Concept mapping key elements and performance measures in a state nursing home-to-community transition project

Science, Technology, Engineering, and Mathematics (STEM) education has become a key focus in the U.S. government's public education agenda. Many STEM degrees require the successful completion of undergraduate introductory organic chemistry (O-Chem), which is notorious for its difficulty and high attrition rate. Concept Maps (CM) have been used as a tool to improve teaching and learning by providing feedback to teacher and students. Although numerous studies have examined the use of concept maps (CMs) as an assessment tool in science classes, none to date has examined such applications of CMs in O-Chem. Furthermore, studies investigating the validity of CMs in post-secondary science courses are rare. Thus, the present study investigated the validity of CMs as an assessment tool and their diagnostic uses in O-Chem by examining the relationship between CM scores and other key performance measures in O-Chem. Results indicated that CM scores were significantly correlated with problem set scores and final course grade. In addition, a mediation analysis revealed that problem solving scores partially mediated the relationship between problem solving and final course grade, confirming the role CMs are expected to play in O-Chem achievement. Implications for using CMs as diagnostic and formative tools in instruction are discussed.

Background Improving the quality of colonoscopy in inflammatory bowel disease is expected to improve clinical outcomes for patients. The European Society of Gastrointestinal Endoscopy (ESGE) recently published key performance measures for IBD colonoscopy assessment. This study aimed to assess the impact of implementing key performance measures and assess for sustainable improvement through a multimodal education intervention. Methods A baseline retrospective analysis was performed in patients with established IBD between June and August of 2022 at a tertiary hospital. The key performance measures included 1) pre-procedure metrics including indication, consent, and safety checklist (target of 100%) and 2) bowel preparation score, photo-documentation, disease activity scores, adequate biopsies, use of high-definition endoscopy and chromoendoscopy. There were six proceduralists involved and data was collected from electronic medical records including endoscopy and histopathology results. The ESGE performance measures were used to set minimum standards and we have adopted overall standards for our unit based on the ECCO and SCENIC consensus guidelines. Over 12 months, proceduralists and endoscopy nursing staff were engaged with educational interventions including didactic teaching for one hour and diagrammatic reminders in the endoscopy suites of the ESGE key performance measures. A post-implementation analysis was conducted at 1 year from baseline, from August to November of 2023. Results Baseline standards showed suboptimal performance in the use of disease activity scores and chromoendoscopy. Educational interventions were implemented and after 12 months, a repeat analysis of 50 consecutive patients showed significant improvement in all performance measures (see Table 1). Conclusion Quality metrics are important and underrecognised components in colonoscopy for IBD patients and form an integral part of improving patient care. Our study demonstrated that the implementation of the ESGE key performance measures is effective in improving the quality of colonoscopy assessment in IBD patients, identifying areas requiring further development and increasing the dysplasia detection rate. Acknowledging quality attrition over time, we recognise that regular teaching and education are required in addressing the challenge of sustainable long-term improvement.

The European Society of Gastrointestinal Endoscopy and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at center and endoscopist level: 1: Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90 %); 2: Antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95 %); 3: Bile duct cannulation rate (key performance measure, at least 90 %); 4: Tissue sampling during EUS (key performance measure, at least 85 %); 5: Appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95 %); 6: Bile duct stone extraction (key performance measure, at least 90 %); 7: Post-ERCP pancreatitis (key performance measure, less than 10 %). 8: Adequate documentation of EUS landmarks (minor performance measure, at least 90 %).This present list of quality performance measures for ERCP and EUS recommended by ESGE should not be considered to be exhaustive: it might be extended in future to address further clinical and scientific issues.

The Accreditation Council for Graduate Medical Education (ACGME) requires sponsoring institutions to demonstrate effective oversight through an annual institutional review (AIR). The ACGME only requires 3 elements to be reported, and it is up to the discretion of the designated institutional official (DIO) whether other supporting information should be included. This leads to uncertainty and inconsistency for DIOs as they decide what to report. We surveyed DIOs in an effort to provide national data on key performance indicators and other relevant components of the AIR process. In July 2019, we conducted a national survey of 847 DIOs. The survey had 16 questions that explored basic institutional demographics, timelines, and processes for the AIR and key performance indicators. Written answers were grouped by similar responses, and we performed descriptive statistics on all variables to assess distributions of responses. We also explored associations between variables using cross-tabulation and chi-square statistics. A total of 267 DIOs responded to the survey (32% response rate). There were 7 institutional performance measures that achieved over 50% consensus. These reviews required the majority of DIOs (62%, 167 of 267) 5 to 20 hours to complete. Less than one-third of sponsoring institutions reported diversity data. The majority of DIOs (68%, 182 of 267) felt the AIR process added substantial value. This survey reports key performance measures and processes included by DIOs in the AIR. Our results show a wide range of institutional responses though consensus was achieved on 7 key performance measures.

The Landscape Design Theory class at Oregon State Univ. is composed of undergraduate students from a variety of majors including, horticulture, housing and interior design, business, criminal justice, and art. This diversity of majors means there is a wide range of student knowledge about the history of landscape design and creates a unique teaching opportunity. To capitalize on this diversity and to encourage student participation, concept or knowledge maps were used at the beginning of the term before the material being covered in class lectures. Students were divided into groups of three and asked to develop a group concept map. They were given major societies or events that occurred in history from about 2000 BC (ancient Egypt) through the early 20th century. Additionally each group was given a list of 20 landscape design elements or features. Initially each group developed a historical timeline. After the timeline was complete they linked the different landscape design elements or features with a historical era thereby creating a map of their understanding of landscape design history. After the landscape design history segment of the class was completed the small groups reconvened and evaluated their initial concept map in light of the recently completed lectures. Each group discussed their original map, what associations were correct, and how they would do it differently with their newfound understanding of landscape design history. A class discussion followed regarding initial perceptions and benefits of this learning activity. This teaching strategy could easily be adapted to a number of other horticulture topics.

Assessment of Level-Of-Service for Freeway Segments Using HCM and Microsimulation Methods

The purpose of this paper is to improve overall healthcare maintenance (HM) service performance in NHS infection control (IC). Hence, the authors identify critical success factors (CSFs) and key performance measures in maintenance-associated infections. These infections occur because of the poor performance of HM service in IC. In the first Delphi exercise, complete CSFs and performance measures were presented to the Delphi participants for refinement and modification. Delphi round 1 data were analysed manually and used to refine the rounds 2 and 3 Delphi instruments. In subsequent Delphi rounds, the results were analysed through descriptive statistics. In total, eight CSFs and 53 key performance measures were identified for reducing maintenance-associated infections in hospitals. For example, establishing clear communication between the infection control team (ICT) and HM unit is important for preventing maintenance-associated HAIs. Dust prevention is also identified by the healthcare experts as an important measure to prevent maintenance-associated HAIs in high-risk patient areas. The findings provide CSFs and key performance measures for measuring performance in HM in IC. Reducing the rate of maintenance-associated infections will have important socio-economic and health ramifications for hospitals. It will reduce cost and free up additional resources for alternative projects. It will also raise confidence among healthcare users about the quality of services provided by hospitals.

The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a short list of key performance measures for endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). We recommend that endoscopy services across Europe adopt the following seven key and one minor performance measures for EUS and ERCP, for measurement and evaluation in daily practice at centre and endoscopist level: 1 Adequate antibiotic prophylaxis before ERCP (key performance measure, at least 90%); 2 antibiotic prophylaxis before EUS-guided puncture of cystic lesions (key performance measure, at least 95%); 3 bile duct cannulation rate (key performance measure, at least 90%); 4 tissue sampling during EUS (key performance measure, at least 85%); 5 appropriate stent placement in patients with biliary obstruction below the hilum (key performance measure, at least 95%); 6 bile duct stone extraction (key performance measure, at least 90%); 7 post-ERCP pancreatitis (key performance measure, less than 10%); and 8 adequate documentation of EUS landmarks (minor performance measure, at least 90%). This present list of quality performance measures for ERCP and EUS recommended by the ESGE should not be considered to be exhaustive; it might be extended in future to address further clinical and scientific issues.

Linking organizational effectiveness, key success factors and performance measures: an analytical framework

'Repertory grid analysis' was used as a way of constructing representations of learners conceptions of living things; and finding a common structure or understanding; this was described in previous work. 'Concept mapping' has been stated as an appropriate assessment procedure in science curricula in a number of countries. Previous relevant published work describing the benefits of 'concept mapping' as a learning, teaching, and assessing tool is large. However, the existence of a large literature is not justification in itself, and in this work we provide a critique of the current literature. Problems with 'concept mapping' are simply ignored. However, it is thought that 'repertory grid analysis' does overcome some of the recognized problems of 'concept mapping' such as: i) comparison of concept maps between students or between students and educators: in repertory grid this becomes not only possible but a reliable method - this has proven to be one of the more problematic areas in traditional 'concept mapping'; ii) quantification of concept mapping - integer scoring of whole concept maps in 'repertory grid analysis' is eliminated since the arranged structure of the graph produced holds significance for the conceptual structure. More research needs to be done in repertory grid analysis and its implications and applications in curricular research have yet to be fully explored. Key words: concept mapping, conceptual frameworks, repertory grid analysis.

Purpose – The purpose of this paper is to investigate the impact of lean production practices on performance measures in machine tool industry and determines the lean criteria that can have significant positive impact on performance. Design/methodology/approach – The research paper presents a blend of theoretical framework and practical applications. Extant literature was reviewed and to achieve the research objectives, an exploratory survey was carried out in machine tool supply chains located in the national capital region of India. Reliability test, factor analysis and stepwise multiple regression analysis bring out several lean criteria that can affect key performance measures. Findings – It was found that two lean criteria, namely, strategic partnership with suppliers and cross-functional cross-organizational design and development teams significantly influenced most of the key performance measures. Some lean criteria were found to negatively affect the overall competitive potential of machine tool firms. Originality/value – The findings can encourage the management of non-adopter firms to adopt lean thinking and to select the lean production criteria that can be implemented to have significant positive impact on key performance indicators in machine tool value chains. This study is perhaps among the first few that focus on machine tool industry in India. The paper provides useful insights to the lean production implementers, consultants and researchers.

The search for new, authentic science assessments of what students know and can do is well under way. This has unearthed measures of students' hands-on performance in carrying out science investigations, and has been expanded to discover more or less direct measures of students' knowledge structures. One potential finding is concept mapping, the focus of this review. A concept map is a graph consisting of nodes representing concepts and labeled lines denoting the relation between a pair of nodes. A student's concept map is interpreted as representing important aspects of the organization of concepts in his or her memory (cognitive structure). In this article we characterize a concept map used as an assessment tool as: (a) a task that elicits evidence bearing on a student's knowledge structure in a domain, (b) a format for the student's response, and (c) a scoring system by which the student's concept map can be evaluated accurately and consistently. Based on this definition, multiple concept-mapping techniques were found from the myriad of task, response format, and scoring system variations identified in the literature. Moreover, little attention has been paid to the reliability and validity of these variations. The review led us to arrive at the following conclusions: (a) an integrative working cognitive theory is needed to begin to limit this variation in concept-mapping techniques for assessment purposes; (b) before concept maps are used for assessment and before map scores are reported to teachers, students, the public, and policy makers, research needs to provide reliability and validity information on the effect of different mapping techniques; and (c) research on students' facility in using concept maps, on training techniques, and on the effect on teaching is needed if concept map assessments are to be used in classrooms and in large-scale accountability systems. © 1996 John Wiley & Sons, Inc.

Analysis and Priorities: Developing a Modern, Effective, Regulatory Framework

The European Society of Gastrointestinal Endoscopy (ESGE) has published guidelines on key performance measures for colonoscopy. We analyzed whether those standards were met in the Polish Colonoscopy Screening Program (PCSP) and whether the monitoring was feasible. We analyzed database records for 43 277 PCSP participants (25 PCSP centers) for the years 2014 - 2015. We used the guideline definitions to calculate values for all key performance measures and compared these with the proposed standards at individual, center, and program level. All data were acquired from the PCSP database, apart from complication data which was assessed from external registries. At the program level, four of five minimum standards and one of two target standards (no set minimum standard) were met. Adequate bowel preparation rate was 91.3 % for the whole program (range among individual centers 79.2 % - 99.2 %). Cecal intubation rate was 97.4 % (93.4 % - 99.4 %). Adenoma detection rate was 29.8 % (19.1 % - 39.1 %). An appropriate polypectomy technique was applied in 62.7 % of cases (0.4 % - 97.8 %). Regarding complications, 7-day hospitalization rate after screening colonoscopy was 0.3 % (n = 127), and 30-day all-cause mortality was 0.02 % (n = 9). Patient feedback was assessed in 66.2 % of colonoscopies (7.6 % - 81.8 %). Appropriate post-polypectomy surveillance was proposed in 95.4 % of cases (range 84.9 % - -99.7 %). It was easy to monitor 6 of 7 key performance measures within the PCSP database, but monitoring complications required the additional effort of data extraction from external registries. The PCSP meets most proposed minimum standards at program level. Some centers need additional interventions to meet the complete set of quality standards. Use of ESGE performance measures for monitoring colonoscopy is generally feasible in the setting of the colonoscopy screening program.

Performance analysis of queueing networks is one of the most challenging areas of queueing theory. Barring very specialized models such as product-form type queueing networks, there exist very few results that provide provable nonasymptotic upper and lower bounds on key performance measures. In this paper we propose a new performance analysis method, which is based on the robust optimization. The basic premise of our approach is as follows: rather than assuming that the stochastic primitives of a queueing model satisfy certain probability laws—such as i.i.d. interarrival and service times distributions—we assume that the underlying primitives are deterministic and satisfy the implications of such probability laws. These implications take the form of simple linear constraints, namely, those motivated by the law of the iterated logarithm (LIL). Using this approach we are able to obtain performance bounds on some key performance measures. Furthermore, these performance bounds imply similar bounds in the underlying stochastic queueing models. We demonstrate our approach on two types of queueing networks: (a) tandem single-class queueing network and (b) multiclass single-server queueing network. In both cases, using the proposed robust optimization approach, we are able to obtain explicit upper bounds on some steady-state performance measures. For example, for the case of TSC system we obtain a bound of the form C(1 − ρ)−1 ln ln((1 − ρ)−1) on the expected steady-state sojourn time, where C is an explicit constant and ρ is the bottleneck traffic intensity. This qualitatively agrees with the correct heavy traffic scaling of this performance measure up to the ln ln((1 − ρ)−1) correction factor.