Ongoing Feedback Research Articles

Formative Assessment in Online Distance Learning Modality through the Lens of Mathematics and Science Teachers

Formative assessment provides ongoing feedback to monitor student learning and improve teachers’ instruction. But the COVID-19 pandemic has changed the mode of learning delivery and has affected formative assessment. Hence, the researchers explored the practices, challenges, and adaptive strategies of Mathematics and Science Senior High school teachers on formative assessment of students’ learning in an online distance learning modality. Narrative inquiry research design was used in which eight teachers and six students who were chosen through convenience sampling were subjected to in-depth interview. The audio-recorded interviews were transcribed and underwent coding, categorizing, and thematizing. Results revealed that teachers employ practices that allow them to provide immediate feedback, utilize online assessment tools, probe questions, encourage students’ active participation, and align learning competencies with formative assessment. However, they encounter challenges that affect students’ learning such as lack of motivation, unavailability of internet/data connection and gadgets, low digital literacy skills, minimal peer assistance, and authenticity of formative assessment results. But they adapt strategies to address these challenges through designing differentiated assessment, showing empathy, reinventing pedagogical goals through meaningful online tools, promoting student-centered learning, and providing consistent means of communication. Findings implied that teachers use various online formative assessment practices similar to what they do in face-to-face classes. Challenges are evident in the entirety of instruction. However, teachers are dynamic in improving their practices. An action plan consisting of activities, objectives, and description is hereby proposed to improve the online formative assessment practices of mathematics and science teachers to enhance students’ learning.

Migranthood: Youth in a new era of deportationbyLaurenHeidbrink (2020) Stanford: Stanford University Press, ISBN 9781503612075, 240 pp., $25 (paperback).

Migranthood: Youth in a new era of deportationbyLaurenHeidbrink (2020) Stanford: Stanford University Press, ISBN 9781503612075, 240 pp., $25 (paperback).

Development of a laparoscopic surgical skills simulation curriculum: Enhancing resident training through directed coaching and closed-loop feedback

BackgroundPerformance feedback through peer coaching and rigorous self-assessment is a critical part of technical skills improvement. However, formal collaborative programs using operative video-based skills assessments to generate peer coaching feedback have only been validated among attending surgeons. In this study, we developed a unique longitudinal, simulation video-based laparoscopic skills resident curriculum using video-based peer coaching and evaluated its association with skills acquisition among surgical trainees. MethodsThe laparoscopic simulation curriculum consists of a pre-practice laparoscopic skill video recording, followed by receipt of directed coaching and feedback on performance from a faculty coach, a peer coach, and self-coaching. Residents then completed 6 weeks of feedback-directed practice and submitted a second post-practice laparoscopic skill video recording of the same skill, which was evaluated by a minimally invasive surgery expert grader. All general surgery residents in a single institution were enrolled, with 107 residents completing the curriculum in its initial 2 years. ResultsOverall, more than two-thirds of residents achieved skills proficiency on their expert assessments, with similar rates of residents achieving skills proficiency at all postgraduate year levels. Significant improvements between the pre-practice assessments and post-practice assessments were most frequently seen in the instrument handling, precision, and motion & flow categories (P < .05 each). Faculty provided the highest number and proportion of closed-loop comments; residents’ self-coaching feedback had the lowest number of closed-loop comments, with 83% of self-assessments containing none. ConclusionIn this study, we describe the successful implementation of a longitudinal laparoscopic skills video-based coaching curriculum designed to improve residents’ laparoscopic technical abilities through iterative directed practice supplemented by formative closed-loop feedback. This feasible, reproducible, and low-cost simulation curriculum can be adapted to other training programs and skills acquisition endeavors. This program also prepares trainees for ongoing performance feedback after completion of residency through rigorous self-assessment and peer-to-peer coaching.

Central Curation of Glasgow Outcome Scale-Extended Data: Lessons Learned from TRACK-TBI.

The Glasgow Outcome Scale (GOS) in its original or extended (GOSE) form is the most widely used assessment of global disability in traumatic brain injury (TBI) research. Several publications have reported concerns about assessor scoring inconsistencies, but without documentation of contributing factors. We reviewed 6801 GOSE assessments collected longitudinally, across 18 sites in the 5-year, observational Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. We recorded error rates (i.e., corrections to a section or an overall rating) based on site assessor documentation and categorized scoring issues, which then informed further training. In cohort 1 (n = 1261; February 2014 to May 2016), 24% of GOSEs had errors identified by central review. In cohort 2 (n = 1130; June 2016 to July 2018), acquired after curation of cohort 1 data, feedback, and further training of site assessors, the error rate was reduced to 10%. GOSE sections associated with the most frequent interpretation and scoring difficulties included whether current functioning represented a change from pre-injury (466 corrected ratings in cohort 1; 62 in cohort 2), defining dependency in the home and community (163 corrections in cohort 1; three in cohort 2) and return to work/school (72 corrections in cohort 1; 35 in cohort 2). These results highlight the importance of central review in improving consistency across sites and over time. Establishing clear scoring criteria, coupled with ongoing guidance and feedback to data collectors, is essential to avoid scoring errors and resultant misclassification, which carry potential to result in “failure” of clinical trials that rely on the GOSE as their primary outcome measure.

Learning from remote decentralised clinical trial experiences: A qualitative analysis of interviews with trial personnel, patient representatives and other stakeholders.

AimsThe aim of the study was to identify actionable learning points from stakeholders in remote decentralised clinical trials (RDCTs) to inform their future design and conduct.MethodsSemistructured interviews were carried out with a purposive sample of stakeholders, including senior managers, trial managers, technology experts, principal investigators, clinical investigators, research scientists, research nurses, vendors, patient representatives and project assistants. The interview data were coded using a thematic approach, identifying similarities, differences and clustering to generate descriptive themes. Further refinement of themes was guided by empirical phenomenology, grounding explanation in the meanings that interviewees gave to their experiences.ResultsForty‐eight stakeholders were interviewed. Actionable learning points were generated from the thematic analysis. Patient involvement and participant engagement were seen as critical to the success of RDCTs where in‐person contact is minimal or nonexistent. Involving patients in identifying the research question, creating recruitment materials, apps and websites, and providing ongoing feedback to trial participants were regarded as facilitating recruitment and engagement. Building strong relationships early with trial partners was thought to support RDCT conduct. Multiple modes of capturing information, including patient‐reported outcomes (PROs) and routinely collected data, were felt to contribute to data completeness. However, RDCTs may transfer trial activity burden onto participants and remote‐working research staff, therefore additional support may be needed.ConclusionRDCTs will continue to face challenges in implementing novel technologies. However, maximising patient and partner involvement, reducing participant and staff burden, and simplifying how participants and staff interact with the RDCT may facilitate their implementation.

Formative Assessment and Motivation in ESP: A Case Study

The paper presents a case study of an ESP course illustrating the implementation of formative assessment to increase students’ participation and motivation. Formative assessment is an ongoing process teachers and students engage in while focusing on the learning goals and taking action to achieve them. It refers to monitoring students’ learning and the in-process evaluation of student performance by the teacher and by peers providing ongoing feedback to both the teacher and the students. The Business English for Engineers course, designed for graduate students of mechanical engineering, focuses on developing the presentation skills of future mechanical engineers. The students enrolled on the course prepare presentations on engineering topics planned by the syllabus, thus taking direct responsibility for learning. The presentations are followed by questions and group discussions on the presented topics and are subsequently assessed by the rest of the students, the presenters themselves and the teacher. Apart from presentations, students are also assigned smaller tasks to do in class in pairs or groups. A grade in the form of points is attached to the delivered presentations and completed tasks, contributing to the student’s final grade. The results of the questionnaire completed by the students at the end of the course show that such formative activities and assessment increased the students’ motivation and participation in class.

A strategic framework for delivering ongoing feedback at scale

The growing trend for massification in higher education delivery has contributed to challenges in student engagement and experience. This has been further compounded by the global pandemic, with the sector experiencing reduced financial, staffing and resourcing budgets. The authors identified the delivery of meaningful feedback at scale as a critical emerging challenge. Although models of feedback exist within education, there are few discipline-agnostic frameworks for providing feedback that accounts for first-year education in the context of massification. With a focus on feedback within large-scale teaching and the first-year experience, and drawing on the authors’ lived experiences, the paper proposes a conceptual non-disciplinary framework to scaffold the delivery of timely feedback in three stages. The proposed ‘strategic framework for feedback at scale’ promotes deeper first-year undergraduate students’ learning and engagement across multiple teaching contexts through the feed-forward assessment design of automated ongoing feedback, peer-led staged feedback and teacher-led staged feedback. Examples of activities are discussed as well as steps for implementation applicable to tailoring to any discipline setting. Limitations and areas for future research are then discussed, calling for empirical research into the practice and effectiveness of the conceptual framework.

Evaluation of an eLearning teaching innovation to assist clinical radiation therapy educators in the provision of student feedback

BackgroundClinical placement is an integral part of the Radiation Therapy undergraduate programme. Feedback and formative assessment during clinical placement are regarded as key to developing clinical skills and competencies. Students regularly report dissatisfaction with the feedback process while clinical educators report heavy clinical workloads and a lack of guidance on feedback mechanisms as barriers to providing meaningful student feedback. MethodsAn eLearning teaching intervention was developed to support radiation therapists in the provision of student feedback in the clinic. Thematic analysis was used to report attitudes to feedback and feedback practices collected in a pre and a post intervention evaluation. Results30 radiation therapists completed the module and pre and post intervention evaluations. Prior to taking the module just over half of respondents stated that they offered regular and on-going feedback throughout the student's placement. Positive attitudes to feedback were reported. Following completion of the eLearning tool respondents reported a higher level of confidence in the provision of student feedback and almost 70% said the module had changed how they would approach the feedback process by using feedback models in the future. DiscussionGood and timely feedback is essential and allows a student opportunity to improve prior to the end of the placement. It also teaches students how to self-assess and self-reflect - skills that they can use in continuous professional development after they graduate. Radiation therapists appreciate the structure that using a model in the feedback process offers. ConclusionThis eLearning teaching intervention was received favourably by radiation therapists who are key to creating a culture of feedback in the clinical environment that will facilitate students in becoming competent healthcare professionals.

Abstract 889: Qualitative findings from a survey on patient experiences and satisfaction with lung cancer screening

Abstract Background: In 2014, Moffitt Cancer Center initiated a lung cancer screening program for high-risk individuals who meet USPSTF inclusion criteria. As of January 2020, 576 patients have completed one or more lung cancer screenings. However, approximately 40% of lung cancer screening patients were noncompliant with their recommended follow-up. To understand reasons for lack of follow-up screening and to determine patient satisfaction and experiences, we conducted a survey with open-ended items to assess patient experiences and satisfaction among lung cancer screening patients. Methods: In this analysis, we report on findings from the qualitative portion of the survey. Six open-ended items elicited barriers related to returning for screening, experience with other cancer screenings, positive and negative experiences with the LDCT visit, as well as suggestions for improving the process of LDCT screening visits. Content analysis using the constant comparison method was applied to the text and coded based on the a priori codes of the open-ended questions. Results: As of November 2020, 190 people responded to the quantitative survey and 77 provided responses to one or more open-ended questions. Thirty-five respondents provided general positive comments about their lung cancer screening experience with typical responses of “positive” and “good experience”. Twenty respondents mentioned that the staff was “caring”, “knowledgeable”, and “great staff”. Ten respondents mentioned that they were “always treated well”, “treated with respect”, “high quality care”.. Negative comments were provided by 32 respondents in the areas of: “wanting more information on results” or “waiting too long for results” (N=7), “inefficient scheduling issues” (N=6), and billing issues (N=5). Additionally, six patients reported COVID-related issues impacted their lung cancer screening experience. Suggestion for improvements included: on-line appointments or text or email reminders (N = 10), lower costs (N=6), and uncertainty about remaining qualified for lung cancer screening due to age or current/prior medical conditions (N=5). Conclusion: Overall, findings provide insights about patient experiences and satisfaction for lung cancer screening. Suggestions for improvement centered on better scheduling systems and appointment reminders as well as the ability to speak to a clinician to better understand results and future eligibility. Ongoing patient-centered feedback may improve the lung cancer screening experience and increase follow-up screening rates. Citation Format: Jaileene Perez-Morales, Rashmi Pathak, Monica Reyes, Ada Sulbaran, Tiffany Gilliard, Haley Tolbert, Rajwantee Tirbene, Jhanelle Gray, Vani N. Simmons, Matthew B. Schabath, Gwendolyn P. Quinn. Qualitative findings from a survey on patient experiences and satisfaction with lung cancer screening [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 889.

Topical Review: Vision and Gait in Older Adults: A Clinician’s Perspective

Gait is an important human function, and vision is the dominant sensory input used during gait. Vision aids pathfinding decisions and provide ongoing sensory feedback to maintain appropriate balance and prevent falls. Eye care providers who wish to effectively address the impact of vision impairment on the risk of falling will customize their management plan based on specific impairments. This article provides an overview of normal sensory integration as it applies to gait, with an emphasis on vision. It also presents an evidence-based review of visual dysfunctions that cause falls, as well as strategies to reduce falls in adults with visual impairment, with emphasis on patients over age 65.

De novo learning versus adaptation of continuous control in a manual tracking task.

How do people learn to perform tasks that require continuous adjustments of motor output, like riding a bicycle? People rely heavily on cognitive strategies when learning discrete movement tasks, but such time-consuming strategies are infeasible in continuous control tasks that demand rapid responses to ongoing sensory feedback. To understand how people can learn to perform such tasks without the benefit of cognitive strategies, we imposed a rotation/mirror reversal of visual feedback while participants performed a continuous tracking task. We analyzed behavior using a system identification approach, which revealed two qualitatively different components of learning: adaptation of a baseline controller and formation of a new, task-specific continuous controller. These components exhibited different signatures in the frequency domain and were differentially engaged under the rotation/mirror reversal. Our results demonstrate that people can rapidly build a new continuous controller de novo and can simultaneously deploy this process with adaptation of an existing controller.

Misdirected attentional focus in functional tremor.

A characteristic and intriguing feature of functional neurological disorder is that symptoms typically manifest with attention and improve or disappear with distraction. Attentional phenomena are therefore likely to be important in functional neurological disorder, but exactly how this manifests is unknown. The aim of the study was to establish whether in functional tremor the attentional focus is misdirected, and whether this misdirection is detrimental to the movement, or rather reflects a beneficial compensatory strategy.Patients with a functional action tremor, between the ages of 21–75, were compared to two age and gender matched control groups: healthy control participants and patients with an organic action tremor. The groups included between 17 and 28 participants. First, we compared the natural attentional focus on different aspects of a reaching movement (target, ongoing visual feedback, proprioceptive-motor aspect). This revealed that the attentional focus in the functional tremor group, in contrast to both control groups, was directed to ongoing visual feedback from the movement. Next, we established that all groups were able to shift their attentional focus to different aspects of the reaching movement when instructed. Subsequently, the impact of attentional focus on the ongoing visual feedback on movement performance was evaluated under several conditions: the reaching movement was performed with direct, or indirect visual feedback, without any visual feedback, under three different instruction conditions (as accurately as possible/very slowly/very quickly) and finally as a preparatory movement that was supposedly of no importance. Low trajectory length and low movement duration were taken as measures of good motor performance.For all three groups, motor performance deteriorated with attention to indirect visual feedback, to accuracy and when instructed to move slowly. It improved without visual feedback and when instructed to move fast. Motor performance improved, in participants with functional tremor only, when the movement was performed as a preparatory movement without any apparent importance.In addition to providing experimental evidence for improvement with distraction, we found that the normal allocation of attention during aimed movement is altered in functional tremor. Attention is disproportionately directed towards the ongoing visual feedback from the moving hand. This altered attentional focus may be partly responsible for the tremor, since it also worsens motor performance in healthy control participants and patients with an organic action tremor. It may have its detrimental impact through interference with automatic movement processes, due to a maladaptive shift from lower- to higher-level motor control circuitry.

Oscillation in the electrical conductivity of a thick graphene oxide membrane

Because of their unusual fundamental behavior that arises at the molecular scale, the electrical conductivity of stacked graphene oxide (GO) sheets in the presence of external parameters is not adequately understood. Previous studies concentrated on the DC response of thin GO membranes giving their resistive switching properties. Here, we observe anomalous low-frequency (&amp;lt;1 Hz) oscillations in the electrical conductivity of micrometer size GO, which is repeated in a process over and over in an ongoing feedback loop. Such vibrations and their unique trajectories are not only fundamentally important but also have characteristic frequencies that can be directly linked to the formation and destruction of regions with sp2 hybridization. Also, the reported switching time (of the order of seconds) makes our resistive switching system different than all the previously reported systems and introduces a new class of switching phenomena. The observed phenomena improve our understanding of the electrical conductivity of GO membranes and the corresponding microscopic details that pave the way for the promising application of these new observed low-frequency oscillations.

Reinventing Performance Management

Performance appraisals have traditionally been conducted annually or semi-annually. Recently, many companies are transitioning to ongoing feedback and coaching, either in addition to periodic appraisals, or lieu of them. There have also been calls for completely reinventing performance management systems, as the result of an abundance of research that indicates performance processes are over-engineered and time-consuming, and they tend to demotivate employees while hindering candid and honest conversations. This paper examines the common problems with attribution error and rater bias in traditional performance appraisal systems. Five mini-case studies are then presented by exploring how five large companies (Netflix, Adobe, Deloitte, IBM, GE), have reinvented the way in which performance management is implemented. The paper examines why these companies moved away from traditional performance appraisal and what processes replaced it. The paper also identifies emerging trends that will impact the future of performance management and offers suggestions for the road ahead.

Developing eHealth tools for diverse older adults: Lessons learned from the PREPARE for Your Care Program.

Electronic Health (eHealth) tools offer opportunities for people to access health information online; yet, most tools are not designed to meet the unique needs of diverse older adults, leading to health disparities. Our goal was to provide guidance for the development of eHealth tools for diverse older populations for use in geriatric care models. Guidance for eHealth tools was compiled from user design resources and eHealth design literature. Pragmatic examples were provided from an evidenced-based eHealth tool called PREPAREforYourCare.org (PREPARE). We used quantitative feasibility data from PREPARE research studies and qualitative analysis of PREPARE focus groups, cognitive interviews, and feedback from randomized trials to further inform our recommendations. Guidance and lessons learned include: (1) define clear objectives and a conceptual framework; (2) co-create with the target population; (3) optimize the design and layout for accessibility and ease of use, such as text at the 5th grade reading level, closed captioning, etc.; (4) use simple, standardized navigation design; (5) use actionable information to enhance behavior change, such as modeling of behaviors; (6) align accompanying written materials with the eHealth tool; and (7) create tracking mechanisms for ongoing user feedback. PREPARE is used as a case example to provide pragmatic illustrations for how the guidance may be operationalized. eHealth tools can be tailored to the unique characteristics, preferences, and needs of diverse older populations. Following the "lessons learned" may help decrease health disparities among diverse older adults and ensure eHealth tools are readily accessible and culturally appropriate.

Induction shouldn't be painful: improving psychiatry local induction for junior doctors across the South West

AimsThe GMC recommends that organisations ensure learners have an induction in preparation for each placement. We aimed to ensure that high quality induction was being delivered in psychiatry posts across the whole of the Severn Deanery. This included multiple localities (Bristol, Bath, Swindon, Devizes, Weston-Super-Mare, Gloucester, Cheltenham, Taunton and Yeovil) across three NHS trusts.BackgroundInduction plays a vital role in preparing doctors for their new roles. Crucially, some doctors are not only new to the specific role and site, but also new to the specialty (for example, Foundation Doctors and GP Trainees). In Severn, each locality takes responsibility for providing Junior Doctors with a locality-specific induction; these occur four times per year. Previous feedback from trainees in Severn was poor; as demonstrated by informal feedback and the August 2018's GMC survey results, showing some localities ‘required improvement’.MethodPre- and post-intervention measurements were ascertained by written questionnaires for Foundation Doctors, GP Trainees and Core Trainees in Psychiatry. Baseline questionnaires were completed in August/September 2019. Five ‘Plan, Do, Study, Act’ Cycles were completed over the following eighteen months. Examples of the changes made included incorporating ‘missed’ topics (such as wellbeing, seclusion reviews and exception reporting) and specific information to on-call responsibilities, reducing replicated information, and touring clinical sites. These changes were coordinated via monthly meetings between Locality Trainee Leads (LTLs).ResultThere was an overall improvement in trainee's satisfaction with induction. Outcomes also included the development of an induction checklist specific to each locality and a ‘gold standard’ list for what local induction should involve. This is hopefully soon to be ratified by the Medical Education department and Severn Deanery.ConclusionHaving worked on this project for over 18 months, sustainability of change remains a crucial issue. In response to this, we have established several recommendations: the LTL job role needs to be revised to include updating the written induction handbook in each locality and delivering face-to-face induction. Outgoing and incoming LTLs will plan each induction together, at least 4 to 8 weeks before the start date. Support from Medical Education regarding attendees at each induction is to be put in place. Handbooks will be shared across localities, so that the ‘core’ information is consistent. Ongoing feedback will ensure that Junior Doctors continue to receive a high quality and relevant induction.

Psychological pressure and compounded errors during elite-level tennis

ObjectivesIn the context of Grand Slam tennis, we sought to examine how situational pressure and prior errors can disrupt subsequent performance in elite performers. MethodsA retrospective analysis of more than 650,000 points across 12 Grand Slam tennis tournaments from 2016 to 2019 was conducted to identify pressurised in-game moments and unforced errors. A scoring system was used to index situational pressure based on the current match situation (e.g., break points, stage of the match) on a point-by-point basis. The occurrence of performance errors was identified based on double faults and unforced errors, as instances of controllable mistakes. ResultsA mixed effects logistic regression model revealed that an increase in the pressure index (a 1–5 score) significantly increased the probability of a performance error (ps < .001), as did an error on the preceding point (OR = 1.2, 95%CI [1.17, 1.23], p < .001). A multiplicative effect of pressure and prior errors also emerged, as the negative impact of prior errors on performance was greater when situational pressure was already high, in line with the predictions of Attentional Control Theory: Sport (ACTS). Analyses of the distribution of winners and unforced errors across individual players revealed that winning players were as susceptible to pressure and prior errors as losing players. ConclusionsThese findings extend our understanding of how ongoing feedback from prior mistakes may further exacerbate the effects of pressure on performance.

Participatory research for the development of information, education and communication tools to promote intermittent preventive treatment of malaria in pregnancy in the Democratic Republic of the Congo, Nigeria and Mozambique

BackgroundTo improve the coverage of intermittent preventive treatment of malaria in pregnancy (IPTp) in Africa, Medicines for Malaria Venture (MMV) developed, tested and validated a new packaging of sulfadoxine–pyrimethamine (SP), as well as specific communications tools designed to improve knowledge of IPTp and the motivation of women to adhere to it, particularly if it is distributed by community health workers (CHW).MethodsThis article describes and analyses the results of an empirical research carried out in the Democratic Republic of the Congo (DRC), Nigeria and Mozambique, to evaluate the perception and social acceptability of SP for healthcare providers, CHW and pregnant women, and to assess the ability of the new SP packaging and the communications tools to change their perception of SP and improve their attitudes towards IPTp.ResultsThe results indicate that SP’s new individual packaging was perceived by pregnant women and healthcare providers as a “hygienic” and “safe”, with a specific identity. The graphics used in IPTp communications tools were modified according to the respondents’ feedback to make them more culturally and socially sensitive, and then validated. However, although the new blister packaging and IPTp communications tools generated greater confidence and motivation, SP side effects as well as preconceived ideas, particularly regarding its efficacy, remain a challenge that must be addressed to improve IPTp acceptance and compliance by healthcare providers and pregnant women.ConclusionThis participatory approach to social research based on ongoing feedback to the graphic designer provided more empirical evidence to improve and adapt the textual and visual content of communication tools (SP blister packaging, leaflet, user guide) to local contexts and user preferences. Tested and validated in different socio-cultural and socio-political contexts, these tools provide a good basis for the promotion of IPTp in Africa.

Adapting a Person's Home in 3D Using a Mobile App (MapIt): Participatory Design Framework Investigating the App's Acceptability.

BackgroundHome adaptation processes enhancing occupational engagement rely on identifying environmental barriers, generally during time-consuming home visits performed by occupational therapists (OTs). Relevance of a 3D model to the OT’s work has been attested, but a convenient and consumer-available technology to map the home environment in 3D is currently lacking. For instance, such a technology would support the exploration of home adaptations for a person with disability, with or without an OT visit.ObjectiveThe aim of this study was to document the development and acceptability of a 3D mapping eHealth technology, optimizing its contribution to the OT’s work when conducting assessments in which home representations are essential to fit a person’s needs.MethodsA user-centered perspective, embedded in a participatory design framework where users are considered as research partners (not as just study participants), is reported. OTs, engineers, clinicians, researchers, and students, as well as the relatives of older adults contributed by providing ongoing feedback (eg, demonstrations, brainstorming, usability testing, questionnaires, prototyping). System acceptability, as per the Nielsen model, is documented by deductively integrating the data.ResultsA total of 24 stakeholders contributed significantly to MapIt technology’s co-design over a span of 4 years. Fueled by the objective to enhance MapIt’s acceptability, 11 iterations lead to a mobile app to scan a room and produce its 3D model in less than 5 minutes. The app is available for smartphones and paired with computer software. Scanning, visualization, and automatic measurements are done on a smartphone equipped with a motion sensor and a camera with depth perception, and the computer software facilitates visualization, while allowing custom measurement of architectural elements directly on the 3D model. Stakeholders’ perception was favorable regarding MapIt’s acceptability, testifying to its usefulness (ie, usability and utility). Residual usability issues as well as concerns about accessibility and scan rendering still need to be addressed to foster its integration to a clinical context.ConclusionsMapIt allows to scan a room quickly and simply, providing a 3D model from images taken in real-world settings and to remotely but jointly explore home adaptations to enhance a person’s occupational engagement.

Objective and Subjective Perspectives on Implementation of a Violence Risk Screening Program in an Emergency Department.

The objective of this study was to use quantitative and qualitative data to gather information about emergency medicine and psychiatric provider perspectives regarding the evolution of a violence risk screening process including the simultaneous implementation of a universal suicide screening program. A retrospective review of violence risk screening data for 496 patient encounters over a 2-year period and across 4 phases of implementation and improvement was completed. Four focus groups were conducted with emergency medicine and psychiatric providers using nondirective facilitation methods to gather data regarding provider perspectives about violence and suicide risk screening. The focus groups were recorded, transcribed, and analyzed for thematic content. Four of the 6 violence risk screening items were most strongly associated with high-risk stratification across all phases. There were no changes in proportions of positive responses for 3 of the items. The proportion of positive responses for the other items changed significantly after expert feedback and clarification of item wording. Only 3% of the focus group passages included discussion of the universal suicide screening program. The providers indicated that they believed the violence risk screening and suicide screening procedures helped improve clinical thoroughness and documentation. Ongoing feedback between providers and program developers was beneficial. The implementation of the universal suicide screening process was relatively seamless for these providers.