Development Of Assessment Tool Research Articles

초등학생용 수행형 디지털 리터러시 온라인 평가도구 개발

Objectives The purpose of this study is to develop a performance-based online assessment tool to measure the level of digital literacy of primary school students. Methods To achieve this, test items were developed based on several scenarios that reflected the context of schools, families, and communities that primary school students encounter in their daily lives, and an online as-sessment system was developed in the form of several sub-tasks being connected to perform one integrated task. The developed assessment tool consisted of 4 test modules and a total of 28 sub-task items. A preliminary test was conducted on 462 primary school students to verify the reliability and validity of the developed online as-sessment system. Results As a result of analyzing the preliminary test results, the test reliability was found to be good. As a result of correlation analysis with the multiple-choice assessment tool, it was found to be distinguished from the exist-ing tool as a performance-based assessment tool. In addition, as a result of item analysis, the overall discrim-ination and difficulty level was found to be at an appropriate level except for a few items. Conclusions This study is significant in that it developed a performance-based online assessment tool beyond self-reporting or knowledge-based multiple-choice assessment, and provided primary data for future research on measuring students’ digital literacy level using a performance-based online assessment tool based on the pre-liminary test results.

Shortening and Personalizing Psychodiagnostic Assessments with Decision Tree-Machine Learning Classifiers: An Application Example Based on the Patient Health Questionnaire-9

AbstractThe development of psychological assessment tools that accurately and efficiently classify individuals as having or not a specific diagnosis is a major challenge for test developers and mental health professionals. This paper shows how machine learning (ML) provides a valuable framework to improve the accuracy and efficiency of psychodiagnostic classifications. The method is illustrated using an empirical example based on the Patient Health Questionnaire-9 (PHQ-9). The results show that, compared to traditional scorings of the PHQ-9, that based on decision tree (DT) algorithms is more advantageous in terms of accuracy and efficiency. In addition, the DT-based method facilitates the development of short test forms and improves the diagnostic performance of the test by integrating external information (e.g., demographic variables) into the scoring process. These findings suggest that DT-algorithms and ML applications such as feature selection represent a valuable method for supporting test developers and mental health professionals, and highlight the potential of ML for advancing the field of psychological assessment.

Development of a Competency-Based Assessment Framework for High School Home Economics

The dual aims of this study were i) to explore the effectiveness of an assessment method that can measure the competencies learned through high school home economics and ii) develop a competency-based assessment framework for high school home economics, including components of competency-based assessment, item development system, and other elements. The study involved the following stages: literature analysis, draft development, concretization, validity verification, and final version. Based on the results of the literature analysis and expert deliberation, a competency-based assessment framework for high school home economics was developed which comprised three dimensions: ‘core idea’ × ‘process’ × ‘context and value’. Based on this, an item analysis table was presented to systematize various activities for the competency-based assessment of high school home economics, following which a holistic rubric suitable for competency assessment tasks was proposed by referring to the newly developed ‘process’ dimension assessment criteria. This study is significant in that it is the first to propose a competency-based assessment framework that systematically presents a variety of assessment activities. These will facilitate the development of assessment standards and tools that teachers can refer to or trust in the changing school environment due to the introduction of the standard-based assessment system based on a high school credit system, and the guarantee of a minimum achievement level.

Dementia Among Minority Populations: A Scoping Review of Meaning, Language, And Translation.

Dementia as a neurocognitive disorder is becoming increasingly common worldwide, and minority groups are more vulnerable than the general population. Many factors may contribute to their vulnerability such as misconceptions, language barriers, cultural factors, invalid assessment tools, lack of knowledge or assigning spiritual beliefs to dementia symptoms. Therefore, this scoping literature review aims to clarify how empirical studies reflect the meaning of dementia, language, and translation among minority ethnic groups. The PRISMA extension for the scoping review protocol was used. Thirty-eight studies published in English were reviewed and analysed. The findings revealed that lack of knowledge about dementia and attributing the disease to the normal ageing process were frequent among minority groups. Furthermore, their cultural-specific perspectives and worldviews of wellness and wellbeing can impact the way dementia is perceived, consequent help-seeking behaviours, or caregiving. Facilitating educational programs to enhance the knowledge and experiences of ethnic communities might be beneficial. Moreover, language is shown to be an important aspect in dementia assessment and participants' educational level could significantly impact their functional capacity when responding to cognitive measures. Even though there are some useful screening tests, diagnosis barriers might be eased by assessment tool development, modifications, and accurate translations for ethnic communities. A promising pathway to support ethnically diverse communities regarding dementia can be raising awareness, providing ethnic-specific services, developing cultural-specific tools to assess dementia or any cognitive impairment by considering perceptions, language, and culture among ethnic groups. Cultural and spiritual considerations could also encourage engagement during assessment.

Demonstrating consensus in argumentative settings: Co-constructions in children’s peer discussions

Abstract‘Taking part’ in conversations requires different activities from the interactants depending on the kind of conversation. This article investigates co-constructions in oral peer group discussions of elementary school children from grades 2 to 6 (7–12 years old). Although dissent is the starting point of argumentations, negotiating processes in oral argumentations are often co-constructed by two or more speakers on different levels, including consensual contexts. Co-constructions presuppose that the second speakers recognize structures and expectations based on the turn of the first speaker and that they are able to complete or expand these structures. Therefore, co-constructions can be understood as an indicator for oral skills and as a key site of ‘taking part’ in small group discussions. The article will discuss two different kinds of co-constructions (morpho-syntactical and argumentative-structural) based on 60 transcripts from a bigger corpus of 180 peer discussions. The analysis will show that these co-constructions can be understood as synchronizations of thinking and acting and to what extent they are an indicator of oral skills and play an important role in cooperative learning settings. The results are relevant in school contexts when it comes to assess oral argumentation of students. For teachers, they are helpful to elicit requirements for children’s argumentation skills and to design tasks conducive to learn to argue and develop assessment tools accordingly.

Short developmental milestone risk assessment tool to identify Duchenne muscular dystrophy in primary care

BackgroundIn patients without a family history, Duchenne muscular dystrophy (DMD) is typically diagnosed at around 4–5 years of age. It is important to diagnose DMD during infancy or toddler stage in order to have timely access to treatment, opportunities for reproductive options, prevention of potential fatal reactions to inhaled anesthetics, awareness of a child’s abilities needed for good parenting, and opportunities for enrolment in clinical trials.MethodWe aimed to develop a short risk assessment tool based on developmental milestones that may contribute to the early detection of boys with DMD in primary care. As part of the case-control 4D-DMD study (Detection by Developmental Delay in Dutch boys with DMD), data on developmental milestones, symptoms and therapies for 76 boys with DMD and 12,414 boys from a control group were extracted from the health records of youth health care services and questionnaires. Multiple imputation, diagnostic validity and pooled backward logistic regression analyses with DMD (yes/no) as the dependent variable and attainment of 26 milestones until 36 months of age (yes/no) as the independent variable were performed. Descriptive statistics on symptoms and therapies were provided.ResultsA tool with seven milestones assessed at specific ages between 12 and 36 months resulted in a sensitivity of 79% (95CI:67–88%), a specificity of 95.8% (95%CI:95.3–96.2), and a positive predictive value of 1:268 boys. Boys with DMD often had symptoms (e.g. 43% had calf muscle pseudohypertrophy) and were referred to therapy (e.g. 59% for physical therapy) before diagnosis.DiscussionThis tool followed by the examination of other DMD-related symptoms could be used by youth health care professionals during day-to-day health assessments in the general population to flag children who require further action.ConclusionsThe majority of boys (79%) with DMD can be identified between 12 and 36 months of age with this tool. It increases the initial a priori risk of DMD from 1 in 5,000 to approximately 1 in 268 boys. We expect that other neuromuscular disorders and disabilities can also be found with this tool.

A hybrid model for post-earthquake performance assessments in challenging contexts

AbstractDisasters provide an invaluable opportunity to evaluate contemporary design standards and construction practices; these evaluations have historically relied upon experts, which inherently limited the speed, scope and coverage of post-disaster reconnaissance. However, hybrid assessments that localize data collection and engage remote expertise offer a promising alternative, particularly in challenging contexts. This paper describes a multi-phase hybrid assessment conducting rapid assessments with wide coverage followed by detailed assessments of specific building subclasses following the 2021 M7.2 earthquake in Haiti, where security issues limited international participation. The rapid assessment classified and assigned global damage ratings to over 12,500 buildings using over 40 non-expert local data collectors to feed imagery to dozens of remote engineers. A detailed assessment protocol then conducted component-level evaluations of over 200 homes employing enhanced vernacular construction, identified via machine learning from nearly 40,000 acquired images. A second mobile application guided local data collectors through a systematic forensic documentation of 30 of these homes, providing remote engineers with essential implementation details. In total, this hybrid assessment underscored that performance in the 2021 earthquake fundamentally depended upon the type and consistency of the bracing scheme. The developed assessment tools and mobile apps have been shared as a demonstration of how a hybrid approach can be used for rapid and detailed assessments following major earthquakes in challenging contexts. More importantly, the open datasets generated continue to inform efforts to promote greater use of enhanced vernacular architecture as a multi-hazard resilient typology that can deliver life-safety in low-income countries.

Decision-Making Confidence of Clinical Competency Committees for Entrustable Professional Activities

A competency-based assessment framework using entrustable professional activities (EPAs) was endorsed by the American Board of Surgery following a 2-year feasibility pilot study. Pilot study programs' clinical competency committees (CCCs) rated residents on EPA entrustment semiannually using this newly developed assessment tool, but factors associated with their decision-making are not yet known. To identify factors associated with variation in decision-making confidence of CCCs in EPA summative entrustment decisions. This cohort study used deidentified data from the EPA Pilot Study, with participating sites at 28 general surgery residency programs, prospectively collected from July 1, 2018, to June 30, 2020. Data were analyzed from September 27, 2022, to February 15, 2023. Microassessments of resident entrustment for pilot EPAs (gallbladder disease, inguinal hernia, right lower quadrant pain, trauma, and consultation) collected within the course of routine clinical care across four 6-month study cycles. Summative entrustment ratings were then determined by program CCCs for each study cycle. The primary outcome was CCC decision-making confidence rating (high, moderate, slight, or no confidence) for summative entrustment decisions, with a secondary outcome of number of EPA microassessments received per summative entrustment decision. Bivariate tests and mixed-effects regression modeling were used to evaluate factors associated with CCC confidence. Among 565 residents receiving at least 1 EPA microassessment, 1765 summative entrustment decisions were reported. Overall, 72.5% (1279 of 1765) of summative entrustment decisions were made with moderate or high confidence. Confidence ratings increased with increasing mean number of EPA microassessments, with 1.7 (95% CI, 1.4-2.0) at no confidence, 1.9 (95% CI, 1.7-2.1) at slight confidence, 2.9 (95% CI, 2.6-3.2) at moderate confidence, and 4.1 (95% CI, 3.8-4.4) at high confidence. Increasing number of EPA microassessments was associated with increased likelihood of higher CCC confidence for all except 1 EPA phase after controlling for program effects (odds ratio range: 1.21 [95% CI, 1.07-1.37] for intraoperative EPA-4 to 2.93 [95% CI, 1.64-5.85] for postoperative EPA-2); for preoperative EPA-3, there was no association. In this cohort study, the CCC confidence in EPA summative entrustment decisions increased as the number of EPA microassessments increased, and CCCs endorsed moderate to high confidence in most entrustment decisions. These findings provide early validity evidence for this novel assessment framework and may inform program practices as EPAs are implemented nationally.

Development and validation of a nomogram for predicting specific mortality risk: A study of competing risk model based on real endometrial cancer patients.

This study aimed to construct a competing risk prediction model for predicting specific mortality risks in endometrial cancer patients from the SEER database based on their demographic characteristics and tumor information. We collected relevant clinical data on patients with histologically confirmed endometrial cancer in the SEER database between 2010 and 2015. Univariate and multivariate competing risk models were used to analyze the risk factors for endometrial cancer-specific death, and a predictive nomogram was constructed. C-index and receiver operating characteristic curve (ROC) at different time points were used to verify the accuracy of the constructed nomogram. There were 26 109 eligible endometrial cancer patients in the training cohort and 11 189 in the validation cohort. Univariate and multivariate analyses revealed that Age, Marriage, Grade, Behav, FIGO, Size, Surgery, SurgOth, Radiation, ParaAortic_Nodes, Peritonea, N positive, DX_liver, and DX_lung were independent prognostic factors for specific mortality in endometrial cancer patients. Based on these factors, a nomogram was constructed. Internal validation showed that the nomogram had a good discriminative ability (C-index = 0.883 [95% confidence interval [CI]: 0.881-0.884]), and the 1-, 3-, and 5-year AUC values were 0.901, 0.886 and 0.874, respectively. External validation indicated similar results (C-index = 0.883 [95%CI: 0.882-0.883]), and the 1-, 3-, and 5- AUC values were 0.908, 0.885 and 0.870, respectively. We constructed a competing risk model to predict the specific mortality risk among endometrial cancer patients. This model has favorable accuracy and reliability and can provide a reference for the development and update of endometrial cancer prognostic risk assessment tools.

The donation method: A new behavioral measure for white collar crime?

AbstractTo comprehensively grasp, predict, and address the complexity of white collar crime, robust measurement tools are imperative. The burgeoning interdisciplinary interest in this domain has spurred the development of diverse assessment tools aimed at capturing offending behavior and its proxies. In the present paper, we provide an overview of the strengths and weaknesses of several commonly employed measures, including official statistics, victimization surveys, self‐report surveys, and (quasi)experimental measures. Drawing insights from this review, we then introduce a novel behavioral measure: the donation method. Although the task was originally designed to examine behaviors of interest to behavioral economists, we carefully outline strategies to refine and implement the donation method to assess white collar crime, addressing challenges such as task suitability and controlling for respondent behavior. Additionally, we provide a sample task to illustrate how such a tool could be used within this field. We conclude by underlining the appeal of adopting innovative measurement tools like the donation method to advance our collective understanding of white collar crime. By advocating for its widespread adoption and providing guidance for its use, we endeavor to catalyze progress in the field, facilitating unique insights and, potentially, more efficacious strategies for confronting and surmounting the methodological obstacles inherent in studying this elusive form of criminal activity.

P18. Development And Comparative Evaluation Of Computer-based Assessment Tools for Manual and Robotic Microsurgery

P18. Development And Comparative Evaluation Of Computer-based Assessment Tools for Manual and Robotic Microsurgery

Language Matters: Comparisons of Concussion Assessments Among English- and Spanish-Speaking Middle School Athletes.

The Child Sport Concussion Assessment Tool, fifth edition (Child SCAT5), is among the most widely used international pediatric concussion evaluation tools. However, the tool's English-only aspect may limit its use for patients who speak different languages. Prior researchers have suggested one's preferred language (ie, home language) could be associated with concussion assessments in adults, yet how this might affect pediatric athletes is not well understood. To compare baseline Child SCAT5 assessment outcomes between middle school athletes whose home language was Spanish and matched control athletes whose home language was English. Case-control study. Middle school athletics. Athletes self-reported their home language (ie, language spoken at home). Those indicating their home language was Spanish were individually matched to athletes who spoke English at home on age, sex, sport, school, and pertinent comorbidities (eg, concussion history). The final sample consisted of 144 athletes (Spanish home language = 72, English home language = 72). We used Mann-Whitney U tests to compare the Child SCAT5 component scores of the home language groups (ie, Spanish versus English). Athletes in the Spanish home language group scored lower on the Standardized Assessment of Concussion-Child version (P < .01, r = -0.25), Immediate Memory (P < .01, r = -0.45), and total modified Balance Error Scoring System scores (P < .01, r = -0.25) than the English home language group. Matched athletes whose home language was Spanish versus English scored differently on baseline Child SCAT5 assessment components. Those with the home language of Spanish scored lower on cognitive and balance tasks than those whose home language was English. These findings may serve as a rationale for the development of future concussion assessment tools to properly capture clinically relevant data regarding language differences among pediatric athletes.

Learning in the workplace: Development of a simple language statement assessment tool that supports second-level nurse practice

AimTo focus learning through clarity of the enrolled nurse (EN) role (a second tier nurse position) through development of a user-friendly workplace performance assessment tool commensurate with EN standards for practice. BackgroundInternationally, the nursing workforce comprises regulated and unregulated staff. In Australia, similar to other western countries, there are two tiers of regulated workforce, namely Registered Nurses (RNs) and Enrolled Nurses (ENs). Differences in RN and EN standards based on the education preparation are not always clearly differentiated in workplace practice. Roles are often seen as interchangeable: Improved clarity of both regulated and unregulated roles, when numbers of healthcare workers are burgeoning, assists performance assessment that guides further learning and safe practice. DesignTwo phase sequential, non-experimental design. MethodsPhase one used focus groups (n=48), expert reference panel (n=8) and end-users (n=16) to develop simple language statements. Phase two involved field testing of the statements. FindingsA 30-item, criterion-based workplace performance tool was developed. Principal component analysis of completed tools indicated work could be organised around three key areas of practice, namely, higher order thinking and problem solving, routine daily activities of care and personal and social attributes. DiscussionParticipants reported the statement items assisted in determining suitable activities and accompanying cues in discussing learning needs. Analysis assisted with discriminating broader elements of EN workplace performance. ConclusionsWorkplace learning is important for nurses to continue to build their capacity to deliver optimum care. Assessment tools that describe professional capability in plain language statements and provide examples of supportive behavioural cues help guide on-going learning through improving the validity and thereby consistency of assessment processes. Furthermore, comprehensible and meaningful statements and cues can readily be adopted by students and educators to target learning and feedback thereby enhancing clarity of the EN role, to distinguish from other nursing roles.

Development of quality assessment tool for systematic reviews and meta-analyses of real-world studies: a Delphi consensus survey.

The increasing adoption of real-world studies in healthcare for decision making and planning has further necessitated the need for a specific quality assessment tool for evidence synthesis. This study aimed to develop a quality assessment tool for systematic reviews (SR) and meta-analysis (MA) involving real-world studies (QATSM-RWS) using a formal consensus method. Based on scoping review, the authors identified a list of items for possible inclusion in the quality assessment tool. A Delphi survey was formulated based on the identified items. A total of 89 experts, purposively recruited, with research experience in real-world data were invited to participate in the first round of Delphi survey. The participants who responded in the first Delphi round were invited to participate (n = 15) in the phrasing of the items. Strong level of agreement was found on the proposed list of items after the first round of Delphi. A rate of agreement ≥ 0.70 was used to define which items to keep in the tool. A list of 14 items emerged as suitable for QATSM-RWS. The items were structured under five domains: introduction, methods, results, discussions, and others. All participants agreed with the proposed phrasing of the items. This is the first study that has developed a specific tool that can be used to appraise the quality of SR and MA involving real-world studies. QATSM-RWS may be used by policymakers, clinicians, and practitioners when evaluating and generating real-world evidence. This tool is now undergoing validation process.

Development of a scale for attitude toward sexually transmitted infections based on the Health Belief Model

ObjectivesDetermination of the attitudes of individuals toward sexually transmitted infections (STIs) can also help identify barriers to health service-seeking behavior. Hence, this study aimed to develop a scale for determining the attitudes of individuals toward sexually transmitted diseases. Study DesignThis was a methodological study. The Health Belief Model (HBM) framework was used to elucidate the perceptions and interpretations of illnesses among individuals. After reviewing the relevant literature, an item pool was created to include 4 dimensions (perceived susceptibility (A), perceived severity (B), perceived benefit (C), and perceived barriers and self-efficacy (D)) about sexually transmitted diseases from the perspective of HBM. Exploratory factor analysis was conducted to evaluate the construct validity of the scale. Moreover, confirmatory factor analysis was used to examine the suitability of the items in terms of factor structures. ResultsThe final version of the scale comprised 19 items and 4 subdimensions. The first subdimension of the scale accounted for 20.11% of the total variance, whereas the second, third, and fourth subdimensions accounted for 17.83%, 12.50%, and 8.75% of the total variance, respectively. Collectively, these four subdimensions accounted for 59.19% of the total variance. The Cronbach’s alpha reliability coefficient of the scale was found to be 0.74. Conclusions: Briefly, the present study led to the development of a novel assessment tool, Attitude Toward Sexually Transmitted Infections Scale. Higher scores on the scale indicated higher likelihood of taking action for a possible STI treatment according to the HBM approach.

Cardiovascular Risk Associated With Social Determinants of Health at Individual and Area Levels

The benefit of adding social determinants of health (SDOH) when estimating atherosclerotic cardiovascular disease (ASCVD) risk is unclear. To examine the association of SDOH at both individual and area levels with ASCVD risks, and to assess if adding individual- and area-level SDOH to the pooled cohort equations (PCEs) or the Predicting Risk of CVD Events (PREVENT) equations improves the accuracy of risk estimates. This cohort study included participants data from 4 large US cohort studies. Eligible participants were aged 40 to 79 years without a history of ASCVD. Baseline data were collected from 1995 to 2007; median (IQR) follow-up was 13.0 (9.3-15.0) years. Data were analyzed from September 2023 to February 2024. Individual- and area-level education, income, and employment status. ASCVD was defined as the composite outcome of nonfatal myocardial infarction, death from coronary heart disease, and fatal or nonfatal stroke. A total of 26 316 participants were included (mean [SD] age, 61.0 [9.1] years; 15 494 women [58.9%]; 11 365 Black [43.2%], 703 Chinese American [2.7%], 1278 Hispanic [4.9%], and 12 970 White [49.3%]); 11 764 individuals (44.7%) had at least 1 adverse individual-level SDOH and 10 908 (41.5%) had at least 1 adverse area-level SDOH. A total of 2673 ASCVD events occurred during follow-up. SDOH were associated with increased risk of ASCVD at both the individual and area levels, including for low education (individual: hazard ratio [HR], 1.39 [95% CI, 1.25-1.55]; area: HR, 1.31 [95% CI, 1.20-1.42]), low income (individual: 1.35 [95% CI, 1.25-1.47]; area: HR, 1.28 [95% CI, 1.17-1.40]), and unemployment (individual: HR, 1.61 [95% CI, 1.24-2.10]; area: HR, 1.25 [95% CI, 1.14-1.37]). Adding area-level SDOH alone to the PCEs did not change model discrimination but modestly improved calibration. Furthermore, adding both individual- and area-level SDOH to the PCEs led to a modest improvement in both discrimination and calibration in non-Hispanic Black individuals (change in C index, 0.0051 [95% CI, 0.0011 to 0.0126]; change in scaled integrated Brier score [IBS], 0.396% [95% CI, 0.221% to 0.802%]), and improvement in calibration in White individuals (change in scaled IBS, 0.274% [95% CI, 0.095% to 0.665%]). Adding individual-level SDOH to the PREVENT plus area-level social deprivation index (SDI) equations did not improve discrimination but modestly improved calibration in White participants (change in scaled IBS, 0.182% [95% CI, 0.040% to 0.496%]), Black participants (0.187% [95% CI, 0.039% to 0.501%]), and women (0.289% [95% CI, 0.115% to 0.574%]). In this cohort study, both individual- and area-level SDOH were associated with ASCVD risk; adding both individual- and area-level SDOH to the PCEs modestly improved discrimination and calibration for estimating ASCVD risk for Black individuals, and adding individual-level SDOH to PREVENT plus SDI also modestly improved calibration. These findings suggest that both individual- and area-level SDOH may be considered in future development of ASCVD risk assessment tools, particularly among Black individuals.

Territorial Impact Assessment for Coal Sites in Transition

This article describes a part of the POTENTIALS project promoted by the Research Fund for Coal and Steel (RFCS) of the EU, which, in general, has aimed to develop business models for the reuse of former industrial and mining sites in different European regions. The goal of this project focused on the creation of so-called eco-industrial parks to enable sustainable energy production and reduce waste and pollution on coal sites in transition. A key aspect was the development of a suitable territorial impact assessment (TIA), a new and complex policy tool for the assessment of the territorial impacts of EU policies and projects on territorial cohesion. Therefore, the special TEQUILA (Territorial Efficiency, Quality and Identity Layer Assessment) approach is used to describe the TIA for this case and emphasizes its application in assessing ex ante the impacts of the transition from a coal site to an eco-industrial park. It underlines the need for a differentiated understanding of the regional characteristics and potential impacts of transition policies or projects. Furthermore, the process and results of applying the TEQUILA methodology, a multicriteria analysis, in the context of regionalized impact models has shown how important it is to select well-defined, expert-based criteria, but at the same time, to establish a system that is flexible and adaptable to the needs of political decision makers and stakeholders considering the normative weights of the criteria. This has been illustrated by some examples.

Preliminary Development of Items for a Nurses' Physical Environmental Stress Scale.

This study aimed to develop a preliminary Nurses' Physical Environmental Stress Scale (NPESS) that explores the relationships between the physical environment in the intensive care unit (ICU) and work-related stress among ICU nurses. Working within the healthcare field is stressful and comes with a high level of responsibility for nurses, especially ICU nurses. The ICU work environment is associated with risk factors such as excessive workload, increased expectations, and long working hours that can lead to burnout among nurses. There is some evidence that environmental design has the potential to prevent or mitigate work-related stress; however, an adequate assessment tool to identify physical environmental stressors or supports for moderating stress is lacking. To develop the preliminary environmental assessment tool, an exploratory sequential methodology was used. The approach consisted of three distinct phases, including (a) a qualitative content analysis of existing focus group data, (b) a qualitative content analysis of pertinent literature related to environmental assessment tools in a healthcare context, and (c) the development and refinement of the NPESS assessment tool. Tool refinement was based on interviews with ICU nurses. The resulting NPESS tool was comprised of seven sections (sounds, lighting, smells, staff respite spaces, staff workspaces, patient rooms, and aesthetic qualities) containing a total of and 81 items that address factors that were identified as potential moderators of environmental stress in ICU settings. The resulting NPESS assessment tool provides a feasible approach for evaluating ICU settings to identify possible improvements to reduce stress among nurses. Future research will be conducted to assess the validity and reliability of the final tool by distributing it to a larger sample of ICU nurses.

Objective assessment tools in laparoscopic or robotic-assisted gynecological surgery: A systematic review.

There is a growing emphasis on proficiency-based progression within surgical training. To enable this, clearly defined metrics for those newly acquired surgical skills are needed. These can be formulated in objective assessment tools. The aim of the present study was to systematically review the literature reporting on available tools for objective assessment of minimally invasive gynecological surgery (simulated) performance and evaluate their reliability and validity. A systematic search (1989-2022) was conducted in MEDLINE, Embase, PubMed, Web of Science in accordance with PRISMA. The trial was registered with the Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022376552. Randomized controlled trials, prospective comparative studies, prospective single-group (with pre- and post-training assessment) or consensus studies that reported on the development, validation or usage of assessment tools of surgical performance in minimally invasive gynecological surgery, were included. Three independent assessors assessed study setting and validity evidence according to a contemporary framework of validity, which was adapted from Messick's validity framework. Methodological quality of included studies was assessed using the modified medical education research study quality instrument (MERSQI) checklist. Heterogeneity in data reporting on types of tools, data collection, study design, definition of expertise (novice vs. experts) and statistical values prevented a meaningful meta-analysis. A total of 19 746 titles and abstracts were screened of which 72 articles met the inclusion criteria. A total of 37 different assessment tools were identified of which 13 represented manual global assessment tools, 13 manual procedure-specific assessment tools and 11 automated performance metrices. Only two tools showed substantive evidence of validity. Reliability and validity per tool were provided. No assessment tools showed direct correlation between tool scores and patient related outcomes. Existing objective assessment tools lack evidence on predicting patient outcomes and suffer from limitations in transferability outside of the research environment, particularly for automated performance metrics. Future research should prioritize filling these gaps while integrating advanced technologies like kinematic data and AI for robust, objective surgical skill assessment within gynecological advanced surgical training programs.

Assessments for multi-heritage couple therapy: A review of existing tools.

As diversity in the United States increases, marriage and family therapists are encountering more multi-heritage couples in therapy. Recent research shows that around 11% of adults are married to someone from a different racial or ethnic group, rising to 19% among new marriages. Multi-heritage couples encompass inherent differences in race, ethnicity, religion, gender, sexual orientation, national origin, and culture. This article addresses the unique challenges faced by multi-heritage couples in therapy and explores the strengths and weaknesses of existing assessment tools suitable for their needs. The study highlights a limited number of existing tools that are available for therapists working with multi-heritage couples. Consequently, the article suggests future directions to enhance the development of assessment tools tailored to the specific needs of multi-heritage couples.