Continuous Quality Improvement Research Articles

Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study.

Tanzania has shown some improvements in the adoption of electronic medical record (EMR) systems in public health facilities; however, the rate of utilization of data generated from EMRs among health managers is not well documented. This study aims to assess the use of electronic medical record systems data in decision-making among health managers at public primary health facilities in Dodoma Region, Central Tanzania. A facility-based quantitative cross-sectional analytical study was conducted among 308 randomly selected health managers. A self-administered questionnaire supplemented with documentary review was used. Descriptive summary statistics and bivariable and multivariable logistic regression analyses (crude and adjusted odds ratios) were used. A P-value of <0.05 was used to declare statistically significant associations. Overall, more than a third (40.6%) of the health managers, that is 174 of the 308 included in the study, reported using data generated by EMR systems in decision-making. One-third (33.4%) of the health managers were adequately using data generated by EMR systems, of which 39.3% used data to support continuous quality improvement initiatives. Among the facilities visited, only nine (30%) had good documented EMR systems data use. Access to computers [adjusted odds ratio (AOR) = 4.72, 95% confidence interval (CI): 1.65, 13.48, p-value (p) = 0.004] and discussions on EMRs during meetings (AOR = 2.77, 95% CI: 1.01, 7.58, p = 0.047) were independent predictors of EMR system data use. Those who reported having EMR systems in all working areas were seven times more likely to use EMR system data (AOR = 7.23, 95% CI: 3.15, 16.59, p = 0.001). The respondents with good perceived EMR system information quality were more likely to use EMR system data (AOR = 2.84, 95% CI: 1.50, 5.39, p = 0.001) than those with poor perception. Furthermore, health managers who had excellent knowledge of computers and data use had higher odds of using EMR system data (AOR = 1.84, 95% CI: 3.38, 10.13, p = 0.001) compared with their counterparts. The findings of this study indicate that utilization of EMR system data in decision-making among health managers was optimal. It was found that training in itself is insufficient to improve use of EMR, which points to more organizational aspects of work routine as a challenge. Hence, a comprehensive approach that addresses these factors is essential for maximizing EMR system data use in decision-making.

Creation of a National Emergency Medicine Medical Education Journal Club.

Background There are a relatively limited number of emergency medicine (EM) medical education (MedEd) fellowships with few trainees at each program, creating barriers to local collaboration and networking. While best practices for developing MedEd journal clubs exist, there has not been an established national EM MedEd journal club. To address this need, we created a national journal club, the Council of Residency Directors (CORD) MedEd Journal Club (MEJC), to facilitate collaboration and networking opportunities by providing a synchronous online journal club. Objectives Our primary objective was to create a network for collaboration across geographical barriers to form a virtual community of practice (CoP) around the shared domain of evidence-based MedEd. Our secondary objective was to improve MedEd fellows' knowledge, skills, and attitudes surrounding MedEd research. Tertiary objectives included (1) broadening fellow exposure to key topics within MedEd, (2) describing how to develop scholarly work within MedEd, and (3) filling a perceived need for building a national MedEd virtual CoP. Curricular design The concept and objectives of the CORD MEJC were introduced to fellows and fellowship directors through a national listserv in March of 2022. Fellows volunteered to lead virtual sessions via Zoom on a monthly basis. Session fellow leaders independently chose the topics and were asked to submit two to three journal club articles discussing the topic at least two weeks in advance of each session. No topics were repeated throughout the academic year. Impact/effectiveness Our quality improvement survey results indicated that the CORD MEJC is meeting its primary and secondary objectives. Survey results will be utilized as part of a continuous quality improvement initiative to enhance our program structure and curricula for the 2023-2024 academic year.

Continuous improvement of quality of care in pediatric diabetes: the ISPED CARD clinical registry

Abstract Aim In Italy, the ISPED CARD initiative was launched to measure and improve quality of care in children and adolescents with type 1 diabetes. Methods Process and outcome indicators and the related information derived from electronic medical records were identified. A network of pediatric diabetes centers was created on a voluntary basis. Results Overall, 20 centers provided data on 3284 patients aged &lt; = 18 years. HbA1c was monitored ≥ 2/year in 81.2% of the cases. BMI was monitored ≥ 1/year in 99.0%, lipid profile in 45.3%, and blood pressure in 91.7%. Pubertal status, albuminuria, eye examination, and screening of celiac disease and thyroiditis were underreported. From 2017 to 2021, average HbA1c levels decreased from 7.8 ± 1.2 to 7.6 ± 1.3%, while patients with LDL cholesterol &gt; 100 mg/dl increased from 18.9 to 36.7%. Prevalence of patients with elevated blood pressure and BMI/SDS values also increased. In 2021, 44.7% of patients were treated with the newest basal insulins, while use of regular human insulin had dropped to 7.7%. Use of insulin pump remained stable (37.9%). Conclusions This report documents the feasibility of the ISPED CARD initiative and shows lights and shadows in the care provided. Improving care, increasing number of centers, and ameliorating data recording represent future challenges.

Sentiment analysis in online education: An analytical approach and application

This paper presents a groundbreaking approach to the application of sentiment analysis within the domain of online education. By introducing an innovative methodology, the aim is to streamline the process of automatically evaluating sentiments and extracting opinions from the vast sea of content produced by learners during their online interactions. This not only aids educators in swiftly gauging the general mood and perspective of their student body, but also allows them to delve deeper into the nuanced feedback provided, thus ensuring the continual improvement of course quality. In an era where digital learning platforms are growing exponentially, understanding students' attitudes, concerns, and overall satisfaction is paramount. Our methodology, therefore, is not just a technical advancement, but also a strategic tool for educational institutions aiming to thrive in the digital age. The current research landscape, while expansive, has often overlooked the significance of real-time sentiment analysis in e-learning environments. This study, therefore, bridges an important gap, bringing to the forefront the importance of harnessing student feedback in a digital format, allowing educators to tailor their approach for optimal student engagement and success.

Abstract WP91: Stroke Tracking: Improving Core Measure Compliance Tracking &amp; Efficiency

Background: Stroke program development and expansion requires excellent patient care and continued quality improvement via ongoing data collection. Substantial time and effort are required to identify patient records and manually assess metrics within charts. While real-time assessment of this data is ideal, achieving this is challenging. Purpose: We sought to create a real-time, electronic medical record (EMR) derived patient tracking list to improve accuracy, efficiency, and timeliness of stroke patient data collection. Methods: Ischemic stroke patient identification was optimized utilizing current patient lists, which over capture, and applying filters based on EMR entries applicable to stroke patients. Patient capture was reviewed to ensure adequate sensitivity and specificity. Subsequently, key stroke quality data points were identified. Custom columns were created to pull data from across the EMR into a central list. Column data was validated to ensure accuracy and confirm improved efficiency via timed chart reviews. A Mann-Whitney test was used to compare means pre and post-review. Of note, different reviewers performed pre and post reviews. Results: A stroke tracking list was successfully implemented. Chart review in the previous process averaged 173.2 seconds (STD 40.6) vs. 121.3 seconds (STD 17.8) in the new process (p&lt;0.05). Patient identification times were not compared, though identifying charts in the old workflow ranged from 12 to 15 minutes per chart. Conclusions: Creation of a central tracking list within the electronic medical record is feasible and can improve patient identification, coordination of critical data sharing, and data collection efficiency. Utilization decreased data collection times and prompted creation of similar tracking lists for other core measure data. While sample sizes were small and pre and post reviewers were different, this work demonstrates feasibility and early foundational work.

Abstract WMP35: What's Your Time Worth?: Improving Efficiency in Tracking Core Measures Compliance in Real Time

Background: Stroke program development and expansion requires excellent patient care and continued quality improvement via ongoing data collection. Substantial time and effort are required to identify patient records and manually assess metrics within charts. While real-time assessment of this data is ideal, achieving this is challenging. Purpose: We sought to create a real-time, electronic medical record (EMR) derived patient tracking list to improve accuracy, efficiency, and timeliness of stroke patient data collection. Methods: Ischemic stroke patient identification was optimized utilizing current patient lists, which over capture, and applying filters based on EMR entries applicable to stroke patients. Patient capture was reviewed to ensure adequate sensitivity and specificity. Subsequently, key stroke quality data points were identified. Custom columns were created to pull data from across the EMR into a central list. Column data was validated to ensure accuracy and confirm improved efficiency via timed chart reviews. A Mann-Whitney test was used to compare means pre and post-review. Of note, different reviewers performed pre and post reviews. Results: A stroke tracking list was successfully implemented. Chart review in the previous process averaged 173.2 seconds (STD 40.6) vs. 121.3 seconds (STD 17.8) in the new process (p&lt;0.05). Patient identification times were not compared, though identifying charts in the old workflow ranged from 12 to 15 minutes per chart. Conclusions: Creation of a central tracking list within the electronic medical record is feasible and can improve patient identification, coordination of critical data sharing, and data collection efficiency. Utilization decreased data collection times and prompted creation of similar tracking lists for other core measure data. While sample sizes were small and pre and post reviewers were different, this work demonstrates feasibility and early foundational work.

Summary of the best evidence for the prevention of nasal injury in preterm infants with nasal noninvasive ventilation.

Due to immaturity, the nose of preterm infants can easily be injured, by even a short application of a nasal device. However, 20% to 60% of preterm infants suffer nasal damage while using nasal continuous positive airway pressure (NCPAP) due to weak skin tissue, prolonged use of nasal device, and improper nursing practices, leading to increased risk of infection and decreased compliance and tolerance. In this study, we retrieved, obtained and integrated the related evidences of prevention of nasal injury in premature infants with nasal noninvasive ventilation to provide reference for clinical practice. We searched the relevant guidelines, expert consensus, evidence summaries and systematic reviews in the databases and guideline websites of the National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), the Agency for Health care Research and Quality (AHRQ), Guidelines International Network (GIN), the World Health Organization (WHO) guideline websites, Registered Nurses' Association of Ontario (RANO), Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), European Pressure Ulcer Advisory Panel (EPUAP), Yi Maitong, British Medical Journal best-practice, Cochrane Library, UpToDate, Embase, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang. The search was limited to the time of library establishment to February 2023. In total, 16 articles were included, including six guidelines, three expert consensuses, two evidence summaries and five systematic reviews. Twenty-eight pieces of evidence were summarized from six aspects: risk assessment, ventilation and connection, skin protection, skin assessment, training and support, and continuous quality improvement. This study summarized the best evidence for the prevention of nasal injury in premature infants through nasal noninvasive ventilation. It is suggested that nurses should consider the actual clinical situation when applying the suggestions from the evidence, formulate corresponding nursing measures, and reduce the occurrence of nasal injury in premature infants.

Five years of Hospital at Home adoption in Catalonia: impact, challenges, and proposals for quality assurance

BackgroundHospital at home (HaH) was increasingly implemented in Catalonia (7.7 M citizens, Spain) achieving regional adoption within the 2011-2015 Health Plan. This study aimed to assess population-wide HaH outcomes over five years (2015-2019) in a consolidated regional program and provide context-independent recommendations for continuous quality improvement of the service.MethodsA mixed-methods approach was adopted, combining population-based retrospective analyses of registry information with qualitative research. HaH (admission avoidance modality) was compared with a conventional hospitalization group using propensity score matching techniques. We evaluated the 12-month period before the admission, the hospitalization, and use of healthcare resources at 30 days after discharge. A panel of experts discussed the results and provided recommendations for monitoring HaH services.ResultsThe adoption of HaH steadily increased from 5,185 episodes/year in 2015 to 8,086 episodes/year in 2019 (total episodes 31,901; mean age 73 (SD 17) years; 79% high-risk patients. Mortality rates were similar between HaH and conventional hospitalization within the episode [76 (0.31%) vs. 112 (0.45%)] and at 30-days after discharge [973(3.94%) vs. 1112(3.24%)]. Likewise, the rates of hospital re-admissions at 30 days after discharge were also similar between groups: 2,00 (8.08%) vs. 1,63 (6.58%)] or ER visits [4,11 (16.62%) vs. 3,97 (16.03%). The 27 hospitals assessed showed high variability in patients’ age, multimorbidity, severity of episodes, recurrences, and length of stay of HaH episodes. Recommendations aiming at enhancing service delivery were produced.ConclusionsBesides confirming safety and value generation of HaH for selected patients, we found that this service is delivered in a case-mix of different scenarios, encouraging hospital-profiled monitoring of the service.

Creating a Culture of Assessment

Programmatic and curricular assessment, as mechanisms of continuous quality improvement, are essential and require input from multiple stakeholders. Despite its essential nature, there are few resources to help guide the development of a sustainable model of assessment. The aims of this organizational case study are to describe a sustainable model. Data was collected from various stakeholders of the Doctor of Physical Therapy (DPT) program. Results were compared between and within groups to determine level of agreement and yearly trends. These results were discussed at the faculty assessment retreat. The outcomes included data collection timelines that have been operationalized and systematized. Five out of nine faculty participated in a post-survey. All respondents (100%) indicated a favorable impression of the event. Building a culture of assessment requires an intentional and sustainable plan. A retreat was an effective method to communicate the results of the assessment and to build trust and transparency.

A Health Service Transition to Adult Patient Care for Sickle Cell Disease

This paper explores the challenges related to long-term conditions, focusing on sickle cell disease (SCD) as a case study. Long-term conditions, characterized by the need for ongoing management, present a substantial burden on healthcare systems globally. A careful transition from pediatric to adult healthcare is needed for SCD. The discussion extends to the broader health service transition to adult patient care in SCD, emphasizing the World Health Organization’s definition of care transitions and the necessity for an integrated healthcare service. The emphasis is on a multidisciplinary approach to medical, mental health, and educational problems. A person-centered model of care should be used more consistently to resolve these long-term condition-related challenges. To evaluate the effectiveness of new interventions in improving the transition of care from pediatrics to adult patients with SCD, continuous quality improvement strategies should be implemented and prospectively measured in younger patients. In conclusion, this study highlights the critical importance of an effective transition from pediatric to adult healthcare. The continued research of effective transition practices is essential for the future and there is still a requirement to develop pragmatic approaches to enhance research on the transition to improve the quality of healthcare for patients with long-term conditions.

Faculty Feedback Mining System using Sentiment Analysis

In higher education, the continuous improvement of teaching quality is paramount for fostering a conducive learning environment. This study presents a Faculty Feedback Extraction System (FFES) that utilizes state-of-the-art sentiment analysis techniques to derive actionable insights from faculty feedback. The system uses natural language processing (NLP) and machine learning algorithms to analyze and classify emotions, giving schools a better understanding of teachers' emotions and fostering a culture of continuous improvement. The FFMS employs a multifaceted sentiment analysis approach, considering both textual and contextual features to ensure nuanced interpretation of faculty feedback. Leveraging a diverse dataset of faculty evaluations, the system uses the highest sentiment rating standards to classify emotions into positive, negative or neutral categories. This research focuses on to apply the approach which allows schools to better understand teachers' views and helps influence professional and overall development. FFMS provides deep learning models such as neural network (RNN) and tracking techniques to improve the accuracy and depth of emotion classification. These models enable the system to capture subtle nuances in feedback, providing a more nuanced understanding of faculty sentiments. Additionally, the FFMS facilitates real-time monitoring and analysis through intuitive dashboards, empowering academic administrators to make informed decisions based on the latest feedback trends.

Agile Change Management of Ukraine's IT Sector's and Value Creation Amidst Conflict

The ongoing conflict in Ukraine has posed significant challenges to the country's IT sector. Despite these challenges, the sector has demonstrated remarkable resilience, adapting to the new realities and continuing to provide critical services to both domestic and international clients.&#x0D; This research examines the Ukrainian IT industry before and after the war, and designs a value stream mapping of the sector that is applicable to current realities. It also explores the value creation strategies employed by the sector to maintain productivity and deliver value to its clients.&#x0D; The research finds that the sector has adopted a number of strategies to mitigate the impact of the war on its value stream, including attracting and retaining talent, investing in skill development and upskilling, adopting agile project management, implementing automated testing and continuous quality improvement, enhancing cybersecurity measures, and expanding into new markets and diversifying customer base. The sector's ability to adapt, innovate, and deliver value in the face of adversity provides valuable insights and lessons for other sectors and countries facing similar challenges.&#x0D;

Impact of Enhanced Recovery after Surgery® Protocol Compliance on Length of Stay, Bowel Recovery and Complications after Radical Cystectomy

Background: Despite existing standardized surgical techniques and the development of new perioperative care protocols, radical cystectomy (RC) morbidity remains a serious challenge for urologists. Postoperative ileus (POI) is one of the most common postoperative complications, often leading to a longer length of stay (LOS). The aim of our study was to assess the impact of compliance to the Enhanced Recovery After Surgery (ERAS®) protocol on bowel recovery, 30-day complications and LOS after RC for bladder cancer (BC). Methods: Data from consecutive patients undergoing RC for BC within an ERAS® dedicated protocol were analyzed. Exclusion criteria were urinary diversion other than ileal conduit and palliative RC. Patients were divided into two groups according to their compliance (A: low-compliance and B: high-compliance). ERAS® compliance was extracted from the ERAS® Interactive Audit System (EIAS) database. Postoperative complications were prospectively recorded by a dedicated study nurse 30 days after RC. POI was defined as the placement of a nasogastric tube. Logistic regression analysis was used to identify predictors of 30-day complications and POI. Results: After considering the exclusion criteria, 108 patients were included for the final analysis. The median global compliance to the ERAS® protocol was 61%. A total of 78 (72%) patients had a compliance &lt;65% (group A), while the remaining 30 (28%) had a compliance &gt;65% (group B). No significant differences were found among the two groups regarding the 30-day complication rate (86% in group A versus 73% in group B, p = 0.82) and LOS (14 days in group A versus 15 days in group B, p = 0.82). The time to stool was significantly shorter in group B (4 days versus 6 days, p = 0.02), and the time to tolerate solid food was slightly faster in group B but not significant (8 versus 7 days, p = 0.23). The POI rate was significantly lower in patients with a higher ERAS® compliance (20% versus 46%, p = 0.01). A multivariate analysis showed that ERAS® compliance was not significantly associated with 30-day total complications. However, a lower compliance to the ERAS® protocol and age &gt; 75 years were significant independent predictors of POI. Conclusions: Our study provides further evidence to support the beneficial effect of the ERAS® protocol in patients undergoing RC, particularly in terms of facilitating a faster recovery of bowel function and preventing POI. Future research should focus on investigating novel approaches and interventions to improve compliance with the ERAS® protocol. This may involve patient education, multidisciplinary teamwork, and continuous quality improvement initiatives.

Developing an Appendicectomy Surgical Pathway Ontology (ASPO).

This study proposes an ontology model to represent the surgical pathways for appendicectomy, incorporating domain knowledge extracted from literature and electronic records in an Australian health district. The ontology comprised 108 concepts and 81 object properties. The model is useful for continuous quality improvement initiatives, i.e., process mining to understand what happens in the hospital versus what is required by the policy.

A Proposed Comprehensive Novel Model (CN-Model): To Drive Continuous Quality Improvement (CQI) on Engineering Programme in Institution of Higher Learning

A Proposed Comprehensive Novel Model (CN-Model): To Drive Continuous Quality Improvement (CQI) on Engineering Programme in Institution of Higher Learning

The quest for continuous quality improvement in Australian long day care services: getting the most out of the Assessment and Rating process

The National Quality Framework (NQF) was intended to drive continuous improvement in education and care services in Australia. Ten years into implementation, the effectiveness of the NQF is demonstrated by steady improvements in quality as measured against the National Quality Standard (NQS). The process of assessing and rating services is a key element in the NQF, drawing together regulatory compliance and quality assurance. This paper draws on findings from a national Quality Improvement Research Project investigating the characteristics, processes, challenges and enablers of quality improvement in long day care services, concentrating on Quality Area 1 Educational program and practice and Quality Area 7 Governance and leadership. This was a mixed-method study focusing on long day care services that had improved their rating from Working toward NQS to Meeting NQS or to Exceeding NQS. The study comprised three phases, and in this paper, we draw on Phase 3 to understand the contribution of the NQS Assessment and Rating (A&amp;amp;R) process to continuous quality improvement from the standpoint of providers and professionals delivering these services. Phase 3 involved qualitative case studies of 15 long day care services to investigate factors that enabled and challenged quality improvement. Data was collected during two-day site visits, using professional conversations and field notes to elicit the views and experiences of service providers, leaders and educators. In this paper, we look at how the A&amp;amp;R process is experienced by those involved in service provision, with a focus on the factors that enabled and challenged quality improvement. Recognizing the interchangeability of enablers and challenges, three broad themes emerged: (i) curriculum knowledge, pedagogical skills and agency; (ii) collaborative leadership and teamwork; and (iii) meaningful engagement in the A&amp;amp;R process. The study found that meaningful engagement in the A&amp;amp;R process informed priorities for ongoing learning and acted as a catalyst for continuous quality improvement. Apprised by stakeholder views and experiences of A&amp;amp;R, we offer a model to foster stakeholder participation in quality assurance matters through affordances of meaningful engagement.

Severe acute maternal morbidity reporting in Australia: Why is it so hard?

Adverse outcomes associated with pregnancy, including severe acute maternal morbidity (SAMM) and mortality, are internationally regarded as important indicators of quality of maternity services. Varied definitions and processes are barriers for SAMM recording, reporting and review. Identifying and documenting these cases of SAMM is a critical first step. Case reviews allow exploration of factors contributing to SAMM. Translation of the lessons learnt into practice improvement strategies and dissemination of this knowledge is essential for continual quality improvement. This review will outline the current status of SAMM review internationally and in Australia.

Optimizing workflow of urgent stroke endovascular intervention: A focused lean six sigma project

IntroductionUrgent endovascular intervention is currently accepted as the primary and critical therapeutic approach to patients whose acute ischemic stroke results from a large arterial occlusion (LAO). In this context, one of the quality metrics most widely applied to the assessment of emergency systems performance is the “door-to-puncture” (D-P) time. We undertook a project to identify the subinterval of the D-P metric causing the most impact on workflow delays and created a narrowly focused project on improving such subinterval. MethodsUsing the DMAIC (i.e., define, measure, analyze, improve and control) approach, we retrospectively reviewed our quality stroke data for calendar year (CY) 2021 (i.e., baseline population), completed a statistical process control assessment, defined the various subintervals of the D-P interval, and completed a Pareto analysis of their duration and their proportional contribution to the D-P interval. We retooled our workflow based on these analyses and analyzed the data resulting from its implementation between May and December 2022 (i.e., outcome population). ResultsThe baseline population included 87 patients (44 men; mean age = 67.2 years). Their D-P process was uncontrolled, and times varied between 35-235 minutes (Mean = 97; SD = 38.40). Their door to angiography arrival (D-AA) subinterval was significantly slower than their arrival to puncture (AA-P) (73.4 v. 23.5 minutes; p < 0.01), accounted for 73% of the average length of the D-P interval. The group page activation to angiography arrival (GP-AA) subinterval accounted for 41.5% of the entire D-AA duration, making it the target of our project. The outcome population originally consisted of 38 patients (15 men; mean age = 70.3 years). Their D-P process was controlled, its times varying between 43-177 minutes (Mean = 85.8; SD = 34.46), but not significantly difference than the baseline population (p = 0.127). Their target subinterval GP-AA varied between 0-37 minutes and was significantly improved from the baseline population (Mean = 13.21 v. 29.68; p < 0.001). ConclusionsIt seems feasible and reasonable to analyze the subinterval components of complex quality metrics such as the D-P time and carry out more focused quality improvement projects. Care must be exercised when interpreting the impact on overall system performance, due to unexpected variations within interdependent subprocesses. The application of a robust and comprehensive LSS continuous quality improvement process in any CSC will have to include individualized focused projects that simultaneously control the different components of overall system performance.

An improved method for extracting essay tangency features in intelligent scoring of English essays

With the continuous improvement of teaching quality in China's colleges and universities, English teaching has received more and more attention, and the automatic scoring system for English composition has begun to be gradually applied in English teaching in colleges and universities, but the system can only score compositions objectively, which is difficult to meet the actual teaching needs. Therefore, this study first proposes a topic richness based approach for analyzing composition cut points, and then proposes a combination based automatic grading method for English compositions. Based on the above, an intelligent grading improvement method based on composition tangent feature extraction is proposed to improve the efficiency of the English composition grading system and reduce the teaching burden on teachers. The traditional grading method is to grade grammar or essays by introducing Analytic Hierarchy Process, artificial neural networks, or combining machine learning theory with multi feature fusion. However, based on the characteristics of single semantic similarity and keyword alignment, the comprehensiveness of the grading is insufficient, making it difficult to analyze the correlation between essay sentences and the overall theme. The experimental results show that the topic decision-making model proposed in this study has better deep learning performance, and its scoring accuracy shows an upward trend with the increase of the sample data size of the essay, increasing from 40.05% to 91.46%. And the main content of the learned is the irrelevant information of the first sentence of a new topic and the truncation point, which can effectively distinguish whether a sentence is a topic segmentation point, and effectively identifies whether two sentences belong to the same topic; the proposed topic segmentation model has better practicality and its ability to segment topics is stronger; the combined method proposed in this study The overall performance of the model is better than the composition scoring methods based on RNN and BiLSTM models. Under the same semantic vectorization processing operation, the per values present in the composition sets are all different, and this result indicates that the writers' ability and the difficulty of writing on the topics are all different. It is hoped that this study can provide some solution ideas for the research of intelligent scoring feature extraction methods in English.

Perceptions and Utility of Course Evaluations in US Pharmacy Schools

ObjectiveThis study aimed to describe the purpose, implementation, and perceived utility of course evaluations in pharmacy programs. MethodsAfter a literature review, a 34-item survey was developed, pretested, and sent to assessment administrators at accredited pharmacy programs (N = 139) with at least 3 follow-ups. Descriptive and inferential statistics were performed in IBM SPSS Statistics software. ResultsA total of 90 programs responded (64.7% response rate). Most students (94%) were offered the opportunity to complete course evaluations. Some students completed evaluations during the course (47%), while others did so within 1 week of completion of the course (49%). Whether or not class time was given for students to complete the survey was often dependent on faculty choice (52.2%). Results were typically released after final grades were posted (92%), in time to use for the next semester of teaching (77%). Faculty were chosen to be evaluated by the number of teaching hours (50%) followed by all instructors (45.6%). Programs used the results for performance reviews by chairs (91%), course coordinator reviews (84%), and committee continuous quality improvement efforts (72%). Most programs did not provide faculty guidance on using evaluations (78%) nor development/mentoring (57%); only 22% of programs offered student development in completing evaluations. ConclusionWhile most programs invite feedback from all students via evaluations, most did not provide guidance to faculty on how to use this feedback for faculty or course development purposes. A more robust process to optimize the use of course evaluations should be developed.