A. Nadler, Philip H. Mirvis, and Cortland T. Cammann, "The Ongoing Feedback

  20. Adaptive Interface Approach Using a Real Time Biocybernetic System: Control of Hazardous Awareness

    NASA Technical Reports Server (NTRS)

    Ray, William J.

    2002-01-01

    The focus of this current grant was to continue our work which focused on the manner in which psychophysiological markers can be used to index hazardous states of awareness and to explore the feasibility of developing on-line systems that utilize real time feedback to modify on-going behavioral processes. In this work we have incorporated a multifaceted approach which includes psychophysiological, subjective, and performance based measures. We have considered this from both an internal and external perspective as reflected in work from a variety of labs.

  1. Lessons from Alternative Grading: Essential Qualities of Teacher Feedback

    ERIC Educational Resources Information Center

    Percell, Jay C.

    2017-01-01

    One critically important step in the instructional process is providing feedback to students, and yet, providing timely and thorough feedback is often lacking due attention. Reasons for this oversight could range from several factors including increased class sizes, vast content coverage requirements, extracurricular responsibilities, and the…

  2. Archive interoperability in the Virtual Observatory

    NASA Astrophysics Data System (ADS)

    Genova, Françoise

    2003-02-01

    Main goals of Virtual Observatory projects are to build interoperability between astronomical on-line services, observatory archives, databases and results published in journals, and to develop tools permitting the best scientific usage from the very large data sets stored in observatory archives and produced by large surveys. The different Virtual Observatory projects collaborate to define common exchange standards, which are the key for a truly International Virtual Observatory: for instance their first common milestone has been a standard allowing exchange of tabular data, called VOTable. The Interoperability Work Area of the European Astrophysical Virtual Observatory project aims at networking European archives, by building a prototype using the CDS VizieR and Aladin tools, and at defining basic rules to help archive providers in interoperability implementation. The prototype is accessible for scientific usage, to get user feedback (and science results!) at an early stage of the project. ISO archive participates very actively to this endeavour, and more generally to information networking. The on-going inclusion of the ISO log in SIMBAD will allow higher level links for users.

  3. Building Capacity for Data-Driven Decision Making in African HIV Testing Programs: Field Perspectives on Data Use Workshops.

    PubMed

    Courtenay-Quirk, Cari; Spindler, Hilary; Leidich, Aimee; Bachanas, Pam

    2016-12-01

    Strategic, high quality HIV testing services (HTS) delivery is an essential step towards reaching the end of AIDS by 2030. We conducted HTS Data Use workshops in five African countries to increase data use for strategic program decision-making. Feedback was collected on the extent to which workshop skills and tools were applied in practice and to identify future capacity-building needs. We later conducted six semistructured phone interviews with workshop planning teams and sent a web-based survey to 92 past participants. The HTS Data Use workshops provided accessible tools that were readily learned by most respondents. While most respondents reported increased confidence in interpreting data and frequency of using such tools over time, planning team representatives indicated ongoing needs for more automated tools that can function across data systems. To achieve ambitious global HIV/AIDS targets, national decision makers may continue to seek tools and skill-building opportunities to monitor programs and identify opportunities to refine strategies.

  4. Object and event recognition for stroke rehabilitation

    NASA Astrophysics Data System (ADS)

    Ghali, Ahmed; Cunningham, Andrew S.; Pridmore, Tony P.

    2003-06-01

    Stroke is a major cause of disability and health care expenditure around the world. Existing stroke rehabilitation methods can be effective but are costly and need to be improved. Even modest improvements in the effectiveness of rehabilitation techniques could produce large benefits in terms of quality of life. The work reported here is part of an ongoing effort to integrate virtual reality and machine vision technologies to produce innovative stroke rehabilitation methods. We describe a combined object recognition and event detection system that provides real time feedback to stroke patients performing everyday kitchen tasks necessary for independent living, e.g. making a cup of coffee. The image plane position of each object, including the patient"s hand, is monitored using histogram-based recognition methods. The relative positions of hand and objects are then reported to a task monitor that compares the patient"s actions against a model of the target task. A prototype system has been constructed and is currently undergoing technical and clinical evaluation.

  5. Ecohydrological consequences of vegetation interactions within the critical zone in the tropical Andes: multi-scale assessment of vegetation change consequences

    NASA Astrophysics Data System (ADS)

    Villegas, J. C.; Salazar, J. F.; Arias, P. A.; León, J. D.

    2017-12-01

    Land cover transformation is currently one of the most important challenges in tropical South America. These transformations occur both because of climate-related ecological perturbations, as well as in response to ongoing socio-economic processes. A fundamental difference between those two drivers is the spatial and temporal scale at which they operate. However, when considered in a larger context, both drivers affect the ability of ecosystems to provide fundamental services to society. In this work, we use a multi-scale approach to identify key-mechanisms through which land cover transformation significantly affects ecological, hydrological and ecoclimatological dynamics, potentially leading to loss of societally-critical regulation services. We propose a suite of examples spanning multiple spatial and temporal scales that illustrate the effects of land cover trnasformations in ecological, hydrological, biogeochemical and climatic functions in tropical South America. These examples highlight important global-change-effects management challenges, as well as the need to consider the feedbacks and interactions between multi-scale processes.

  6. An Exploratory Study of Intensive Neurofeedback Training for Schizophrenia.

    PubMed

    Nan, Wenya; Wan, Feng; Chang, Lanshin; Pun, Sio Hang; Vai, Mang I; Rosa, Agostinho

    2017-01-01

    Schizophrenia is a chronic and devastating brain disorder with ongoing cognitive, behavioral, and emotional deteriorated functions. Neurofeedback training, which enables the individuals to regulate their brain activity using a real-time feedback loop, is increasingly investigated as a potential alternative intervention for schizophrenia. This study aimed to explore the effect of short but intensive neurofeedback training for schizophrenic patients with difficulty for long-time training. A middle-aged woman with chronic schizophrenia completed the intensive training of alpha/beta2 (20-30 Hz) in four consecutive days with a total training duration of 13.5 hours. The results showed that her alpha/beta2 increased over sessions, and her behavior performance including short-term memory, mood, and speech pattern was improved at the end of neurofeedback training. Importantly, a 22-month follow-up found a dramatic improvement in both positive and negative symptoms. These positive outcomes suggest that such intensive neurofeedback training may provide new insight into the treatment of schizophrenia and thus deserves further study to fully examine its scope.

  7. Grant writing in the home health arena: the proposal.

    PubMed

    Alvarez, M E

    1999-01-01

    If at first you don't get funded, try, try, try again. Match your program with another funder. Some funders, such as private foundations, have ongoing deadlines. Grant funding is extremely competitive and can be political. Network with funders. Also network with board members, businesses, etc., who may know someone who serves on the grant funders review committee. Take a grant writing workshop and have your proposal reviewed by someone who can provide feedback. Gather grant-writing resources in the form of books, workshop materials, and Websites. Lastly, try to keep abreast of the trends in the grant field. The latest trend I have heard is an interest in having the problem statement become more positive. Focus on the strengths upon which you can build rather than the weaknesses of a community. Grant money is available from many resources in differing amounts. Test your ability at a local level. Begin developing a track record, then work to the state and federal levels. It is an exciting and challenging opportunity to better your community.

  8. The Self-Paced Graz Brain-Computer Interface: Methods and Applications

    PubMed Central

    Scherer, Reinhold; Schloegl, Alois; Lee, Felix; Bischof, Horst; Janša, Janez; Pfurtscheller, Gert

    2007-01-01

    We present the self-paced 3-class Graz brain-computer interface (BCI) which is based on the detection of sensorimotor electroencephalogram (EEG) rhythms induced by motor imagery. Self-paced operation means that the BCI is able to determine whether the ongoing brain activity is intended as control signal (intentional control) or not (non-control state). The presented system is able to automatically reduce electrooculogram (EOG) artifacts, to detect electromyographic (EMG) activity, and uses only three bipolar EEG channels. Two applications are presented: the freeSpace virtual environment (VE) and the Brainloop interface. The freeSpace is a computer-game-like application where subjects have to navigate through the environment and collect coins by autonomously selecting navigation commands. Three subjects participated in these feedback experiments and each learned to navigate through the VE and collect coins. Two out of the three succeeded in collecting all three coins. The Brainloop interface provides an interface between the Graz-BCI and Google Earth. PMID:18350133

  9. A survey of pedagogical approaches and quality mechanisms used in education programs for mental health professionals.

    PubMed

    McCann, Edward; Higgins, Agnes; Maguire, Gerry; Alexander, Jane; Watts, Mike; Creaner, Mary; Rani, Shobha

    2012-09-01

    The provision of high-quality education and training that is responsive, relevant, accessible and evidence based is critical if the vision for quality mental health services presented in recent policy initiatives in Ireland is to be fulfilled. This paper reports the findings related to pedagogical approaches and quality assurance mechanisms utilized within mental health education. The study involved canvassing all Higher Education Institutions in Ireland. A total of 227 courses in 31 educational institutes were identified and 149 questionnaires were returned from 129 Course Coordinators. Various quality processes were identified in existing programs; however, formal feedback from service providers, service users and carers was seldom reported. Ongoing evaluation and quality assurance strategies are a key element of governance and there is a need to develop strategies that explore the impact of education programs on mental health education and health outcomes. Recommendations are made in terms of future interprofessional mental health education and practice.

  10. The Green Bank Ammonia Survey: Unveiling the Dynamics of the Barnard 59 Star-forming Clump

    NASA Astrophysics Data System (ADS)

    Redaelli, E.; Alves, F. O.; Caselli, P.; Pineda, J. E.; Friesen, R. K.; Chacón-Tanarro, A.; Matzner, C. D.; Ginsburg, A.; Rosolowsky, E.; Keown, J.; Offner, S. S. R.; Di Francesco, J.; Kirk, H.; Myers, P. C.; Hacar, A.; Cimatti, A.; Chen, H. H.; Chen, M. C.; Lee, K. I.; Seo, Y. M.

    2017-12-01

    Understanding the early stages of star formation is a research field of ongoing development, both theoretically and observationally. In this context, molecular data have been continuously providing observational constraints on the gas dynamics at different excitation conditions and depths in the sources. We have investigated the Barnard 59 core, the only active site of star formation in the Pipe Nebula, to achieve a comprehensive view of the kinematic properties of the source. This information was derived by simultaneously fitting ammonia inversion transition lines (1, 1) and (2, 2). Our analysis unveils the imprint of protostellar feedback, such as increasing line widths, temperature, and turbulent motions in our molecular data. Combined with complementary observations of dust thermal emission, we estimate that the core is gravitationally bound following a virial analysis. If the core is not contracting, another source of internal pressure, most likely the magnetic field, is supporting it against gravitational collapse and limits its star formation efficiency.

  11. The NCI Thesaurus quality assurance life cycle.

    PubMed

    de Coronado, Sherri; Wright, Lawrence W; Fragoso, Gilberto; Haber, Margaret W; Hahn-Dantona, Elizabeth A; Hartel, Francis W; Quan, Sharon L; Safran, Tracy; Thomas, Nicole; Whiteman, Lori

    2009-06-01

    The National Cancer Institute Enterprise Vocabulary Services (NCI EVS) uses a wide range of quality assurance (QA) techniques to maintain and extend NCI Thesaurus (NCIt). NCIt is a reference terminology and biomedical ontology used in a growing number of NCI and other systems that extend from translational and basic research through clinical care to public information and administrative activities. Both automated and manual QA techniques are employed throughout the editing and publication cycle, which includes inserting and editing NCIt in NCI Metathesaurus. NCI EVS conducts its own additional periodic and ongoing content QA. External reviews, and extensive evaluation by and interaction with EVS partners and other users, have also played an important part in the QA process. There have always been tensions and compromises between meeting the needs of dependent systems and providing consistent and well-structured content; external QA and feedback have been important in identifying and addressing such issues. Currently, NCI EVS is exploring new approaches to broaden external participation in the terminology development and QA process.

  12. The Leadership Lab for Women: Advancing and Retaining Women in STEM through Professional Development

    PubMed Central

    Van Oosten, Ellen B.; Buse, Kathleen; Bilimoria, Diana

    2017-01-01

    Innovative professional development approaches are needed to address the ongoing lack of women leaders in science, technology, engineering, and math (STEM) careers. Developed from the research on women who persist in engineering and computing professions and essential elements of women’s leadership development, the Leadership Lab for Women in STEM Program was launched in 2014. The Leadership Lab was created as a research-based leadership development program, offering 360-degree feedback, coaching, and practical strategies aimed at increasing the advancement and retention of women in the STEM professions. The goal is to provide women with knowledge, tools and a supportive learning environment to help them navigate, achieve, flourish, and catalyze organizational change in male-dominated and technology-driven organizations. This article describes the importance of creating unique development experiences for women in STEM fields, the genesis of the Leadership Lab, the design and content of the program, and the outcomes for the participants. PMID:29326618

  13. Driving experience and special skills reflected in eye movements

    NASA Astrophysics Data System (ADS)

    Paeglis, Roberts; Bluss, Kristaps; Atvars, Aigars

    2011-10-01

    When driving a vehicle, people use the central vision both to plan ahead and monitor their performance feedback (research by Donges, 1978 [1], and after). Discussion is ongoing if making eye movements do more than gathering information. Moving eyes may also prepare the following body movements like steering. Different paradigms exist to explore vision in driving. Our perspective was to quantify eye movements and fixation patterns of different proficiency individuals, a driving learner, a novice, an experienced driver and a European level car racer. Thus for safety reasons we started by asking them to follow a video tour through a known city, remote from an infrared eye tracker sampling at 250 Hz. We report that gaze strategy of an experienced driver differs qualitatively from that of an automobile sports master. Quantitative differences only were found between the latter and a driving learner or a novice driver. Experience in a motor action provides skills different from sports training. We are aiming at testing this finding in real world driving.

  14. Online Instructor's Use of Audio Feedback to Increase Social Presence and Student Satisfaction

    ERIC Educational Resources Information Center

    Portolese Dias, Laura; Trumpy, Robert

    2014-01-01

    This study investigates the impact of written group feedback, versus audio feedback, based upon four student satisfaction measures in the online classroom environment. Undergraduate students in the control group were provided both individual written feedback and group written feedback, while undergraduate students in the experimental treatment…

  15. Complexity, Cues and Relationships: Student Perceptions of Feedback

    ERIC Educational Resources Information Center

    Pokorny, Helen; Pickford, Pamela

    2010-01-01

    This article discusses issues relating to the effectiveness of feedback and the student perspective. The study described provides rich data relating to student perceptions of useful feedback, their perceptions of feedback cues and their feelings about the importance of feedback relationships in the process. The outcomes suggest that written…

  16. Written Corrective Feedback: Student Preferences and Teacher Feedback Practices

    ERIC Educational Resources Information Center

    Irwin, Bradley

    2017-01-01

    This case study explores the intricate interaction between students' preferences for written corrective feedback and actual teacher feedback practices in a second year academic EFL writing class in a Japanese university. Specific institutional and instructional details establish the context in which written feedback is being provided. A…

  17. Feedback on Feedback Practice: Perceptions of Students and Academics

    ERIC Educational Resources Information Center

    Mulliner, Emma; Tucker, Matthew

    2017-01-01

    While feedback is widely considered central to student learning, students across the higher education sector commonly report dissatisfaction with the feedback they receive. In contrast, academics often feel they provide quality and informative feedback. This article explores and compares the perceptions of students and academics with regard to…

  18. Provider perceptions of an integrated primary care quality improvement strategy: The PPAQ toolkit.

    PubMed

    Beehler, Gregory P; Lilienthal, Kaitlin R

    2017-02-01

    The Primary Care Behavioral Health (PCBH) model of integrated primary care is challenging to implement with high fidelity. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) was designed to assess provider adherence to essential model components and has recently been adapted into a quality improvement toolkit. The aim of this pilot project was to gather preliminary feedback on providers' perceptions of the acceptability and utility of the PPAQ toolkit for making beneficial practice changes. Twelve mental health providers working in Department of Veterans Affairs integrated primary care clinics participated in semistructured interviews to gather quantitative and qualitative data. Descriptive statistics and qualitative content analysis were used to analyze data. Providers identified several positive features of the PPAQ toolkit organization and structure that resulted in high ratings of acceptability, while also identifying several toolkit components in need of modification to improve usability. Toolkit content was considered highly representative of the (PCBH) model and therefore could be used as a diagnostic self-assessment of model adherence. The toolkit was considered to be high in applicability to providers regardless of their degree of prior professional preparation or current clinical setting. Additionally, providers identified several system-level contextual factors that could impact the usefulness of the toolkit. These findings suggest that frontline mental health providers working in (PCBH) settings may be receptive to using an adherence-focused toolkit for ongoing quality improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Beneficial "halo effects" of surgical resident performance feedback.

    PubMed

    Lau, Brandyn D; Streiff, Michael B; Hobson, Deborah B; Kraus, Peggy S; Shaffer, Dauryne L; Popoola, Victor O; Farrow, Norma E; Efron, David T; Haut, Elliott R

    2016-09-01

    Venous thromboembolism (VTE) prevention is one of the most frequent measures of quality in hospital settings. In 2013, we began providing individualized feedback to general surgery residents about their VTE prophylaxis prescribing habits for general surgical patients. The purpose of this study was to investigate the indirect, or "halo effects" of providing individualized performance feedback to residents regarding prescription of appropriate VTE prophylaxis. This retrospective cohort study compared appropriate VTE prophylaxis prescription for all patients admitted to the adult trauma service from July 1, 2012 to May 31, 2015 at The Johns Hopkins Hospital, an academic hospital and Level 1 trauma center in Baltimore, Maryland. On October 1, 2013, we began providing monthly performance feedback to general surgery residents regarding their VTE prophylaxis prescribing habits for general surgery patients. Data were not provided about their prescription practice for trauma patients, or to any other prescribers within the hospital. During the study period, 931 adult trauma patients were admitted to the adult trauma service. After providing individualized feedback about general surgery patients, general surgery residents' prescribing practice for writing appropriate VTE prophylaxis orders for adult trauma patients significantly improved (93.9% versus 78.1%, P < 0.001). Prescription practice significantly improved among all other prescribers although they did not receive any specific individualized feedback, (84.9% versus 75.1%, P = 0.025); however, practice was significantly better among general surgery residents versus other providers (93.9% versus 84.9%, P = 0.003). There is a beneficial "halo effect" for patients treated by residents receiving individualized feedback about practice habits. Individualized feedback regarding practice habits for one patient type has both a direct and indirect effect on the quality of care patients receive and should be implemented for all providers. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Tributaries affect the thermal response of lakes to climate change

    NASA Astrophysics Data System (ADS)

    Råman Vinnå, Love; Wüest, Alfred; Zappa, Massimiliano; Fink, Gabriel; Bouffard, Damien

    2018-01-01

    Thermal responses of inland waters to climate change varies on global and regional scales. The extent of warming is determined by system-specific characteristics such as fluvial input. Here we examine the impact of ongoing climate change on two alpine tributaries, the Aare River and the Rhône River, and their respective downstream peri-alpine lakes: Lake Biel and Lake Geneva. We propagate regional atmospheric temperature effects into river discharge projections. These, together with anthropogenic heat sources, are in turn incorporated into simple and efficient deterministic models that predict future water temperatures, river-borne suspended sediment concentration (SSC), lake stratification and river intrusion depth/volume in the lakes. Climate-induced shifts in river discharge regimes, including seasonal flow variations, act as positive and negative feedbacks in influencing river water temperature and SSC. Differences in temperature and heating regimes between rivers and lakes in turn result in large seasonal shifts in warming of downstream lakes. The extent of this repressive effect on warming is controlled by the lakes hydraulic residence time. Previous studies suggest that climate change will diminish deep-water oxygen renewal in lakes. We find that climate-related seasonal variations in river temperatures and SSC shift deep penetrating river intrusions from summer towards winter. Thus potentially counteracting the otherwise negative effects associated with climate change on deep-water oxygen content. Our findings provide a template for evaluating the response of similar hydrologic systems to on-going climate change.

  1. Developing students' teaching through peer observation and feedback.

    PubMed

    Rees, Eliot L; Davies, Benjamin; Eastwood, Michael

    2015-10-01

    With the increasing popularity and scale of peer teaching, it is imperative to develop methods that ensure the quality of teaching provided by undergraduate students. We used an established faculty development and quality assurance process in a novel context: peer observation of teaching for undergraduate peer tutors. We have developed a form to record observations and aid the facilitation of feedback. In addition, experienced peer tutors have been trained to observe peer-taught sessions and provide tutors with verbal and written feedback. We have found peer observation of teaching to be a feasible and acceptable process for improving quality of teaching provided by undergraduate medical students. However, feedback regarding the quality of peer observer's feedback may help to develop students' abilities further.

  2. Audit feedback on reading performance of screening mammograms: An international comparison.

    PubMed

    Hofvind, S; Bennett, R L; Brisson, J; Lee, W; Pelletier, E; Flugelman, A; Geller, B

    2016-09-01

    Providing feedback to mammography radiologists and facilities may improve interpretive performance. We conducted a web-based survey to investigate how and why such feedback is undertaken and used in mammographic screening programmes. The survey was sent to representatives in 30 International Cancer Screening Network member countries where mammographic screening is offered. Seventeen programmes in 14 countries responded to the survey. Audit feedback was aimed at readers in 14 programmes, and facilities in 12 programmes. Monitoring quality assurance was the most common purpose of audit feedback. Screening volume, recall rate, and rate of screen-detected cancers were typically reported performance measures. Audit reports were commonly provided annually, but more frequently when target guidelines were not reached. The purpose, target audience, performance measures included, form and frequency of the audit feedback varied amongst mammographic screening programmes. These variations may provide a basis for those developing and improving such programmes. © The Author(s) 2016.

  3. The challenge of giving written thesis feedback to nursing students.

    PubMed

    Tuvesson, Hanna; Borglin, Gunilla

    2014-11-01

    Providing effective written feedback on nursing student's assignments can be a challenging task for any assessor. Additionally, as the student groups tend to become larger, written feedback is likely to gain an overall more prominent position than verbal feedback. Lack of formal training or regular discussion in the teaching faculty about the skill set needed to provide written feedback could negatively affect the students' learning abilities. In this brief paper, we discuss written feedback practices, whilst using the Bachelor of Science in Nursing thesis as an example. Our aim is to highlight the importance of an informed understanding of the impact written feedback can have on students. Creating awareness about this can facilitate the development of more strategic and successful written feedback strategies. We end by offering examples of some relatively simple strategies for improving this practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Collaborative and Bidirectional Feedback Between Students and Clinical Preceptors: Promoting Effective Communication Skills on Health Care Teams.

    PubMed

    Myers, Kara; Chou, Calvin L

    2016-11-01

    Current literature on feedback suggests that clinical preceptors lead feedback conversations that are primarily unidirectional, from preceptor to student. While this approach may promote clinical competency, it does not actively develop students' competency in facilitating feedback discussions and providing feedback across power differentials (ie, from student to preceptor). This latter competency warrants particular attention given its fundamental role in effective health care team communication and its related influence on patient safety. Reframing the feedback process as collaborative and bidirectional, where both preceptors and students provide and receive feedback, maximizes opportunities for role modeling and skills practice in the context of a supportive relationship, thereby enhancing team preparedness. We describe an initiative to introduce these fundamental skills of collaborative, bidirectional feedback in the nurse-midwifery education program at the University of California, San Francisco. © 2016 by the American College of Nurse-Midwives.

  5. Harnessing Scientific Literature Reports for Pharmacovigilance

    PubMed Central

    Ripple, Anna; Tonning, Joseph; Munoz, Monica; Hasan, Rashedul; Ly, Thomas; Francis, Henry; Bodenreider, Olivier

    2017-01-01

    Summary Objectives We seek to develop a prototype software analytical tool to augment FDA regulatory reviewers’ capacity to harness scientific literature reports in PubMed/MEDLINE for pharmacovigilance and adverse drug event (ADE) safety signal detection. We also aim to gather feedback through usability testing to assess design, performance, and user satisfaction with the tool. Methods A prototype, open source, web-based, software analytical tool generated statistical disproportionality data mining signal scores and dynamic visual analytics for ADE safety signal detection and management. We leveraged Medical Subject Heading (MeSH) indexing terms assigned to published citations in PubMed/MEDLINE to generate candidate drug-adverse event pairs for quantitative data mining. Six FDA regulatory reviewers participated in usability testing by employing the tool as part of their ongoing real-life pharmacovigilance activities to provide subjective feedback on its practical impact, added value, and fitness for use. Results All usability test participants cited the tool’s ease of learning, ease of use, and generation of quantitative ADE safety signals, some of which corresponded to known established adverse drug reactions. Potential concerns included the comparability of the tool’s automated literature search relative to a manual ‘all fields’ PubMed search, missing drugs and adverse event terms, interpretation of signal scores, and integration with existing computer-based analytical tools. Conclusions Usability testing demonstrated that this novel tool can automate the detection of ADE safety signals from published literature reports. Various mitigation strategies are described to foster improvements in design, productivity, and end user satisfaction. PMID:28326432

  6. A Randomized Trial of Genetic and Environmental Risk Assessment (GERA) for Colorectal Cancer Risk in Primary Care: Trial Design and Baseline Findings

    PubMed Central

    Myers, Ronald E.; Manne, Sharon L.; Wilfond, Benjamin; Sifri, Randa; Ziring, Barry; Wolf, Thomas A.; Cocroft, James; Ueland, Amy; Petrich, Anett; Swan, Heidi; DiCarlo, Melissa; Weinberg, David S.

    2010-01-01

    Purpose This paper describes an ongoing randomized controlled trial designed to assess the impact of genetic and environmental risk assessment (GERA) on colorectal cancer (CRC) screening. Methods The trial includes asymptomatic patients who are 50-79 years and are not up-to-date with CRC screening guidelines. Patients who responded to a baseline telephone survey are randomized to a GERA or Control group. GERA Group participants meet with a nurse, decide whether to have a GERA blood test (a combination of genetic polymorphism and folate), and, if tested, receive GERA feedback. Follow-up telephone surveys are conducted at one and six months. A chart audit is performed at six months. Results Of 2,223 eligible patients, 562 (25%) have enrolled. Patients who enrolled in the study were significantly younger than those who did not (p<0.001). Participants tended to be 50-59 years (64%), female (58%), white (52%), married (51%), and have more than a high school education (67%). At baseline, most participants had some knowledge of CRC screening and GERA, viewed CRC screening favorably, and reported that they had decided to do screening. Almost half had worries and concerns about CRC. Conclusions One in four eligible primary care patients enrolled in the study. Age was negatively associated with enrollment. Prospective analyses using data for all participants will provide more definitive information on GERA uptake and the impact of GERA feedback. PMID:20828635

  7. ESA SSA Space Radiation Expert Service Centre: the Importance of Community Feedback

    NASA Astrophysics Data System (ADS)

    Crosby, Norma; Dierckxsens, Mark; Kruglanski, Michel; De Donder, Erwin; Calders, Stijn; Messios, Neophytos; Glover, Alexi

    2017-04-01

    End-users in a wide range of sectors both in space and on the ground are affected by space weather. In the frame of its Space Situational Awareness (SSA) programme (http://swe.ssa.esa.int/) the European Space Agency (ESA) is establishing a Space Weather (SWE) Service Network to support end-users in three ways: mitigate the effects of space weather on their systems, reduce costs, and improve reliability. Almost 40 expert groups from institutes and organisations across Europe contribute to this Network organised in five Expert Service Centres (ESCs) - Solar Weather, Heliospheric Weather, Space Radiation, Ionospheric Weather, Geomagnetic Conditions. To understand the end-user needs, the ESCs are supported by the SSCC (SSA Space Weather Coordination Centre) that offers first line support to the end-users. Here we present the mission of the Space Radiation ESC (R-ESC) (http://swe.ssa.esa.int/space-radiation) and the space domain services it supports. Furthermore, we describe how the R-ESC project complements past and ongoing projects both on national level as well as international (e.g. EU projects), emphasizing the importance of inter-disciplinary communication between different communities ranging from scientists, engineers to end-users. Such collaboration is needed if basic science is to be used most efficiently for the development of products and tools that provide end-users with what they actually need. Additionally, feedback from the various communities (projects) is also essential when defining future projects.

  8. A randomized trial of genetic and environmental risk assessment (GERA) for colorectal cancer risk in primary care: trial design and baseline findings.

    PubMed

    Myers, Ronald E; Manne, Sharon L; Wilfond, Benjamin; Sifri, Randa; Ziring, Barry; Wolf, Thomas A; Cocroft, James; Ueland, Amy; Petrich, Anett; Swan, Heidi; DiCarlo, Melissa; Weinberg, David S

    2011-01-01

    This paper describes an ongoing randomized controlled trial designed to assess the impact of genetic and environmental risk assessment (GERA) on colorectal cancer (CRC) screening. The trial includes asymptomatic patients who are 50-79years and are not up-to-date with CRC screening guidelines. Patients who responded to a baseline telephone survey are randomized to a GERA or Control group. GERA group participants meet with a nurse, decide whether to have a GERA blood test (a combination of genetic polymorphism and folate), and, if tested, receive GERA feedback. Follow-up telephone surveys are conducted at 1 and 6months. A chart audit is performed at 6months. Of 2,223 eligible patients, 562 (25%) have enrolled. Patients who enrolled in the study were significantly younger than those who did not (p<0.001). Participants tended to be 50-59years (64%), female (58%), white (52%), married (51%), and have more than a high school education (67%). At baseline, most participants had some knowledge of CRC screening and GERA, viewed CRC screening favorably, and reported that they had decided to do screening. Almost half had worries and concerns about CRC. One in four eligible primary care patients enrolled in the study. Age was negatively associated with enrollment. Prospective analyses using data for all participants will provide more definitive information on GERA uptake and the impact of GERA feedback. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. Harnessing scientific literature reports for pharmacovigilance. Prototype software analytical tool development and usability testing.

    PubMed

    Sorbello, Alfred; Ripple, Anna; Tonning, Joseph; Munoz, Monica; Hasan, Rashedul; Ly, Thomas; Francis, Henry; Bodenreider, Olivier

    2017-03-22

    We seek to develop a prototype software analytical tool to augment FDA regulatory reviewers' capacity to harness scientific literature reports in PubMed/MEDLINE for pharmacovigilance and adverse drug event (ADE) safety signal detection. We also aim to gather feedback through usability testing to assess design, performance, and user satisfaction with the tool. A prototype, open source, web-based, software analytical tool generated statistical disproportionality data mining signal scores and dynamic visual analytics for ADE safety signal detection and management. We leveraged Medical Subject Heading (MeSH) indexing terms assigned to published citations in PubMed/MEDLINE to generate candidate drug-adverse event pairs for quantitative data mining. Six FDA regulatory reviewers participated in usability testing by employing the tool as part of their ongoing real-life pharmacovigilance activities to provide subjective feedback on its practical impact, added value, and fitness for use. All usability test participants cited the tool's ease of learning, ease of use, and generation of quantitative ADE safety signals, some of which corresponded to known established adverse drug reactions. Potential concerns included the comparability of the tool's automated literature search relative to a manual 'all fields' PubMed search, missing drugs and adverse event terms, interpretation of signal scores, and integration with existing computer-based analytical tools. Usability testing demonstrated that this novel tool can automate the detection of ADE safety signals from published literature reports. Various mitigation strategies are described to foster improvements in design, productivity, and end user satisfaction.

  10. Teachers' Discoursal Strategies in Providing Positive Feedback to Student Responses: A Study of Four English Immersion Teachers in People's Republic of China

    ERIC Educational Resources Information Center

    Pei, Miao

    2012-01-01

    This paper investigates the discoursal strategies of four teachers in providing feedback to student responses in English classrooms in Xi'an, People's Republic of China. The findings indicate that the teachers provide positive feedback for students English learning in various ways, including using the most common strategies such as accepting,…

  11. Feedback by AGN Jets and Wide-angle Winds on a Galactic Scale

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dugan, Zachary; Silk, Joseph; Gaibler, Volker

    To investigate the differences in mechanical feedback from radio-loud and radio-quiet active galactic nuclei on the host galaxy, we perform 3D AMR hydrodynamic simulations of wide-angle, radio-quiet winds with different inclinations on a single, massive, gas-rich disk galaxy at a redshift of 2–3. We compare our results to hydrodynamic simulations of the same galaxy but with a jet. The jet has an inclination of 0° (perpendicular to the galactic plane), and the winds have inclinations of 0°, 45°, and 90°. We analyze the impact on the host’s gas, star formation, and circumgalactic medium. We find that jet feedback is energy-drivenmore » and wind feedback is momentum-driven. In all the simulations, the jet or wind creates a cavity mostly devoid of dense gas in the nuclear region where star formation is then quenched, but we find strong positive feedback in all the simulations at radii greater than 3 kpc. All four simulations have similar SFRs and stellar velocities with large radial and vertical components. However, the wind at an inclination of 90° creates the highest density regions through ram pressure and generates the highest rates of star formation due to its ongoing strong interaction with the dense gas of the galactic plane. With increased wind inclination, we find greater asymmetry in gas distribution and resulting star formation. Our model generates an expanding ring of triggered star formation with typical velocities of the order of 1/3 of the circular velocity, superimposed on the older stellar population. This should result in a potentially detectable blue asymmetry in stellar absorption features at kiloparsec scales.« less

  12. Feedback by AGN Jets and Wide-angle Winds on a Galactic Scale

    NASA Astrophysics Data System (ADS)

    Dugan, Zachary; Gaibler, Volker; Silk, Joseph

    2017-07-01

    To investigate the differences in mechanical feedback from radio-loud and radio-quiet active galactic nuclei on the host galaxy, we perform 3D AMR hydrodynamic simulations of wide-angle, radio-quiet winds with different inclinations on a single, massive, gas-rich disk galaxy at a redshift of 2-3. We compare our results to hydrodynamic simulations of the same galaxy but with a jet. The jet has an inclination of 0° (perpendicular to the galactic plane), and the winds have inclinations of 0°, 45°, and 90°. We analyze the impact on the host’s gas, star formation, and circumgalactic medium. We find that jet feedback is energy-driven and wind feedback is momentum-driven. In all the simulations, the jet or wind creates a cavity mostly devoid of dense gas in the nuclear region where star formation is then quenched, but we find strong positive feedback in all the simulations at radii greater than 3 kpc. All four simulations have similar SFRs and stellar velocities with large radial and vertical components. However, the wind at an inclination of 90° creates the highest density regions through ram pressure and generates the highest rates of star formation due to its ongoing strong interaction with the dense gas of the galactic plane. With increased wind inclination, we find greater asymmetry in gas distribution and resulting star formation. Our model generates an expanding ring of triggered star formation with typical velocities of the order of 1/3 of the circular velocity, superimposed on the older stellar population. This should result in a potentially detectable blue asymmetry in stellar absorption features at kiloparsec scales.

  13. The quality of visual information about the lower extremities influences visuomotor coordination during virtual obstacle negotiation.

    PubMed

    Kim, Aram; Kretch, Kari S; Zhou, Zixuan; Finley, James M

    2018-05-09

    Successful negotiation of obstacles during walking relies on the integration of visual information about the environment with ongoing locomotor commands. When information about the body and environment are removed through occlusion of the lower visual field, individuals increase downward head pitch angle, reduce foot placement precision, and increase safety margins during crossing. However, whether these effects are mediated by loss of visual information about the lower extremities, the obstacle, or both remains to be seen. Here, we used a fully immersive, virtual obstacle negotiation task to investigate how visual information about the lower extremities is integrated with information about the environment to facilitate skillful obstacle negotiation. Participants stepped over virtual obstacles while walking on a treadmill with one of three types of visual feedback about the lower extremities: no feedback, end-point feedback, or a link-segment model. We found that absence of visual information about the lower extremities led to an increase in the variability of leading foot placement after crossing. The presence of a visual representation of the lower extremities promoted greater downward head pitch angle during the approach to and subsequent crossing of an obstacle. In addition, having greater downward head pitch was associated with closer placement of the trailing foot to the obstacle, further placement of the leading foot after the obstacle, and higher trailing foot clearance. These results demonstrate that the fidelity of visual information about the lower extremities influences both feed-forward and feedback aspects of visuomotor coordination during obstacle negotiation.

  14. Hip proprioceptive feedback influences the control of mediolateral stability during human walking

    PubMed Central

    Roden-Reynolds, Devin C.; Walker, Megan H.; Wasserman, Camille R.

    2015-01-01

    Active control of the mediolateral location of the feet is an important component of a stable bipedal walking pattern, although the roles of sensory feedback in this process are unclear. In the present experiments, we tested whether hip abductor proprioception influenced the control of mediolateral gait motion. Participants performed a series of quiet standing and treadmill walking trials. In some trials, 80-Hz vibration was applied intermittently over the right gluteus medius (GM) to evoke artificial proprioceptive feedback. During walking, the GM was vibrated during either right leg stance (to elicit a perception that the pelvis was closer mediolaterally to the stance foot) or swing (to elicit a perception that the swing leg was more adducted). Vibration during quiet standing evoked leftward sway in most participants (13 of 16), as expected from its predicted perceptual effects. Across the 13 participants sensitive to vibration, stance phase vibration caused the contralateral leg to be placed significantly closer to the midline (by ∼2 mm) at the end of the ongoing step. In contrast, swing phase vibration caused the vibrated leg to be placed significantly farther mediolaterally from the midline (by ∼2 mm), whereas the pelvis was held closer to the stance foot (by ∼1 mm). The estimated mediolateral margin of stability was thus decreased by stance phase vibration but increased by swing phase vibration. Although the observed effects of vibration were small, they were consistent with humans monitoring hip proprioceptive feedback while walking to maintain stable mediolateral gait motion. PMID:26289467

  15. Learning new vocabulary in German: the effects of inferring word meanings, type of feedback, and time of test.

    PubMed

    Carpenter, Shana K; Sachs, Riebana E; Martin, Beth; Schmidt, Kristian; Looft, Ruxandra

    2012-02-01

    In the present study, introductory-level German students read a simplified story and learned the meanings of new German words by reading English translations in marginal glosses versus trying to infer (i.e., guess) their translations. Students who inferred translations were given feedback in English or in German, or no feedback at all. Although immediate retention of new vocabulary was better for students who used marginal glosses, students who inferred word meanings and then received English feedback forgot fewer translations over time. Plausible but inaccurate inferences (i.e., those that made sense in the context) were more likely to be corrected by students who received English feedback as compared with German feedback, providing support for the beneficial effects of mediating information. Implausible inaccurate inferences, however, were more likely to be corrected on the delayed vocabulary test by students who received German feedback as compared with English feedback, possibly because of the additional contextual support provided by German feedback.

  16. Lingual electrotactile stimulation as an alternative sensory feedback pathway for brain-computer interface applications

    NASA Astrophysics Data System (ADS)

    Wilson, J. Adam; Walton, Léo M.; Tyler, Mitch; Williams, Justin

    2012-08-01

    This article describes a new method of providing feedback during a brain-computer interface movement task using a non-invasive, high-resolution electrotactile vision substitution system. We compared the accuracy and movement times during a center-out cursor movement task, and found that the task performance with tactile feedback was comparable to visual feedback for 11 participants. These subjects were able to modulate the chosen BCI EEG features during both feedback modalities, indicating that the type of feedback chosen does not matter provided that the task information is clearly conveyed through the chosen medium. In addition, we tested a blind subject with the tactile feedback system, and found that the training time, accuracy, and movement times were indistinguishable from results obtained from subjects using visual feedback. We believe that BCI systems with alternative feedback pathways should be explored, allowing individuals with severe motor disabilities and accompanying reduced visual and sensory capabilities to effectively use a BCI.

  17. Analysis of dental students' written peer feedback from a prospective peer assessment protocol.

    PubMed

    Tricio, J; Woolford, M; Escudier, M

    2016-11-01

    Peer assessment and feedback is encouraged to enhance students' learning. The aim of this study was to quantitatively and qualitatively analyse pre-clinical and clinical dental students' written peer feedback provided as part of a continuous, formative and structured peer assessment protocol. A total of 309 Year-2 and Year-5 dental students were invited to participate in a peer assessment and peer feedback protocol. Consenting volunteer students were trained to observe each other whilst working in the skills laboratory (Year-2) and in the dental clinic (Year-5). Subsequently, they followed a structured protocol of peer assessment and peer feedback using specially designed work-based forms during a complete academic year. The content of their written feedback was coded according to the UK General Dental Council domain, sign (positive or negative), specificity (task specific or general), and grouped into themes. A total of 108 participants (40 Year-2 and 68 Year-5) completed 1169 peer assessment work-based forms (516 pre-clinical and 653 clinical); 94% contained written feedback. The large majority (82%) of Year-2 feedback represented the clinical domain, 89% were positive, 77% were task specific, and they were grouped into 14 themes. Year-5 feedback was related mostly to Management and Leadership (37%) and Communication (32%), 64% were positive, 75% task specific, and they were clustered into 24 themes. The content of the feedback showed notable differences between Year-2 and Year-5 students. Senior students focused more on Communication and Management and Leadership skills, whilst juniors were more concerned with clinical skills. Year-5 students provided 13% negative feedback compared to only 2% from Year-2. Regulatory focus theory is discussed to explain these differences. Both groups provided peer feedback on a wide and different range of themes. However, four themes emerged in both groups: efficiency, infection control, time management and working speed. A structured peer assessment framework can be used to guide pre-clinical and clinical students to provide peer feedback focused on different domains, and on contrasting signs and specificities. It can also present an opportunity to complement tutors' feedback. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Effects of Web-Based Feedback on Students' Learning

    ERIC Educational Resources Information Center

    van Kol, Simone; Rietz, Christian

    2016-01-01

    Feedback plays an important role in supporting students' learning process. Nonetheless, providing feedback is still rather unusual in higher education. Moreover, research on the design of ideal feedback as well as its effects is rare. In order to contribute to the development of this field, a web-based feedback system was implemented in a lecture…

  19. The Value of Oral Feedback in the Context of Capstone Projects in Design Education

    ERIC Educational Resources Information Center

    Karlsen, Kristine Hoeg

    2017-01-01

    Research frequently reports student dissatisfaction with feedback in higher education. Large class sizes and modularization challenge teachers in providing useful feedback. Most of these studies have investigated student perceptions of written feedback in coursework, and few attempts have been made considering feedback in face-to-face contexts…

  20. Students' Attitudes to and Usage of Academic Feedback Provided via Audio Files

    ERIC Educational Resources Information Center

    Merry, Stephen; Orsmond, Paul

    2008-01-01

    This study explores students' attitudes to the provision of formative feedback on academic work using audio files together with the ways in which students implement such feedback within their learning. Fifteen students received audio file feedback on written work and were subsequently interviewed regarding their utilisation of that feedback within…

  1. When Feedback Is Cognitively-Demanding: The Importance of Working Memory Capacity

    ERIC Educational Resources Information Center

    Fyfe, Emily R.; DeCaro, Marci S.; Rittle-Johnson, Bethany

    2015-01-01

    Feedback is generally considered a beneficial learning tool, and providing feedback is a recommended instructional practice. However, there are a variety of feedback types with little guidance on how to choose the most effective one. We examined individual differences in working memory capacity as a potential moderator of feedback type. Second-…

  2. A Longitudinal, Quantitative Study of Student Attitudes towards Audio Feedback for Assessment

    ERIC Educational Resources Information Center

    Parkes, Mitchell; Fletcher, Peter

    2017-01-01

    This paper reports on the findings of a three-year longitudinal study investigating the experiences of postgraduate level students who were provided with audio feedback for their assessment. Results indicated that students positively received audio feedback. Overall, students indicated a preference for audio feedback over written feedback. No…

  3. Evaluating performance feedback: a research study into issues of credibility and utility for nursing clinicians.

    PubMed

    Fereday, Jennifer; Muir-Cochrane, Eimear

    2004-01-01

    Performance feedback is information provided to employees about how well they are performing in their work role. The nursing profession has a long history of providing formal, written performance reviews, traditionally from a manager to subordinate, with less formal feedback sources including peers, clients and multidisciplinary team members. This paper is based on one aspect of a PhD research study exploring the dynamics of performance feedback primarily from the nursing clinicians' perspective. The research reported here discusses the impact of the social relationship (between the source and recipient of performance feedback) on the recipient's evaluation of feedback as being 'credible' and 'useful' for self-assessment. Focus group interviews were utilised to ascertain the nursing clinicians' perspectives of performance feedback. Thematic analysis of the data was informed by the Social Phenomenology of Alfred Schutz (1967) specifically his theories of intersubjective understanding. Findings supported the level of familiarity between the feedback source and the nursing clinician as a significant criterion influencing the acceptance or rejection of feedback. Implications for the selection of performance feedback sources and processes within nursing are discussed.

  4. Effects of Written Peer-Feedback Content and Sender's Competence on Perceptions, Performance, and Mindful Cognitive Processing

    ERIC Educational Resources Information Center

    Berndt, Markus; Strijbos, Jan-Willem; Fischer, Frank

    2018-01-01

    Peer-feedback efficiency might be influenced by the oftentimes voiced concern of students that they perceive their peers' competence to provide feedback as inadequate. Feedback literature also identifies mindful processing of (peer)feedback and (peer)feedback content as important for its efficiency, but lacks systematic investigation. In a 2 × 2…

  5. Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study.

    PubMed

    Cantrell, Jennifer; Shelley, Donna

    2009-12-17

    Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax referral program in primary care. The study involved implementation of a fax referral system paired with a chart stamp prompting providers to identify smoking patients, provide advice to quit and refer interested smokers to a state-based fax quitline. Three focus groups (n = 26) and eight key informant interviews were conducted with staff and physicians at two clinics after the intervention. We used the Chronic Care Model as a framework to analyze the data, examining how well the systems changes were implemented and the impact of these changes on care processes, and to develop recommendations for improvement. Physicians and staff described numerous benefits of the fax referral program for providers and patients but pointed out significant barriers to full implementation, including the time-consuming process of referring patients to the Quitline, substantial patient resistance, and limitations in information and care delivery systems for referring and tracking smokers. Respondents identified several strategies for improving integration, including simplification of the referral form, enhanced teamwork, formal assignment of responsibility for referrals, ongoing staff training and patient education. Improvements in Quitline feedback were needed to compensate for clinics' limited internal information systems for tracking smokers. Establishing sustainable linkages to quitline services in clinical sites requires knowledge of existing patterns of care and tailored organizational changes to ensure new systems are prioritized, easily integrated into current office routines, formally assigned to specific staff members, and supported by internal systems that ensure adequate tracking and follow up of smokers. Ongoing staff training and patient self-management techniques are also needed to ease the introduction of new programs and increase their acceptability to smokers.

  6. The assessment of stat laboratory test ordering practice and impact of targeted individual feedback in an urban teaching hospital.

    PubMed

    Sorita, Atsushi; Steinberg, Daniel I; Leitman, Michael; Burger, Alfred; Husk, Gregg; Sivaprasad, Latha

    2014-01-01

    Overuse of inpatient stat laboratory orders ("stat" is an abbreviation of the Latin word "statim," meaning immediately, without delay) is a major problem in the modern healthcare system. To understand patterns of stat laboratory ordering practices at our institution and to assess the effectiveness of individual feedback in reducing these orders. Medicine and General Surgery residents were given a teaching session about appropriate stat ordering practice in January 2010. Individual feedback was given to providers who were the highest utilizers of stat laboratory orders by their direct supervisors from February through June of 2010. The proportion of stat orders out of total laboratory orders per provider was the main outcome measure. All inpatient laboratory orders from September 2009 to June 2010 were analyzed. The median proportion of stat orders out of total laboratory orders was 41.6% for nontrainee providers (N = 500), 38.7% for Medicine residents (N = 125), 80.2% for General Surgery residents (N = 32), and 24.2% for other trainee providers (N = 150). Among 27 providers who received feedback (7 nontrainees, 16 Medicine residents, and 4 General Surgery residents), the proportion of stat laboratory orders per provider decreased by 15.7% (95% confidence interval: 5.6%-25.9%, P = 0.004) after feedback, whereas the decrease among providers who were high utilizers but did not receive feedback (N = 39) was not significant (4.5%; 95% confidence interval: 2.1%-11.0%, P = 0.18). Monthly trends showed reduction in the proportion of stat orders among Medicine and General Surgery residents, but not among other trainee providers. The frequency of stat ordering was highly variable among providers. Individual feedback to the highest utilizers of stat orders was effective in decreasing these orders. © 2013 Society of Hospital Medicine.

  7. Providing Context for Complexity: Using Infographics and Conceptual Models to Teach Global Change Processes

    NASA Astrophysics Data System (ADS)

    Bean, J. R.; White, L. D.

    2015-12-01

    Understanding modern and historical global changes requires interdisciplinary knowledge of the physical and life sciences. The Understanding Global Change website from the UC Museum of Paleontology will use a focal infographic that unifies diverse content often taught in separate K-12 science units. This visualization tool provides scientists with a structure for presenting research within the broad context of global change, and supports educators with a framework for teaching and assessing student understanding of complex global change processes. This new approach to teaching the science of global change is currently being piloted and refined based on feedback from educators and scientists in anticipation of a 2016 website launch. Global change concepts are categorized within the infographic as causes of global change (e.g., burning of fossil fuels, volcanism), ongoing Earth system processes (e.g., ocean circulation, the greenhouse effect), and the changes scientists measure in Earth's physical and biological systems (e.g., temperature, extinctions/radiations). The infographic will appear on all website content pages and provides a template for the creation of flowcharts, which are conceptual models that allow teachers and students to visualize the interdependencies and feedbacks among processes in the atmosphere, hydrosphere, biosphere, and geosphere. The development of this resource is timely given that the newly adopted Next Generation Science Standards emphasize cross-cutting concepts, including model building, and Earth system science. Flowchart activities will be available on the website to scaffold inquiry-based lessons, determine student preconceptions, and assess student content knowledge. The infographic has already served as a learning and evaluation tool during professional development workshops at UC Berkeley, Stanford University, and the Smithsonian National Museum of Natural History. At these workshops, scientists and educators used the infographic to highlight how their research and activities reinforce conceptual links among global change topics. Pre- and post-workshop assessment results and responses to questionnaires have guided the refinement of classroom activities and assessment tools utilizing flowcharts as models for global change processes.

  8. Designing feedback to mitigate teen distracted driving: A social norms approach.

    PubMed

    Merrikhpour, Maryam; Donmez, Birsen

    2017-07-01

    The purpose of this research is to investigate teens' perceived social norms and whether providing normative information can reduce distracted driving behaviors among them. Parents are among the most important social referents for teens; they have significant influences on teens' driving behaviors, including distracted driving which significantly contributes to teens' crash risks. Social norms interventions have been successfully applied in various domains including driving; however, this approach is yet to be explored for mitigating driver distraction among teens. Forty teens completed a driving simulator experiment while performing a self-paced visual-manual secondary task in four between-subject conditions: a) social norms feedback that provided a report at the end of each drive on teens' distracted driving behavior, comparing their distraction engagement to their parent's, b) post-drive feedback that provided just the report on teens' distracted driving behavior without information on their parents, c) real-time feedback in the form of auditory warnings based on eyes of road-time, and d) no feedback as control. Questionnaires were administered to collect data on these teens' and their parents' self-reported engagement in driver distractions and the associated social norms. Social norms and real-time feedback conditions resulted in significantly smaller average off-road glance duration, rate of long (>2s) off-road glances, and standard deviation of lane position compared to no feedback. Further, social norms feedback decreased brake response time and percentage of time not looking at the road compared to no feedback. No major effect was observed for post-drive feedback. Questionnaire results suggest that teens appeared to overestimate parental norms, but no effect of feedback was found on their perceptions. Feedback systems that leverage social norms can help mitigate driver distraction among teens. Overall, both social norms and real-time feedback induced positive driving behaviors, with social norms feedback outperforming real-time feedback. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Haptic Feedback in Robot-Assisted Minimally Invasive Surgery

    PubMed Central

    Okamura, Allison M.

    2009-01-01

    Purpose of Review Robot-assisted minimally invasive surgery (RMIS) holds great promise for improving the accuracy and dexterity of a surgeon while minimizing trauma to the patient. However, widespread clinical success with RMIS has been marginal. It is hypothesized that the lack of haptic (force and tactile) feedback presented to the surgeon is a limiting factor. This review explains the technical challenges of creating haptic feedback for robot-assisted surgery and provides recent results that evaluate the effectiveness of haptic feedback in mock surgical tasks. Recent Findings Haptic feedback systems for RMIS are still under development and evaluation. Most provide only force feedback, with limited fidelity. The major challenge at this time is sensing forces applied to the patient. A few tactile feedback systems for RMIS have been created, but their practicality for clinical implementation needs to be shown. It is particularly difficult to sense and display spatially distributed tactile information. The cost-benefit ratio for haptic feedback in RMIS has not been established. Summary The designs of existing commercial RMIS systems are not conducive for force feedback, and creative solutions are needed to create compelling tactile feedback systems. Surgeons, engineers, and neuroscientists should work together to develop effective solutions for haptic feedback in RMIS. PMID:19057225

  10. Evaluating an Earlybird Scheme: Encouraging Early Assignment Writing and Revising

    ERIC Educational Resources Information Center

    Unsworth, Kerrie; Kauter, Katherine

    2008-01-01

    It is widely suggested that feedback on assignments is useful to students' learning, however, little research has examined how this feedback may be provided in large classes or the actual effects of such a scheme. We designed and implemented a voluntary "earlybird scheme" that provided detailed feedback to undergraduate Business students on a…

  11. Strategies for the Management of Lecturer Stress in Feedback Tutorials

    ERIC Educational Resources Information Center

    Hartney, Elizabeth

    2007-01-01

    The process of providing students with individual feedback on assessed work was identified as a source of lecturer stress (Stough and Emmer, 1998). An action research approach was used to address the following research question. What approaches to providing students with feedback minimize lecturer stress? Data were collected using written feedback…

  12. Universities Reaching Outwards: Science Education Partnerships with Urban School Systems

    NASA Astrophysics Data System (ADS)

    Sandifer, Cody

    2013-03-01

    The goals of this talk are to: (1) describe how universities, physics departments, and individual faculty can partner with urban school systems to benefit K-16 students, teacher education programs, and university instructors, (2) summarize research on effective university-school system education partnerships, and (3) offer advice and share lessons learned so that university partners can avoid common pitfalls and maximize the potential for collaborative success. Possible areas of university-school collaboration include resident teachers, curricular review, early teaching experiences, demo sharing sessions, ongoing professional development, on- and off-campus science outreach, RET programs, science education resource centers, and others. University-school educational partnerships offer numerous benefits but can be challenging to implement and maintain. Research shows that most successful partnerships possess the following characteristics: mutual self-interest, participant commitment, mutual trust and respect, shared decision-making, information sharing, and ongoing evaluation. K-16 course and curriculum redesign is a specific issue that has its own unique set of contextual factors that impact the project's chance at success, including available materials, administrative support, formative assessments, pilot-testing and instructor feedback, and ongoing professional development. I have learned a number of lessons in own science education collaborations with the Baltimore City Public School System, which is an urban school system with 200 schools, 84,000 students, and 10,700 teachers and administrators. These lessons pertain to: communication, administrative power, and the structure of the school system; relevant contextual factors in the university and K-12 schools; and good old-fashioned common sense.Specific advice on K-16 science education partnerships will be provided to help universities increase student and instructor satisfaction with their physics and teacher education programs, maintain a positive and mutually beneficial relationship with local schools, and improve science education at all levels of instruction. Common sense is encouraged, but not required, to attend the invited talk.

  13. Facilitating the Feedback Process on a Clinical Clerkship Using a Smartphone Application.

    PubMed

    Joshi, Aditya; Generalla, Jenilee; Thompson, Britta; Haidet, Paul

    2017-10-01

    This pilot study evaluated the effects of a smartphone-triggered method of feedback delivery on students' perceptions of the feedback process. An interactive electronic feedback form was made available to students through a smartphone app. Students were asked to evaluate various aspects of the feedback process. Responses from a previous year served as control. In the first three quarters of academic year 2014-2015 (pre-implementation), only 65% of responders reported receiving oral feedback and 40% reported receiving written feedback. During the pilot phase (transition), these increased to 80% for both forms. Following full implementation in academic year 2015-2016 (post-implementation), 97% reported receiving oral feedback, and 92% reported receiving written feedback. A statistically significant difference was noted pre- to post-implementation for both oral and written feedback (p < 0.01). A significant increase from pre-implementation to transition was noted for written feedback (p < 0.01) and from transition to post-implementation for oral feedback (p < 0.01). Ninety-one and 94% of responders reported ease of access and timeliness of the feedback, 75% perceived the quality of the feedback to be good to excellent; 64% felt receiving feedback via the app improved their performance; 69% indicated the feedback method as better compared to other methods. Students acknowledged the facilitation of conversation with supervisors and the convenience of receiving feedback, as well as the promptness with which feedback was provided. The use of a drop-down menu was thought to limit the scope of conversation. These data point to the effectiveness of this method to cue supervisors to provide feedback to students.

  14. Combining Statistics and Physics to Improve Climate Downscaling

    NASA Astrophysics Data System (ADS)

    Gutmann, E. D.; Eidhammer, T.; Arnold, J.; Nowak, K.; Clark, M. P.

    2017-12-01

    Getting useful information from climate models is an ongoing problem that has plagued climate science and hydrologic prediction for decades. While it is possible to develop statistical corrections for climate models that mimic current climate almost perfectly, this does not necessarily guarantee that future changes are portrayed correctly. In contrast, convection permitting regional climate models (RCMs) have begun to provide an excellent representation of the regional climate system purely from first principles, providing greater confidence in their change signal. However, the computational cost of such RCMs prohibits the generation of ensembles of simulations or long time periods, thus limiting their applicability for hydrologic applications. Here we discuss a new approach combining statistical corrections with physical relationships for a modest computational cost. We have developed the Intermediate Complexity Atmospheric Research model (ICAR) to provide a climate and weather downscaling option that is based primarily on physics for a fraction of the computational requirements of a traditional regional climate model. ICAR also enables the incorporation of statistical adjustments directly within the model. We demonstrate that applying even simple corrections to precipitation while the model is running can improve the simulation of land atmosphere feedbacks in ICAR. For example, by incorporating statistical corrections earlier in the modeling chain, we permit the model physics to better represent the effect of mountain snowpack on air temperature changes.

  15. Summary Report of Cable Aging and Performance Data for Fiscal Year 2014.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Celina, Mathias C.; Celina, Mathias C.; Redline, Erica Marie

    2014-09-01

    As part of the Light Water Reactor Sustainability Program, science - based engineering approaches were employed to address cable degradation behavior under a range of exposure environments. Experiments were conducted with the goal to provide best guidance for aged material states, remaining life and expected performance under specific conditions for a range of cable materials. Generic engineering tests , which focus on rapid accelerated aging and tensile elongation , were combined with complementar y methods from polymer degradation science. Sandia's approach, building on previous years' efforts, enabled the generation of some of the necessary data supporting the development of improvedmore » lifetime predictions models, which incorporate known material b ehaviors and feedback from field - returned 'aged' cable materials. Oxidation rate measurements have provided access to material behavior under low dose rate thermal conditions, where slow degradation is not apparent in mechanical property changes. Such da ta have shown aging kinetics consistent with established radiati on - thermal degradation models. ACKNOWLEDGEMENTS We gratefully acknowledge ongoing technical support at the LICA facility and extensive sample handling provided by Maryla Wasiolek and Don Hans on. Sam Durbin and Patrick Mattie are recognized for valuable guidance throughout the year and assistance in the preparation of the final report. Doug Brunson is appreciated for sample analysis, compilation and plotting of experimental data.« less

  16. A team public health research project for first-year pharmacy students to apply content from didactic courses.

    PubMed

    Fuentes, David; Deguire, Nancy; Patel, Rajul; Boyce, Eric

    2010-08-10

    To implement and assess a first-year pharmacy student group research project that provided practical hands-on application and reinforced the curricula of concurrent didactic courses. Groups of 6 to 7 students chose a public health topic based on the Healthy People 2010 Priority Areas and created a survey instrument. Faculty facilitated mock institutional review board (IRB) review sessions which provided teams with ongoing feedback and refinement recommendations before each team administered their survey instrument to a predefined population. Data analysis, formal written reports, and oral presentations were presented to peers and project faculty members. Teams complied with the requirements of the mock IRB, effectively applied basic research principles learned in class, collected survey data, performed inferential statistical analyses on the data, , and presented their project findings. Two-hundred six of 210 students (98%) reported feeling satisfied with both the results of their project and the accomplishments of their team. Teams applied a varied skill set including primary literature evaluation, basic research principles, statistics, public speaking, and peer collaboration in conducting a public health research project. First-year pharmacy students may benefit from participation in a collaborative research project that provides hands-on application of material being taught in didactic courses.

  17. Patient-perceived acceptability and behaviour change benefits of inhaler reminders and adherence feedback: A qualitative study.

    PubMed

    Foster, Juliet M; Reddel, Helen K; Usherwood, Tim; Sawyer, Susan M; Smith, Lorraine

    2017-08-01

    Little is known about patients' perceptions of electronic inhaler reminders, which have emerged in recent years as adherence promotion aids. This study explored asthma patients' attitudes toward the acceptability and utility of inhaler reminders. Participants from a 6-month cluster randomized controlled trial who received reminders for missed doses via SmartTrack adherence monitors (Adherium Ltd) were interviewed to explore their perceptions; interviews were audio-recorded, transcribed and analysed thematically. 18 participants (50% male, mean age 39 years [range 17-68]) were interviewed. Three themes were identified. Acceptability and Feasibility: Interviewees found the monitor easy to use. For some, concerns about the monitor itself affected adherence, e.g. leaving it at home to avoid breakage. Positive features included that reminders played only for missed doses, and the choice of reminder tunes. Utility and Behavioural Impact: Interviewees described reminders as an effective "training" tool for adherence, encouraging habit-formation, behaviour change and attitude change. Reminders were considered less acceptable or useful by participants who preferred taking medication only when symptomatic or who doubted the necessity or safety of their medication. Sustainability: Some interviewees reported sustained behaviour change, supported by reminders, through the establishment of routine or via experiential learning that good adherence improved their asthma. Other interviewees wanted ongoing support (i.e. reminders or substitute adherence cues) after study end. Patients with asthma found 6-months' use of reminders and adherence feedback acceptable and useful for improving their adherence attitudes, adherence behaviours and confidence in asthma self-management. Some patients may benefit from ongoing adherence support. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Vibrotactile grasping force and hand aperture feedback for myoelectric forearm prosthesis users.

    PubMed

    Witteveen, Heidi J B; Rietman, Hans S; Veltink, Peter H

    2015-06-01

    User feedback about grasping force and hand aperture is very important in object handling with myoelectric forearm prostheses but is lacking in current prostheses. Vibrotactile feedback increases the performance of healthy subjects in virtual grasping tasks, but no extensive validation on potential users has been performed. Investigate the performance of upper-limb loss subjects in grasping tasks with vibrotactile stimulation, providing hand aperture, and grasping force feedback. Cross-over trial. A total of 10 subjects with upper-limb loss performed virtual grasping tasks while perceiving vibrotactile feedback. Hand aperture feedback was provided through an array of coin motors and grasping force feedback through a single miniature stimulator or an array of coin motors. Objects with varying sizes and weights had to be grasped by a virtual hand. Percentages correctly applied hand apertures and correct grasping force levels were all higher for the vibrotactile feedback condition compared to the no-feedback condition. With visual feedback, the results were always better compared to the vibrotactile feedback condition. Task durations were comparable for all feedback conditions. Vibrotactile grasping force and hand aperture feedback improves grasping performance of subjects with upper-limb loss. However, it should be investigated whether this is of additional value in daily-life tasks. This study is a first step toward the implementation of sensory vibrotactile feedback for users of myoelectric forearm prostheses. Grasping force feedback is crucial for optimal object handling, and hand aperture feedback is essential for reduction of required visual attention. Grasping performance with feedback is evaluated for the potential users. © The International Society for Prosthetics and Orthotics 2014.

  19. WCALive: broadcasting a major medical conference on the Internet.

    PubMed

    Palmer, T E; Cumpston, P H; Ruskin, K; Jones, R D

    1997-11-01

    Live video and sound from the 11th World Congress of Anaesthesiology in Sydney, Australia were broadcast over the Internet using the CuSeeme software package as part of an ongoing evaluation of Internet-based telecommunication in the delivery of Continuing Medical Education (CME). This was the first time such a broadcast had been attempted from a medical convention. The broadcast lasted for four days, during which a functioning combination of computer hardware and software was established. Technical issues relating to broadcast of these real time signals over ISDN links and the Internet itself were addressed. Over 200 anaesthetists from around the world were able to 'attend' the plenary sessions via the Internet. Evidenced by feedback received audio reception was quite good. Video reception was less successful for those receiving the broadcast via a modem based Internet connection. The received signal in such circumstances was adequate to provide a video presence of the speaker but inadequate to allow details of 35 mm slides to be visualised. We conclude that this technology will be of use in the delivery of CME materials to remote areas provided simultaneous viewing of high resolution still images is possible using another medium, such as the World Wide Web.

  20. We're all in this together: Midwifery student peer mentoring.

    PubMed

    McKellar, Lois; Kempster, Cathy

    2017-05-01

    Many higher education institutions have adopted mentoring programs for students as a means of providing support, improve learning and enhance the student experience. The aim of this project was to improve midwifery students experience by offering a peer mentoring program to commencing students to assist with the transition to university life and the rigours of the midwifery program. This paper reports the evaluation of this specific mentoring program and the ongoing development and implementation of a sustainable program within an Australian University. A survey design was adopted to gather feedback from both mentees to evaluate if the peer mentoring program enhanced the first year midwifery student experience and ascertain how the program could be further developed. Fifty-five students engaged with the peer mentors and completed the questionnaire regarding the mentoring program. Specifically valuable was the positive impact that mentoring had on midwifery student confidence, managing the demands of the program and being motivated to keep going when the program requirements were challenging. The success of this program rested largely with mentoring students sharing their own experiences and providing reassurance that other students could also succeed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Follower-Centered Perspective on Feedback: Effects of Feedback Seeking on Identification and Feedback Environment.

    PubMed

    Gong, Zhenxing; Li, Miaomiao; Qi, Yaoyuan; Zhang, Na

    2017-01-01

    In the formation mechanism of the feedback environment, the existing research pays attention to external feedback sources and regards individuals as objects passively accepting feedback. Thus, the external source fails to realize the individuals' need for feedback, and the feedback environment cannot provide them with useful information, leading to a feedback vacuum. The aim of this study is to examine the effect of feedback-seeking by different strategies on the supervisor-feedback environment through supervisor identification. The article consists of an empirical study with a sample of 264 employees in China; here, participants complete a series of questionnaires in three waves. After controlling for the effects of demography, the results indicate that supervisor identification partially mediates the relationship between feedback-seeking (including feedback monitoring and feedback inquiry) and the supervisor-feedback environment. Implications are also discussed.

  2. Giving Feedback: Development of Scales for the Mum Effect, Discomfort Giving Feedback, and Feedback Medium Preference

    ERIC Educational Resources Information Center

    Cox, Susie S.; Marler, Laura E.; Simmering, Marcia J.; Totten, Jeff W.

    2011-01-01

    Research in organizational behavior and human resources promotes the view that it is critical for managers to provide accurate feedback to employees, yet little research addresses rater tendencies (i.e., the "mum effect") and attitudes that influence how performance feedback is given. Because technology has changed the nature of…

  3. Seven Keys to Effective Feedback

    ERIC Educational Resources Information Center

    Wiggins, Grant

    2012-01-01

    The term "feedback" is often used to describe all kinds of comments made after the fact, including advice, praise, and evaluation. But none of these are feedback, strictly speaking. Basically, feedback is information about how one is doing in his or her efforts to reach a goal. Whether feedback is just there to be grasped or is provided by another…

  4. "Only True Friends Could Be Cruelly Honest": Cognitive Scaffolding and Social-Affective Support in Teacher Feedback Literacy

    ERIC Educational Resources Information Center

    Xu, Yueting; Carless, David

    2017-01-01

    Feedback is an important but challenging aspect of higher education pedagogy. In addition to providing quality feedback, teachers are expected to develop students' skills and awareness for effective feedback processes. This case study addresses both processes and products of a Chinese university English teacher's feedback enabling practice by…

  5. Combining Ecosystem Observations, Manipulations and the Data Assimilation Research Testbed to Provide New Insights into Community Land Model Performance

    NASA Astrophysics Data System (ADS)

    Foster, A.; Armstrong, A. H.; Shuman, J. K.; Ranson, K.; Shugart, H. H., Jr.; Rogers, B. M.; Goetz, S. J.

    2016-12-01

    Global temperatures have increased about 0.2°C per decade since 1979, and the high latitudes are warming faster than the rest of the globe. Climate change within Alaska is likely to bring about increased drought and longer fire seasons, as well as increases in the severity and frequency of fires. These changes in disturbance regimes and their associated effects on ecosystem C stocks, including permafrost, may lead to a positive feedback to further climate warming. As of now, it is uncertain how vegetation will respond to ongoing climate change, and the addition of disturbance effects leads to even more complicated and varied scenarios. Through ecological modeling, we have the capacity to examine forest processes at multiple temporal and spatial scales, allowing for the testing of complex interactions between vegetation, climate, and disturbances. The University of Virginia Forest Model Enhanced (UVAFME) is an individual tree-based forest model that has been updated for use in interior boreal Alaska, with a new permafrost model and updated fire simulation. These updated submodels allow for feedback between soils, vegetation, and fire severity through fuels tracking and impact of depth of burn on permafrost dynamics. We present these updated submodels as well as calibration and validation of UVAFME to the Yukon River Basin in Alaska, with comparisons to inventory data. We also present initial findings from simulations of potential future forest biomass, structure, and species composition across the Yukon River Basin under expected changes in precipitation, temperature, and disturbances. We predict changing climate and the associated impacts on wildfire and permafrost dynamics will result in shifts in biomass and species composition across the region, with potential for further feedback to the climate-vegetation-disturbance system. These simulations advance our understanding of the possible futures for the Alaskan boreal forest, which is a valuable part of the global carbon budget.

  6. Students’ perceptions of lecturing approaches: traditional versus interactive teaching

    PubMed Central

    Abdel Meguid, Eiman; Collins, Matthew

    2017-01-01

    Background There is an increasing trend toward transcending from traditional teaching to student-centered methodologies that actively engage students. We aimed to analyze students’ perceptions of effective interactive teaching using PollEverywhere Audience Response System (ARS) as a worthwhile teaching methodology. It can be of great help in maintaining students’ attention and in facilitating the lecturer to pick up students’ misunderstandings and correct them. Materials and methods This system was introduced to the undergraduate dental curriculum to increase student’s motivation and attention, giving immediate feedback on student understanding during an anatomy module. Computer science (CS) students who were more familiar with the use of this technology were also involved in the study for comparison and validation of the findings. The lecturer strategically inserted questions using PollEverywhere ARS. Students’ perception of the effective interactive teaching using this technology was evaluated statistically using a questionnaire and focus groups. Results It promoted interactivity, focused attention, and provided feedback on comprehension. A total of 95% reported that it increased their participation and found that it clarified their thinking and helped to focus on key points. Another 81.7% mentioned that it increased their motivation to learn. Students regarded it as a useful method for giving real-time feedback, which stimulated their performance and participation. Data from CS students echoed the findings from the dental students. Reports from focus groups demonstrated that this strategy was helpful in focusing students’ attention and in clarifying information. Discussion PollEverywhere encouraged all students to participate during the learning process. This has proven to be an effective tool for improving students’ understanding and critical thinking. Conclusion Students regarded PollEverywhere as an effective teaching innovation that encouraged deeper ongoing retention of information. It was found to be an effective teaching aid in monitoring students’ progress and identifying deficiencies. This is of benefit in a module where interactivity is considered important. PMID:28360541

  7. Modeling global change impacts on Northern Eurasia

    NASA Astrophysics Data System (ADS)

    Kicklighter, D. W.; Monier, E.; Sokolov, A. P.; Zhuang, Q.; Melillo, J. M.; Reilly, J. M.

    2016-12-01

    Northern Eurasia is a major player in the global carbon budget and includes roughly 70% of the Earth's boreal forest and more than two-thirds of the Earth's permafrost. The region has experienced dramatic climate change (increase in temperature, growing season length, floods and droughts), natural disturbances (wildfires and insect outbreaks), and land-use change (timber harvest, urbanization, expansion and abandonment of agricultural lands) over the past century. These large environmental and socioeconomic impacts have major implications for the carbon cycle in the region. Northern Eurasia is made up of a diverse set of ecosystems that range from deserts to forests, with significant areas of croplands, pastures, and urban areas. As such, it represents a complex system with substantial challenges for the modeling community. We provide an overview of past, ongoing and possible future efforts of the integrated modeling of global change for Northern Eurasia. First, we review the variety of existing modeling approaches to investigate specific components of Earth system dynamics in the region. While there are a limited number of studies that try to integrate various aspects of the Earth system through scale, teleconnections or processes, there are few systematic analyses of the various feedbacks among components within the Earth system. As a result, there is a lack of knowledge of the relative importance of such feedbacks, and it is unclear how relevant current studies, which do not account for these feedbacks, may be for policymaking. Next, we review the role of Earth system models, and their advantages/limitations compared to detailed single component models. We further introduce human activity models (e.g., global trade, economic models, demographic models), and the need for Integrated Assessment Models (IAMs), a suite of models that couple human activity models to Earth System Models. Finally, we examine emerging issues that require a representation of the coupled human/earth system models to address.

  8. Large turbulent reservoirs of cold molecular gas around high-redshift starburst galaxies.

    PubMed

    Falgarone, E; Zwaan, M A; Godard, B; Bergin, E; Ivison, R J; Andreani, P M; Bournaud, F; Bussmann, R S; Elbaz, D; Omont, A; Oteo, I; Walter, F

    2017-08-24

    Starburst galaxies at the peak of cosmic star formation are among the most extreme star-forming engines in the Universe, producing stars over about 100 million years (ref. 2). The star-formation rates of these galaxies, which exceed 100 solar masses per year, require large reservoirs of cold molecular gas to be delivered to their cores, despite strong feedback from stars or active galactic nuclei. Consequently, starburst galaxies are ideal for studying the interplay between this feedback and the growth of a galaxy. The methylidyne cation, CH + , is a most useful molecule for such studies because it cannot form in cold gas without suprathermal energy input, so its presence indicates dissipation of mechanical energy or strong ultraviolet irradiation. Here we report the detection of CH + (J = 1-0) emission and absorption lines in the spectra of six lensed starburst galaxies at redshifts near 2.5. This line has such a high critical density for excitation that it is emitted only in very dense gas, and is absorbed in low-density gas. We find that the CH + emission lines, which are broader than 1,000 kilometres per second, originate in dense shock waves powered by hot galactic winds. The CH + absorption lines reveal highly turbulent reservoirs of cool (about 100 kelvin), low-density gas, extending far (more than 10 kiloparsecs) outside the starburst galaxies (which have radii of less than 1 kiloparsec). We show that the galactic winds sustain turbulence in the 10-kiloparsec-scale environments of the galaxies, processing these environments into multiphase, gravitationally bound reservoirs. However, the mass outflow rates are found to be insufficient to balance the star-formation rates. Another mass input is therefore required for these reservoirs, which could be provided by ongoing mergers or cold-stream accretion. Our results suggest that galactic feedback, coupled jointly to turbulence and gravity, extends the starburst phase of a galaxy instead of quenching it.

  9. Interface Prostheses With Classifier-Feedback-Based User Training.

    PubMed

    Fang, Yinfeng; Zhou, Dalin; Li, Kairu; Liu, Honghai

    2017-11-01

    It is evident that user training significantly affects performance of pattern-recognition-based myoelectric prosthetic device control. Despite plausible classification accuracy on offline datasets, online accuracy usually suffers from the changes in physiological conditions and electrode displacement. The user ability in generating consistent electromyographic (EMG) patterns can be enhanced via proper user training strategies in order to improve online performance. This study proposes a clustering-feedback strategy that provides real-time feedback to users by means of a visualized online EMG signal input as well as the centroids of the training samples, whose dimensionality is reduced to minimal number by dimension reduction. Clustering feedback provides a criterion that guides users to adjust motion gestures and muscle contraction forces intentionally. The experiment results have demonstrated that hand motion recognition accuracy increases steadily along the progress of the clustering-feedback-based user training, while conventional classifier-feedback methods, i.e., label feedback, hardly achieve any improvement. The result concludes that the use of proper classifier feedback can accelerate the process of user training, and implies prosperous future for the amputees with limited or no experience in pattern-recognition-based prosthetic device manipulation.It is evident that user training significantly affects performance of pattern-recognition-based myoelectric prosthetic device control. Despite plausible classification accuracy on offline datasets, online accuracy usually suffers from the changes in physiological conditions and electrode displacement. The user ability in generating consistent electromyographic (EMG) patterns can be enhanced via proper user training strategies in order to improve online performance. This study proposes a clustering-feedback strategy that provides real-time feedback to users by means of a visualized online EMG signal input as well as the centroids of the training samples, whose dimensionality is reduced to minimal number by dimension reduction. Clustering feedback provides a criterion that guides users to adjust motion gestures and muscle contraction forces intentionally. The experiment results have demonstrated that hand motion recognition accuracy increases steadily along the progress of the clustering-feedback-based user training, while conventional classifier-feedback methods, i.e., label feedback, hardly achieve any improvement. The result concludes that the use of proper classifier feedback can accelerate the process of user training, and implies prosperous future for the amputees with limited or no experience in pattern-recognition-based prosthetic device manipulation.

  10. Toward Harnessing User Feedback For Machine Learning

    DTIC Science & Technology

    2006-10-02

    machine learning systems. If this resource-the users themselves-could somehow work hand-in-hand with machine learning systems, the accuracy of learning systems could be improved and the users? understanding and trust of the system could improve as well. We conducted a think-aloud study to see how willing users were to provide feedback and to understand what kinds of feedback users could give. Users were shown explanations of machine learning predictions and asked to provide feedback to improve the predictions. We found that users

  11. Experts by experience; the views of service user educators providing feedback on medical students' work based assessments.

    PubMed

    Muir, Delia; Laxton, Julie Clare

    2012-02-01

    Assessment tools were designed to provide health and social care students with multi-sourced, interprofessional feedback in practice. This includes feedback from service users. Third year medical students at the University of Leeds were given accesses to 4 assessment tools whilst in practice. Completed assessments were then sent to the university where service users and carers worked with university tutors to give further feedback and comment on the overall development of students. Three service users then took part in a focus group and one provided written feedback. Four key themes were identified from the focus group: • Preparation and support • The design of the tools • The process of using the tools in practice • Feedback. We found that the project provided both challenges and rewards for all involved. The service user educators involved were able to bring a different and valuable perspective to formative feedback. The combination of their personal and professional experiences, along with the preparation they had received, helped bridge the gap between service users in practice and university based tutors. The findings from this study went on to inform a review of the assessment tools and revised versions are now being used. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Cross-entropy optimization for neuromodulation.

    PubMed

    Brar, Harleen K; Yunpeng Pan; Mahmoudi, Babak; Theodorou, Evangelos A

    2016-08-01

    This study presents a reinforcement learning approach for the optimization of the proportional-integral gains of the feedback controller represented in a computational model of epilepsy. The chaotic oscillator model provides a feedback control systems view of the dynamics of an epileptic brain with an internal feedback controller representative of the natural seizure suppression mechanism within the brain circuitry. Normal and pathological brain activity is simulated in this model by adjusting the feedback gain values of the internal controller. With insufficient gains, the internal controller cannot provide enough feedback to the brain dynamics causing an increase in correlation between different brain sites. This increase in synchronization results in the destabilization of the brain dynamics, which is representative of an epileptic seizure. To provide compensation for an insufficient internal controller an external controller is designed using proportional-integral feedback control strategy. A cross-entropy optimization algorithm is applied to the chaotic oscillator network model to learn the optimal feedback gains for the external controller instead of hand-tuning the gains to provide sufficient control to the pathological brain and prevent seizure generation. The correlation between the dynamics of neural activity within different brain sites is calculated for experimental data to show similar dynamics of epileptic neural activity as simulated by the network of chaotic oscillators.

  13. Impact of Personalised Feedback about Physical Activity on Change in Objectively Measured Physical Activity (the FAB Study): A Randomised Controlled Trial

    PubMed Central

    Godino, Job G.; Watkinson, Clare; Corder, Kirsten; Marteau, Theresa M.; Sutton, Stephen; Sharp, Stephen J.; Griffin, Simon J.; van Sluijs, Esther M. F.

    2013-01-01

    Background Low levels of physical activity are a major public health concern, and interventions to promote physical activity have had limited success. Whether or not personalised feedback about physical activity following objective measurement motivates behaviour change has yet to be rigorously examined. Methods And Findings: In a parallel group, open randomised controlled trial, 466 healthy adults aged 32 to 54 years were recruited from the ongoing population-based Fenland Study (Cambridgeshire, UK). Participants were randomised to receive either no feedback until the end of the trial (control group, n=120) or one of three different types of feedback: simple, visual, or contextualised (intervention groups, n=346). The primary outcome was physical activity (physical activity energy expenditure (PAEE) in kJ/kg/day and average body acceleration (ACC) in m/s2) measured objectively using a combined heart rate monitor and accelerometer (Actiheart®). The main secondary outcomes included self-reported physical activity, intention to increase physical activity, and awareness of physical activity (the agreement between self-rated and objectively measured physical activity). At 8 weeks, 391 (83.9%) participants had complete physical activity data. The intervention had no effect on objectively measured physical activity (PAEE: β=-0.92, 95% CI=-3.50 to 1.66, p=0.48 and ACC: β=0.01, 95% CI=-0.00 to 0.02, p=0.21), self-reported physical activity (β=-0.39, 95% CI=-1.59 to 0.81), or intention to increase physical activity (β=-0.05, 95% CI=-0.22 to 0.11). However, it was associated with an increase in awareness of physical activity (OR=1.74, 95% CI=1.05 to 2.89). Results did not differ according to the type of feedback. Conclusions Personalised feedback about physical activity following objective measurement increased awareness but did not result in changes in physical activity in the short term. Measurement and feedback may have a role in promoting behaviour change but are ineffective on their own. Trial Registration Current Controlled Trials ISRCTN92551397 http://www.controlled-trials.com/ISRCTN92551397 PMID:24066178

  14. Impact of personalised feedback about physical activity on change in objectively measured physical activity (the FAB study): a randomised controlled trial.

    PubMed

    Godino, Job G; Watkinson, Clare; Corder, Kirsten; Marteau, Theresa M; Sutton, Stephen; Sharp, Stephen J; Griffin, Simon J; van Sluijs, Esther M F

    2013-01-01

    Low levels of physical activity are a major public health concern, and interventions to promote physical activity have had limited success. Whether or not personalised feedback about physical activity following objective measurement motivates behaviour change has yet to be rigorously examined. And Findings: In a parallel group, open randomised controlled trial, 466 healthy adults aged 32 to 54 years were recruited from the ongoing population-based Fenland Study (Cambridgeshire, UK). Participants were randomised to receive either no feedback until the end of the trial (control group, n=120) or one of three different types of feedback: simple, visual, or contextualised (intervention groups, n=346). The primary outcome was physical activity (physical activity energy expenditure (PAEE) in kJ/kg/day and average body acceleration (ACC) in m/s(2)) measured objectively using a combined heart rate monitor and accelerometer (Actiheart(®)). The main secondary outcomes included self-reported physical activity, intention to increase physical activity, and awareness of physical activity (the agreement between self-rated and objectively measured physical activity). At 8 weeks, 391 (83.9%) participants had complete physical activity data. The intervention had no effect on objectively measured physical activity (PAEE: β=-0.92, 95% CI=-3.50 to 1.66, p=0.48 and ACC: β=0.01, 95% CI=-0.00 to 0.02, p=0.21), self-reported physical activity (β=-0.39, 95% CI=-1.59 to 0.81), or intention to increase physical activity (β=-0.05, 95% CI=-0.22 to 0.11). However, it was associated with an increase in awareness of physical activity (OR=1.74, 95% CI=1.05 to 2.89). Results did not differ according to the type of feedback. Personalised feedback about physical activity following objective measurement increased awareness but did not result in changes in physical activity in the short term. Measurement and feedback may have a role in promoting behaviour change but are ineffective on their own. Current Controlled Trials ISRCTN92551397 http://www.controlled-trials.com/ISRCTN92551397.

  15. Galaxy formation in the Planck cosmology - IV. Mass and environmental quenching, conformity and clustering

    NASA Astrophysics Data System (ADS)

    Henriques, Bruno M. B.; White, Simon D. M.; Thomas, Peter A.; Angulo, Raul E.; Guo, Qi; Lemson, Gerard; Wang, Wenting

    2017-08-01

    We study the quenching of star formation as a function of redshift, environment and stellar mass in the galaxy formation simulations of Henriques et al. (2015), which implement an updated version of the Munich semi-analytic model (L-GALAXIES) on the two Millennium Simulations after scaling to a Planck cosmology. In this model, massive galaxies are quenched by active galactic nucleus (AGN) feedback depending on both black hole and hot gas mass, and hence indirectly on stellar mass. In addition, satellite galaxies of any mass can be quenched by ram-pressure or tidal stripping of gas and through the suppression of gaseous infall. This combination of processes produces quenching efficiencies which depend on stellar mass, host halo mass, environment density, distance to group centre and group central galaxy properties in ways which agree qualitatively with observation. Some discrepancies remain in dense regions and close to group centres, where quenching still seems too efficient. In addition, although the mean stellar age of massive galaxies agrees with observation, the assumed AGN feedback model allows too much ongoing star formation at late times. The fact that both AGN feedback and environmental effects are stronger in higher density environments leads to a correlation between the quenching of central and satellite galaxies which roughly reproduces observed conformity trends inside haloes.

  16. SDSS-IV MaNGA: evidence of the importance of AGN feedback in low-mass galaxies

    NASA Astrophysics Data System (ADS)

    Penny, Samantha J.; Masters, Karen L.; Smethurst, Rebecca; Nichol, Robert C.; Krawczyk, Coleman M.; Bizyaev, Dmitry; Greene, Olivia; Liu, Charles; Marinelli, Mariarosa; Rembold, Sandro B.; Riffel, Rogemar A.; Ilha, Gabriele da Silva; Wylezalek, Dominika; Andrews, Brett H.; Bundy, Kevin; Drory, Niv; Oravetz, Daniel; Pan, Kaike

    2018-05-01

    We present new evidence for AGN feedback in a subset of 69 quenched low-mass galaxies (M⋆ ≲ 5 × 109 M⊙, Mr > -19) selected from the first 2 yr of the Sloan Digital Sky Survey-IV Mapping Nearby Galaxies at APO (SDSS-IV MaNGA) survey. The majority (85 per cent) of these quenched galaxies appear to reside in a group environment. We find six galaxies in our sample that appear to have an active AGN that is preventing on-going star formation; this is the first time such a feedback mechanism has been observed in this mass range. Interestingly, five of these six galaxies have an ionized gas component that is kinematically offset from their stellar component, suggesting the gas is either recently accreted or outflowing. We hypothesize these six galaxies are low-mass equivalents to the `red geysers' observed in more massive galaxies. Of the other 63 galaxies in the sample, we find 8 do appear for have some low level, residual star formation, or emission from hot, evolved stars. The remaining galaxies in our sample have no detectable ionized gas emission throughout their structures, consistent with them being quenched. This work shows the potential for understanding the detailed physical properties of dwarf galaxies through spatially resolved spectroscopy.

  17. The development, outline and evaluation of the second level of an interprofessional learning programme – listening to the students.

    PubMed

    Wright, Anna; Lindqvist, Susanne

    2008-10-01

    The delivery and content of interprofessional education (IPE) varies greatly. Currently there is little evidence to suggest the most effective approach. This paper describes an interprofessional learning programme offered to second year healthcare students (IPL2), which was developed together with the students. At the outset of developing IPL2, an interprofessional student planning group (supported by a facilitator) was formed. The student planning group (SPG) reported back their ideas to an IPL steering group. Student feedback forms from 2005–2006 were used for the review and further development of IPL2. Analysis of student feedback was completed using median (for the quantitative elements of the form) and content analysis (for the qualitative elements). Post-programme student feedback included suggestions such as improvements to the case scenario, issues such as the logistical problems associated with students being on placement and how to overcome this by expanding the use of a virtual learning environment. Student views have informed both the original and ongoing development of IPL2 and ensure that the IPL programme remains relevant to the students. This model of involving students in the development of IPL has proven effective and can be applied to other settings.

  18. STABILIZING CLOUD FEEDBACK DRAMATICALLY EXPANDS THE HABITABLE ZONE OF TIDALLY LOCKED PLANETS

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yang Jun; Abbot, Dorian S.; Cowan, Nicolas B., E-mail: abbot@uchicago.edu

    2013-07-10

    The habitable zone (HZ) is the circumstellar region where a planet can sustain surface liquid water. Searching for terrestrial planets in the HZ of nearby stars is the stated goal of ongoing and planned extrasolar planet surveys. Previous estimates of the inner edge of the HZ were based on one-dimensional radiative-convective models. The most serious limitation of these models is the inability to predict cloud behavior. Here we use global climate models with sophisticated cloud schemes to show that due to a stabilizing cloud feedback, tidally locked planets can be habitable at twice the stellar flux found by previous studies.more » This dramatically expands the HZ and roughly doubles the frequency of habitable planets orbiting red dwarf stars. At high stellar flux, strong convection produces thick water clouds near the substellar location that greatly increase the planetary albedo and reduce surface temperatures. Higher insolation produces stronger substellar convection and therefore higher albedo, making this phenomenon a stabilizing climate feedback. Substellar clouds also effectively block outgoing radiation from the surface, reducing or even completely reversing the thermal emission contrast between dayside and nightside. The presence of substellar water clouds and the resulting clement surface conditions will therefore be detectable with the James Webb Space Telescope.« less

  19. Computerized visual feedback: an adjunct to robotic-assisted gait training.

    PubMed

    Banz, Raphael; Bolliger, Marc; Colombo, Gery; Dietz, Volker; Lünenburger, Lars

    2008-10-01

    Robotic devices for walking rehabilitation allow new possibilities for providing performance-related information to patients during gait training. Based on motor learning principles, augmented feedback during robotic-assisted gait training might improve the rehabilitation process used to regain walking function. This report presents a method to provide visual feedback implemented in a driven gait orthosis (DGO). The purpose of the study was to compare the immediate effect on motor output in subjects during robotic-assisted gait training when they used computerized visual feedback and when they followed verbal instructions of a physical therapist. Twelve people with neurological gait disorders due to incomplete spinal cord injury participated. Subjects were instructed to walk within the DGO in 2 different conditions. They were asked to increase their motor output by following the instructions of a therapist and by observing visual feedback. In addition, the subjects' opinions about using visual feedback were investigated by a questionnaire. Computerized visual feedback and verbal instructions by the therapist were observed to result in a similar change in motor output in subjects when walking within the DGO. Subjects reported that they were more motivated and concentrated on their movements when using computerized visual feedback compared with when no form of feedback was provided. Computerized visual feedback is a valuable adjunct to robotic-assisted gait training. It represents a relevant tool to increase patients' motor output, involvement, and motivation during gait training, similar to verbal instructions by a therapist.

  20. Vibrotactile sensory substitution for object manipulation: amplitude versus pulse train frequency modulation.

    PubMed

    Stepp, Cara E; Matsuoka, Yoky

    2012-01-01

    Incorporating sensory feedback with prosthetic devices is now possible, but the optimal methods of providing such feedback are still unknown. The relative utility of amplitude and pulse train frequency modulated stimulation paradigms for providing vibrotactile feedback for object manipulation was assessed in 10 participants. The two approaches were studied during virtual object manipulation using a robotic interface as a function of presentation order and a simultaneous cognitive load. Despite the potential pragmatic benefits associated with pulse train frequency modulated vibrotactile stimulation, comparison of the approach with amplitude modulation indicates that amplitude modulation vibrotactile stimulation provides superior feedback for object manipulation.

  1. Multidecadal Variability in Surface Albedo Feedback Across CMIP5 Models

    NASA Astrophysics Data System (ADS)

    Schneider, Adam; Flanner, Mark; Perket, Justin

    2018-02-01

    Previous studies quantify surface albedo feedback (SAF) in climate change, but few assess its variability on decadal time scales. Using the Coupled Model Intercomparison Project Version 5 (CMIP5) multimodel ensemble data set, we calculate time evolving SAF in multiple decades from surface albedo and temperature linear regressions. Results are meaningful when temperature change exceeds 0.5 K. Decadal-scale SAF is strongly correlated with century-scale SAF during the 21st century. Throughout the 21st century, multimodel ensemble mean SAF increases from 0.37 to 0.42 W m-2 K-1. These results suggest that models' mean decadal-scale SAFs are good estimates of their century-scale SAFs if there is at least 0.5 K temperature change. Persistent SAF into the late 21st century indicates ongoing capacity for Arctic albedo decline despite there being less sea ice. If the CMIP5 multimodel ensemble results are representative of the Earth, we cannot expect decreasing Arctic sea ice extent to suppress SAF in the 21st century.

  2. In psychotherapy with severe patients discouraging news may be worse than no news: The impact of providing feedback to therapists on psychotherapy outcome, session attendance, and the alliance.

    PubMed

    Errázuriz, Paula; Zilcha-Mano, Sigal

    2018-02-01

    Our objective was to assess low-cost and feasible feedback alternatives and compare them to Lambert's OQ feedback system. We also studied patient, therapist, and process characteristics that could moderate the effect of feedback on outcome, session attendance, and alliance. A total of 547 patients, 75% female, average age 41 (SD = 13), 95% Latino, treated in an outpatient individual psychotherapy setting in Chile were randomly assigned to five feedback conditions: no feedback, feedback on symptomatology, feedback on the alliance, feedback on both symptomatology and alliance, and Lambert's OQ progress feedback report. The measures included the Outcome Questionnaire and the Working Alliance Inventory. We also had follow-up interviews with therapists. We found through multilevel modeling that feedback had no effect on outcome, session attendance, and alliance. Contrary to previous findings, these results were maintained even when focusing only on patients "not-on-track." However, patients' former psychiatric hospitalization history and baseline severity, combined with lack of progress, significantly moderated the impact of feedback. For this more dysfunctional population, "positive feedback" (i.e., low symptomatology) to therapists had a positive impact on therapy outcome, while "negative feedback" (i.e., high symptomatology) had a negative impact. Providing feedback to therapists without offering them tools to improve treatment may be ineffective and even be detrimental. This may be especially the case for patients who suffer more severe mental health issues and whose therapists receive mostly discouraging news as feedback. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  3. A Journey towards Sustainable Feedback

    ERIC Educational Resources Information Center

    Mutch, Allyson; Young, Charlotte; Davey, Tamzyn; Fitzgerald, Lisa

    2018-01-01

    Meeting students' expectations associated with the provision of feedback is a perennial challenge for tertiary education. Efforts to provide comprehensive, timely feedback within our own first year undergraduate public health courses have not always met students' expectations. In response, we sought to develop peer feedback activities to support…

  4. Feedback and its effectiveness in a computer-aided personalized system of instruction course.

    PubMed Central

    Martin, Toby L; Pear, Joseph J; Martin, Garry L

    2002-01-01

    In a computer-managed version of Keller's personalized system of instruction, students received frequent feedback from more advanced students within the course. Overall accuracy of student-provided feedback was 87%, and students complied with 61% of the feedback. PMID:12555917

  5. Feedback and the Reconstruction of Meaning.

    ERIC Educational Resources Information Center

    Langer, Philip; And Others

    This investigation of the impact of feedback upon scrambled discourse was intended to show the effects of idiosyncratic processing and to provide a more sensitive indicator of feedback usefulness. Learner schemata, text organization, and feedback strategies interact in processing discourse, although past research has favored limited models…

  6. Effects of Vibrotactile Feedback on Human Learning of Arm Motions

    PubMed Central

    Bark, Karlin; Hyman, Emily; Tan, Frank; Cha, Elizabeth; Jax, Steven A.; Buxbaum, Laurel J.; Kuchenbecker, Katherine J.

    2015-01-01

    Tactile cues generated from lightweight, wearable actuators can help users learn new motions by providing immediate feedback on when and how to correct their movements. We present a vibrotactile motion guidance system that measures arm motions and provides vibration feedback when the user deviates from a desired trajectory. A study was conducted to test the effects of vibrotactile guidance on a subject’s ability to learn arm motions. Twenty-six subjects learned motions of varying difficulty with both visual (V), and visual and vibrotactile (VVT) feedback over the course of four days of training. After four days of rest, subjects returned to perform the motions from memory with no feedback. We found that augmenting visual feedback with vibrotactile feedback helped subjects reduce the root mean square (rms) angle error of their limb significantly while they were learning the motions, particularly for 1DOF motions. Analysis of the retention data showed no significant difference in rms angle errors between feedback conditions. PMID:25486644

  7. Rapid control and feedback rates enhance neuroprosthetic control

    PubMed Central

    Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

    2017-01-01

    Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms. PMID:28059065

  8. Rapid control and feedback rates enhance neuroprosthetic control

    NASA Astrophysics Data System (ADS)

    Shanechi, Maryam M.; Orsborn, Amy L.; Moorman, Helene G.; Gowda, Suraj; Dangi, Siddharth; Carmena, Jose M.

    2017-01-01

    Brain-machine interfaces (BMI) create novel sensorimotor pathways for action. Much as the sensorimotor apparatus shapes natural motor control, the BMI pathway characteristics may also influence neuroprosthetic control. Here, we explore the influence of control and feedback rates, where control rate indicates how often motor commands are sent from the brain to the prosthetic, and feedback rate indicates how often visual feedback of the prosthetic is provided to the subject. We developed a new BMI that allows arbitrarily fast control and feedback rates, and used it to dissociate the effects of each rate in two monkeys. Increasing the control rate significantly improved control even when feedback rate was unchanged. Increasing the feedback rate further facilitated control. We also show that our high-rate BMI significantly outperformed state-of-the-art methods due to higher control and feedback rates, combined with a different point process mathematical encoding model. Our BMI paradigm can dissect the contribution of different elements in the sensorimotor pathway, providing a unique tool for studying neuroprosthetic control mechanisms.

  9. Teacher Cognition in Corrective Feedback in Japan

    ERIC Educational Resources Information Center

    Mori, Reiko

    2011-01-01

    Based on qualitative data, the current study explored how the knowledge and beliefs of two EFL professionals shaped their corrective feedback practices. The two teachers teaching in Japan had in common two main agendas that they kept in mind as they provided or opted not to provide corrective feedback. They aimed to teach the language and to…

  10. "Listen to This!" Utilizing Audio Recordings to Improve Instructor Feedback on Writing in Mathematics

    ERIC Educational Resources Information Center

    Weld, Christopher

    2014-01-01

    Providing audio files in lieu of written remarks on graded assignments is arguably a more effective means of feedback, allowing students to better process and understand the critique and improve their future work. With emerging technologies and software, this audio feedback alternative to the traditional paradigm of providing written comments…

  11. Managing Written and Oral Negative Feedback in a Synchronous Online Teaching Situation

    ERIC Educational Resources Information Center

    Guichon, Nicolas; Betrancourt, Mireille; Prie, Yannick

    2012-01-01

    This case study focuses on the feedback that is provided by tutors to learners in the course of synchronous online teaching. More specifically, we study how trainee tutors used the affordances of Visu, an experimental web videoconferencing system, to provide negative feedback. Visu features classical functionalities such as video and chat, and it…

  12. Peer Assessment: Judging the Quality of Students' Work by Comments Rather than Marks

    ERIC Educational Resources Information Center

    Davies, Phil

    2006-01-01

    This paper reports the results of a study into the quality of peer feedback provided by students within a computerised peer-assessment environment. The study looks at the creation of a "feedback index" that represents the quality of an essay based upon the feedback provided during a peer-marking process and identifies a significant…

  13. Exploring Doctoral Students' Perceptions of Language Use in Supervisory Written Feedback Practices--Because "Feedback Is Hard to Have"

    ERIC Educational Resources Information Center

    Stracke, Elke; Kumar, Vijay

    2016-01-01

    The mastery of academic writing is essential in doctoral writing. Supervisory feedback provides opportunities for students to improve their writing. It is a communicative tool that can be categorised based on fundamental functions of speech: referential, directive, and expressive. This study provides some understanding of the impact that language…

  14. The Effects of Computer-Mediated Synchronous and Asynchronous Direct Corrective Feedback on Writing: A Case Study

    ERIC Educational Resources Information Center

    Shintani, Natsuko

    2016-01-01

    This case study investigated the characteristics of computer-mediated synchronous corrective feedback (SCF, provided while students wrote) and asynchronous corrective feedback (ACF, provided after students had finished writing) in an EFL writing task. The task, designed to elicit the use of the hypothetical conditional, was completed by two…

  15. Random bit generation at tunable rates using a chaotic semiconductor laser under distributed feedback.

    PubMed

    Li, Xiao-Zhou; Li, Song-Sui; Zhuang, Jun-Ping; Chan, Sze-Chun

    2015-09-01

    A semiconductor laser with distributed feedback from a fiber Bragg grating (FBG) is investigated for random bit generation (RBG). The feedback perturbs the laser to emit chaotically with the intensity being sampled periodically. The samples are then converted into random bits by a simple postprocessing of self-differencing and selecting bits. Unlike a conventional mirror that provides localized feedback, the FBG provides distributed feedback which effectively suppresses the information of the round-trip feedback delay time. Randomness is ensured even when the sampling period is commensurate with the feedback delay between the laser and the grating. Consequently, in RBG, the FBG feedback enables continuous tuning of the output bit rate, reduces the minimum sampling period, and increases the number of bits selected per sample. RBG is experimentally investigated at a sampling period continuously tunable from over 16 ns down to 50 ps, while the feedback delay is fixed at 7.7 ns. By selecting 5 least-significant bits per sample, output bit rates from 0.3 to 100 Gbps are achieved with randomness examined by the National Institute of Standards and Technology test suite.

  16. Computer-Supported Feedback Message Tailoring for Healthcare Providers in Malawi: Proof-of-Concept.

    PubMed

    Landis-Lewis, Zach; Douglas, Gerald P; Hochheiser, Harry; Kam, Matthew; Gadabu, Oliver; Bwanali, Mwatha; Jacobson, Rebecca S

    2015-01-01

    Although performance feedback has the potential to help clinicians improve the quality and safety of care, healthcare organizations generally lack knowledge about how this guidance is best provided. In low-resource settings, tools for theory-informed feedback tailoring may enhance limited clinical supervision resources. Our objectives were to establish proof-of-concept for computer-supported feedback message tailoring in Malawi, Africa. We conducted this research in five stages: clinical performance measurement, modeling the influence of feedback on antiretroviral therapy (ART) performance, creating a rule-based message tailoring process, generating tailored messages for recipients, and finally analysis of performance and message tailoring data. We retrospectively generated tailored messages for 7,448 monthly performance reports from 11 ART clinics. We found that tailored feedback could be routinely generated for four guideline-based performance indicators, with 35% of reports having messages prioritized to optimize the effect of feedback. This research establishes proof-of-concept for a novel approach to improving the use of clinical performance feedback in low-resource settings and suggests possible directions for prospective evaluations comparing alternative designs of feedback messages.

  17. Persuasive Performance Feedback: The Effect of Framing on Self-Efficacy

    PubMed Central

    Choe, Eun Kyoung; Lee, Bongshin; Munson, Sean; Pratt, Wanda; Kientz, Julie A.

    2013-01-01

    Self-monitoring technologies have proliferated in recent years as they offer excellent potential for promoting healthy behaviors. Although these technologies have varied ways of providing real-time feedback on a user’s current progress, we have a dearth of knowledge of the framing effects on the performance feedback these tools provide. With an aim to create influential, persuasive performance feedback that will nudge people toward healthy behaviors, we conducted an online experiment to investigate the effect of framing on an individual’s self-efficacy. We identified 3 different types of framing that can be applicable in presenting performance feedback: (1) the valence of performance (remaining vs. achieved framing), (2) presentation type (text-only vs. text with visual), and (3) data unit (raw vs. percentage). Results show that the achieved framing could lead to an increased perception of individual’s performance capabilities. This work provides empirical guidance for creating persuasive performance feedback, thereby helping people designing self-monitoring technologies to promote healthy behaviors. PMID:24551378

  18. Persuasive performance feedback: the effect of framing on self-efficacy.

    PubMed

    Choe, Eun Kyoung; Lee, Bongshin; Munson, Sean; Pratt, Wanda; Kientz, Julie A

    2013-01-01

    Self-monitoring technologies have proliferated in recent years as they offer excellent potential for promoting healthy behaviors. Although these technologies have varied ways of providing real-time feedback on a user's current progress, we have a dearth of knowledge of the framing effects on the performance feedback these tools provide. With an aim to create influential, persuasive performance feedback that will nudge people toward healthy behaviors, we conducted an online experiment to investigate the effect of framing on an individual's self-efficacy. We identified 3 different types of framing that can be applicable in presenting performance feedback: (1) the valence of performance (remaining vs. achieved framing), (2) presentation type (text-only vs. text with visual), and (3) data unit (raw vs. percentage). Results show that the achieved framing could lead to an increased perception of individual's performance capabilities. This work provides empirical guidance for creating persuasive performance feedback, thereby helping people designing self-monitoring technologies to promote healthy behaviors.

  19. Understanding constructive feedback: a commitment between teachers and students for academic and professional development.

    PubMed

    Hamid, Yasir; Mahmood, Sajid

    2010-03-01

    This review highlights the need in the Pakistani medical education system for teachers and students to be able to: define constructive feedback; provide constructive feedback; identify standards for constructive feedback; identify a suitable model for the provision of constructive feedback and evaluate the use of constructive feedback. For the purpose of literature review we had defined the key word glossary as: feedback, constructive feedback, teaching constructive feedback, models for feedback, models for constructive feedback and giving and receiving feedback. The data bases for the search include: Medline (EBSCO), Web of Knowledge, SCOPUS, TRIP, ScienceDirect, Pubmed, U.K. Pubmed Central, ZETOC, University of Dundee Library catalogue, SCIRUS (Elsevier) and Google Scholar. This article states that the Pakistani medical schools do not reflect on or use the benefits of the constructive feedback process. The discussion about constructive feedback suggests that in the context of Pakistan, constructive feedback will facilitate the teaching and learning activities.

  20. Follower-Centered Perspective on Feedback: Effects of Feedback Seeking on Identification and Feedback Environment

    PubMed Central

    Gong, Zhenxing; Li, Miaomiao; Qi, Yaoyuan; Zhang, Na

    2017-01-01

    In the formation mechanism of the feedback environment, the existing research pays attention to external feedback sources and regards individuals as objects passively accepting feedback. Thus, the external source fails to realize the individuals’ need for feedback, and the feedback environment cannot provide them with useful information, leading to a feedback vacuum. The aim of this study is to examine the effect of feedback-seeking by different strategies on the supervisor-feedback environment through supervisor identification. The article consists of an empirical study with a sample of 264 employees in China; here, participants complete a series of questionnaires in three waves. After controlling for the effects of demography, the results indicate that supervisor identification partially mediates the relationship between feedback-seeking (including feedback monitoring and feedback inquiry) and the supervisor-feedback environment. Implications are also discussed. PMID:28919872

  1. Counterintuitive Effects of Online Feedback in Middle School Math: Results from a Randomized Controlled Trial in ASSISTments

    ERIC Educational Resources Information Center

    McGuire, Patrick; Tu, Shihfen; Logue, Mary Ellin; Mason, Craig A.; Ostrow, Korinn

    2017-01-01

    This study compared the effects of three different feedback formats provided to sixth grade mathematics students within a web-based online learning platform, ASSISTments. A sample of 196 students were randomly assigned to one of three conditions: (1) text-based feedback; (2) image-based feedback; and (3) correctness only feedback. Regardless of…

  2. Are They Using My Feedback? The Extent of Students' Feedback Use Has a Large Impact on Subsequent Academic Performance

    ERIC Educational Resources Information Center

    Zimbardi, Kirsten; Colthorpe, Kay; Dekker, Andrew; Engstrom, Craig; Bugarcic, Andrea; Worthy, Peter; Victor, Ruban; Chunduri, Prasad; Lluka, Lesley; Long, Phil

    2017-01-01

    Feedback is known to have a large influence on student learning gains, and the emergence of online tools has greatly enhanced the opportunity for delivering timely, expressive, digital feedback and for investigating its learning impacts. However, to date there have been no large quantitative investigations of the feedback provided by large teams…

  3. Shaper design in CMOS for high dynamic range

    DOEpatents

    De Geronimo, Gianluigi; Li, Shaorui

    2015-06-30

    An analog filter is presented that comprises a chain of filter stages, a feedback resistor for providing a negative feedback, and a feedback capacitor for providing a positive feedback. Each filter stage has an input node and an output node. The output node of a filter stage is connected to the input node of an immediately succeeding filter stage through a resistor. The feedback resistor has a first end connected to the output node of the last filter stage along the chain of filter stages, and a second end connected to the input node of a first preceding filter stage. The feedback capacitor has a first end connected to the output node of one of the chain of filter stages, and a second end connected to the input node of a second preceding filter stage.

  4. A temporal bone surgery simulator with real-time feedback for surgical training.

    PubMed

    Wijewickrema, Sudanthi; Ioannou, Ioanna; Zhou, Yun; Piromchai, Patorn; Bailey, James; Kennedy, Gregor; O'Leary, Stephen

    2014-01-01

    Timely feedback on surgical technique is an important aspect of surgical skill training in any learning environment, be it virtual or otherwise. Feedback on technique should be provided in real-time to allow trainees to recognize and amend their errors as they occur. Expert surgeons have typically carried out this task, but they have limited time available to spend with trainees. Virtual reality surgical simulators offer effective, repeatable training at relatively low cost, but their benefits may not be fully realized while they still require the presence of experts to provide feedback. We attempt to overcome this limitation by introducing a real-time feedback system for surgical technique within a temporal bone surgical simulator. Our evaluation study shows that this feedback system performs exceptionally well with respect to accuracy and effectiveness.

  5. Scenario and modelling uncertainty in global mean temperature change derived from emission-driven global climate models

    NASA Astrophysics Data System (ADS)

    Booth, B. B. B.; Bernie, D.; McNeall, D.; Hawkins, E.; Caesar, J.; Boulton, C.; Friedlingstein, P.; Sexton, D. M. H.

    2013-04-01

    We compare future changes in global mean temperature in response to different future scenarios which, for the first time, arise from emission-driven rather than concentration-driven perturbed parameter ensemble of a global climate model (GCM). These new GCM simulations sample uncertainties in atmospheric feedbacks, land carbon cycle, ocean physics and aerosol sulphur cycle processes. We find broader ranges of projected temperature responses arising when considering emission rather than concentration-driven simulations (with 10-90th percentile ranges of 1.7 K for the aggressive mitigation scenario, up to 3.9 K for the high-end, business as usual scenario). A small minority of simulations resulting from combinations of strong atmospheric feedbacks and carbon cycle responses show temperature increases in excess of 9 K (RCP8.5) and even under aggressive mitigation (RCP2.6) temperatures in excess of 4 K. While the simulations point to much larger temperature ranges for emission-driven experiments, they do not change existing expectations (based on previous concentration-driven experiments) on the timescales over which different sources of uncertainty are important. The new simulations sample a range of future atmospheric concentrations for each emission scenario. Both in the case of SRES A1B and the Representative Concentration Pathways (RCPs), the concentration scenarios used to drive GCM ensembles, lies towards the lower end of our simulated distribution. This design decision (a legacy of previous assessments) is likely to lead concentration-driven experiments to under-sample strong feedback responses in future projections. Our ensemble of emission-driven simulations span the global temperature response of the CMIP5 emission-driven simulations, except at the low end. Combinations of low climate sensitivity and low carbon cycle feedbacks lead to a number of CMIP5 responses to lie below our ensemble range. The ensemble simulates a number of high-end responses which lie above the CMIP5 carbon cycle range. These high-end simulations can be linked to sampling a number of stronger carbon cycle feedbacks and to sampling climate sensitivities above 4.5 K. This latter aspect highlights the priority in identifying real-world climate-sensitivity constraints which, if achieved, would lead to reductions on the upper bound of projected global mean temperature change. The ensembles of simulations presented here provides a framework to explore relationships between present-day observables and future changes, while the large spread of future-projected changes highlights the ongoing need for such work.

  6. Uncovering the unknown: A grounded theory study exploring the impact of self-awareness on the culture of feedback in residency education.

    PubMed

    Ramani, Subha; Könings, Karen; Mann, Karen V; van der Vleuten, Cees

    2017-10-01

    Self-assessment and reflection are essential for meaningful feedback. We aimed to explore whether the well-known Johari window model of self-awareness could guide feedback conversations between faculty and residents and enhance the institutional feedback culture. We had previously explored perceptions of residents and faculty regarding sociocultural factors impacting feedback. We re-analyzed data targeting themes related to self-assessment, reflection, feedback seeking and acceptance, aiming to generate individual and institutional feedback strategies applicable to each quadrant of the window. We identified the following themes for each quadrant: (1) Behaviors known to self and others - Validating the known; (2) Behaviors unknown to self but known to others - Accepting the blind; (3) Behaviors known to self and unknown to others - Disclosure of hidden; and (4) Behaviors unknown to self and others - Uncovering the unknown. Normalizing self-disclosure of limitations, encouraging feedback seeking, training in nonjudgmental feedback and providing opportunities for longitudinal relationships could promote self-awareness, ultimately expanding the "open" quadrant of the Johari window. The Johari window, a model of self-awareness in interpersonal communications, could provide a robust framework for individuals to improve their feedback conversations and institutions to design feedback initiatives that enhance its quality and impact.

  7. Overview of the ARPA/WL Smart Structures and Materials Development-Smart Wing contract

    NASA Astrophysics Data System (ADS)

    Kudva, Jayanth N.; Jardine, A. Peter; Martin, Christopher A.; Appa, Kari

    1996-05-01

    While the concept of an adaptive aircraft wing, i.e., a wing whose shape parameters such as camber, wing twist, and thickness can be varied to optimize the wing shape for various flight conditions, has been extensively studied, the complexity and weight penalty of the actuation mechanisms have precluded their practical implementation. Recent development of sensors and actuators using smart materials could potentially alleviate the shortcomings of prior designs, paving the way for a practical, `smart' adaptive wing which responds to changes in flight and environmental conditions by modifying its shape to provide optimal performance. This paper presents a summary of recent work done on adaptive wing designs under an on-going ARPA/WL contract entitled `Smart Structures and Materials Development--Smart Wing.' Specifically, the design, development and planned wind tunnel testing of a 16% model representative of a fighter aircraft wing and incorporating the following features, are discussed: (1) a composite wing torque box whose span-wise twist can be varied by activating built-in shape memory alloy (SMA) torque tubes to provide increased lift and enhanced maneuverability at multiple flight conditions, (2) trailing edge control surfaces deployed using composite SMA actuators to provide smooth, hingeless aerodynamic surfaces, and (3) a suite of fiber optic sensors integrated into the wing skin which provide real-time strain and pressure data to a feedback control system.

  8. Student and Peer Evaluation: Feedback for All Learners

    ERIC Educational Resources Information Center

    Carr, Sonya C.

    2008-01-01

    Assessment for learning provides feedback to improve teaching and learning in the classroom. However, many teachers focus on measuring what students have learned at the end of a unit of instruction and fail to allow opportunities for feedback and revision during instruction. As Bransford, Brown, and Cocking (2000) explained, "Feedback is…

  9. A Content Analysis of Peer Feedback in Triadic Supervision

    ERIC Educational Resources Information Center

    Avent, Janeé R.; Wahesh, Edward; Purgason, Lucy L.; Borders, L. DiAnne; Mobley, A. Keith

    2015-01-01

    There is limited research on the types of peer feedback exchanged during triadic supervision. Through a content analysis, the authors found that students provided feedback about counseling performance and cognitive counseling skills most often in supervision sessions. However, there were differences in the types of feedback exchanged across three…

  10. Does visual feedback during walking result in similar improvements in trunk control for young and older healthy adults?

    PubMed

    Anson, Eric; Rosenberg, Russell; Agada, Peter; Kiemel, Tim; Jeka, John

    2013-11-26

    Most current applications of visual feedback to improve postural control are limited to a fixed base of support and produce mixed results regarding improved postural control and transfer to functional tasks. Currently there are few options available to provide visual feedback regarding trunk motion while walking. We have developed a low cost platform to provide visual feedback of trunk motion during walking. Here we investigated whether augmented visual position feedback would reduce trunk movement variability in both young and older healthy adults. The subjects who participated were 10 young and 10 older adults. Subjects walked on a treadmill under conditions of visual position feedback and no feedback. The visual feedback consisted of anterior-posterior (AP) and medial-lateral (ML) position of the subject's trunk during treadmill walking. Fourier transforms of the AP and ML trunk kinematics were used to calculate power spectral densities which were integrated as frequency bins "below the gait cycle" and "gait cycle and above" for analysis purposes. Visual feedback reduced movement power at very low frequencies for lumbar and neck translation but not trunk angle in both age groups. At very low frequencies of body movement, older adults had equivalent levels of movement variability with feedback as young adults without feedback. Lower variability was specific to translational (not angular) trunk movement. Visual feedback did not affect any of the measured lower extremity gait pattern characteristics of either group, suggesting that changes were not invoked by a different gait pattern. Reduced translational variability while walking on the treadmill reflects more precise control maintaining a central position on the treadmill. Such feedback may provide an important technique to augment rehabilitation to minimize body translation while walking. Individuals with poor balance during walking may benefit from this type of training to enhance path consistency during over-ground locomotion.

  11. Feedback Consistencies and Inconsistencies: Eight Mentors' Observations on One Preservice Teacher's Lesson

    ERIC Educational Resources Information Center

    Hudson, Peter

    2014-01-01

    Mentors play a key role in developing preservice teachers for their chosen careers, and providing feedback appears as a significant relational interaction between the mentor and mentee that assists in guiding the mentee's practices. But what are mentors' perspectives on providing feedback to their mentees? In this case study, eight…

  12. An Assessment of Feedback Procedures and Information Provided to Instructors within Computer Managed Learning Environments--Implications for Instruction and Software Redesign.

    ERIC Educational Resources Information Center

    Kotesky, Arturo A.

    Feedback procedures and information provided to instructors within computer managed learning environments were assessed to determine current usefulness and meaningfulness to users, and to present the design of a different instructor feedback instrument. Kaufman's system model was applied to accomplish the needs assessment phase of the study; and…

  13. Volunteer Expert Readers: Drawing on the University Community to Provide Professional Feedback for Engineering Student Writers

    ERIC Educational Resources Information Center

    Moskovitz, Cary

    2017-01-01

    This paper reports on a 3-year study utilizing a novel approach to providing students in an introductory engineering course with feedback on drafts of course writing projects. In the Volunteer Expert Reader (VER) approach, students are matched with university alumni or employees who have the background to give feedback from the perspective of the…

  14. The Differential Effects of Elaborate Feedback and Basic Feedback on Student Performance in a Modified, Personalized System of Instruction Course

    ERIC Educational Resources Information Center

    Chase, Jared A.; Houmanfar, Ramona

    2009-01-01

    Educators in large-enrollment courses are faced with the challenge of effectively disseminating information to their students to ensure that they learn the content provided. A related issue involves the means by which instructors evaluate student performance. Offering effective forms of performance feedback may be one technique to provide students…

  15. Using Confidence as Feedback in Multi-Sized Learning Environments

    ERIC Educational Resources Information Center

    Hench, Thomas L.

    2014-01-01

    This paper describes the use of existing confidence and performance data to provide feedback by first demonstrating the data's fit to a simple linear model. The paper continues by showing how the model's use as a benchmark provides feedback to allow current or future students to infer either the difficulty or the degree of under or over…

  16. Physical examination skills training: Faculty staff vs. patient instructor feedback-A controlled trial.

    PubMed

    Krautter, Markus; Diefenbacher, Katja; Schultz, Jobst-Hendrik; Maatouk, Imad; Herrmann-Werner, Anne; Koehl-Hackert, Nadja; Herzog, Wolfgang; Nikendei, Christoph

    2017-01-01

    Standardized patients are widely used in training of medical students, both in teaching and assessment. They also frequently lead complete training sessions delivering physical examination skills without the aid of faculty teaching staff-acting as "patient instructors" (PIs). An important part of this training is their ability to provide detailed structured feedback to students which has a strong impact on their learning success. Yet, to date no study has assessed the quality of physical examination related feedback by PIs. Therefore, we conducted a randomized controlled study comparing feedback of PIs and faculty staff following a physical examination assessed by students and video assessors. 14 PIs and 14 different faculty staff physicians both delivered feedback to 40 medical students that had performed a physical examination on the respective PI while the physicians observed the performance. The physical examination was rated by two independent video assessors to provide an objective performance standard (gold standard). Feedback of PI and physicians was content analyzed by two different independent video assessors based on a provided checklist and compared to the performance standard. Feedback of PIs and physicians was also rated by medical students and video assessors using a questionnaire consisting of 12 items. There was no statistical significant difference concerning overall matching of physician or PI feedback with gold standard ratings by video assessment (p = .219). There was also no statistical difference when focusing only on items that were classified as major key steps (p = .802), mistakes or parts that were left out during physical examination (p = .219) or mistakes in communication items (p = .517). The feedback of physicians was significantly better rated than PI feedback both by students (p = .043) as well as by video assessors (p = .034). In summary, our study demonstrates that trained PIs are able to provide feedback of equal quantitative value to that of faculty staff physicians with regard to a physical examination performed on them. However, both the students and the video raters judged the quality of the feedback given by the physicians to be significantly better than that of the PIs.

  17. Social closeness and feedback modulate susceptibility to the framing effect.

    PubMed

    Sip, Kamila E; Smith, David V; Porcelli, Anthony J; Kar, Kohitij; Delgado, Mauricio R

    2015-01-01

    Although we often seek social feedback (SFB) from others to help us make decisions, little is known about how SFB affects decisions under risk, particularly from a close peer. We conducted two experiments using an established framing task to probe how decision-making is modulated by SFB valence (positive, negative) and the level of closeness with feedback provider (friend, confederate). Participants faced mathematically equivalent decisions framed as either an opportunity to keep (gain frame) or lose (loss frame) part of an initial endowment. Periodically, participants were provided with positive (e.g., "Nice!") or negative (e.g., "Lame!") feedback about their choices. Such feedback was provided by either a confederate (Experiment 1) or a gender-matched close friend (Experiment 2). As expected, the framing effect was observed in both experiments. Critically, an individual's susceptibility to the framing effect was modulated by the valence of the SFB, but only when the feedback provider was a close friend. This effect was reflected in the activation patterns of ventromedial prefrontal cortex and posterior cingulate cortex, regions involved in complex decision-making. Taken together, these results highlight social closeness as an important factor in understanding the impact of SFB on neural mechanisms of decision-making.

  18. The impact of immediate or delayed feedback on driving behaviour in a simulated Pay-As-You-Drive system.

    PubMed

    Dijksterhuis, Chris; Lewis-Evans, Ben; Jelijs, Bart; de Waard, Dick; Brookhuis, Karel; Tucha, Oliver

    2015-02-01

    Pay-As-You-Drive (PAYD) insurance links an individual's driving behaviour to the insurance fee that they pay, making car insurance more actuarially accurate. The best known PAYD insurance format is purely mileage based and is estimated to reduce accidents by about 15% (Litman, 2011). However, these benefits could be further enhanced by incorporating a wider range of driving behaviours, such as lateral and longitudinal accelerations and speeding behaviour, thereby stimulating not only a safe but also an eco-friendly driving style. Currently, feedback on rewards and driver behaviour is mostly provided through a web-based interface, which is presented temporally separated from driving. However, providing immediate feedback within the vehicle itself could elicit more effect. To investigate this hypothesis, two groups of 20 participants drove with a behavioural based PAYD system in a driving simulator and were provided with either delayed feedback through a website, or immediate feedback through an in-car interface, allowing them to earn up to €6 extra. To be clear, every participant in the web group did actually view their feedback during the one week between sessions. Results indicate clear driving behaviour improvements for both PAYD groups as compared to baseline rides and an equal sized control group. After both PAYD groups had received feedback, the initial advantage of the in-car group was reduced substantially. Taken together with usability ratings and driving behaviours in specific situations these results show a moderate advantage of using immediate in-car feedback. However, the study also showed that under conditions of feedback certainty, the effectiveness of delayed feedback approaches that of immediate feedback as compared to a naïve control group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. A Review of Literature on Formative Evaluation of Teachers through Mid-Term Student Feedback and How the Reiser and Dick Instructional Planning Model Can Enhance This Feedback.

    ERIC Educational Resources Information Center

    Hampton, Scott E.

    Research has shown that student mid-term feedback has significantly increased subsequent ratings of teacher effectiveness, student achievement, and student attitudes when the feedback results were accompanied by expert consultation. A gap in the literature is an instrument intended to provide specific feedback on systematic planning and delivery…

  20. Feedback Codes and Action Plans: Building the Capacity of First-Year Students to Apply Feedback to a Scientific Report

    ERIC Educational Resources Information Center

    Bird, Fiona L.; Yucel, Robyn

    2015-01-01

    Effective feedback can build self-assessment skills in students so that they become more competent and confident to identify and self-correct weaknesses in their work. In this study, we trialled a feedback code as part of an integrated programme of formative and summative assessment tasks, which provided feedback to first-year students on their…

  1. Feedback in the OSCE: What Do Residents Remember?

    PubMed

    Humphrey-Murto, Susan; Mihok, Marika; Pugh, Debra; Touchie, Claire; Halman, Samantha; Wood, Timothy J

    2016-01-01

    The move to competency-based education has heightened the importance of direct observation of clinical skills and effective feedback. The Objective Structured Clinical Examination (OSCE) is widely used for assessment and affords an opportunity for both direct observation and feedback to occur simultaneously. For feedback to be effective, it should include direct observation, assessment of performance, provision of feedback, reflection, decision making, and use of feedback for learning and change. If one of the goals of feedback is to engage students to think about their performance (i.e., reflection), it would seem imperative that they can recall this feedback both immediately and into the future. This study explores recall of feedback in the context of an OSCE. Specifically, the purpose of this study was to (a) determine the amount and the accuracy of feedback that trainees remember immediately after an OSCE, as well as 1 month later, and (b) assess whether prompting immediate recall improved delayed recall. Internal medicine residents received 2 minutes of verbal feedback from physician examiners in the context of an OSCE. The feedback was audio-recorded and later transcribed. Residents were randomly allocated to the immediate recall group (immediate-RG; n = 10) or the delayed recall group (delayed-RG; n = 8). The immediate-RG completed a questionnaire prompting recall of feedback received immediately after the OSCE, and then again 1 month later. The delayed-RG completed a questionnaire only 1 month after the OSCE. The total number and accuracy of feedback points provided by examiners were compared to the points recalled by residents. Results comparing recall at 1 month between the immediate-RG and the delayed-RG were also studied. Physician examiners provided considerably more feedback points (M = 16.3) than the residents recalled immediately after the OSCE (M = 2.61, p < .001). There was no significant difference between the number of feedback points recalled upon completion of the OSCE (2.61) compared to 1 month later (M = 1.96, p = .06, Cohen's d = .70). Prompting immediate recall did not improve later recall. The mean accuracy score for feedback recall immediately after the OSCE was 4.3/9 or "somewhat representative," and at 1 month the score dropped to 3.5/9 or "not representative" (ns). Residents recall very few feedback points immediately after the OSCE and 1 month later. The feedback points that are recalled are neither very accurate nor representative of the feedback actually provided.

  2. The effects of outcome and process feedback

    NASA Technical Reports Server (NTRS)

    Johnson, Debra Steele

    1990-01-01

    A study was conducted to examine the effects of process and outcome feedback on performance during a skill acquisition phase and a transfer test phase. The research also examined the role of two moderators: self-efficacy and intrinsic motivation. Subjects were college students participating for course credit. The task involved using a computerized simulation of the Space Shuttle's Remote Manipulation System (RMS). Results provided evidence of the beneficial effects of process feedback during skill acquisition. Results also provided evidence that self-efficacy and intrinsic motivation moderate the effects of feedback type on performance.

  3. Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format

    PubMed Central

    Angus, Steven; Moriarty, John; Nardino, Robert J.; Chmielewski, Amy; Rosenblum, Michael J.

    2015-01-01

    Background In contrast to historical feedback, which was vague or provided residents' numerical scores without clear meaning, milestone-based feedback is focused on specific knowledge, skills, and behaviors that define developmental trajectory. It was anticipated that residents would welcome the more specific and actionable feedback provided by the milestone framework, but this has not been studied. Objective We assessed internal medicine (IM) residents' perceptions of receiving feedback in the milestone framework, particularly assessing perception of the utility of milestone-based feedback compared to non–milestone-based feedback. Methods We surveyed a total of 510 IM residents from 7 institutions. Survey questions assessed resident perception of milestone feedback in identifying strengths, weaknesses, and trajectory of professional development. Postgraduate years 2 and 3 (PGY-2 and PGY-3) residents were asked to compare milestones with prior methods of feedback. Results Of 510 residents, 356 (69.8%) responded. Slightly less than half of the residents found milestone-based feedback “extremely useful” or “very useful” in identifying strengths (44%), weaknesses (43%), specific areas for improvement (45%), and appropriate education progress (48%). Few residents found such feedback “not very useful” or “not at all useful” in these domains. A total of 51% of PGY-2 and PGY-3 residents agreed that receiving milestone-based feedback was more helpful than previous forms of feedback. Conclusions IM residents are aware of the concepts of milestones, and half of the residents surveyed found milestone feedback more helpful than previous forms of feedback. More work needs to be done to understand how milestone-based feedback could be delivered more effectively to enhance resident development. PMID:26221438

  4. Effects of invalid feedback on learning and feedback-related brain activity in decision-making.

    PubMed

    Ernst, Benjamin; Steinhauser, Marco

    2015-10-01

    For adaptive decision-making it is important to utilize only relevant, valid and to ignore irrelevant feedback. The present study investigated how feedback processing in decision-making is impaired when relevant feedback is combined with irrelevant and potentially invalid feedback. We analyzed two electrophysiological markers of feedback processing, the feedback-related negativity (FRN) and the P300, in a simple decision-making task, in which participants processed feedback stimuli consisting of relevant and irrelevant feedback provided by the color and meaning of a Stroop stimulus. We found that invalid, irrelevant feedback not only impaired learning, it also altered the amplitude of the P300 to relevant feedback, suggesting an interfering effect of irrelevant feedback on the processing of relevant feedback. In contrast, no such effect on the FRN was obtained. These results indicate that detrimental effects of invalid, irrelevant feedback result from failures of controlled feedback processing. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. “Booster” training: Evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest

    PubMed Central

    Sutton, Robert M.; Niles, Dana; Meaney, Peter A.; Aplenc, Richard; French, Benjamin; Abella, Benjamin S.; Lengetti, Evelyn L.; Berg, Robert A.; Helfaer, Mark A.; Nadkarni, Vinay

    2013-01-01

    Objective To investigate the effectiveness of brief bedside “booster” cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Design Prospective, randomized trial. Setting General pediatric wards at Children’s Hospital of Philadelphia. Subjects Sixty-nine Basic Life Support–certified hospital-based providers. Intervention CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Measurements and Main Results Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min−1 and <120 min−1); 71% met minimum depth targets (depth, >38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p < .02]; automated feedback only: rate, 70% to 96% [p = .02], depth, 61% to 100% [p < .01], and overall CPR compliance, 35% to 96% [p < .01]; and instructor training combined with automated feedback: rate 48% to 100% [p < .01], depth, 78% to 100% [p < .02], and overall CPR compliance, 30% to 100% [p < .01]). Conclusions Before booster CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests. PMID:20625336

  6. "Booster" training: evaluation of instructor-led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during simulated cardiac arrest.

    PubMed

    Sutton, Robert M; Niles, Dana; Meaney, Peter A; Aplenc, Richard; French, Benjamin; Abella, Benjamin S; Lengetti, Evelyn L; Berg, Robert A; Helfaer, Mark A; Nadkarni, Vinay

    2011-05-01

    To investigate the effectiveness of brief bedside "booster" cardiopulmonary resuscitation (CPR) training to improve CPR guideline compliance of hospital-based pediatric providers. Prospective, randomized trial. General pediatric wards at Children's Hospital of Philadelphia. Sixty-nine Basic Life Support-certified hospital-based providers. CPR recording/feedback defibrillators were used to evaluate CPR quality during simulated pediatric arrest. After a 60-sec pretraining CPR evaluation, subjects were randomly assigned to one of three instructional/feedback methods to be used during CPR booster training sessions. All sessions (training/CPR manikin practice) were of equal duration (2 mins) and differed only in the method of corrective feedback given to participants during the session. The study arms were as follows: 1) instructor-only training; 2) automated defibrillator feedback only; and 3) instructor training combined with automated feedback. Before instruction, 57% of the care providers performed compressions within guideline rate recommendations (rate >90 min(-1) and <120 min(-1)); 71% met minimum depth targets (depth, >38 mm); and 36% met overall CPR compliance (rate and depth within targets). After instruction, guideline compliance improved (instructor-only training: rate 52% to 87% [p .01], and overall CPR compliance, 43% to 78% [p < .02]; automated feedback only: rate, 70% to 96% [p = .02], depth, 61% to 100% [p < .01], and overall CPR compliance, 35% to 96% [p < .01]; and instructor training combined with automated feedback: rate 48% to 100% [p < .01], depth, 78% to 100% [p < .02], and overall CPR compliance, 30% to 100% [p < .01]). Before booster CPR instruction, most certified Pediatric Basic Life Support providers did not perform guideline-compliant CPR. After a brief bedside training, CPR quality improved irrespective of training content (instructor vs. automated feedback). Future studies should investigate bedside training to improve CPR quality during actual pediatric cardiac arrests.

  7. Predator-Prey Dynamics Driven by Feedback between Functionally Diverse Trophic Levels

    PubMed Central

    Wirtz, Kai; Gaedke, Ursula

    2011-01-01

    Neglecting the naturally existing functional diversity of communities and the resulting potential to respond to altered conditions may strongly reduce the realism and predictive power of ecological models. We therefore propose and study a predator-prey model that describes mutual feedback via species shifts in both predator and prey, using a dynamic trait approach. Species compositions of the two trophic levels were described by mean functional traits—prey edibility and predator food-selectivity—and functional diversities by the variances. Altered edibility triggered shifts in food-selectivity so that consumers continuously respond to the present prey composition, and vice versa. This trait-mediated feedback mechanism resulted in a complex dynamic behavior with ongoing oscillations in the mean trait values, reflecting continuous reorganization of the trophic levels. The feedback was only possible if sufficient functional diversity was present in both trophic levels. Functional diversity was internally maintained on the prey level as no niche existed in our system, which was ideal under any composition of the predator level due to the trade-offs between edibility, growth and carrying capacity. The predators were only subject to one trade-off between food-selectivity and grazing ability and in the absence of immigration, one predator type became abundant, i.e., functional diversity declined to zero. In the lack of functional diversity the system showed the same dynamics as conventional models of predator-prey interactions ignoring the potential for shifts in species composition. This way, our study identified the crucial role of trade-offs and their shape in physiological and ecological traits for preserving diversity. PMID:22096560

  8. Improving Instruction Using Statistical Process Control.

    ERIC Educational Resources Information Center

    Higgins, Ronald C.; Messer, George H.

    1990-01-01

    Two applications of statistical process control to the process of education are described. Discussed are the use of prompt feedback to teachers and prompt feedback to students. A sample feedback form is provided. (CW)

  9. Real-time feedback on nonverbal clinical communication. Theoretical framework and clinician acceptance of ambient visual design.

    PubMed

    Hartzler, A L; Patel, R A; Czerwinski, M; Pratt, W; Roseway, A; Chandrasekaran, N; Back, A

    2014-01-01

    This article is part of the focus theme of Methods of Information in Medicine on "Pervasive Intelligent Technologies for Health". Effective nonverbal communication between patients and clinicians fosters both the delivery of empathic patient-centered care and positive patient outcomes. Although nonverbal skill training is a recognized need, few efforts to enhance patient-clinician communication provide visual feedback on nonverbal aspects of the clinical encounter. We describe a novel approach that uses social signal processing technology (SSP) to capture nonverbal cues in real time and to display ambient visual feedback on control and affiliation--two primary, yet distinct dimensions of interpersonal nonverbal communication. To examine the design and clinician acceptance of ambient visual feedback on nonverbal communication, we 1) formulated a model of relational communication to ground SSP and 2) conducted a formative user study using mixed methods to explore the design of visual feedback. Based on a model of relational communication, we reviewed interpersonal communication research to map nonverbal cues to signals of affiliation and control evidenced in patient-clinician interaction. Corresponding with our formulation of this theoretical framework, we designed ambient real-time visualizations that reflect variations of affiliation and control. To explore clinicians' acceptance of this visual feedback, we conducted a lab study using the Wizard-of-Oz technique to simulate system use with 16 healthcare professionals. We followed up with seven of those participants through interviews to iterate on the design with a revised visualization that addressed emergent design considerations. Ambient visual feedback on non- verbal communication provides a theoretically grounded and acceptable way to provide clinicians with awareness of their nonverbal communication style. We provide implications for the design of such visual feedback that encourages empathic patient-centered communication and include considerations of metaphor, color, size, position, and timing of feedback. Ambient visual feedback from SSP holds promise as an acceptable means for facilitating empathic patient-centered nonverbal communication.

  10. Effects of different feedback types on information integration in repeated monetary gambles

    PubMed Central

    Haffke, Peter; Hübner, Ronald

    2015-01-01

    Most models of risky decision making assume that all relevant information is taken into account (e.g., von Neumann and Morgenstern, 1944; Kahneman and Tversky, 1979). However, there are also some models supposing that only part of the information is considered (e.g., Brandstätter et al., 2006; Gigerenzer and Gaissmaier, 2011). To further investigate the amount of information that is usually used for decision making, and how the use depends on feedback, we conducted a series of three experiments in which participants choose between two lotteries and where no feedback, outcome feedback, and error feedback was provided, respectively. The results show that without feedback participants mostly chose the lottery with the higher winning probability, and largely ignored the potential gains. The same results occurred when the outcome of each decision was fed back. Only after presenting error feedback (i.e., signaling whether a choice was optimal or not), participants considered probabilities as well as gains, resulting in more optimal choices. We propose that outcome feedback was ineffective, because of its probabilistic and ambiguous nature. Participants improve information integration only if provided with a consistent and deterministic signal such as error feedback. PMID:25667576

  11. Grip force control during virtual object interaction: effect of force feedback,accuracy demands, and training.

    PubMed

    Gibo, Tricia L; Bastian, Amy J; Okamura, Allison M

    2014-03-01

    When grasping and manipulating objects, people are able to efficiently modulate their grip force according to the experienced load force. Effective grip force control involves providing enough grip force to prevent the object from slipping, while avoiding excessive force to avoid damage and fatigue. During indirect object manipulation via teleoperation systems or in virtual environments, users often receive limited somatosensory feedback about objects with which they interact. This study examines the effects of force feedback, accuracy demands, and training on grip force control during object interaction in a virtual environment. The task required subjects to grasp and move a virtual object while tracking a target. When force feedback was not provided, subjects failed to couple grip and load force, a capability fundamental to direct object interaction. Subjects also exerted larger grip force without force feedback and when accuracy demands of the tracking task were high. In addition, the presence or absence of force feedback during training affected subsequent performance, even when the feedback condition was switched. Subjects' grip force control remained reminiscent of their employed grip during the initial training. These results motivate the use of force feedback during telemanipulation and highlight the effect of force feedback during training.

  12. Effects of different feedback types on information integration in repeated monetary gambles.

    PubMed

    Haffke, Peter; Hübner, Ronald

    2014-01-01

    Most models of risky decision making assume that all relevant information is taken into account (e.g., von Neumann and Morgenstern, 1944; Kahneman and Tversky, 1979). However, there are also some models supposing that only part of the information is considered (e.g., Brandstätter et al., 2006; Gigerenzer and Gaissmaier, 2011). To further investigate the amount of information that is usually used for decision making, and how the use depends on feedback, we conducted a series of three experiments in which participants choose between two lotteries and where no feedback, outcome feedback, and error feedback was provided, respectively. The results show that without feedback participants mostly chose the lottery with the higher winning probability, and largely ignored the potential gains. The same results occurred when the outcome of each decision was fed back. Only after presenting error feedback (i.e., signaling whether a choice was optimal or not), participants considered probabilities as well as gains, resulting in more optimal choices. We propose that outcome feedback was ineffective, because of its probabilistic and ambiguous nature. Participants improve information integration only if provided with a consistent and deterministic signal such as error feedback.

  13. Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies.

    PubMed

    Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

    2018-01-01

    Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

  14. Design of a haptic device with grasp and push-pull force feedback for a master-slave surgical robot.

    PubMed

    Hu, Zhenkai; Yoon, Chae-Hyun; Park, Samuel Byeongjun; Jo, Yung-Ho

    2016-07-01

    We propose a portable haptic device providing grasp (kinesthetic) and push-pull (cutaneous) sensations for optical-motion-capture master interfaces. Although optical-motion-capture master interfaces for surgical robot systems can overcome the stiffness, friction, and coupling problems of mechanical master interfaces, it is difficult to add haptic feedback to an optical-motion-capture master interface without constraining the free motion of the operator's hands. Therefore, we utilized a Bowden cable-driven mechanism to provide the grasp and push-pull sensation while retaining the free hand motion of the optical-motion capture master interface. To evaluate the haptic device, we construct a 2-DOF force sensing/force feedback system. We compare the sensed force and the reproduced force of the haptic device. Finally, a needle insertion test was done to evaluate the performance of the haptic interface in the master-slave system. The results demonstrate that both the grasp force feedback and the push-pull force feedback provided by the haptic interface closely matched with the sensed forces of the slave robot. We successfully apply our haptic interface in the optical-motion-capture master-slave system. The results of the needle insertion test showed that our haptic feedback can provide more safety than merely visual observation. We develop a suitable haptic device to produce both kinesthetic grasp force feedback and cutaneous push-pull force feedback. Our future research will include further objective performance evaluations of the optical-motion-capture master-slave robot system with our haptic interface in surgical scenarios.

  15. Effects of Differential Feedback on Students' Examination Performance

    ERIC Educational Resources Information Center

    Lipnevich, Anastasiya A.; Smith, Jeffrey K.

    2009-01-01

    The effects of feedback on performance and factors associated with it were examined in a large introductory psychology course. The experiment involved college students (N = 464) working on an essay examination under 3 conditions: no feedback, detailed feedback that was perceived by participants to be provided by the course instructor, and detailed…

  16. Assessment Certitude as a Feedback Strategy for Learners' Constructed Responses

    ERIC Educational Resources Information Center

    Kealy, W. A.; Ritzhaupt, A. D.

    2010-01-01

    Educational researchers have "rarely" addressed the problem of how to provide feedback on constructed responses. All participants (N = 76) read a story and completed short-answer questions based on the text, with some receiving feedback consisting of the exact material on which the questions were based. During feedback, two groups receiving…

  17. Exploring Student Perceptions of Audiovisual Feedback via Screencasting in Online Courses

    ERIC Educational Resources Information Center

    Mathieson, Kathleen

    2012-01-01

    Using Moore's (1993) theory of transactional distance as a framework, this action research study explored students' perceptions of audiovisual feedback provided via screencasting as a supplement to text-only feedback. A crossover design was employed to ensure that all students experienced both text-only and text-plus-audiovisual feedback and to…

  18. Group Projects in Interior Design Studio Classes: Peer Feedback Benefits

    ERIC Educational Resources Information Center

    Jurado, Juan A.

    2011-01-01

    Group projects have been shown to be effective for providing peer feedback in classrooms. While students in regular enrollment classes benefit from peer feedback, low-enrollment classes face many challenges. This study compares peer feedback effectiveness between two interior design studio classes with different design projects. In one class,…

  19. The Value of a Focused Approach to Written Corrective Feedback

    ERIC Educational Resources Information Center

    Bitchener, John; Knoch, Ute

    2009-01-01

    Investigations into the most effective ways to provide ESL learners with written corrective feedback have often been overly comprehensive in the range of error categories examined. As a result, clear conclusions about the efficacy of such feedback have not been possible. On the other hand, oral corrective feedback studies have produced clear,…

  20. Teacher Feedback during Active Learning: Current Practices in Primary Schools

    ERIC Educational Resources Information Center

    van den Bergh, Linda; Ros, Anje; Beijaard, Douwe

    2013-01-01

    Background: Feedback is one of the most powerful tools, which teachers can use to enhance student learning. It appears dif?cult for teachers to give qualitatively good feedback, especially during active learning. In this context, teachers should provide facilitative feedback that is focused on the development of meta-cognition and social learning.…

  1. Analysis of Peer Review Comments: QM Recommendations and Feedback Intervention Theory

    ERIC Educational Resources Information Center

    Schwegler, Andria F.; Altman, Barbara W.

    2015-01-01

    Because feedback is a critical component of the continuous improvement cycle of the Quality Matters (QM) peer review process, the present research analyzed the feedback that peer reviewers provided to course developers after a voluntary, nonofficial QM peer review of online courses. Previous research reveals that the effects of feedback on…

  2. Where the rubber meets the road: long-term in-stream data collection to inform regional land management monitoring in the Pacific Northwest

    NASA Astrophysics Data System (ADS)

    Hirsch, C.

    2017-12-01

    The initiation of the Northwest Forest Plan (NWFP) in 1994 brought a sea change to federal land management agencies of the Pacific Northwest. The NWFP was developed in response to the listing of the Northern Spotted Owl and concern about declining populations of Pacific Salmon. The Aquatic and Riparian Effectiveness Monitoring Program (AREMP) was developed to track changes that occurred as a result of active and passive management on the landscape. A significant management change affecting riparian areas was the creation of buffers around fish bearing and non-fish bearing streams. Two monitoring arms of the AREMP program focus on upslope and in-stream conditions in order to capture watershed-scale effects of land management changes. Field data to support the in-stream monitoring mission of AREMP began in 2002 with a study design based on an 8-year re-survey rotation. The sampling design was intended to capture watershed-scale variability across the broad and diverse study area in western Washington, western Oregon, and northwest California. 2017 marks repeat visits of every site and opens the door to more detailed assessments of changes that have occurred at local and regional extents over this time period. Results so far show improving trends in characteristics such as water temperature and macroinvertebrate community diversity. Maintaining an ongoing and relevant monitoring program over time has required a strong commitment to quality control in terms of data collection and analysis, and an openness to how AREMP can provide management relevant information as new challenges occur. AREMP's mandated role as the aquatic monitoring arm of the NWFP provides the overarching framework within which the program operates. However, new emerging topics of relevance to aquatic managers such as climate change and aquatic invasive species have been rolled into the mission over time. By being responsive to new challenges, and providing consistent feedback, AREMP has been able to evolve over time. AREMP is now poised to provide relevant feedback on changes to date, while also informing the emerging challenges faced by federal land managers in the west.

  3. Primary Medical Care Provider Accreditation (PMCPA): pilot evaluation

    PubMed Central

    Campbell, Stephen M; Chauhan, Umesh; Lester, Helen

    2010-01-01

    Background While practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the UK. Aim To describe the development, content and piloting of version 1 of the Primary Medical Care Provider Accreditation (PMCPA) scheme, which includes 112 separate criteria across six domains: health inequalities and health promotion; provider management; premises, records, equipment, and medicines management; provider teams; learning organisation; and patient experience/involvement, and to present the results from the pilot service evaluation focusing on the achievement of the 30 core criteria and feedback from practice staff. Design of study Observational service evaluation using evidence uploaded onto an extranet system in support of 30 core summative pilot PMCPA accreditation criteria. Setting Thirty-six nationally representative practices across England, between June and December 2008. Method Study population: interviews with GPs, practice managers, nurses and other relevant staff from the participating practices were conducted, audiotaped, transcribed, and analysed using a thematic approach. For each practice, the number of core criteria that had received either a‘good’or‘satisfactory’rating from a RCGP-trained assessment team, was counted and expressed as a percentage. Results Thirty-two practices completed the scheme, with nine practices passing 100% of core criteria (range: 27–100%). There were no statistical differences in achievement between practices of different sizes and in different localities. Practice feedback highlighted seven key issues: (1) overall view of PMCPA; (2) the role of accreditation; (3) different motivations for taking part; (4) practice managers dominated the workload associated with implementing the scheme; (5) facilitators for implementation; (6) patient benefit — relevance of PMCPA to quality improvement; (7) recommendations for improving the scheme. Conclusion Version 1 of PMCPA has been piloted as a primary care accreditation scheme and shown to be relevant to different types of practice. The scheme is undergoing revision in accordance with the findings from the pilot and ongoing consultation.

  4. The Effectiveness of Instructor Personalized and Formative Feedback Provided by Instructor in an Online Setting: Some Unresolved Issues

    ERIC Educational Resources Information Center

    Planar, Dolors; Moya, Soledad

    2016-01-01

    Formative feedback has great potential for teaching and learning in online undergraduate programmes. There is a large number of courses where the main source of feedback is provided by the instructor. This is particularly seen in subjects where assessments are designed based on specific activities which are the same for all students, and where the…

  5. The effects of non-evaluative feedback on drivers' self-evaluation and performance.

    PubMed

    Dogan, Ebru; Steg, Linda; Delhomme, Patricia; Rothengatter, Talib

    2012-03-01

    Drivers' tend to overestimate their competences, which may result in risk taking behavior. Providing drivers with feedback has been suggested as one of the solutions to overcome drivers' inaccurate self-evaluations. In practice, many tests and driving simulators provide drivers with non-evaluative feedback, which conveys information on the level of performance but not on what caused the performance. Is this type of feedback indeed effective in reducing self-enhancement biases? The current study aimed to investigate the effect of non-evaluative performance feedback on drivers' self-evaluations using a computerized hazard perception test. A between-subjects design was used with one group receiving feedback on performance in the hazard perception test while the other group not receiving any feedback. The results indicated that drivers had a robust self-enhancement bias in their self-evaluations regardless of the presence of performance feedback and that they systematically estimated their performance to be higher than they actually achieved in the test. Furthermore, they devalued the credibility of the test instead of adjusting their self-evaluations in order to cope with the negative feelings following the failure feedback. We discuss the theoretical and practical implications of these counterproductive effects of non-evaluative feedback. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Accuracy and speed feedback: Global and local effects on strategy use

    PubMed Central

    Touron, Dayna R.; Hertzog, Christopher

    2013-01-01

    Background Skill acquisition often involves a shift from an effortful algorithm-based strategy to more fluent memory-based performance. Older adults’ slower strategy transitions can be ascribed to both slowed learning and metacognitive factors. Experimenters often provide feedback on response accuracy; this emphasis may either inadvertently reinforce older adults’ conservatism or might highlight that retrieval is generally quite accurate. RT feedback can lead to more rapid shift to retrieval (Hertzog, Touron, & Hines, 2007). Methods This study parametrically varied trial-by-trial feedback to examine whether strategy shifts in the noun-pair task in younger (M = 19) and older adults (M = 67) were influenced by type of performance feedback: none, trial accuracy, trial RT, or both accuracy and RT. Results Older adults who received accuracy feedback retrieved more often, particularly on difficult rearranged trials, and participants who receive speed feedback performed the scanning strategy more quickly. Age differences were also obtained in local (trial-level) reactivity to task performance, but these were not affected by feedback. Conclusions Accuracy and speed feedback had distinct global (general) influences on task strategies and performance. In particular, it appears that the standard practice of providing trial-by-trial accuracy feedback might facilitate older adults’ use of retrieval strategies in skill acquisition tasks. PMID:24785594

  7. Patient-focused and feedback research in psychotherapy: Where are we and where do we want to go?

    PubMed

    Lutz, Wolfgang; De Jong, Kim; Rubel, Julian

    2015-01-01

    In the last 15 years feedback interventions have had a significant impact on the field of psychotherapy research and have demonstrated their potential to enhance treatment outcomes, especially for patients with an increased risk of treatment failure. This article serves as an introduction to the special issue on "Patient-focused and feedback research in psychotherapy: Where are we and where do we want to go?" Current investigations on feedback research are concerned with potential moderators and mediators of these effects, as well as the design and the implementation of feedback into routine care. This introduction summarizes the current state of feedback research and provides an overview of the three main research topics in this issue: (1) How to implement feedback systems into routine practice and how do therapist and patient attitudes influence its effects?, (2) How to design feedback reports and decision support tools?, and (3) What are the reasons for patients to become at risk of treatment failure and how should therapists intervene with these patients? We believe that the studies included in this special issue reflect the current state of feedback research and provide promising pathways for future endeavors that will enhance our understanding of feedback effects.

  8. Specific interpretation of augmented feedback changes motor performance and cortical processing.

    PubMed

    Lauber, Benedikt; Keller, Martin; Leukel, Christian; Gollhofer, Albert; Taube, Wolfgang

    2013-05-01

    It is well established that the presence of external feedback, also termed augmented feedback, can be used to improve performance of a motor task. The present study aimed to elucidate whether differential interpretation of the external feedback signal influences the time to task failure of a sustained submaximal contraction and modulates motor cortical activity. In Experiment 1, subjects had to maintain a submaximal contraction (30% of maximum force) performed with their thumb and index finger. Half of the tested subjects were always provided with feedback about joint position (pF-group), whereas the other half of the subjects were always provided with feedback about force (fF-group). Subjects in the pF-group were led to belief in half of their trials that they would receive feedback about the applied force, and subjects in the fF-group to receive feedback about the position. In both groups (fF and pF), the time to task failure was increased when subjects thought to receive feedback about the force. In Experiment 2, subthreshold transcranial magnetic stimulation was applied over the right motor cortex and revealed an increased motor cortical activity when subjects thought to receive feedback about the joint position. The results showed that the interpretation of feedback influences motor behavior and alters motor cortical activity. The current results support previous studies suggesting a distinct neural control of force and position.

  9. A software module for implementing auditory and visual feedback on a video-based eye tracking system

    NASA Astrophysics Data System (ADS)

    Rosanlall, Bharat; Gertner, Izidor; Geri, George A.; Arrington, Karl F.

    2016-05-01

    We describe here the design and implementation of a software module that provides both auditory and visual feedback of the eye position measured by a commercially available eye tracking system. The present audio-visual feedback module (AVFM) serves as an extension to the Arrington Research ViewPoint EyeTracker, but it can be easily modified for use with other similar systems. Two modes of audio feedback and one mode of visual feedback are provided in reference to a circular area-of-interest (AOI). Auditory feedback can be either a click tone emitted when the user's gaze point enters or leaves the AOI, or a sinusoidal waveform with frequency inversely proportional to the distance from the gaze point to the center of the AOI. Visual feedback is in the form of a small circular light patch that is presented whenever the gaze-point is within the AOI. The AVFM processes data that are sent to a dynamic-link library by the EyeTracker. The AVFM's multithreaded implementation also allows real-time data collection (1 kHz sampling rate) and graphics processing that allow display of the current/past gaze-points as well as the AOI. The feedback provided by the AVFM described here has applications in military target acquisition and personnel training, as well as in visual experimentation, clinical research, marketing research, and sports training.

  10. Study on real-time force feedback for a master-slave interventional surgical robotic system.

    PubMed

    Guo, Shuxiang; Wang, Yuan; Xiao, Nan; Li, Youxiang; Jiang, Yuhua

    2018-04-13

    In robot-assisted catheterization, haptic feedback is important, but is currently lacking. In addition, conventional interventional surgical robotic systems typically employ a master-slave architecture with an open-loop force feedback, which results in inaccurate control. We develop herein a novel real-time master-slave (RTMS) interventional surgical robotic system with a closed-loop force feedback that allows a surgeon to sense the true force during remote operation, provide adequate haptic feedback, and improve control accuracy in robot-assisted catheterization. As part of this system, we also design a unique master control handle that measures the true force felt by a surgeon, providing the basis for the closed-loop control of the entire system. We use theoretical and empirical methods to demonstrate that the proposed RTMS system provides a surgeon (using the master control handle) with a more accurate and realistic force sensation, which subsequently improves the precision of the master-slave manipulation. The experimental results show a substantial increase in the control accuracy of the force feedback and an increase in operational efficiency during surgery.

  11. Integration of sensory force feedback is disturbed in CRPS-related dystonia.

    PubMed

    Mugge, Winfred; van der Helm, Frans C T; Schouten, Alfred C

    2013-01-01

    Complex regional pain syndrome (CRPS) is characterized by pain and disturbed blood flow, temperature regulation and motor control. Approximately 25% of cases develop fixed dystonia. The origin of this movement disorder is poorly understood, although recent insights suggest involvement of disturbed force feedback. Assessment of sensorimotor integration may provide insight into the pathophysiology of fixed dystonia. Sensory weighting is the process of integrating and weighting sensory feedback channels in the central nervous system to improve the state estimate. It was hypothesized that patients with CRPS-related dystonia bias sensory weighting of force and position toward position due to the unreliability of force feedback. The current study provides experimental evidence for dysfunctional sensory integration in fixed dystonia, showing that CRPS-patients with fixed dystonia weight force and position feedback differently than controls do. The study shows reduced force feedback weights in CRPS-patients with fixed dystonia, making it the first to demonstrate disturbed integration of force feedback in fixed dystonia, an important step towards understanding the pathophysiology of fixed dystonia.

  12. Does Experience of Failure Decrease Executive, Regulatory Abilities and Increase Aggression?

    PubMed Central

    Pahlavan, Farzaneh; Mouchiroud, Christophe; Nemlaghi-Manis, Emna

    2012-01-01

    Recent advances in the study of affective-cognitive regulation of aggressive behavior suggest positive correlations between poor executive capacities (ECF) and dispositional negative reactivity (Posner & Rothbart, 2000). If the global assumption is correct what are the likely implications of predicted relation? The central issue in present research was to verify this assumption and examine how situational characteristics could alter executive performance in persons with Dysexecutive Syndrome (DES, Baddeley, 1998) and healthy adults (students, health workers) to explore some of the consequences of those modifications for aggressive tendencies. Precisely, we expected the positive correlations between poor executive performances and high aggressive tendencies at dispositional as well situational levels, except for health workers, given their professional duties. In order to assess cognitive capacities and dispositional as well as situational aggressive tendencies, during two studies (First study: N=60 students; Second study: N= 60 students, N= 24 patient with Dysexecutive Syndrome, N= 45 health care workers) right-handed French-speakers participants completed twice, during an initial phase of the study and one week after, a series of standard executive functions neuropsychological tests and aggression questionnaires. During second phase, participants executed a task introducing the experimental feedbacks (success, neutral, failure) before completion of neuropsychological tests and questionnaires. The results provided evidence of a dispositional relationship between poor executive functioning and aggressive tendencies, and extended it to situational level. For all participants, it showed that increases in impulsiveness (negative emotionality and aggressive choices) due to a negative feedback were concomitant with an inability to focus individuals’ attention on ongoing tasks. PMID:23121744

  13. Stable "Waterbelt" climates controlled by tropical ocean heat transport: A nonlinear coupled climate mechanism of relevance to Snowball Earth

    NASA Astrophysics Data System (ADS)

    Rose, Brian E. J.

    2015-02-01

    Ongoing controversy about Neoproterozoic Snowball Earth events motivates a theoretical study of stability and hysteresis properties of very cold climates. A coupled atmosphere-ocean-sea ice general circulation model (GCM) has four stable equilibria ranging from 0% to 100% ice cover, including a "Waterbelt" state with tropical sea ice. All four states are found at present-day insolation and greenhouse gas levels and with two idealized ocean basin configurations. The Waterbelt is stabilized against albedo feedback by intense but narrow wind-driven ocean overturning cells that deliver roughly 100 W m-2 heating to the ice edges. This requires three-way feedback between winds, ocean circulation, and ice extent in which circulation is shifted equatorward, following the baroclinicity at the ice margins. The thermocline is much shallower and outcrops in the tropics. Sea ice is snow-covered everywhere and has a minuscule seasonal cycle. The Waterbelt state spans a 46 W m-2 range in solar constant, has a significant hysteresis, and permits near-freezing equatorial surface temperatures. Additional context is provided by a slab ocean GCM and a diffusive energy balance model, both with prescribed ocean heat transport (OHT). Unlike the fully coupled model, these support no more than one stable ice margin, the position of which is slaved to regions of rapid poleward decrease in OHT convergence. Wide ranges of different climates (including the stable Waterbelt) are found by varying the magnitude and spatial structure of OHT in both models. Some thermodynamic arguments for the sensitivity of climate, and ice extent to OHT are presented.

  14. Accurate chromatic control and color rendering optimization in LED lighting systems using junction temperature feedback

    NASA Astrophysics Data System (ADS)

    Sisto, Marco Michele; Gauvin, Jonny

    2014-09-01

    Accurate color control of LED lighting systems is a challenging task: noticeable chromaticity shifts are commonly observed in mixed-color and phosphor converted LEDs due to intensity dimming. Furthermore, the emitted color varies with the LED temperature. We present a novel color control method for tri-chromatic and tetra-chromatic LEDs, which enable to set and maintain the LED emission at a target color, or combination of correlated color temperature (CCT) and intensity. The LED color point is maintained over variations in the LED junctions' temperatures and intensity dimming levels. The method does not require color feedback sensors, so to minimize system complexity and cost, but relies on estimation of the LED junctions' temperatures from the junction voltages. If operated with tetra-chromatic LEDs, the method allows meeting an additional optimization criterion: for example, the maximization of a color rendering metric like the Color Rendering Index (CRI) or the Color Quality Scale (CQS), thus providing a high quality and clarity of colors on the surface illuminated by the LED. We demonstrate the control of a RGBW LED at target D65 white point with CIELAB color difference metric triangle;a,bE < 1 for simultaneous variations of flux from approximately 30 lm to 100 lm and LED heat sink temperature from 25°C to 58°C. In the same conditions, we demonstrate a CCT error <1%. Furthermore, the method allows varying the LED CCT from 5500K to 8000K while maintaining luminance within 1% of target. Further work is ongoing to evaluate the stability of the method over LED aging.

  15. Multiple factors, including non-motor impairments, influence decision making with regard to exercise participation in Parkinson's disease: a qualitative enquiry.

    PubMed

    O'Brien, Christine; Clemson, Lindy; Canning, Colleen G

    2016-01-01

    To explore how the meaning of exercise and other factors interact and influence the exercise behaviour of individuals with Parkinson's disease (PD) enrolled in a 6-month minimally supervised exercise program to prevent falls, regardless of whether they completed the prescribed exercise or not. This qualitative study utilised in-depth semi-structured interviews analysed using grounded theory methodology. Four main themes were constructed from the data: adapting to change and loss, the influence of others, making sense of the exercise experience and hope for a more active future. Participation in the PD-specific physiotherapy program involving group exercise provided an opportunity for participants to reframe their identity of their "active" self. Three new influences on exercise participation were identified and explored: non-motor impairments of apathy and fatigue, the belief in a finite energy quota, and the importance of feedback. A model was developed incorporating the themes and influences to explain decision-making for exercise participation in this group. Complex and interacting issues, including non-motor impairments, need to be considered in order to enhance the development and ongoing implementation of effective exercise programmes for people with PD. Exercise participation can assist individuals to reframe their identity as they are faced with losses associated with Parkinson's disease and ageing. Non-motor impairments of apathy and fatigue may influence exercise participation in people with Parkinson's disease. Particular attention needs to be paid to the provision of feedback in exercise programs for people with Parkinson's disease as it important for their decision-making about continuing exercise.

  16. Physical examination skills training: Faculty staff vs. patient instructor feedback—A controlled trial

    PubMed Central

    Diefenbacher, Katja; Schultz, Jobst-Hendrik; Maatouk, Imad; Herrmann-Werner, Anne; Koehl-Hackert, Nadja; Herzog, Wolfgang; Nikendei, Christoph

    2017-01-01

    Background Standardized patients are widely used in training of medical students, both in teaching and assessment. They also frequently lead complete training sessions delivering physical examination skills without the aid of faculty teaching staff–acting as “patient instructors” (PIs). An important part of this training is their ability to provide detailed structured feedback to students which has a strong impact on their learning success. Yet, to date no study has assessed the quality of physical examination related feedback by PIs. Therefore, we conducted a randomized controlled study comparing feedback of PIs and faculty staff following a physical examination assessed by students and video assessors. Methods 14 PIs and 14 different faculty staff physicians both delivered feedback to 40 medical students that had performed a physical examination on the respective PI while the physicians observed the performance. The physical examination was rated by two independent video assessors to provide an objective performance standard (gold standard). Feedback of PI and physicians was content analyzed by two different independent video assessors based on a provided checklist and compared to the performance standard. Feedback of PIs and physicians was also rated by medical students and video assessors using a questionnaire consisting of 12 items. Results There was no statistical significant difference concerning overall matching of physician or PI feedback with gold standard ratings by video assessment (p = .219). There was also no statistical difference when focusing only on items that were classified as major key steps (p = .802), mistakes or parts that were left out during physical examination (p = .219) or mistakes in communication items (p = .517). The feedback of physicians was significantly better rated than PI feedback both by students (p = .043) as well as by video assessors (p = .034). Conclusions In summary, our study demonstrates that trained PIs are able to provide feedback of equal quantitative value to that of faculty staff physicians with regard to a physical examination performed on them. However, both the students and the video raters judged the quality of the feedback given by the physicians to be significantly better than that of the PIs. PMID:28692703

  17. Nurses' perceptions of feedback to nursing teams on quality measurements: An embedded case study design.

    PubMed

    Giesbers, A P M Suzanne; Schouteten, Roel L J; Poutsma, Erik; van der Heijden, Beatrice I J M; van Achterberg, Theo

    2016-12-01

    Providing nursing teams with feedback on quality measurements is used as a quality improvement instrument in healthcare organizations worldwide. Previous research indicated contradictory results regarding the effect of such feedback on both nurses' well-being and performance. Building on the Job Demands-Resources model this study explores: (1) whether and how nurses' perceptions of feedback on quality measurements (as a burdening job demand or rather as an intrinsically or extrinsically motivating job resource) are respectively related to nurses' well-being and performance; and (2) whether and how team reflection influences nurses' perceptions. An embedded case study. Four surgical wards within three different acute teaching-hospital settings in the Netherlands. During a period of four months, the nurses on each ward were provided with similar feedback on quality measurements. After this period, interviews with eight nurses and the ward manager for each ward were conducted. Additionally, observational data were collected from three oral feedback moments on each of the participating wards. The data revealed that individual nurses perceive the same feedback on quality measurements differently, leading to different effects on nurses' well-being and performance: 1) feedback can be perceived as a job demand that pressures nurses to improve the results on the quality measurements; 2) feedback can be perceived as an extrinsically motivating job resource, that is instrumental to improve the results on quality measurements; 3) feedback can be perceived as an intrinsically motivating job resource that stimulates nurses to improve the results on the quality measurements; and 4) feedback can be perceived neither as a job demand, nor as a job resource, and has no effect on nurses' well-being and performance. Additionally, this study indicates that team reflection after feedback seems to be very low in practice, while our data also provides evidence that nursing teams using the feedback to jointly reflect and analyse their performance and strategies will be able to better translate information about quality measurements into corrective behaviours, which may result in more positive perceptions of feedback on quality measurements among individual nurses. To better understand the impact of feedback to nursing teams on quality measurements, we should take nurses' individual perceptions of this feedback into account. Supporting nursing teams in team reflection after them having received feedback on quality measurements may help in eliciting positive perceptions among nurses, and therewith create positive effects of feedback on both their well-being and performance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. The Coordinated Ocean Wave Climate Project

    NASA Astrophysics Data System (ADS)

    Hemer, Mark; Dobrynin, Mikhail; Erikson, Li; Lionello, Piero; Mori, Nobuhito; Semedo, Alvaro; Wang, Xiaolan

    2016-04-01

    Future 21st Century changes in wind-wave climate have broad implications for marine and coastal infrastructure and ecosystems. Atmosphere-ocean general circulation models (GCM) are now routinely used for assessing and providing future projections of climatological parameters such as temperature and precipitation, but generally these provide no information on ocean wind-waves. To fill this information gap a growing number of studies are using GCM outputs and independently producing global and regional scale wind-wave climate projections. Furthermore, additional studies are actively coupling wind-wave dependent atmosphere-ocean exchanges into GCMs, to improve physical representation and quantify the impact of waves in the coupled climate system, and can also deliver wave characteristics as another variable in the climate system. To consolidate these efforts, understand the sources of variance between projections generated by different methodologies and International groups, and ultimately provide a robust picture of the role of wind-waves in the climate system and their projected changes, we present outcomes of the JCOMM supported Coordinated Ocean Wave Climate Project (COWCLIP). The objective of COWCLIP is twofold: to make community based ensembles of wave climate projections openly accessible, to provide the necessary information to support diligent marine and coastal impacts of climate change studies; and to understand the effects and feedback influences of wind-waves in the coupled ocean-atmosphere climate system. We will present the current status of COWCLIP, providing an overview of the objectives, analysis and results of the initial phase - now complete - and the progress of ongoing phases of the project.

  19. Interaction in Spoken Word Recognition Models: Feedback Helps.

    PubMed

    Magnuson, James S; Mirman, Daniel; Luthra, Sahil; Strauss, Ted; Harris, Harlan D

    2018-01-01

    Human perception, cognition, and action requires fast integration of bottom-up signals with top-down knowledge and context. A key theoretical perspective in cognitive science is the interactive activation hypothesis: forward and backward flow in bidirectionally connected neural networks allows humans and other biological systems to approximate optimal integration of bottom-up and top-down information under real-world constraints. An alternative view is that online feedback is neither necessary nor helpful; purely feed forward alternatives can be constructed for any feedback system, and online feedback could not improve processing and would preclude veridical perception. In the domain of spoken word recognition, the latter view was apparently supported by simulations using the interactive activation model, TRACE, with and without feedback: as many words were recognized more quickly without feedback as were recognized faster with feedback, However, these simulations used only a small set of words and did not address a primary motivation for interaction: making a model robust in noise. We conducted simulations using hundreds of words, and found that the majority were recognized more quickly with feedback than without. More importantly, as we added noise to inputs, accuracy and recognition times were better with feedback than without. We follow these simulations with a critical review of recent arguments that online feedback in interactive activation models like TRACE is distinct from other potentially helpful forms of feedback. We conclude that in addition to providing the benefits demonstrated in our simulations, online feedback provides a plausible means of implementing putatively distinct forms of feedback, supporting the interactive activation hypothesis.

  20. Interaction in Spoken Word Recognition Models: Feedback Helps

    PubMed Central

    Magnuson, James S.; Mirman, Daniel; Luthra, Sahil; Strauss, Ted; Harris, Harlan D.

    2018-01-01

    Human perception, cognition, and action requires fast integration of bottom-up signals with top-down knowledge and context. A key theoretical perspective in cognitive science is the interactive activation hypothesis: forward and backward flow in bidirectionally connected neural networks allows humans and other biological systems to approximate optimal integration of bottom-up and top-down information under real-world constraints. An alternative view is that online feedback is neither necessary nor helpful; purely feed forward alternatives can be constructed for any feedback system, and online feedback could not improve processing and would preclude veridical perception. In the domain of spoken word recognition, the latter view was apparently supported by simulations using the interactive activation model, TRACE, with and without feedback: as many words were recognized more quickly without feedback as were recognized faster with feedback, However, these simulations used only a small set of words and did not address a primary motivation for interaction: making a model robust in noise. We conducted simulations using hundreds of words, and found that the majority were recognized more quickly with feedback than without. More importantly, as we added noise to inputs, accuracy and recognition times were better with feedback than without. We follow these simulations with a critical review of recent arguments that online feedback in interactive activation models like TRACE is distinct from other potentially helpful forms of feedback. We conclude that in addition to providing the benefits demonstrated in our simulations, online feedback provides a plausible means of implementing putatively distinct forms of feedback, supporting the interactive activation hypothesis. PMID:29666593

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