Feedback Information Research Articles

Welcome to the operating theatre! Introductory bootcamp in operating theatre specialities for medical students.

Since the early 2000's, the appeal of certain operating room specialties has decreasedamong medical school graduate students. The recent reform of the second and third cycles of medical studies in France provides an opportunity to set up teaching programs around operating room specialties. We have organised a teaching unit which is part of the final year of medical studies. The main objectives are: (1) to examine whether a boot camp can modify students' opinions and preconceived assumptions about a surgical and/or anaesthetist career (2) to determine whether these changes in perception, have an impact on students' interest in pursuing a surgical/anaesthetic career compared with the current situation. The "working in the operating theatre" boot camp (UETB) took place after the written exams of the sixth year of medical school, before students choose their future specialty for residency. This program included practical workshops, readings and time for exchanges surgeons and anaesthetists. At the beginning and at the end of the UETB, feedback forms were collected. The cohort included 59 students from the Toulouse medical school, academic year 2023-2024. After attending the UETB, there was a significant qualitative improvement in interest in a surgical and intensive care-anaesthesia career. Feedback on how the UETB influenced the choice of a future specialty was very positive, with statistically significant qualitive improvement., Additionally, the students' perception of a work-life quality as a surgeon and/or anaesthetist improved significantly. The outcome of this study makes a strong case for integrating additional exposure to the various surgical subspecialties into the graduate medical curriculum in France. By helping to dispel misperceptions of "a surgical/anaesthetist career" early on, opportunities such as the UETB program may enable addressing the attrition rate observed among surgical and anaesthetic residency applications.

Assessing the feasibility and acceptability of a hands-on surgical robotics workshop for medical students and early-career doctors.

Despite the increased adoption of robotic surgery across various specialities, medical students and early-career doctors have limited exposure. This study aims to assess the feasibility and acceptability of a hands-on surgical robotics workshop for those early-career medics. 26 participants with minimal prior exposure to robotic surgery attended a workshop using the Versius© robotic surgical system and Virtual Reality simulation platforms. We analysed pre-workshop registration form and post-workshop feedback form utilising mixed quantitative and qualitative approach. Pre-workshop registration revealed motivations and barriers to attending surgical robotics courses. Post-workshop evaluations showed significant improvements in self-assessment scores, familiarity with robotic surgery, and confidence in using the technology. All participants expressed a strong enthusiasm for greater access to robotic surgery education and 84% of participants strongly agreed this workshop increased their interests in surgical specialities. The study also highlighted the perceived ease of use of robotic systems compared to laparoscopic instruments and explored the potential of virtual reality in surgical training. Further efforts are needed for better integration of robotic surgery training into medical curricula to prepare future surgeons for the evolving surgical landscape.

Effects of posttransfer feedback informativeness in a transitive inference task.

Transitive inference (TI), referring to one's ability to learn that if A > B and B > C, one can infer that A > C, is a form of serial learning that has been tested using a variety of experimental protocols. An element of most of these protocols is the presentation of some form of visual corrective feedback to help inform naïve participants about the nature of the task. Therefore, corrective feedback is often used as a critical tool for experimental TI. To further explore this tool, we presented varying forms/presence of visual feedback during TI performance: corrective, none, and ambiguous. Of the three conditions, presentation of the ambiguous feedback yielded the clearest disruption of TI performance, obvious in measurements of both response accuracy and reaction times. Participants appears to remain engaged with feedback was withheld entirely, but to disengage when presented with ambiguous feedback. Therefore, the choice regarding the form of feedback provided during testing may be critical for information processing of inferences.

Formative feedback through digital MCQs: Students´ perceived learning in a bachelor-level physiology course

Feedback is defined as a process in which students can benefit from information about their own performance to improve the quality of their work and learning strategies. This case study examines how students in a bachelor-level physiology course experienced their learning when receiving formative feedback through digital multiple-choice questions (MCQs) in the web-based learning platform Canvas. The poorly attended colloquia in the course were replaced by a compulsory assignment comprising eight modules of MCQs. The MCQs could be repeated multiple times by the students providing ample low threshold, low risk opportunities to test knowledge and understanding and to receive feedback on whether they had achieved the learning objectives of the course (“feedback loops”). A student survey at the end of the course underlined the potential of using MCQs for automated feedback and learning. Thematic analysis of semi-structured one-on-one interviews with eight random students from the course identified two main themes related to student learning: the importance of the MCQs format and how student characteristics can affect MCQ-aided learning. Challenges were related to the formulations of the MCQs, and the feedback received, and to procrastination of the students’ work with the MCQs reducing the learning outcome of the work. We discuss the potential of further developing and integrating online formative feedback loops through MCQs as a systematic approach to enhance learning and emphasize the importance of student and teacher feedback literacy when working with assessments tasks such as MCQs.

The role of early orthotic intervention in the management of post-traumatic elbow contractures: Study protocol for phase II double-blinded randomised controlled trial

Background Restoration of full elbow extension following trauma is difficult and influenced by the injury profile, surgeon preference, patient and environmental factors. The literature suggests that orthotic interventions are effective in improving contractures when movement plateaus despite normal therapeutic interventions. It is not known if extension orthotic intervention is more superior to standard treatment regardless of when it is commenced. The literature lacks patient-reported considerations to contracture management using elbow orthoses. Methods and analysis This protocol describes a Phase II double blinded randomised controlled feasibility trial (RCT) and mixed methods study, aimed to examine outcome with extension in an orthotic intervention group (OG) versus control (CG). All participants will undergo six weekly therapy sessions, which include a standardised therapeutic program. OG participants will be provided with an additional extension orthosis and the outcome is assessed according to the change in elbow extension motion after 6 weeks of intervention. Data will be collected via questionnaires, logbooks, feedback forms, and semi-structured interviews at baseline and final assessments for descriptive statistical analysis. Under the guidance of a statistician, all quantitative data will be evaluated using the appropriate parametric or non-parametric analyses to evaluate for systematic differences between groups. Preliminary extension gains are used to determine the final sample size required to achieve adequate power for a full-scaled RCT. Interview data on OG participants will be qualitatively analysed using the “five-factorial dimensions of adherence” framework to identify key differences in the influencers between adherent or non-adherent groups. Trial registration number ANZCTR ACTRN12619001402134p.

Learning the Universe: GalactISM Simulations of Resolved Star Formation and Galactic Outflows across Main-sequence and Quenched Galactic Environments

We present a suite of six high-resolution chemodynamical simulations of isolated galaxies, spanning observed disk-dominated environments on the star-forming main sequence, as well as quenched, bulge-dominated environments. We compare and contrast the physics driving star formation and stellar feedback among the galaxies, with a view to modeling these processes in cosmological simulations. We find that the mass loading of galactic outflows is coupled to the clustering of supernova explosions, which varies strongly with the rate of galactic rotation Ω = v circ/R via the Toomre length, leading to smoother gas disks in the bulge-dominated galaxies. This sets an equation of state in the star-forming gas that also varies strongly with Ω, so that the bulge-dominated galaxies have higher midplane densities, lower velocity dispersions, and higher molecular gas fractions than their main-sequence counterparts. The star formation rate in five out of six galaxies is independent of Ω and is consistent with regulation by the midplane gas pressure alone. In the sixth galaxy, which has the most centrally concentrated bulge and thus the highest Ω, we reproduce dynamical suppression of the star formation efficiency in agreement with observations. This produces a transition away from pressure-regulated star formation.

Development and Validation of a Low-Cost, High-Fidelity Simulation Model for Robotic Internal Mammary Artery Harvest Using the da Vinci Xi Robot.

We created and validated a low-cost simulation model for robotic internal mammary artery (IMA) takedown. The simulation model utilized a calf fetus thorax cavity stented open internally and secured to a table. The simulation model was validated at a 2-day robotic cardiac surgery workshop. Each participant harvested one IMA using the da Vinci Xi robot (Intuitive Surgical, Sunnyvale, CA, USA). We compared participant self-reported confidence at robotic IMA harvest before and after using the simulator. Our novel thorax-securing strategy resulted in a stable structure and allowed access to both IMAs from the same 3 ports. The cost to set up the first simulation model was $176 and $133 for every subsequent model. Fifty participants used the simulation model: 42 cardiothoracic surgery attendings and 8 fellows or residents. The feedback form response rate was 78% (n = 39). On the Likert scale, participants rated realism of the calf model to simulate robotic IMA harvesting (0 = not realistic, 10 = highly realistic) with a median of 8 out of 10 (interquartile range [IQR] 7 to 9). Participant confidence (0 = not at all confident, 10 = very confident) in robotic IMA harvesting before and after using the simulator increased (P = 0.001) from a median of 5 (IQR 1 to 7) to 9 (IQR 7 to 10). This robotic IMA harvest simulation model is affordable, realistic, and improved participant confidence in robotic IMA harvest. It may provide a valuable training tool for surgeons learning robotic coronary bypass surgery and allows for training frequency necessary to pass basic learning curves.

Systematically Measuring Ultradiffuse Galaxies. VII. The H i Survey Overview

We present the results from the neutral hydrogen (H i) follow-up survey of 378 optically detected ultradiffuse galaxy (UDG) candidates from the Systematically Measuring Ultra-Diffuse Galaxies survey using the Robert C. Byrd Green Bank Telescope. We detect H i in 110 targets and determine 37 to be UDGs and 73 to be low-surface-brightness (LSB) dwarfs based on their effective radii and central surface brightnesses. In line with previous studies, we find that: (i) our H i detections have on average bluer g − r colors and more irregular morphologies than our H i nondetections, (ii) our H i detections populate the tail end of the star-forming main sequence from the ALFALFA catalog with marginally lower specific star formation rates, and (iii) H i detections are mostly in relatively isolated (i.e., field) environments, while most nondetections have at least one nearby neighbor in projection. We find that the H i mass to stellar mass ratios (i.e., gas richnesses) scale with the physical sizes for UDGs and LSB dwarfs alike, suggesting that mechanisms other than bursty star formation feedback may be at play for UDGs. However, we find a stronger trend between gas richnesses and physical sizes if we define UDGs using their effective surface brightness instead of their central surface brightness. We are in the process of using this unprecedented sample of UDG candidates to carry out detailed follow-up studies (i.e., star formation and environmental analysis, comparisons to simulations) and are obtaining resolved H i observations for several of them.

Crowd-Sourced Assessment of Laparoscopic Surgical Skills for Ob/Gyn Residents

Importance Feedback is an essential part of graduate medical education. With increasing demands on time and fewer opportunities for formal feedback in residency, there is an increasing need for objective and actionable feedback. Objective To understand how the Crowd-Sourced Assessment of Technical Skills (CSATS) assessment of residents’ laparoscopic skills compares with the current faculty assessment in an obstetrics/gynecology residency program. Design, Setting, and Participants This was a prospective educational intervention study involving residents from a single academic obstetrics/gynecology residency program at a large tertiary teaching hospital. Individual performance videos of hysterectomies, myomectomies, and endometriosis resections were recorded and uploaded to the CSATS database where they were analyzed. Formal written feedback reports from the CSATS system were sent to the residents. Residents then completed a survey addressing satisfaction, timeliness, and utility of the CSATS feedback method overall and in comparison with the residency’s in-person feedback and with the standard written, electronic feedback evaluation. Results A total of 16 residents submitted 65 videos of operations. Overall comparison of CSATS vs faculty evaluation was equivalent. Residents found that CSATS response time was slower than receiving in-person feedback from faculty. When comparing CSATS with the standard feedback form, residents felt strongly that CSATS was superior for both surgical skill feedback and procedure evaluation, with both categories having a mean top score. When comparing low-volume CSATS utilization vs high-volume CSATS utilization, there were no statistical differences. Overall, residents reported high satisfaction with CSATS evaluation. Conclusions Residents were generally satisfied with CSATS as an overall feedback tool. CSATS could be a possible addition to help improve resident education.

Addressing deficits in malnutrition care in northern Sierra Leone; an educational intervention

Abstract The 2017 Sierra Leone National Nutrition Survey reported poor practice regarding the medical management of severe acute malnutrition and the provision of emergency food to patients, particularly in the northern city of Makeni. We developed a training package for paediatric nurses, aiming to design an easily reproducible format which could be utilised nationally. Our aims were to empower and educate staff to provide more consistent care by challenging the negative cultural perception of malnourished patients and increasing knowledge of key guidelines. A two-day course based around UNICEF guidance on malnutrition was developed with the financial support of the Sierra Leonean office of the World Health Organisation. We sought the advice of local staff on issues impacting the quality of malnutrition care, including cultural barriers, educational limitations and supply issues. Lectures and practical sessions were devised covering recognition, assessment and management. Communication skills were taught using role play, focussing on the key role of nurses in parental education, and nursing skills were reinforced using practical tasks. Local staff identified for their strong teaching and leadership were recruited as instructors and to provide feedback on session design and content. 21 candidates attended from across the region, with the majority based in inpatient feeding units. Candidates completed a pre- and post-course written examination and a qualitative feedback form. Pre-course exam results ranged from 35%-85% with an average of 65%; post-course results showed improvement with a range of 55%-100% and an average of 88%. Candidates rated the course on average 9.7 out of 10 and the written feedback was positive. We subsequently observed positive changes in clinical practice in the inpatient feeding units across the region. Based on these assessments the course achieved its aims. Further study is needed to know if noted clinical improvements were sustained. Key messages • Challenging local cultural perceptions of malnourished patients is crucial to establishing improvement in medical care for this group. • Sustainable educational intervention requires local instructors who can independently deliver teaching, and establishing this cohort at the course inception is critical to its ongoing success.

Enhancing cardiology trainee competence through simulation-based pericardiocentesis training: a pilot programme evaluation

Abstract Introduction Cardiology training requires trainees to manage clinical duties whilst developing practical skills. Changes to the UK curriculum have resulted in reduced time available for procedural teaching. Pericardiocentesis is one of many required competencies. The Joint Royal College of Physicians Training Board cardiology curriculum cites the importance of simulation-based education to teach procedures. Procedural training encompasses the development of clinical reasoning alongside motor skills. Gange (1962) and Carless (2010) emphasized the importance of expert-guided practice, interactive teaching, and instant feedback in motor skills teaching to maximize the educational experience. Aim Develop a simulation teaching programme to enhance trainees' confidence and competency in pericardiocentesis. Procedures form part of a summative Direct Observation of Procedural Skills, enabling trainees to learn in a safe environment and use as evidence at their Annual Review of Competence Progression (ARCP). Method We developed a pilot programme for pericardiocentesis facilitated through high-fidelity equipment between February 2023 and February 2024. Participants were recruited through medical education departments. The sessions were delivered on a one-to-one basis by a cardiology consultant to facilitate discussion and interactivity. The teaching involved a core knowledge presentation, discussion of trainee experiences, case studies as examples, including review of echocardiography features. This was followed by clinical skills teaching of pericardiocentesis, utilizing a model, and transthoracic echocardiography. Trainees were sent anonymous feedback forms after the session. Results 46 cardiology registrars participated; 48% were within their first few years of training. 87% reported difficulty in practicing this skill in clinical practice due to: lack of exposure, other clinical responsibilities taking priority, and the need for consultant-delivered care on patients requiring an urgent or emergency procedure. Mean trainee confidence before teaching was 3.24 out of 5 (SD = 1.14), with a significant improvement to 4.48 (SD = 0.59 p<0.001). 52% improved in confidence by 1 unit and, 31% improved in confidence by 2 or more units. Trainees reported the following themes regarding the session: knowledgeable trainer, high fidelity equipment, instant feedback to predict, prevent, and overcome challenges, and a multi-modal approach to teaching, incorporating presentation and discussion on pericardial effusion, tamponade, and drainage. Conclusion Our programme offers a unique multi-modal teaching approach, with dedicated time with an expert. We supported the progress of 46 trainees and enhanced their training competencies. We aim to expand the programme to incorporate more procedures in line with growing curriculum requirements. Tracking trainee progress until ARCP outcomes will reveal the impact of simulation teaching on their experience and professional development.

Finite-time bounded security control of networked switched stochastic systems

This paper is dedicated to discussing stochastic finite-time bounded control of switched stochastic systems with feedback information sampled by an event-triggered mechanism and transmitted by network. Besides the incomplete information because of sample, data loss and corruption during information transmission caused by hybrid cyber attacks including DoS attacks and false-data injection attacks, are also taken into consideration. Based on the above incomplete information, state feedback controllers are established to fulfil stochastic finite-time boundedness of switched stochastic systems and make it have a certain disturbance attenuation capability, i.e. have a finite-time L 2 -gain, successfully. Sufficient conditions are cast into a convex optimisation problem which can be easily solved by fixing some parameters. Simulation results are employed to verify the validity of results.

Finite-Time Synchronization Criteria for Caputo Fractional-Order Uncertain Memristive Neural Networks with Fuzzy Operators and Transmission Delay Under Communication Feedback

Unlike existing memristive neural networks or fuzzy neural networks, this article investigates a class of Caputo fractional-order uncertain memristive neural networks (CFUMNNs) with fuzzy operators and transmission delay to realistically model complex environments. Especially, the fuzzy symbol AND and the fuzzy symbol OR as well as nonlinear activation behaviors are all concerned in the generalized master-slave networks. Based on the characteristics of the neural networks being studied, we have designed distinctive information feedback control protocols including three different functional sub-modules. Combining comparative theorems, inequality techniques, and stability theory, novel delay-independent conditions can be derived to ensure the finite-time synchronization (FTS) of fuzzy CFUMNNs. Besides, the upper bound of the settling time can be effectively evaluated based on feedback coefficients and control parameters, which makes the achievements of this study more practical for engineering applications such as signal encryption and secure communications. Ultimately, simulation experiments show the feasibility of the derived results.

Enhancing legal writing skills: The impact of formative feedback in a hybrid intelligence learning environment

AbstractRecent developments in artificial intelligence (AI) have significantly influenced educational technologies, reshaping the teaching and learning landscape. However, the notion of fully automating the teaching process remains contentious. This paper explores the concept of hybrid intelligence (HI), which emphasizes the synergistic collaboration between AI and humans to optimize learning outcomes. Despite the potential of AI‐enhanced learning systems, their application in a human‐AI collaboration system often fails to meet anticipated standards, and there needs to be more empirical evidence showcasing their effectiveness. To address this gap, this study investigates whether formative feedback in an HI learning environment helps law students learn from their errors and write more structured and persuasive legal texts. We conducted a field experiment in a law course to analyse the impact of formative feedback on the exam results of 43 law students, as well as on the writer (students), the writing product and the writing process. In the control group, students received feedback conforming to the legal common practice, where they solved legal problems and subsequently received general feedback from a lecturer based on a sample solution. Students in the treatment group were provided with formative feedback that specifically targeted their individual errors, thereby stimulating internal cognitive processes within the students. Our investigation revealed that participants who were provided with formative feedback rooted in their errors within structured and persuasive legal writing outperformed the control group in producing qualitative, better legal text during an exam. Furthermore, the analysed qualitative student statements also suggest that formative feedback promotes students' self‐efficacy and self‐regulated learning. Our findings indicate that integrating formative feedback rooted in individual errors enhances students' legal writing skills. This underscores the hybrid nature of AI, empowering students to identify their errors and improve in a more self‐regulated manner. Practitioner notesWhat is already known about this topic Collaboration between humans and AI in educational settings advances learning mutually, fostering a unified developmental process. Collaborative education models advocate leveraging human and AI strengths for adaptive learning. Despite abundant theoretical research, empirical studies in HI remain limited. This gap underscores the need for more evidence‐based approaches in integrating AI into educational settings. What this paper adds Field experiment investigating the impact of formative feedback in a hybrid intelligence learning environment based on the theory of learning from errors. Comparison of a traditional legal learning environment (lecturer teaching using sample solutions) versus formative feedback in a hybrid intelligence learning environment. Implementing formative machine learning‐based feedback supports law students in producing more structured and persuasive legal texts, leading to enhanced exam performance and higher grades. Implications for practice and/or policy Our research contributes significantly to computer‐based education by presenting empirical evidence of how formative writing feedback impacts students' legal knowledge and skills in educational settings. This underscores the importance of incorporating empirical data into the development of AI‐based educational tools to ensure their effectiveness. By focusing on individual errors corrected by formative feedback, we contribute to the learning from errors literature stream. This perspective offers valuable insights into how such feedback can support students' writing and learning processes, filling a gap in empirical evidence. Our findings demonstrate the potential impact of ML‐based learning systems, particularly in large‐scale learning environments like legal mass lectures. Formative writing feedback emerges as a scalable and beneficial addition to traditional learning environments, triggering internal learning processes, fostering self‐regulated learning and increasing self‐efficacy among students. By demonstrating the effectiveness of formative feedback within the framework of HI, particularly in legal education, our research underscores the potential of combining human understanding with AI‐supported feedback to enhance learning outcomes.

Development, field testing, and initial validation of an adherence rubric for caregiver coaching

IntroductionThe translation and use of evidence-based practices (EBPs) within early intervention (EI) systems presents challenges. The Office of Special Education (OSEP) has emphasized results-driven accountability to expand state accountability from compliance to also include quality services that align with EBPs. OSEP’s results-driven accountability provided states the opportunity to design State Systemic Improvement Plans (SSIP) to strengthen the quality of EI services by increasing the capacity of EI systems to implement, scale-up, and sustain use of EBPs. Caregiver coaching is widely accepted as an EBP within EI settings, yet uptake and fidelity to coaching practices remains limited. Such widespread implementation of caregiver coaching is partially limited by a lack of measurement tools that operationalize behaviors consistent with coaching. In this study, we describe the development of the Kentucky Coaching Adherence Rubric-Revised (KCAR-R) and psychometric testing of the instrument.MethodsWe developed and tested the KCAR-R to measure fidelity of coaching practices within a state-wide professional development program, the Coaching in Early Intervention Training and Mentorship Program. We define operational elements of the KCAR-R and rubric design elements related to: creators; users and uses; specificity, judgment complexity; evaluative criteria; quality levels; quality definitions; scoring strategies; presentation; explanation; quality processes; accompanying feedback information; secrecy; and exemplars. With regard to psychometric validation of the KCAR-R, interrater reliability was analyzed using intraclass correlation coefficients across eight raters and 301 randomly selected video submissions. Internal consistency was evaluated using Cronbach’s alpha across 429 video submissions.ResultsResults showed 0.987 agreement, indicating excellent interrater reliability; item level internal consistency values ranged from 0.860 to 0.882. for scale if item deleted and 0.834 for the total scale.DiscussionFindings from this study showed that the KCAR-R operationalized behaviors that exemplify caregiver coaching and may serve as a resource for other states or programs to document the quality and fidelity of evidence-based EI services. To influence EI provider practices at a systems level, we used implementation science to guide our work and provide examples of how EI systems seeking ways to create sustainable quality services may build upon our approach.

Application of the Contemporary Psychometrics for Assessing Economic Literacy

Currently, new skills and various types of "new literacies" relevant to the modern world are becoming issues of growing importance. One of them is economic literacy; however, there are only few assessment instruments that fulfil the academic requirements for its assessment among university students. One of such internationally established instruments is the Test of Understanding in College Economics (TUCE), which is a popular tool in empirical studies of economic literacy in many countries around the world. Despite its advantages, the currently available version of the TUCE designed for American colleges back in 2006, is prone to cheating and provides limited opportunities for formative feedback. The purpose of this paper is to present the Updated Test of Understanding in College Economics (U-TUCE). In developing the U-TUCE, we utilized the capabilities of contemporary psychometrics, which offer sufficient advances in overcoming all limitations of the original TUCE mentioned before. First, we present a revised theoretical framework of the U-TUCE, highlighting that the test measures different types of mastery of economic literacy. Second, we describe the approaches used for modifying the TUCE items and developing new items. A half of the original test items have been replaced or redesigned to reflect the economic context that has changed since 2006. Third, we utilize the logic of automatic item generation algorithms to increaseg the level of test protection against cheating. We made all changes in such a way as to maintain comparability with the previous versions of the TUCE test if necessary. Finally, the use of the Item Response Theory (IRT) is paired up with that of Cognitive Diagnostic Modeling (CDM) to ensure the quality of the U-TUCE and enhance its formative value. We show that IRT can be used to estimate the construct as a whole (which is of interest to researchers, administrators, and policy makers), while CDM provides information relating to each of the construct components, which are of interest to educational practitioners and students themselves. The results of the data analyses show that the test can be used for both purposes simultaneously.

Best Evidence Summary for Management of Older People With Type 2 Diabetes Mellitus Using 'Internet Plus Nursing Services'.

To evaluate and summarise the evidence for the management of older people with Type 2 diabetes mellitus (T2DM) using 'Internet Plus nursing services (IPNS)'. This study was conducted as an evidence summary, adhering strictly to the evidence summary reporting standards established by Fudan University Center for Evidence-based Nursing. We systematically searched for the best available evidence pertaining to the management of older people with T2DM using the IPNS. The literature types encompassed clinical guidelines, expert consensuses, systematic reviews, evidence summaries and original research studies. In order to gather pertinent information, we conducted a comprehensive search across various databases, including UpToDate, BMJ Best Practice, Joanna Briggs Institute, Guidelines International Network, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Scottish Intercollegiate Guidelines Network, the Cochrane Library, PubMed, Web of Science, Yi Maitong Guidelines Network, SinoMed, CNKI, WanFang database, Chinese Biomedical Literature Database and China Science and Technology Journal Database. The search spanned from the inception of each database up to July 2023, ensuring an extensive coverage of relevant resources. After rigorous screening and evaluation, our study ultimately identified 19 articles with high-quality research outcomes. These articles consisted of three guidelines, two expert consensus documents, three systematic reviews and eleven original research studies. Through collaborative and in-depth discussions, we extracted and synthesised 27 pieces of evidence related to the application of the IPNS to enhance the T2DM management for older people. We categorised the evidence into five primary themes: mobile terminal design, team building, health education design, interaction and social support, and information feedback. In designing the IPNS for older people with T2DM, utmost attention should be paid to the intricacies of Internet module development preceded by comprehensive guidance. It is imperative to establish multidisciplinary teams to oversee the curation of patient educational content, ensuring its relevance and effectiveness. Leveraging Internet-based information feedback mechanisms is crucial for fostering peer support, assisting in blood glucose control, enhancing self-management capabilities and ultimately improving overall quality of life. Healthcare professionals are supposed to customise the IPNS for this vulnerable population, taking into account institutional resources and local contextual realities. It is highly recommended that clinical medical personnel worldwide adhere to the evidence-based recommendations for better care of older people with T2DM using the IPNS. No patient or public contribution was incorporated in this study. Our study provides structured ideas for the application of IPNS in T2DM management, provides practicable new ways for IPNS to improve self-management of older people with T2DM, and encourages the provision of Internet-based nursing services based on the needs and characteristics of older people, and jointly solves the challenges of T2DM management in order to enhance the effectiveness of nursing services.

Promoting resilience among medical students using the Wadi framework: a clinical teacher's perspective.

Resilience is essential for medical students to navigate the challenges of their education and future careers. Defined as the ability to adapt well in the face of adversity, resilience can be learned and is critical for maintaining mental health. Medical educators play a pivotal role in fostering resilience by integrating it into both formal and informal curricula, including the hidden curriculum, which can significantly influence students' coping strategies. Research highlights the importance of resilience training in reducing depression and anxiety among students, underscoring its necessity as a core component of medical education. This essay presents the Systematic Assessment for Resilience (SAR) framework, which provides a comprehensive approach to promoting resilience through four key constructs: self-control, management, engagement, and growth. Practical strategies for each construct are discussed, including assessment mapping, time management, and the use of formative assessments to enhance students' preparedness and self-control. Engagement is fostered through collaborative assessments, open book exams, and regular formative feedback, while growth is encouraged via self-reflection and faculty development. Implementing the SAR framework has shown positive outcomes, with students reporting reduced anxiety and improved performance. However, further exploration and institutional support are needed to fully integrate these strategies into medical education. The SAR framework offers a feasible and effective method for cultivating resilience, contributing to students' mental well-being and equipping them to face future challenges in their medical careers. Continued refinement and broader institutional adoption will be crucial to sustaining the impact of resilience training in medical education.

Near Real-Time Responsive Flood Event Representation: An Open-Source Interactive Web Application Architecture

Abstract. The adoption of accessible Digital Twin technology in flood applications has been impeded by a notable lack of practical examples. Arguably, the most distinguishing feature of Digital Twin technology is the integration of near real-time data analytics through IoT sensor connectivity, which has remained underutilised in flood applications and therefore indicates a critical research gap. This project endeavoured to develop a comprehensive and replicable open-source architecture framework, specifically tailored for near real-time responsive flood event representation. The resultant interactive web application integrated near real-time river height and rain fall data streams and performed on-demand data analytics. Key results include the establishment of a back-end spatial database, a coupled physical city and digital space model, and a functional holistic front-end user interface. Additionally, this research aligned with the Gemini Principles by emphasising data interoperability and maintaining an information feedback loop. The study also aimed to configure near real-time IoT sensor connections, implement event triggers, and deliver interactive visualisations in an easily accessible format. The research addressed key questions surrounding the effective integration of IoT sensor data, identification of crucial flood indicators and parameters, and rapid quantification of flood event impacts. Ultimately, this research project demonstrates how Digital Twin technology can swiftly provide decision-makers with crucial insights during flood disaster events.

Patient and carer feedback and engagement with ECHOMANTRA, a digital guided intervention for anorexia nervosa.

We developed ECHOMANTRA, a digital guided intervention for patients with anorexia nervosa and their carers to provide support during transition from inpatient care to community settings. This study reports on participants' engagement with, and feedback of, ECHOMANTRA. Patients and carers (N=184 dyads) were given access to ECHOMANTRA for 12months. The intervention included online groups, a workbook and recovery-oriented videoclips. Satisfactory engagement was defined as attendance of a minimum of four online groups by each dyad. Participants received an Intervention Feedback Form to measure frequency of use and provide feedback of the intervention. Those who did not meet the engagement criterion were asked to complete an Obstacles to Engagement Form. 19% of the sample reached the engagement criterion. Seventy-six patients and 60 carers completed the Intervention Feedback Form. Of those, approximately 60% reported using at least a quarter of the workbook and videoclips. Overall, participants found the materials useful and easy to access (median=3 on a scale 1-5). Obstacles to engagement (35 patients and 14 carers) included lack of time due to caring responsibilities, treatment, work/school commitments. A more personalised form of support may be needed to enhance motivation and ability to change following inpatient care.