Group Experience Research Articles

Measuring Expiratory Diaphragm Activity: An Electrifying Tool to Guide Positive End-Expiratory Pressure Strategy in Critically Ill Children?

Measuring Expiratory Diaphragm Activity: An Electrifying Tool to Guide Positive End-Expiratory Pressure Strategy in Critically Ill Children?

The Reliability and Accuracy of the Medial Malleolar Fracture Classification Based on 3D CT Reconstruction.

There is a new medial malleolar fracture classification based on 3D CT reconstruction. However, there is no study assessing the reliability and accuracy of the new classification system and comparison between the new and the classic classification. This study aimed to compare the reliability and accuracy of the medial malleolar fracture classification based on 3D CT reconstruction and the Herscovici classification system. We retrospectively analyzed the consecutive ankle fractures in our hospital from January 2013 to September 2020. Five inexperienced and five experienced orthopedic surgeons were included as observers to assess 68 cases with medial malleolar fractures. Ten evaluators classified the cases according to the two classification systems. The reference results of each case were made by the consensus of three senior trauma surgeons. The interobserver reliability, intraobserver reliability, and accuracy were evaluated at an interval of 6 weeks using Fleiss's kappa (κ) statistics. We found substantial interobserver and intraobserver reliability and 81.4% accuracy for the new classification, which was statistically superior to the Herscovici classification (P < 0.05). The reliability and accuracy of both classifications were similar in inexperienced and experienced groups, except for type III in the new classification. The interobserver reliability of type II was the best (P < 0.05), and the intraobserver reliability of IVc ranked the worst (P < 0.05) in the new classification. The reliability and accuracy of the new classification are superior to the Herscovici classification. Clinical experiences will not affect the assessment of both classification systems in most instances.

Implementation of point-of-care testing and prevalence of cryptococcal antigenaemia among patients with advanced HIV disease in Mumbai, India

ObjectivesTo describe the implementation of screening for cryptococcal antigenaemia by point-of-care (POC) serum cryptococcal antigen (CrAg) lateral flow assay, measure the prevalence and factors associated with serum cryptococcal antigenaemia in...

Effect of task-based group experience on collaborative learning: Exploring the transaction activities.

Collaborative learning is a widely used approach where students gather in small groups to solve problems and develop skills. However, grouping students is not always effective, and it may be necessary to provide task-specific collaborative experiences to optimize their interactions for subsequent learning tasks. To test this hypothesis, we conducted an experiment with 90 Ecuadorian students in their mathematics class. Participants were 90 Ecuadorian students (average age = 13.80 years, SD = .70; 48.89% female) from a private school in Sangolquí, who participated as part of their mathematics class. The experiment consisted of four phases: preparation, learning, retention one-day testing, and delayed seven-day testing. In the preparation phase, 15 triads received guidance on working collaboratively with quadratic equations (i.e., experienced groups), while 45 other individual learners worked independently. In the learning phase, 15 experienced triads and 45 individual learners (who were later divided into 15 non-experienced triads) received a new learning task in the domain of economics, precisely the break-even point. The experienced group outperformed the non-experienced group in the retention one-day test, investing less mental effort and demonstrating greater efficiency. However, there was no significant difference in the delayed one-week test. We analysed the interactions of the groups and found that experienced groups exhibited more cognitive, fewer regulatory, an equal number of emotional interactions, and fewer task-unrelated interactions than the non-experienced groups. Providing task-specific collaborative experiences can reduce the cognitive load associated with transactional activities and increase learning in new tasks.

노인의 넘어짐 경험에 따른 보행능력과 균형능력 비교

This study was designed to investigate the effects of falling experience on gait ability and balance ability in the elderly women utilizing new instruments with high validity to measure gait ability and balance in the lower extremities. Forty six elderly women were volunteered to participate in the study as subjects. They were divided into two groups, i.e., falling experienced group(FG: n=24) and non-falling experienced group(NFG: n=22). The collected data were calculated with falling experience group and non-falling experience group utilizing independent t-test with repeated measures. Variables related to physique, gait ability(Temporal parameters and Spatial parameters) and balance ability were measured and compared between the two groups. There was no significant difference between the two groups in all variables of step time, gait cycle time, single support time, double support time, ambulation time, velocity, and mean normalized velocity. in the case of spatial parameters, step length(left, right), stride length(left), step/extremity ratio(left), and funcional ambulatory profiles of gait, were significantly lower in FG than NFG. In addition, FG showed signifiantly lower. in the case of level 2, there was a significant differencce in overall, Anterior･Posterior, Medial･Lateral. in level 4, there was a significant difference between Medial･Lateral. it was concluded that low step length, stride length, funcional ambulatory profiles due to the experience of falling, and a decrease in balance ability on unstable ground. Therefore, the results of this study are expected to be helpful as basic data for constructing an exercise program for improving spatial walking ability and balance ability on unstable ground in planning an exercise program for preventing falls in elderly women.

Experienced vs Inexperienced Disabled Swimmers: Training Load and Recovery in Preparation Period

The study purpose was to analyse the training load and recovery of experienced and inexperienced swimmers with disabilities. Materials and methods. The study subjects consisted of seven swimming athletes with disabilities at the provincial level who underwent training camps in preparation for the Indonesia Paralympics Games. The groups of athletes were divided based on their level of training and experience in national championships. For thirteen weeks, the athletes monitored their training load and recovery rate. Borg CR-10 was used to measure the internal training load, while the athlete’s recovery rate was measured using Total Quality Recovery (TQR). IBM SPSS Statistics version 22 was used to analyse normality and test differences between the two groups. The Mann-Whitney test was used to test the significance of the RPE Borg CR-10, while the unpaired T-test was used to test the significance of the TQR. Results. The Borg CR-10 mean for the experienced athlete group was 7.78±0.47, while it was 8.28±0.56 (p&lt;0.05) for the inexperienced athlete group. The RPE mean for the experienced athlete group was 18.24±1.47, while it was 18.52±1.57 (p&gt;0.05) for the inexperienced athlete group. Furthermore, the Borg RPE shows the training load of experienced athletes of 17.12±1.03, which is lower than the average RPE of inexperienced athletes of 18.21±1.24, and also the TQR average of experienced athletes was of 18.24±1.47, while it was of 18.52 ±1.55 (p&lt;0.05) in case of inexperienced athletes. Conclusions. Experienced para-swimmers had a significantly different training load than inexperienced para-athletes. In addition, the training load of experienced para athletes was also significantly different compared to the recovery rates of experienced and inexperienced para swimmers.

The perception–production link varies with stages of L2 development and vowel properties

Abstract This study investigates whether the perception–production link in phonological acquisition varies with stages of L2 development. It also examines whether the perception–production link for L2 vowels varies according to vowel properties, or whether the L2 vowels match or mismatch with L1 vowels. Korean learners of English in the UK were divided into more experienced and less experienced groups based on age of arrival and length of residence. The learners completed English vowel production, English vowel identification, and English–Korean vowel mapping tasks with English words (e.g., beat, bot). The intelligibility of their production and the accuracy of their vowel identification were assessed. Results show that only the more experienced learners’ perception and production were significantly correlated. Among L2 Standard Southern British English vowels similar to L1 Korean vowels (/i, ʌ, u/) only /i/ showed a significant correlation between perception and production, while among L2 vowels dissimilar to L1 vowels (/eɪ, ɘʊ, ɑ, ɒ/) only /ɑ/ showed a negative correlation, indicating that the correlation varied with vowel properties. The study contributes to the L2 phonological acquisition literature by exploring the perception–production link in terms of different stages of L2 development and L2 vowel properties.

A roadmap for early psychosocial support in palliative care for people impacted by ALS-reducing suffering, building resiliency, and setting the stage for delivering timely transdiagnostic psychosocial care.

This commentary describes the current state of psychosocial care for people with amyotrophic lateral sclerosis and their caregivers. We provide recommendations for developing a roadmap for future research based on existing literature and our group's clinical and research experience to inform next steps to expand evidence-based psychosocial care for people with amyotrophic lateral sclerosis and their caregivers, with potential implications for a range of advanced illnesses.

PD30-04 SURGICAL GESTURES TO MEASURE SURGICAL DISSECTION PERFORMANCE IN APICAL DISSECTION OF ROBOT-ASSISTED RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 Apr 2023PD30-04 SURGICAL GESTURES TO MEASURE SURGICAL DISSECTION PERFORMANCE IN APICAL DISSECTION OF ROBOT-ASSISTED RADICAL PROSTATECTOMY Maxwell X. Otiato, Runzhuo Ma, Timothy N. Chu, Elyssa Y. Wong, Christian Wagner, and Andrew J. Hung Maxwell X. OtiatoMaxwell X. Otiato More articles by this author , Runzhuo MaRunzhuo Ma More articles by this author , Timothy N. ChuTimothy N. Chu More articles by this author , Elyssa Y. WongElyssa Y. Wong More articles by this author , Christian WagnerChristian Wagner More articles by this author , and Andrew J. HungAndrew J. Hung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003316.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Surgical performance impacts patient outcomes, yet ideal performance is challenging to objectively quantify. Previously, we established a surgical gesture classification system that deconstructs robotic tissue dissection into discrete basic surgical maneuvers. Here, we evaluate surgical gestures as a novel assessment method by correlating this metric with surgeon experience and technical skill assessment scores in the apical dissection (AD) of robotic-assisted radical prostatectomy (RARP). METHODS: RARPs from 2016-2018 across two international institutions were included. After standardized training, raters decoded AD surgical videos with surgical gestures. Surgeons were grouped into two experience levels by the median robotic caseload (range 80-5,800 cases; median 475 cases). The less experienced group performed <475 robotic cases and more experienced group performed ≥475 robotic cases. Videos were assessed by a validated assessment tool, Dissection Assessment for Robotic Technique (DART), which contains six domains. A Kruskal-Wallis test was used to compare surgical gesture proportion with DART scores from surgeons of different experience levels. Spearman’s correlation coefficients were used to assess the associations between surgical gesture usage and DART. RESULTS: In total, 78 surgical videos from 20 surgeons were included. More experienced surgeons (n=10) utilized larger proportions of cold cut (50% vs 39%, p=0.008) and smaller proportions of peel/push (12% vs 25%, p=0.02) than less experienced surgeons (n=10). Correlations between the surgical gestures and technical skills assessments ranged from -0.40 to 0.32 using the Spearman’s correlation coefficient (p<0.05, Figure 1b). Surgeons who utilized more retraction gestures had a lower retraction score, efficiency score, and total DART score (all p<0.05). Those who used more discrete gestures and spent more time per gesture had a lower efficiency score (both p<0.01). CONCLUSIONS: Surgeons of different experience levels use different surgical gestures during AD. Significant correlations were demonstrated between surgical gestures and dissection technical skills. Surgical gestures can serve as a novel method to teach and evaluate dissection skill. Source of Funding: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA273031. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e832 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maxwell X. Otiato More articles by this author Runzhuo Ma More articles by this author Timothy N. Chu More articles by this author Elyssa Y. Wong More articles by this author Christian Wagner More articles by this author Andrew J. Hung More articles by this author Expand All Advertisement PDF downloadLoading ...

Evaluating the User Experience of a Gamification-Based Moodle LMS

Gamification is the integration of game mechanics in non-gaming contexts, such as education, to enhance motivation and engagement. This study aimed to evaluate the usability of a gamification-based Moodle learning management system (LMS) by having 48 computer science students aged between 15 and 24 years perform tasks and provide feedback on the System Usability Scale (SUS). 29 participants provided feedback, with 18 having prior LMS experience and 11 reporting no prior experience. An Independent Samples T-Test determined that there was no significant difference in System Usability Scale scores between male and female groups or between experienced and non-experienced groups. This suggests that gender and prior experience with an LMS do not affect the perceived usability of a gamification-based Moodle LMS.

Practical Application and Influence of “Avigen duck” Immunomodulator to White Pekin Ducks Humoral Immune Factors

Factors of non-specific immunity are responsible for protecting birds from a number of viruses and bacteria. Bactericidal proteins are played here lysozyme and complement, interferon, as well as beta-lysine. Adding appropriate active compounds to the bird's diet to activate the innate immune response are subject to studies by many authors. The practical application and influence of the "Avigen Duck". immunomodulator in the cultivation of White Pekin ducks aims to clarify the dynamics of the indicators. It was found that the ducks treated with the immunomodulator had higher non-specific protection expressed in the values of the observed indicators. Complement activity for the experienced group (529.45 ± 17,85 CH50) is significantly higher than that of untrained birds (308.56 ± 10.19 CH50), on the 30th day of their lives (P &amp;lt;0.001). Lysozyme values for the experienced group (6.34 ± 0.86 mg L-1) is more than twice as high as its concentration in control birds - 2.52 ± 0.59 mg L-1. At 30 days of age, the mean concentration of IFN γ in the control group of ducks was 108.86±6.12 pg ml-1, and in the experimental group treated with immunomodulator - 518.06±12.80 pg ml-1, accompanied by an increase in the values of IL-2 and IL-6 and beta-lysine activity. These data show that, despite the short life of the ducks, the concentrations of the investigated factors of non-specific immunity increase significantly and statistically reliably, even after a single treatment with immunomodulator "Avigen Duck". The practical application of the immunomodulator in the duck diet has a strong effect on their non-specific immunity.

Management of Brachial Plexus Birth Palsies: The Stanford Experience.

The start of Stanford's brachial plexus birth palsy (BPBP) experience dates back to 1983, when Dr. Vincent Rod Hentz visited Dr. Alain Gilbert on sabbatical. Since then, our principles of care for patients with BPBP have evolved based on our group's longitudinal experience caring for children with the entire spectrum of sequelae that arise in children with BPBP. We base our clinical decision making on frequent serial examinations and use intraoperative evoked potentials to guide surgical decisions. Here, we discuss our current principles on surgical indications, timing of surgery, and preferred techniques for secondary surgery in patients with BPBP.

Acquisition of Competencies of Nurses: Improving the Performance of the Healthcare System.

Perspectives of the core competencies of nurses are varied among postgraduate-year nurses, which makes it challenging to establish training programs and develop evaluation instruments. Particularly critical for nurses is the ongoing acquisition of competencies throughout life. Sometimes this acquisition is funded by the healthcare system, but the key question is how the system leverages this acquisition and ultimately how it translates into patient care. This study seeks to explore nurses' key competencies acquired through continuing education from the perspective of two groups of postgraduate nurses with different levels of experience and with different objectives to be assessed. An NGT procedure was applied to the group discussion. The participants were recruited according to basic factors such as the number of years of professional experience, their level of education, and their preferred professional status. Thus, seventeen professionals participated in the study, representing two public hospitals in the city. Following the NGT procedure, the competencies identified from the thematic analysis were scored and ranked to achieve a consensus. Eight core issues were derived in the novel group concerning transferring the competencies to patient care quality: holism, care work, organizational barriers, specialization, no transfer, confidence, knowledge, and instrumental tools. Four core issues were derived when asked about the relationship between the resources invested and the organizational and professional development of the nursing staff: professional development, positive learning, negative learning, and recognition. In the more experienced group, seven issues were derived from the first issue raised: continuous learning, quality, confidence, holism, safe care, autonomy, and technical issues. Additionally, six issues arose from the second question: satisfaction, autonomy, creativity, productivity, professional development, and recognition. In conclusion, the perceptions of the two selected groups are negative when it comes to assessing the extent to which the competencies acquired in lifelong learning are transferred to the patient and the system evaluates and recognizes these competencies for improvement.

Research group as helpers due to the war in Ukraine: Focus group experiences of women researchers.

World Health Organization studies have shown that one in every five people who have experienced war or other conflicts suffers from a mental health disorder, the most vulnerable groups being children and women. According to international guidelines, mental health care should be made available immediately in the event of disaster. With the first influx of Ukrainian refugees to Hungary at the outbreak of the war, the Research Group of Childhood Mental Health at Eötvös Loránd University and Semmelweis University in Budapest immediately decided to help by transforming itself into a support group for refugee families. The members of the support group are all women. The aim of the present study is to explore the motivation behind the transformation of the research group and the help it provided. A further aim was to compare the group's experiences with descriptions in the literature of impacts on helpers who work with refugees. The current paper reflects on the transformation from researchers to helpers and the effects of that transformation at group and individual level using the focus group method and consensual text analysis. The transformation of the support group necessitated the involvement of students, whose experiences are also examined. We identified five main categories: context; the help recipients' perspective; the personal level; the professional level; and the level between the personal and professional. The analysis revealed the way in which the voluntary helping developed, the resulting difficulties, and coping options. Volunteering among Ukrainian refugees has both positive and negative psychological consequences. While stress and trauma threaten the psychological well-being of the helpers, positive aspects, such as flexibility and professional development, are also reported. Due to the strong motivation among group members and their experience in practical work, the all female research group was quickly able to transform itself into a support group.

Visual Interpretation of Vocal Fold Paralysis in Flexible Laryngoscopy Using Eye Tracking Technology

Interpretation of laryngoscopy is an important diagnostic skill in otolaryngology. There is, however, limited understanding of the specific visual strategies used while assessing flexible laryngoscopy video. Eye-tracking technology allows for objective study of eye movements during dynamic tasks. The purpose of the present study was to explore visual gaze strategies during laryngoscopy interpretation of unilateral vocal fold paralysis (UVFP) across clinician experience from novice to expert. Thirty individuals were shown five flexible laryngoscopy videos, each 10 seconds long. After viewing each video, participants reported their impressions of "left vocal fold paralysis," "right vocal fold paralysis," or "no vocal fold paralysis." Eye tracking data were collected and analyzed for duration of fixation and number of fixations on select areas of interest (AOI). Diagnostic accuracy and visual gaze patterns were compared between novice, experienced, and expert groups. Diagnostic accuracy among learners in the novice group was significantly lower than those in the more experienced groups (P=0.04). All groups demonstrated similar visual gaze patterns when viewing the video with normal bilateral vocal fold mobility, spending the greatest percentage of time viewing the trachea. There were differences among groups when viewing the videos of left or right VFP, but the trachea was always in the top three structures for greatest fixation duration and highest number of fixations. Eye-tracking is a novel tool in the setting of laryngoscopy interpretation. With further study it has the potential to be useful for the training of otolaryngology learners to improve diagnostic skills.

Impact of Surgeon Experience and Centre Volume on Outcome After Off-Pump Coronary Artery Bypass Surgery: Results From the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) Registry.

The aim of this study was to assess the impact of surgeon experience and centre volume on early operative outcomes in patients undergoing off-pump coronary artery bypass (OPCAB) surgery. Of 7,352 patients in the European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG) registry, 1,549 underwent OPCAB and were included in the present analysis. Using adjusted regression analysis, we compared major early adverse events after procedures performed by experienced OPCAB surgeons (i.e., ≥20 cases per year; n=1,201) to those performed by non-OPCAB surgeons (n=348). Furthermore, the same end points were compared between procedures performed by OPCAB surgeons in high OPCAB volume centres (off-pump technique used in >50% of cases; n=894) and low OPCAB volume centres (n=307). In the experienced OPCAB surgeon group, we observed shorter procedure times (β -43.858, 95% confidence interval [CI] -53.322 to -34.393; p<0.001), a lower rate of conversion to cardiopulmonary bypass (odds ratio [OR] 0.284, 95% CI 0.147-0.551; p<0.001), a lower rate of prolonged inotrope or vasoconstrictor use (OR 0.492, 95% CI 0.371-0.653; p<0.001), a lower rate of early postprocedural percutaneous coronary interventions (OR 0.335, 95% CI 0.169-0.663; p=0.002), and lower 30-day mortality (OR 0.423, 95% CI 0.194-0.924; p=0.031). In high OPCAB volume centres, we found a lower rate of prolonged inotrope use (OR 0.584, 95% CI 0.419-0.814; p=0.002), a lower rate of postprocedural acute kidney injury (OR 0.382, 95% CI 0.198-0.738; p=0.004), shorter duration of intensive care unit (β -1.752, 95% CI -2.240 to -1.264; p<0.001) and hospital (β -1.967; 95% CI -2.717 to -1.216; p<0.001) stays, and lower 30-day mortality (OR 0.316, 95% CI 0.114-0.881; p=0.028). Surgeon experience and centre volume may play an important role on the early outcomes after OPCAB surgery.

Visual Analysis of Agricultural Workers using Explainable Artificial Intelligence (XAI) on Class Activation Map (CAM) with Characteristic Point Data Output from OpenCV-based Analysis

In this study, we use explainable artificial intelligence (XAI) based on class activation map (CAM) techniques. Specifically, we use Grad-CAM, Grad-CAM++, and ScoreCAM to analyze outdoor physical agricultural (agri-) worker image datasets. In previous studies, we developed body-sensing systems to analyze human dynamics with the aim of enhancing agri-techniques, training methodologies, and worker development. These include distant, visual data-based sensing systems that capture image and movie datasets related to agri-worker motion and posture. For this study, we first obtained the aforementioned image datasets for researcher review. Then, we developed and executed Python programs with Open-Source Computer Vision (OpenCV) libraries and PyTorch to run XAI-oriented systems based on CAM techniques and obtained heat map-pictures of the visual explanations. Besides, we implement optical flow-based image analyses using our Visual C++ programs with OpenCV libraries, automatically set and chase the characteristic points related to the video datasets. Next, we analyze the dataset features and compare experienced and inexperienced subject groups. We investigate the output’s features, accuracies, and robustness to be able to make recommendations for real agri-workers, managers, product-developers, and researchers. Our findings indicate that the visualized output datasets are especially useful and may support further development of applied methods for these groups.

Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)

RAPN training usually takes place in-vivo and methods vary across countries/institutions. No common system exists to objectively assess trainee capacity to perform RAPN at predetermined performance levels prior to in-vivo practice. The identification of objective performance metrics for RAPN training is a crucial starting point to improve training and surgical outcomes. The authors sought to examine the reliability, construct and discriminative validity of objective intraoperative performance metrics which best characterize the optimal and suboptimal performance of a reference approach for training novice RAPN surgeons. Seven Novice and 9 Experienced RAPN surgeons video recorded one or two independently performed RAPN procedures in the human. The videos were anonymized and two experienced urology surgeons were trained to reliably score RAPN performance, using previously developed metrics. The assessors were blinded to the performing surgeon, hospital and surgeon group. They independently scored surgeon RAPN performance. Novice and Experienced group performance scores were compared for procedure steps completed and errors made. Each group was divided at the median for Total Errors score, and subgroup scores (i.e., Novice HiErrs and LoErrs, Experienced HiErrs and LoErrs) were compared. The mean inter-rater reliability (IRR) for scoring was 0.95 (range 0.84–1). Compared with Novices, Experienced RAPN surgeons made 69% fewer procedural Total Errors. This difference was accentuated when the LoErr Expert RAPN surgeon’s performance was compared with the HiErrs Novice RAPN surgeon’s performance with an observed 170% fewer Total Errors. GEARS showed poor reliability (Mean IRR = 0.44; range 0.0–0.8), for scoring RAPN surgical performance. The RAPN procedure metrics reliably distinguish Novice and Experienced surgeon performances. They further differentiated performance levels within a group with similar experiences. Reliable and valid metrics will underpin quality-assured novice RAPN surgical training.

Perception of Autonomy and the Role of Experience within the Maritime Industry

The seafaring occupation will soon evolve as human operators transition to a more supervisory role for autonomous systems onboard. Therefore, gaining a greater understanding of the mindset that officers have towards the world of autonomy will aid the maritime industry by developing a baseline for future navigational training. This paper examines the perceptions and attitudes of 100 navigational seafaring participants of varying navigational ranks and levels of seagoing experience. The aim of the study was to identify the perceptions and self-conscious trust that current seafarers have towards automated and future autonomous systems. Participants were issued a situational judgement test comprising of three questions, allowing them to assess and respond to a hazardous scenario. The results of the study found that seafarers are receptive towards the introduction of autonomous shipping. Furthermore, the participants showed an awareness of what autonomous shipping would mean for the maritime industry. However, concerns remain about the responsibility and safety of the vessel in the event of the introduction of an unmanned vessel. Moreover, when comparing opinions and trust levels among the cohort of ranks, it was found that participants of a higher rank had a similar outlook towards autonomy to that of the less experienced groups.

Objective structured clinical examination in basic thoracic ultrasound: a European study of validity evidence

BackgroundBasic thoracic ultrasound is being used more frequently by clinicians in several settings due to its high diagnostic accuracy for many common causes of respiratory failure and dyspnoea. However, ultrasound examinations are operator-dependent, and sufficient competences are needed to obtain high sensitivity and specificity of examinations. Additionally, it is crucial for ultrasound operators to perceive the competence to interpret the images and integrate them into the patient history and other examinations. This study aims to explore and gather validity evidence for an objective structured clinical examination test of basic thoracic ultrasound competences and establish a pass/fail score.MethodsAn expert panel created the test which included two theoretical and five practical stations representing cases with different diagnoses that cause respiratory symptoms and which are possible to establish by basic thoracic ultrasound. Twenty-five participants with different levels of experience in basic thoracic ultrasound completed the test. Data of the test scores were used for item analysis, and exploring validity evidence was done according to Messick’s framework which is recommended. The contrasting groups' standard setting method was used to establish a pass/fail score.ResultsThe summarised internal consistency reliability was high with a Cronbach’s alpha of 0.87. The novice group (n = 4) had a mean test score of 42 ± 10.1 points, the intermediate group (n = 8) scored 79.1 ± 8.1 points, and the experienced group (n = 13) 89.0 ± 6.2 points (one-way ANOVA, p < 0.001). A pass/fail score of 71 points was thus derived (maximum test score = 105 points).ConclusionWe developed a test for the assessment of clinical competences in basic thoracic ultrasound with solid validity evidence, and a pass/fail standard with no false positives or false negatives.