Foundation Programme Research Articles

Evaluating the Utility of a Near-Peer Situation-Based Course to Prepare Medical Students for the UK Foundation Programme: A Pilot Study.

Starting the Foundation Programme can be challenging for many medical graduates, as medical school alone may not adequately prepare them for complex tasks like managing comorbidities or emergencies. Growing evidence supports the role of transition interventions to meet this knowledge gap, however data on the utility of situation-based learning are limited. This pilot study aimed to assess the efficacy of a near-peer case-based course in improving knowledge and preparedness for foundation training in recent medical graduates. Recent Imperial College graduates who attended a "Junior Doctor on Call" course were eligible for inclusion. This transition intervention, designed and delivered by a Foundation Year 1 doctor, covered six patient cases that integrated high-yield clinical concepts and practical tips. An online questionnaire was distributed one week before and after the course to assess perceptions of knowledge, confidence, and preparedness for training. Participants were also invited to attend an online semi-structured after the course. Out of 19 attendees, 17 (89.5% response rate) completed the pre-course questionnaire, 14 (73.7% response rate) completed the post-course questionnaire, and 3 completed the interview. 68.75% (n=11) had not previously attended a preparatory course for foundation training. Results demonstrated that 85.7% of participants felt more knowledgeable than before in the key topics covered. Participants also demonstrated an increase in self-rated confidence in commencing work as a junior doctor following the course, with 92.9% of participants stating that they felt more confident. This study offers support for short-term situation-based courses in enhancing medical students' knowledge and confidence for foundation training. These findings add to the growing evidence-base encouraging implementation of short-term courses in preparing for practice. However, further research on the utility of such transition interventions is critical to inform the development of evidence-based recommendations for recent medical graduates, educators, and programme directors.

Sensitization and Assessment of Knowledge of Ayurveda Panchakarma Therapy Among ASHA Workers in Wardha Taluka

A village-level community health worker, an "Accredited Social Health Activist " (ASHA), bridges community and healthcare facilities. The ASHA workers act as catalysts in promoting various foundation programs and encourage people to avail the available benefits. The study aimed to assess knowledge of Panchakarma in ASHA Workers & Sensitization with the Panchakarma module in Wardha taluka. The study's objectives include designing a Panchakarma questionnaire module to assess the knowledge and awareness of ASHA workers of Wardha Taluka and sensitizing ASHA workers about Panchakarma procedures with the help of demonstration videos and lectures on Panchakarma. The work was planned to be conducted at Anji and Waifad villages under Wardha taluka. A questionnaire consisting of 30 questions was prepared to assess the knowledge, awareness, and attitudes regarding Panchakarma. Panchakarma's knowledge, awareness, and attitudes were analyzed using pre-and post-test scores. ASHA will be a facilitator for promoting awareness in the community about Panchakarma. The study concluded that the intervention of the Panchakarma module was highly influential in enhancing knowledge about Panchakarma among ASHA workers. In the future, this Panchakarma module will enable people in the community to accept the Panchakarma therapy in Ayurveda. ASHA will provide more referral services of panchakarma therapy to patients by encouraging them to undergo these therapies. It was the first footstep in developing the module on awareness regarding Panchakarma therapy to enrich the knowledge of ASHA workers as per their needs and implementation of this module by the ASHA in the community.

A Cross-Sectional Study of Omani EFL Students’ Competency in Using English Grammatical Aspect Categories

This cross-sectional study has been launched to explore the Omani EFL students’ competency in using English grammatical aspect categories. It determined the most challenging aspect category and differences attributed to the study level and gender. The sample of the study consisted of 120 students representing the four levels of a four-semester General Foundation Program (GFP) at the English Language Unit, Center for Preparatory Studies, University of Technology and Applied Sciences (UTAS) in Salalah, Sultanate of Oman. Data were collected via a competency test and analyzed statistically using SPSS (Version 26.0). Findings showcase great variations in the competency of the learners across the four levels. The lowest scores of competencies were relevant to the first two levels of the program. The students in the third level scored higher, but the highest competency was evident in the scores of the fourth-level students. Concerning gender, there is no significant difference in the level of competency in aspect categories among male and female students at the four levels. The present perfect tense had the lowest competency across all four levels. Hence, it is considered the most problematic grammatical aspect because, unlike Arabic, English has numerous verbal tense and aspect categories that demand detailed knowledge, and this poses difficulties for Omani EFL learners at the entry-levels of the General Foundation Program. Learners at the entry-level seem to be more influenced by their mother-tongue (Arabic) grammatical system. This study can be used as a roadmap to tackle areas of difficulty in learning the English grammatical system, specifically the aspect categories.

Evidence-based appraisal of the role of SJTs in selection

A recent opinion article in Clinical Medicine promoted a new preference-based algorithm to allocate training places for the UK Foundation Programme Office (UKFPO). This replaced the previous process, which ranked candidates based on medical school academic achievement (the educational performance measure; EPM) and the score on a situational judgement test (SJT). Although not without risks, we believe that the new system has positive potential. In presenting their case, Sam et al summarised evidence relating to the UKFPO in an unbalanced way, leading to what we believe are erroneous inferences, particularly with regard to differential attainment. Here, we provide an example of how the general evidence base and conceptual understanding of the validity of SJTs for medical selection is poorly understood. We highlight important research findings that were not cited by Sam et al and provide what we believe is a more balanced and accurate interpretation of the evidence base relating the UKFPO SJT, and SJTs used in medical selection in general. We do this with particular reference to the validity of such tools in this context, as well as their potential impact on under-represented groups in medicine, compared with other selection assessments.

A90Virtual Reality Simulation for the Foundation Programme – Analysis of Phase Two

The COVID-19 pandemic has undoubtedly served as a catalyst for adaptation of effective delivery of medical education, paving the way for the adoption of novel teaching methods [1]. Simulation based education (SBE) has been no exception, with increased delivery of SBE through immersive, virtual mediums such as head mounted displays (HMD) to create a three-dimensional (3D) environment. Simulation is a vital part of the mandatory foundation programme (FP) learning requirement [2]. Our team incorporated synchronous in-person and online virtual reality simulation (VRS) sessions into the foundation doctor (FD) teaching programme at a single trust and supplemented this with additional, facilitated in-person small group 3D VRS sessions. Mixed quantitative and qualitative feedback was obtained from FD through online surveys, which included aspects of the SET-M tool [3]. Semi-structured interviews were then conducted with a purposeful group of FD attending facilitated small group VRS sessions. Interviews were conducted over a sixteen-week period at eight-weekly intervals, with a baseline interview conducted at week zero. Qualitative data obtained were analysed by thematic analysis. Learners expressed that VRS sessions improved their confidence in clinical assessment, decision-making, and management of similar real-life scenarios as well as in the provision of interventions which foster patient safety. Moreover, feedback highlighted that the VRS modality fits well into their current teaching programme, is a format that they wanted more regularly incorporated into their learning and one which they would prioritize attendance at. Feedback also outlined some challenges with this modality; namely accessibility and technological troubleshooting. Our work highlights the value and associated challenges of using VRS in FP education. There is a strongly positive reception amongst learners in our cohort, a call for more exposure and, vitally, a transferability of learning into real-life practice. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

A107Mental Health Simulation for Foundation Doctors: Bridging the gap of placement variation

There is significant variation of foundation programme tracks across the United Kingdom, giving a range of clinical exposure to newly qualified doctors [1]. Common themes in tracks can be identified to include acute/emergency, community, general medicine, surgery and psychiatry components. In the deanery, many Foundation Trainees (FTs) on psychiatry will have up to 3 additional simulation days devoted to psychiatry themes and this is felt to be an especially effective way to supplement education on psychiatry consultation skills [2]. FTs who do not have psychiatry posts will not have the opportunity to attend this training. Typically, mandatory foundation simulation training focuses on human factors related to acute medical and surgical problems [3]. Our education department has developed a pilot programme to support simulation training on key mental health consultations to support well rounded training of FTs. Half day sessions have been delivered to small groups of FTs who do not have psychiatry posts. Faculty has included experienced simulation faculty and psychiatry doctors and the scenarios conducted in a small group format with professional actors playing patients for increased realism of scenarios. The participants rotated between 3 key scenarios covering essential themes of mental state examination, psychiatry team liaison, patient risk assessment and explaining mental health presentations. 2 sessions have been delivered for a total of 18 FTs. FTs showed insight to a number of challenges related to mental health presentations they had experienced outside of psychiatric settings and this formed the outline of the learning objectives for the session. The participants further reflected on discussions in their feedback from the session and portfolio. The sessions were well received, with improvement in confidence in managing these consultations demonstrated in pre and post course survey comparison from the majority of participants. Given the initial success of the session, the team is building a database of local faculty for continuity of the course and looking to secure relevant funding from HEE to provide further sessions for the FTs in the next academic year. This simulation pilot has shown promise to be a useful addition to supplement the education of FTs for mental health consultations applicable in all areas of their clinical practice. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Differential Attainment Within the Specialised Foundation Programme: Creating an Accessible Mentorship Scheme to Increase Diversity Within Academic Medicine.

The Specialised Foundation Programme (SFP), formerly the Academic Foundation Programme, is a highly competitive pathway into academic medicine. There is minimal information available on the demographics of those who apply to the programme, how it scores its applicants and who is successful, making it difficult to assess whether the application process is accessible to all students and promotes a diverse workforce. There are varying levels of support available with coaching, either geographically ring-fenced by universities or available through paid courses. As a result, there is a risk of differential attainment between students who have financial constraints or attend universities where the SFP is less promoted. The aim of the study was to assess student opinion on barriers to the SFP and academic medicine and the demand for the creation of a national, free-to-access SFP mentorship programme to reduce differential attainment amongst student cohorts.Students in the programme received mentorship, peer learning and scheduled teaching events over a six-month period. Surveys were distributed pre- and post-course, and qualitative and quantitative analysis was conducted. Of the respondents,76% felt that medical schools provided insufficient information on SFP, 31% did not feel financially stable at university and 53% stated that they would not enrol if a cost was present. Applicants were tested on pre- and post-course confidence, all of which showed an increase in mean Likert (1-5) scoring post-mentorship. Financial, institutional and geographical barriers to students applying to the programme were identified. Whilst further research is required to better understand the barriers to academic medicine, national, free-to-access mentorship may effectively reduce differential attainment and improve accessibility amongst students.

Teaching in Paediatrics for UK Foundation Doctors: A Cross-Sectional Study.

Background Most doctors will care for children regularly during their careersin settings such as the emergency department, general practice, surgery,or, for a minority, during paediatric specialist training. As such, exposure to topics related to child health ought to be part of the broad curriculum of learning offered to UK Foundation Programme doctors. Objective This study aimed to quantify teaching in paediatrics that is accessed by Foundation doctors. Methods A cross-sectional electronic survey of foundation year one or two (F1/F2) doctors at the end of the 2020-2021 academic year. Ethical approval was granted by the Imperial College London (ICL) Education Ethics Review Process (EERP 2021-082). Results Two-hundred and five Foundation doctors completed the survey, from 16 of the 18 Foundation schools. Respondents attended a median of two hours (interquartile range (IQR) 0-10) of paediatric teaching during the past 12 months, including a median of one hour (IQR 0-2) of core teachingand a median of one hour (IQR 0-9) of non-core teaching. Those who had worked in a paediatric post in the past 12 months, or who were interested in Paediatrics as a career, attended more median hours of teaching. Conclusions Although many doctors will care for children routinely during their later careers, the number of teaching hours in paediatrics experienced by Foundation doctors is low. The UK Foundation Programme should incorporate more teaching in paediatrics to increase exposure to child health amongst newly graduated and as-yet unspecialised doctors.

Plasma metabolomic profiling of patients with transient ischemic attack reveals positive role of neutrophils in ischemic tolerance

Transient ischemic attack (TIA) induces ischemic tolerance that can reduce the subsequent ischemic damage and improve prognosis of patients with stroke. However, the underlying mechanisms remain elusive. Recent advances in plasma metabolomics analysis have made it a powerful tool to investigate human pathophysiological phenotypes and mechanisms of diseases. In this study, we aimed to identify the bioactive metabolites from the plasma of patients with TIA for determination of their prophylactic and therapeutic effects on protection against cerebral ischemic stroke, and the mechanism of TIA-induced ischemic tolerance against subsequent stroke. Metabolomic profiling using liquid chromatography-mass spectrometry was performed to identify the TIA-induced differential bioactive metabolites in the plasma samples of 20 patients at day 1 (time for basal metabolites) and day 7 (time for established chronic ischemic tolerance-associated metabolites) after onset of TIA. Mouse middle cerebral artery occlusion (MCAO)-induced stroke model was used to verify their prophylactic and therapeutic potentials. Transcriptomics changes in circulating neutrophils of patients with TIA were determined by RNA-sequencing. Multivariate statistics and integrative analysis of metabolomics and transcriptomics were performed to elucidate the potential mechanism of TIA-induced ischemic tolerance. Plasma metabolomics analysis identified five differentially upregulated metabolites associated with potentially TIA-induced ischemic tolerance, namely all-trans 13,14 dihydroretinol (atDR), 20-carboxyleukotriene B4, prostaglandin B2, cortisol and 9-KODE. They were associated with the metabolic pathways of retinol, arachidonic acid, and neuroactive ligand-receptor interaction. Prophylactic treatment of MCAO mice with these five metabolites significantly improved neurological functions. Additionally, post-stroke treatment with atDR or 9-KODE significantly reduced the cerebral infarct size and enhanced sensorimotor functions, demonstrating the therapeutic potential of these bioactive metabolites. Mechanistically, we found in patients with TIA that these metabolites were positively correlated with circulating neutrophil counts. Integrative analysis of plasma metabolomics and neutrophil transcriptomics further revealed that TIA-induced metabolites are significantly correlated with specific gene expression in circulating neutrophils which showed prominent enrichment in FoxO signaling pathway and upregulation of the anti-inflammatory cytokine IL-10. Finally, we demonstrated that the protective effect of atDR-pretreatment on MCAO mice was abolished when circulating neutrophils were depleted. TIA-induced potential ischemic tolerance is associated with upregulation of plasma bioactive metabolites which can protect against cerebral ischemic damage and improve neurological functions through a positive role of circulating neutrophils. National Natural Science Foundation of China (81974210), Science and Technology Planning Project of Guangdong Province, China (2020A0505100045), Natural Science Foundation of Guangdong Province (2019A1515010671), Science and Technology Program of Guangzhou, China (2023A03J0577), and Natural Science Foundation of Jiangxi, China（20224BAB216043).

Core competencies of K-12 computer science education from the perspectives of college faculties and K-12 teachers

Given the increasing needs of employees with computational skills, understanding the core competencies of K-12 computer science (CS) education is vital. This phenomenological research aims to identify critical factors of CS education in K-12 schools from the perspectives and visions of CS faculties in higher education and teachers in K-12 schools. This study adopted a phenomenological research design. The researchers conducted a semi-structured interview with 13 CS faculties and K-12 CS teachers in Michigan and analyzed the data using thematic analysis. The findings indicated that: (1) the core competencies for K-12 CS education include problem-solving through computational thinking, math background, and foundational programming skills, and (2) what is essential is not the programming languages taught in K-12 schools but computational thinking, which enables the learners to easily transfer from one language environment to another. The findings provide important implications for K-12 CS education regarding the core competencies and programming languages to be taught.

Taking a Break? The Growing Trend of FY3: Why More Junior Doctors are Taking Time Out after the Foundation Programme and What They Elect to Do?

There is a growing trend of UK doctors taking time out of clinical training following completion of the Foundation Programme. At a time when NHS services are facing unparalleled demand, considering the reasons why early career clinicians are deciding to delay entry into specialist training is paramount. Here, we describe some of the push and pull factors contributing to the “FY3” year phenomenon as well as the avenues doctors explore. Within the NHS, clinical fellowships can offer more flexibility in terms of rota and location compared to specialty training posts whilst also providing clinical experience and the chance to develop highly sought-after skills in teaching, research, and leadership. Similarly, locum rotas can be negotiated and usually offer significantly enhanced pay. Outside of the NHS, healthcare systems in Australia, New Zealand, and Canada actively seek out UK doctors, incentivising them with better work–life balance, increased pay, and improved working conditions, leading many doctors who had intended to return to the NHS to stay abroad. Doctors are also becoming increasingly aware of their transferable skills and the value they can bring to non-clinical roles in the pharmaceutical industry, management consulting, and medical law. Although the FP was originally introduced to address issues surrounding career progression and poor training experiences, current push factors for taking an “FY3” including increasing competition for specialty training posts, an imbalance towards service provision versus training, and high workload suggest systemic issues within the UK health service are undermining this aim and ultimately leading doctors to take time out of training.

ACADEMIC INTEGRITY ON M-READER: THE CASE OF FOUNDATION PROGRAM STUDENTS AT SULTAN QABOOS UNIVERSITY

-reader is an online extensive reading tool that motivates learners to read extensively and ‎autonomously. Through its online quizzes, M-reader tests students' comprehension of ‎graded readers and provides evidence that they have read and understood their reading. ‎Today, M-reader is used by several academic institutions around the world to facilitate ‎their extensive reading programs. However, concerns have been raised about academic ‎integrity in connection with M-reader. For instance, one of the foremost challenges of ‎administering M-reader is students taking quizzes on behalf of others. 229 first-year ‎university students enrolled in Sultan Qaboos University's Foundation Program (FP) in ‎Oman participated in the current study. The purpose of this paper was to investigate the ‎effectiveness of the measures implemented to reduce cheating on M-reader, as well as to ‎discover what students perceive as academic integrity on M-reader. To gauge the efficacy ‎of M-reader in maintaining academic integrity, participants completed an online ‎questionnaire and samples of the various measures were collected and analyzed. The ‎findings of the study revealed that the measures taken to mitigate academic integrity on M-‎reader were ineffective. The findings also indicated that M-reader appeared ineffective in ‎maintaining academic integrity among students. Additionally, the study identified how ‎students perceive the measures taken to mitigate cheating. Moreover, the study suggests ‎ways to improve the effectiveness of M-reader in terms of academic integrity.‎

Transplacental transfer efficiency of maternal antibodies against influenza A(H1N1)pdm09 virus and dynamics of naturally acquired antibodies in Chinese children: a longitudinal, paired mother–neonate cohort study

The 2009 pandemic H1N1 influenza A virus (A(H1N1)pdm09 virus) evolves rapidly and has continued to cause severe infections in children since its emergence in 2009. We aimed to characterise the kinetics of maternally and naturally acquired antibodies against historical A(H1N1)pdm09 strains and to assess the extent to which the response to heterologous strains following infection or vaccination affects observed A(H1N1)pdm09 strain-specific antibody titres in a Chinese paediatric population. In this retrospective study, we used residual serum samples from 528 mother-neonate pairs from a non-interventional, longitudinal cohort study in southern China conducted from Sept 20, 2013, to Aug 24, 2018, from six local hospitals in Anhua County, Hunan Province, China. Mother-neonate pairs were eligible for inclusion if the neonates were born after Sept 20, 2013, and their mothers had resided in the study sites for at least 3 months. We tested samples with a haemagglutination inhibition (HAI) assay to measure antibody levels against three historical A(H1N1)pdm09 strains that were antigenically similar to the strains that circulated during the 2009 pandemic (A/Hunan-Kaifu/SWL4204/2009 [SWL4204/09 strain], A/Hunan-Daxiang/SWL1277/2016 [SWL1277/16 strain], and A/Hunan-Yanfeng/SWL185/2018 [SWL185/18 strain]). We also determined the seroprevalence, geometric mean titres (GMTs), transfer ratio of maternal antibodies, and the dynamics of maternally and naturally acquired antibodies in children, from birth to 3 years of age. 1066 mother-neonate pairs were enrolled in the original cohort between Sept 20, 2013, and Oct 14, 2015. Of these, 528 pairs (523 mothers, 528 neonates) were selected for the present study. The median age of the mothers was 25 years (IQR 23 to 29). 291 (55%) of 528 children were boys and 237 (45%) were girls, and most children (452 [86%]) were breastfed before the age of 6 months. The GMTs and the seroprevalence for the SWL4204/09 strain were higher than those for the SWL1277/16 and SWL185/18 strains among mothers (GMTs: 10·4 [95% CI 9·8 to 11·1] vs 9·3 [8·7 to 9·8] vs 8·0 [7·5 to 8·4], p<0·0001; seroprevalence: 11·1% [95% CI 8·5 to 14·1] vs 6·9% [4·9 to 9·4] vs 4·6% [3·0 to 6·8], p=0·0003) and among neonates (GMTs: 10·7 [10·0 to 11·5] vs 9·4 [8·8 to 10·0] vs 8·1 [7·6 to 8·6], p<0·0001; seroprevalence: 13·4% [10·7 to 16·7] vs 8·7% [6·5 to 11·5] vs 6·1% [4·2 to 8·5], p=0·0002). Regardless of the A(H1N1)pdm09-specific strain, maternal antibodies could be transferred efficiently via the placenta (mean transfer ratios: 1·10 for SWL4204/09 vs 1·09 for SWL1277/16 vs 1·06 for SWL185/18; p=0·93). The A(H1N1)pdm09 strain-specific antibodies waned below the protective threshold of 1:40 within 2 months after birth. After maternal antibody waning, there were periodic increases and decreases in HAI antibody titres against three A(H1N1)pdm09 strains, and such increases were all significantly associated with a higher immune response to heterologous strains. Vaccination against the SWL4204/09 strain was associated with a poor response to the SWL185/18 strain (β-0·20, 95% CI -0·28 to -0·13; p<0·0001). Our findings suggest low pre-existing immunity against influenza A(H1N1)pdm09 virus among unvaccinated Chinese adult female and paediatric populations. This evidence, together with the rapid decay of maternal antibodies and the observed cross-reactivity among different A(H1N1)pdm09 strains, highlights the importance of accelerating maternal and paediatric influenza vaccination in China. The Key Program of the National Natural Science Foundation of China. For the Chinese translation of the abstract see Supplementary Materials section.

ARE EXTRA CURRICULAR ACTIVITIES IMPORTANT FOR GENERAL FOUNDATION PROGRAMME STUDENTS?

Extracurricular activities (ECAs) play a vital role in shaping students’ lives. These activities have been embedded in Higher Education Institutions (HEIs) to complement the curriculum, and augment students’ educational experience. In addition, they are organized to stimulate students’ interpersonal skills, such as leadership, time-management, and communication skills. This paper aims to explore the perceptions of General Foundation Programme (GFP) students regarding the extracurricular activities (ECA) organized by the Centre for Foundation Studies (CFS) of an Omani HEI. It also aims to investigate the role of these activities in enhancing students’ English language proficiency and transferable skills. A survey questionnaire was used to collect students’ perceptions of extracurricular activities. The results indicate that more than 70% of students participating in this study are satisfied with the ECA. Moreover, the participants in this study claimed that participation in ECAs has supported their academic performance and helped them develop their transferable skills. 30% of the participants showed disinterest in participating in extracurricular activities due to the absence of motivation, being in mixed classes, and the fact that no grades are awarded for these activities. This study was conducted on a small population of GFP students; however, it has important implications for education providers in terms of designing extracurricular activities in line with the learning outcomes and student interests. Future studies conducted on larger populations will yield more concrete results.

Educational impact of COVID-19 on foundation doctors and the decision to take a break from structured approved training programmes in the United Kingdom.

The COVID-19 pandemic impacted the Foundation Programme for doctors in the United Kingdom. Foundation doctors were working under increased pressure and significant changes were made to their training. The aim of this study is to explore the educational impact the COVID-19 pandemic had on foundation doctors and to understand how this resulted in doctors choosing to take time away from structured training programmes within the United Kingdom to make up for lost educational opportunities. In this phenomenological research, semi-structured interviews were carried out with post-foundation doctors who had completed their training during the pandemic. The data collected from these interviews were coded to carry out a thematic analysis. All 12 participants reported that their formalised teaching had been cancelled, and due to the pandemic, many doctors felt that service provision was prioritised over their postgraduate education. Some doctors had positive experiences of informal teaching; however, many felt they missed out on educational opportunities. Doctors acknowledged that this was a contributing factor when deciding to take time out of training. This also resulted in doctors seeking educational opportunities outside of training. The pandemic created many educational challenges for foundation doctors; this has contributed to doctors deciding to take time away from training. In some cases, due to a focus on service provision and their 'lost education', doctors are using time away from training to address their own specific educational needs. The impact of this 'lost education' requires further research and needs to be considered when doctors do apply to speciality training.

Implementation of Remedial Feedback and Observable Progression System in GFP English Writing

Despite the fact that teachers and students disagree about feedback methods and its efficacy continues to be a major issue in higher education, it is universally understood that effective feedback improves students' performance. This highlights the necessity for a thorough study and greater justification of any potential discrepancies in practices and behaviour. This study aims to investigate and explore both teachers' and students' acceptance of written corrective feedback and concerted effort towards observable improvement. This study also intends to evaluate related narratives, methods, and constraints that prevent or augment such effectiveness. Furthermore, the outcome of this research will focus on designing and implementing the written corrective feedback as an observable improvement strategy in General Foundation Program (GFP) English writing classrooms. To substantiate the research objectives, an experimental and a control group consisting of 10 teachers each and 100 GFP English students with 25 from level 3 will be subjected for experimental evaluation.

The Booms and Busts of Beta Arbitrage

Low-beta stocks deliver high average returns and low risk relative to high-beta stocks, an opportunity for professional investors to “arbitrage” away. We argue that beta-arbitrage activity generates booms and busts in the strategy’s abnormal trading profits. In times of low arbitrage activity, the beta-arbitrage strategy exhibits delayed correction, taking up to three years for abnormal returns to be realized. In contrast, when arbitrage activity is high, prices overshoot and then revert in the long run. We document a novel positive-feedback channel operating through firm leverage that facilitates these boom-and-bust cycles. This paper was accepted by Lukas Schmid, finance. Funding: This work is financially supported by National Natural Science Foundation of China [NSFC Grant Number 72303226] and the Key Program of National Natural Science Foundation of China [NSFC Grant Number 72233003]. Supplemental Material: The internet appendix and data are available at https://doi.org/10.1287/mnsc.2023.4929 .

CHARACTER EDUCATION MANAGEMENT MODEL DEVELOPMENT IN SOCIETY (Case Study at the Bandung Istiqamah Foundation)

The purpose of this study is to identify the moral principles that the social institution Istiqamah Bandung Istitution has implanted. This study is a qualitative investigation. The data for this type of case study research was gathered through interviews with the board of foundations about the implementation of character education and the management model of character education, as well as observation to track the character education development model. Results study, which focuses on character development and management, is continuously done in the social, religious, and educational sectors of employment. The Bandung Istiqamah Istitution emphasizes a number of qualities in the formation and development of character. These principles include: religion, honesty, decency, discipline, toleration, concern for others, and respect for accomplishment. The inhabitants of the Istiqamah Bandung Foundation, Islamic law based on the Qur'an and Sunnah, and the Foundation's areas of operation are the foundational elements of the Foundation's character education program.

Receptive Vocabulary Size of Omani Post-Basic Education Graduates

This descriptive study examined the receptive vocabulary size of Omani post-basic education graduates. Also, it investigated the relationship between receptive vocabulary size and language proficiency among these students. Finally, it examined differences in receptive vocabulary size with respect to gender. The sample consisted of 294 Omani post-basic education graduates (183 males and 111 females) who were enrolled in foundation programs at Sultan Qaboos University. The study instrument was the Vocabulary Level Test Version B, which was developed by Nation (1983) and revised by Schmitt, Schmitt, and Clapham (2001). The study found that the Omani post-basic graduates had a small receptive vocabulary of approximately 1,725 word families. It also found a statistically significant relationship between students’ receptive vocabulary size and their language proficiency. Finally, it revealed statistically significant differences in receptive vocabulary size with respect to gender in favor of female students. Accordingly, the researcher provides recommendations for practice and further research.

Incidence, process of care, and outcomes of out-of-hospital cardiac arrest in China: a prospective study of the BASIC-OHCA registry

Out-of-hospital cardiac arrest (OHCA) is an important global public health issue, but its epidemiology and outcomes in low-income and middle-income countries remain largely unknown. We aim to comprehensively describe the incidence, process of care, and outcomes of OHCA in China. In the prospective, multicentre, population-based Baseline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA) registry study, participating sites were selected from both urban and rural areas in all seven geographical regions across China. All patients with OHCA assessed by emergency medical service (EMS) staff were consecutively enrolled from Aug 1, 2019, to Dec 31, 2020. Patients with suspected cardiac arrest assessed by bystanders whose return of spontaneous circulation was achieved without the need for defibrillation or EMS personnel cardiopulmonary resuscitation were excluded. Patients with all key variables missing were excluded, including resuscitation attempt, age, sex, witnessed status, cause, all process of care indicators, and all outcome measures. In this analysis, we included data for EMS agencies serving 25 monitoring sites (20 urban and five rural) that included the entire serving population, data for the whole of 2020, and at least 50 OHCA patients in 2020. Data were collected and reported using the Utstein template. We calculated the crude incidence of EMS-assessed OHCA in 2020. We also report data on baseline characteristics (including sex, cause, location of OHCA, and presence of shockable rhythm), process of care (including EMS response time, cardiopulmonary resuscitation, defibrillation, and advanced life support), and outcomes of non-traumatic OHCA between Aug 1, 2019, and Dec 31, 2020, including survival and survival with favourable neurological outcomes at discharge or 30 days, and at 6 and 12 months. Of 115·1 million people served by the 25 participating sites, 132 262 EMS-assessed patients with OHCA were enrolled, and resuscitation was attempted for 42 054 (31·8%) patients between Aug 1, 2019, and Dec 31, 2020. The crude incidence of EMS-assessed OHCA was 95·7 per 100 000 population (95% CI 95·6-95·8) in 2020. Among 38 227 individuals with non-traumatic OHCA, 25 958 (67·9%) were male, 30 282 (79·2%) had a cardiac arrest at home, 32 523 (85·1%) had a presumed cardiac cause, and 2297 (6·0%) presented with an initial shockable rhythm. 4049 (11·5%) of 35 090 patients with an unwitnessed or bystander-witnessed OHCA received dispatcher-assisted cardiopulmonary resuscitation and 7121 (20·3%) received bystander cardiopulmonary resuscitation; only 14 (<0·1%) patients were assessed by bystanders with an automated external defibrillator. The median EMS response time was 12 min (IQR 9-16). At hospital discharge or 30 days, 441 (1·2%) of 38 227 survived, 304 (0·8%) survived up to 6 months, and 269 (0·7%) up to 12 months. At hospital discharge or 30 days, 309 (0·8%) survived with favourable neurological outcomes, 257 (0·7%) had favourable neurological outcomes at 6 months, and 236 (0·6%) at 12 months. Our findings revealed a high burden of EMS-assessed OHCA with a low proportion of resuscitation attempts. The suboptimal implementation of chain of survival and unsatisfactory prognosis call for national efforts to improve the care and outcomes of patients with OHCA in China. The National Science & Technology Fundamental Resources Investigation Program of China, the State Key Program of the National Natural Science Foundation of China, Taishan Pandeng Scholar Program of Shandong Province, the Key Research & Development Program of Shandong Province, the Interdisciplinary Young Researcher Groups Program of Shandong University, the Clinical Research Center of Shandong University, the ECCM Program of Clinical Research Center of Shandong University, and the Natural Science Foundation of Shandong Province.