Feedback Operation Research Articles

Methodological aspects of participatory architectural and landscape design

The methodological aspects of participatory architectural and landscape design in interaction with methods of interactive training in the disciplines "Compositional Modeling" and "Architectural and Landscape Organization of the Territory of Residential and Public Buildings" are considered. The article substantiates the need to introduce active learning and social interaction in the process of professional and additional education of gaming technology architects with the possibility of its direct use here and now. Further, the authors speculate on participation in interactive interaction, activity games, visual fixation of the study of the historically developed language of architectural semantics, a holistic worldview and the ability to solve traditional architectural problems with actual means. The authors provide the methods for the establishment of operative feedback by means of infographic with a designation of a problem and an illustration of means of its decision, use of game prototypes involving citizens of different ages and social status in the collective processes.

Examining the Impact of Using the SIMPL Application on Feedback in Surgical Education

The System for Improving and Measuring Procedural Learning (SIMPL) smartphone application allows physicians to provide dictated feedback to surgical residents. The impact of this novel feedback medium on the quality of feedback is unknown. Our objective was to compare the delivery and quality of best-case operative performance feedback given via SIMPL to feedback given in-person. We collected operative performance feedback given both in-person and via SIMPL from surgeons to residents over 6 weeks. Feedback transcripts were coded using Verbal Response Modes speech acts taxonomy to compare the delivery of feedback. We evaluated quality of feedback using a validated resident survey and third-party assessment form. University of Wisconsin School of Medicine and Public Health, a large academic medical institution. Four surgical attendings and 9 general surgery residents. Nineteen SIMPL and 18 in-person feedback encounters were evaluated. Feedback via SIMPL was more directive (containing thoughts, perceptions, evaluations of resident behavior, or advice) and contained more presumptuous utterances (in which the physician reflected on and assessed resident performance or offered suggestions for improvement) than in-person feedback (p = 0.01). The resident survey showed no significant difference between the quality of feedback given via SIMPL and in-person (p = 0.07). The mean score was 47.74 (SD = 3.00) for SIMPL feedback and 45.33 (SD = 4.77) for in-person feedback, with a total possible score of 50. Third-party assessment showed no significant difference between the quality of feedback given via SIMPL and in-person (p = 0.486). The mean score was 23.40 (SD = 3.75) for SIMPL feedback and 22.25 (SD = 5.94) for in-person feedback, with a total possible score of 30. Although feedback given via SIMPL was more direct and based on the attendings' perspectives, the quality of the feedback did not differ significantly. Use of the dictation feature of SIMPL to deliver resident operative performance feedback is a reasonable alternative to in-person feedback.

OTRA, its implementations and applications: a state-of-the-art review

During the last three decades, a large number of new analog circuit building blocks have emerged beyond the well-known operational amplifier, operational transconductance amplifier, Current Conveyors and Current feedback operational amplifier. Among the new building blocks, the operational transresistance amplifier (OTRA) has received considerable attention in the literature. This paper presents a state-of-the-art review of the OTRAs, their bipolar and CMOS implementations and applications in linear and nonlinear analog signal processing/generation along with a comprehensive list of references covering the period from 1992 till date.

Development of a Small-Pixel Ir-TES for Optical Applications

We designed and fabricated a photon-number-resolving detector based on an iridium (Ir) transition-edge sensors (TES) with small timing jitter time for coherent optical communication. The current–voltage relationship of the small Ir-TES, with an effective area of 7 μm × 7 μm, was measured, and its electrothermal feedback operation was confirmed. This device had a transition temperature of 280 mK, which is higher than that of bulk Ir, because of the wide contact area.

A novel phase-shift-based amplitude detector for a high-speed atomic force microscope.

In any atomic force microscope operated in amplitude modulation mode, aka "tapping mode" or "oscillating mode," the most crucial operation is the detection of the cantilever oscillation amplitude. Indeed, it is the change in the cantilever oscillation amplitude that drives the feedback loop, and thus, the accuracy and speed of amplitude detection are of utmost importance for improved atomic force microscopy operation. This becomes even more crucial for the operation of a high-speed atomic force microscope (HS-AFM), where feedback operation on a single or a low number of cantilever oscillation cycles between 500 kHz and 1000 kHz oscillation frequency is desired. So far, the amplitude detection was performed by Fourier analysis of each oscillation, resulting in a single output amplitude value at the end of each oscillation cycle, i.e., 360° phase delay. Here, we present a novel analog amplitude detection circuit with theoretic continuous amplitude detection at 90° phase delay. In factual operation, when exposed to an abrupt amplitude change, our novel amplitude detector circuit reacted with a phase delay of ∼138° compared with the phase delay of ∼682° achieved by the Fourier analysis method. Integrated to a HS-AFM, the novel amplitude detector should allow faster image acquisition with lower invasiveness due to the faster and more accurate detection of cantilever oscillation amplitude change.

Optical coherence tomography-based angiography device with real-time angiography B-scans visualization and hand-held probe for everyday clinical use.

This work is dedicated to the development of the OCT system with angiography for everyday clinical use. Two major problems were solved during the development: compensation of specific natural tissue displacements, induced by contact scanning mode and physiological motion of patients (eg, respiratory and cardiac motions) and online visualization of vessel cross-sections to provide feedback for the system operator.

Replacing measurement feedback with coherent feedback for quantum state preparation

Measurement feedback is a versatile and powerful tool, although its performance is limited by several practical imperfections resulting from classical components. This paper shows that, for some typical quantum feedback control problems for state preparation (stabilization of a qubit or a qutrit, spin squeezing, and Fock state generation), the classical feedback operation can be replaced by a fully quantum one such that the state autonomously dissipates into the target or a state close to the target. The main common feature of the proposed quantum operation, which is called coherent feedback, is that it is composed of a series of dispersive and dissipative couplings inspired by the corresponding measurement feedback scheme.

Comparative Study of Discrete Component Realizations of Fractional-Order Capacitor and Inductor Active Emulators

Due to the absence of commercially available fractional-order capacitors and inductors, their implementation can be performed using fractional-order differentiators and integrators, respectively, combined with a voltage-to-current conversion stage. The transfer function of fractional-order differentiators and integrators can be approximated through the utilization of appropriate integer-order transfer functions. In order to achieve that, the Continued Fraction Expansion as well as the Oustaloup’s approximations can be utilized. The accuracy, in terms of magnitude and phase response, of transfer functions of differentiators/integrators derived through the employment of the aforementioned approximations, is very important factor for achieving high performance approximation of the fractional-order elements. A comparative study of the accuracy offered by the Continued Fraction Expansion and the Oustaloup’s approximation is performed in this paper. As a next step, the corresponding implementations of the emulators of the fractional-order elements, derived using fundamental active cells such as operational amplifiers, operational transconductance amplifiers, current conveyors, and current feedback operational amplifiers realized in commercially available discrete-component IC form, are compared in terms of the most important performance characteristics. The most suitable of them are further compared using the OrCAD PSpice software.

Analysis and Operational Feedback of the New High-Energy Beam Dump in the CERN SPS

Analysis and Operational Feedback of the New High-Energy Beam Dump in the CERN SPS

Understanding Surgical Resident and Fellow Perspectives on Their Operative Performance Feedback Needs: A Qualitative Study

Operative performance feedback is essential for surgical training. We aimed to understand surgical trainees' views on their operative performance feedback needs and to characterize feedback to elucidate factors affecting its value from the resident perspective. Using a qualitative research approach, 2 research fellows conducted semistructured, one-on-one interviews with surgical trainees. We analyzed recurring themes generated during interviews related to feedback characteristics, as well as the extent to which performance rating tools can help meet trainees' operative feedback needs. Departments or divisions of general or plastic surgery at 9 US academic institutions. Surgical residents and clinical fellows in general or plastic surgery. We conducted 30 interviews with 9 junior residents, 14 senior residents, and 7 clinical fellows. Eighteen (60%) participants were in plastic and 12 (40%) were in general surgery. Twenty-four participants (80%) reported feedback as very or extremely important during surgical training. All trainees stated that verbal, face-to-face feedback is the most valuable, especially if occurring during (92%) or immediately after (65%) cases. Of those trainees using performance rating tools (74%), most (57%) expressed positive views about them but wanted the tools to complement and not replace verbal feedback in surgical education. Trainees value feedback more if received within 1 week or the case. Verbal, face-to-face feedback is very or extremely important to surgical trainees. Residents and fellows prefer to receive feedback during or immediately after a case and continue to value feedback if received within 1 week of the event. Performance rating tools can be useful for providing formative feedback and documentation but should not replace verbal, face-to-face feedback. Considering trainee views on feedback may help reduce perceived gaps in feedback demand-versus-supply in surgical training, which may be essential to overcoming current challenges in surgical education.

The reliability of operative rating tool evaluations: How late is too late to provide operative performance feedback?

BackgroundOperative rating tools can enhance performance assessment in surgical training. However, assessments completed late may have questionable reliability. We evaluated the reliability of assessments according to evaluation time-to-completion. MethodsWe stratified assessments from MileMarker‘s™ Operative Entrustability Assessment by evaluation time-to-completion, using concordance correlation coefficient (CCC) between self-assessment and evaluator scores as a measure of reliability. ResultsOverall, self-assessment and evaluator scores were strongly correlated (CCC = 0.72; p < 0.001) though self-assessments were slightly higher (p = 0.048). Reliability remained stable for evaluations completed within 0 days (CCC = 0.77; p < 0.001), 1–3 days (CCC = 0.73; p < 0.001), and 4–13 days after surgery (CCC = 0.69; p < 0.001), but dropped for evaluations completed within 14–38 days (CCC = 0.60; p < 0.001) and over 38 days (CCC = 0.54; p < 0.001) after surgery. There was strong evidence for an interaction between time-to-completion and reliability (p < 0.001). ConclusionsOur data support the reliability of assessments completed until 2 weeks after surgery. This finding may help refine the interpretation of evaluation scores as surgical specialties move toward competency-based accreditation.

Statistical Methods in Assembly Quality Management of Multi-Element Products on Automatic Rotor Lines

To control the assembly quality of multi-element mass-produced products on automatic rotor lines, control methods with operational feedback are required. However, due to possible failures in the operation of the devices and systems of automatic rotor line, there is always a real probability of getting defective (incomplete) products into the output process stream. Therefore, a continuous sampling control of the products completeness, based on the use of statistical methods, remains an important element in managing the quality of assembly of multi-element mass products on automatic rotor lines. The feature of continuous sampling control of the multi-element products completeness in the assembly process is its breaking sort, which excludes the possibility of returning component parts after sampling control to the process stream and leads to a decrease in the actual productivity of the assembly equipment. Therefore, the use of statistical procedures for continuous sampling control of the multi-element products completeness when assembled on automatic rotor lines requires the use of such sampling plans that ensure a minimum size of control samples. Comparison of the values of the limit of the average output defect level for the continuous sampling plan (CSP) and for the automated continuous sampling plan (ACSP) shows the possibility of providing lower limit values for the average output defects level using the ACSP-1. Also, the average sample size when using the ACSP-1 plan is less than when using the CSP-1 plan. Thus, the application of statistical methods in the assembly quality management of multi-element products on automatic rotor lines, involving the use of proposed plans and methods for continuous selective control, will allow to automating sampling control procedures and the required level of quality of assembled products while minimizing sample size.

Abstract 180: Some Like it Hot; Radiation Safety in the Catheterization Lab

Objective: Ionizing radiation is an unseen and often unappreciated safety concern for patients and cath lab staff. Radiation exposure has both deterministic and stochastic effects, with patient risk estimated by peak Skin Dose and Air kerma Area product. In our lab exposure guidelines have been set for radiation safety (fluoro time &lt; 60 min, 4,000 mGray and 20,000 cGray cm 2 ). A prior audit of practice 2011-2013 found that 17.1% (758/4,439) of patients undergoing interventional procedures exceeded these limits. Safer radiation practices were implemented including: intra procedure operator feedback, decrease in cine frame rate and run length, promote mapping and less angled views. However changing patient characteristics (increased obesity, prior CABG) and an increase in structural procedures warrant reexamination of practice. Procedure: The frequency of guideline excessive radiation exposure for cardiac cath lab patients was tracked over a 12 month period from 11/2016-11/2017. The frequency of radiation exposure exceeding our guidelines was tracked overall and by operator (16), and by specific intervention. Results: Over the one year period 10.2% of interventions [174/1,702] received excessive skin or total body radiation. Rates exceeding guidelines by operator ranged from 4% to 26% with operators performing structural or peripheral procedures having the highest patient radiation exposures. Structural procedures resulted in exposures as high as 123 min fluoro time, TAD of 226,385 cGray cm2, 11,129 mGray skin dose [patient had post procedure skin damage]. Factors associated with high radiation exposures included: increasing obesity, prior surgical revascularization, coronary anomalies, multivessel procedure or high complexity procedure, difficulties in imaging requiring highly angled or multiple views, procedural complications. Interventions associated with limiting exposure included: limiting fellow participation, decrease in frame rate, interim stills with limited cine runs. The default settings of X-Ray equipment have been modified to encourage safe and appropriate use of radiation in the cardiac catheterization lab (however, physician overide of settings is still possible). Conclusions: The changes made in imaging equipment and procedures 5 years ago have been largely sustained and have resulted in less frequent radiation outliers. Patient factors (e.g. obesity, prior CABG) complex and multivessel interventions, structural and vascular procedures are potentially frequently associated with excess radiation. Changing default settings and implementing radiation safety practices, including staging where appropriate, can significantly decrease radiation exposure to patients and staff. Cumulative and target organ specific patient doses of radiation should be tracked and more readily accessible in the patient’s medical record.

Evaluating operator harvest technology within a high-fidelity combine simulator

Farming today is more complex than it has ever been. Operators are increasingly reliant on technology to aid and improve harvest performance. New harvest technology is under development that will advise harvest operators on the proper adjustment of machine harvest settings, as well as automatically adjust these machine settings without operator intervention, improving the harvest performance of the machine, and reducing the cognitive load of the operator. In this work a high-fidelity, interactive harvest combine simulator is used to understand how harvest operators currently use existing harvest technology, and to evaluate the performance improvements provided by new prototype machine control algorithms and human control interface designs. The interactive harvest simulator is used to assess an intermediate advising step for machine controls adjustment compared with a path using fully autonomous machine adjustment. Testing novel harvest technologies using the virtual environment of the combine simulator introduces a specific set of constraints and challenges that are not found in most other vehicle simulation applications, including the need for accurate physical and visual crop flow representations and a requirement for realistic machine responses to a wide variety of operator input commands. Using a high-fidelity combine simulator for testing allows unique harvest scenarios to be repeated by experienced operators in a controlled virtual environment.This study evaluates operator acceptance, performance, and feedback for two novel pieces of harvest technology, Advisor and Director. Advisor is an operator-in-the-loop system providing feedback on proper machine control adjustments during normal harvest operations. Director is designed to continuously monitor the overall harvest health and autonomously adjust the combine harvest settings. In this study, operators harvested the same virtual field twice, first using Advisor, and a second time using Director. Operators overwhelmingly perceived both the Advisor and Director systems as optimizing the harvest performance of the combine and recommended both Advisor and Director. The results presented in this work show that both systems improved the perceived harvest performance, although the Advisor was not as highly rated. Participants recommended the automated nature of Director, and both operator feedback and physiological measures indicates that this harvest technology reduced the cognitive load of the operator. This work demonstrates two main points. First, the interactive combine simulator can be used for evaluating novel harvest technology in the lab. Second, that operators can quickly acclimate to automation within the combine and were able to harvest in a more productive manner when using higher levels of automation.

Information-to-work conversion by Maxwell\u2019s demon in a superconducting circuit quantum electrodynamical system

Information thermodynamics bridges information theory and statistical physics by connecting information content and entropy production through measurement and feedback control. Maxwell’s demon is a hypothetical character that uses information about a system to reduce its entropy. Here we realize a Maxwell’s demon acting on a superconducting quantum circuit. We implement quantum non-demolition projective measurement and feedback operation of a qubit and verify the generalized integral fluctuation theorem. We also evaluate the conversion efficiency from information gain to work in the feedback protocol. Our experiment constitutes a step toward experimental studies of quantum information thermodynamics in artificially made quantum machines.

Effects of the sensory modality and the expectation consistency of the operational feedback on the sense of agency

Effects of the sensory modality and the expectation consistency of the operational feedback on the sense of agency

Research on Power Stability Control of Semiconductor Laser

In order to guarantee the stable emission power and good working environment of semiconductor laser, a new hardware circuit is selected and designed to realize automatic optical power control, in which a negative feedback operation amplifier circuit is adopted to form the constant current source, and an optoelectronic feedback to realize closed loop control in this paper. And then, the corresponding steady control circuit is also designed, so that the stable power can be output. The experimental results show that the stability of laser power is better than 0.74% when the system works.

Quality of Operative Performance Feedback Given to Thoracic Surgery Residents Using an App-Based System

Residents frequently report inadequate feedback both in quantity and quality. The study evaluates the quality of faculty feedback about operative performance given using an app-based system. Residents requested operative performance evaluation from faculty on a real-time basis using the "Zwisch Me!!" mobile application which allows faculty to provide brief written feedback. Qualitative analysis of feedback was performed using grounded theory. The 7 academic medical centers with thoracic surgery training programs. Volunteer thoracic surgery residents in both integrated and traditional training pathways and their affiliated cardiothoracic faculty. Residents (n = 33) at 7 institutions submitted a total of 596 evaluations to faculty (n = 48). Faculty acknowledged the evaluation request in 476 cases (80%) and in 350 cases (74%) provided written feedback. Initial open coding generated 12 categories of feedback type. We identified 3 overarching themes. The first theme was the tone of the feedback. Encouraging elements were identified in 162 comments (46%) and corrective elements in 230 (65%). The second theme was the topic of the feedback. Surgical technique was the most common category at 148 comments (42.2%) followed by preparation for case (n = 69, 19.7%). The final theme was the specificity of the feedback. Just over half of comments (n = 190, 54.3%) contained specific feedback, which could be applied to future cases. However, 51 comments (14.6%) contained no useful information for the learners. An app-based system resulted in thoracic surgery residents receiving identifiable feedback in a high proportion of cases. In over half of comments the feedback was specific enough to allow improvement. Feedback was better quality when addressing error prevention and surgical technique but was less useful when addressing communication, flow of the case, and assisting. Faculty development around feedback should focus on making feedback specific and actionable, avoiding case descriptions, or simple platitudes.

Reliability of Operative Skill Evaluations: How Late Is Too Late to Give Feedback?

INTRODUCTION Evaluating resident operative skill acquisition is a common challenge for all surgical specialties. The Operative Entrustability Assessment (OEA) is a validated assessment tool that facilitates compliance with the Accreditation Council for Graduate Medical Education’s Next Accreditation System and documents resident operative performance at point-of-care.1 The OEA and other operative rating tools have been implemented in surgical training programs across the United States in an effort to incorporate objective, valid, and reliable operative skills assessments into surgical training.2 A recent multi-institutional qualitative study on resident feedback needs raised questions on the reliability of operative skills feedback when this feedback is given more than a week after the case date.3 Using our experience with the OEA, we assessed the reliability of evaluation scores according to the timeliness of feedback completion. METHODS We extracted evaluator and self-assessment scores from all logged cases since OEA implementation at our institution. We defined OEA score reliability as the correlation between self-assessment and evaluator scores. This correlation has been shown in previous studies to be positive, moderate to strong, and statistically significant.4,5 We used paired t test to compare scores and Pearson’s correlation coefficient to assess reliability stratifying by time-to-evaluation completion divided into quintiles (Q1: 0, Q2: 1–3, Q3: 4–13, Q4: 4–38, and Q5: > 38 days after surgery). We used likelihood ratio tests on linear regression to assess the interaction between reliability and timeliness to completion. RESULTS Between September 2013 and October 2016, 1778 complete OEAs were logged. Mean resident self-assessment (3.41 ± 1.09) was slightly higher than evaluator score (3.37 ± 0.99; P = 0.048). Overall, self-assessment score was significantly and strongly correlated with evaluator score [Pearson’s correlation coefficient (r) = 0.72; P < 0.001]. Stratified by delay-to-completion, correlation coefficients were roughly similar for evaluations completed within 0 days (r = 0.77; P < 0.001), 1–3 days (r = 0.73; P < 0.001), and 4–13 days after surgery (r = 0.70; P < 0.001). Although still statistically significant, this correlation was only moderately positive for evaluations entered within 14–38 days (r = 0.60; P < 0.001) or over 38 days (r = 0.52; P < 0.001) after surgery. We found strong evidence for an interaction between the time to completion of OEA scores and OEA evaluator score reliability (P < 0.001). CONCLUSIONS Our data support the reliability of OEA evaluator scores completed until 2 weeks from the case, with significantly decreased reliability associated with delayed completion. This represents a useful refinement in the interpretation of evaluation scores that is crucial as we move toward competency-based accreditation in surgical specialties. ACKNOWLEDGMENTS Michael Cohen assisted with data extraction for Operative Entrustability Assessment data. He was not compensated for this contribution. We thank the residents and faculty at the Johns Hopkins School of Medicine Department of Plastic and Reconstructive Surgery in making use of and continuously providing feedback on the Operative Entrustability Assessment.

Using GoPro to Give Video-Assisted Operative Feedback for Surgery Residents: A Feasibility and Utility Assessment

As an adjunct to simulation-based teaching, laparoscopic video-based surgical coaching has been an effective tool to augment surgical education. However, the wide use of video review in open surgery has been limited primarily due to technological and logistical challenges. The aims of our study were to (1) evaluate perceptions of general surgery (GS) residents on video-assisted operative instruction and (2) conduct a pilot study using a head-mounted GoPro in conjunction with the operative performance rating system to assess feasibility of providing video review to enhance operative feedback during open procedures. GS residents were anonymously surveyed to evaluate their perceptions of oral and written operative feedback and use of video-based operative resources. We then conducted a pilot study of 10 GS residents to assess the utility and feasibility of using a GoPro to record resident performance of an arteriovenous fistula creation with an attending surgeon. Categorical variables were analyzed using the chi-square test. Academic, tertiary medical center. GS residents and faculty. A total of 59 GS residents were anonymously surveyed (response rate = 65.5%). A total of 40% (n = 24) of residents reported that structured evaluations rarely or never provided meaningful feedback. When feedback was received, 55% (n = 32) residents reported that it was only rarely or sometimes in regard to their operative skills. There was no significant difference in surveyed responses among junior postgraduate year (PGY 1-2), senior (PGY 3-4), or chief residents (PGY-5). A total of 80% (n = 8) of residents found the use of GoPro video review very or extremely useful for education; they also deemed video review more useful for operative feedback than written or communicative feedback. An overwhelming majority (90%, n = 9) felt that video review would lead to improved technical skills, wanted to review the video with the attending surgeon for further feedback, and desired expansion of this tool to include additional procedures. Although there has been progress toward improving operative feedback, room for further improvement remains. The use of a head-mounted GoPro is a dynamic tool that provides high-quality video for operative review and has the potential to augment the training experience of GS residents. Future studies exploring a wide array of open procedures involving a greater number of trainees will be needed to further define the use of this resource.