Potential Implications For Training Research Articles

Augmented reality in ultrasound-guided regional anaesthesia: an exploratory study with potential implications for training

Augmented reality in ultrasound-guided regional anaesthesia: an exploratory study with potential implications for training

Augmented Reality in Ultrasound-Guided Regional Anaesthesia: An Exploratory Study on Models With Potential Implications for Training.

Introduction Needle tip visualisation is a key skill required for the safe practice of ultrasound-guided regional anaesthesia (UGRA). This exploratory study assesses the utility of a novel augmented reality device, NeedleTrainer™, to differentiate between anaesthetists with varying levels of UGRA experience in a simulated environment. Methods Four groups of five participants were recruited (n = 20): novice, early career, experienced anaesthetists, and UGRA experts. Each participant performed three simulated UGRA blocks using NeedleTrainer™ on healthy volunteers (n = 60). The primary aim was to determine whether there was a difference in needle tip visibility, as calculated by the device, between groups of anaesthetists with differing levels of UGRA experience. Secondary aims included the assessment of simulated block conduct by an expert assessor and subjective participant self-assessment. Results The percentage of time the simulated needle tip was maintained in view was higher in the UGRA expert group (57.1%) versus the other three groups (novice 41.8%, early career 44.5%, and experienced anaesthetists 43.6%), but did not reach statistical significance (p = 0.05). An expert assessor was able to differentiate between participants of different UGRA experiencewhen assessing needle tip visibility (novice 3.3 out of 10, early career 5.1, experienced anaesthetists 5.9, UGRA expert group 8.7; p < 0.01) and final needle tip placement (novice 4.2 out of 10, early career 5.6, experienced anaesthetists 6.8, UGRA expert group 8.9; p < 0.01). Subjective self-assessment by participants did not differentiate UGRA experience when assessing needle tip visibility (p = 0.07) or final needle tip placement (p = 0.07). Discussion An expert assessor was able to differentiate between participants with different levels of UGRA experience in this simulated environment. Objective NeedleTrainer™ andsubjective participantassessmentsdid not reach statistical significance. The findings are novel as simulated needling using live human subjects has not been assessed before, and no previous studies have attempted to objectively quantify needle tip visibility during simulated UGRA techniques. Future research should include larger sample sizes to further assess the potential use of such technology.

Learning Curve for Ultrasound Assessment of Myometrial Infiltration in Endometrial Cancer Visualizing Videoclips: Potential Implications for Training.

Diagnostic accuracy for estimating myometrial infiltration by ultrasound in endometrial cancer requires experience. The objective of this study is to determine the learning curve (LC) for assessing myometrial infiltration in cases of endometrial cancer using transvaginal ultrasound (TVS). Five trainees (one staff radiologist and four fourth-year OB/GYN residents) participated in this study. All trainees had experience in performing TVS, but none of them had specific training on the assessment of myometrial infiltration. Trainees were given one specific lecture about the topic, and then they observed videoclips from 10 cases explained by the trainer. After this, all trainees visualized 45 videoclips of uterine ultrasound scans of endometrial cancer cases. The assessment of myometrial infiltration was based on the subjective impression. Definitive histology was used as a reference standard. Trainees stated whether myometrial infiltration was ≥50% or <50%. LC-CUSUM and standard CUSUM graphics were plotted to determine how many cases were needed to reach competence, allowing a mistake rate of 15%. All trainees completed the study. LC-CUSUM graphics showed that three trainees reached competence at the 33rd, 35th and 36th case, respectively. All three of them kept the process under control after reaching competence. One trainee reached competence but did not maintain it in the cumulative analysis. One trainee did not reach competence. Our study suggests that 30-40 cases would be needed to be trained for assessing myometrial infiltration by TVS by visual interpretation of videoclips by most trainees.

The Perception of Automation Reliability and Acceptance of Automated Advice

Examine (1) the extent to which humans can accurately estimate automation reliability and calibrate to changes in reliability, and how this is impacted by the recent accuracy of automation; and (2) factors that impact the acceptance of automated advice, including true automation reliability, reliability perception, and the difference between an operator's perception of automation reliability and perception of their own reliability. Existing evidence suggests humans can adapt to changes in automation reliability but generally underestimate reliability. Cognitive science indicates that humans heavily weight evidence from more recent experiences. Participants monitored the behavior of maritime vessels (contacts) in order to classify them, and then received advice from automation regarding classification. Participants were assigned to either an initially high (90%) or low (60%) automation reliability condition. After some time, reliability switched to 75% in both conditions. Participants initially underestimated automation reliability. After the change in true reliability, estimates in both conditions moved towards the common true reliability, but did not reach it. There were recency effects, with lower future reliability estimates immediately following incorrect automation advice. With lower initial reliability, automation acceptance rates tracked true reliability more closely than perceived reliability. A positive difference between participant assessments of the reliability of automation and their own reliability predicted greater automation acceptance. Humans underestimate the reliability of automation, and we have demonstrated several critical factors that impact the perception of automation reliability and automation use. The findings have potential implications for training and adaptive human-automation teaming.

Intuitive and deliberative approaches for diagnosing 'well' versus 'unwell': evidence from eyetracking, and potential implications for training.

Rapidly assessing how ill a patient is based on their immediate presentation-colloquially termed 'eyeballing' in practice-serves a vitalrole in acute care settings. Yet surprisingly little is known about how this diagnostic skill is learned or how it should be taught. Some authors have pointed to a dual-process model, suggesting that assessments of illness severity are driven by two distinct types of processing: an intuitive, fast, pattern recognition-like process (Type 1) that depends on many prior patient encounters and outcomes beingstored in memory; and a deliberate, slow, analytic process (Type 2) characterized by additional data gathering, data scrutiny, or recollection of rules. But prior studies have supported a dual-process model for the assessment of illness severity only insofar as experienced clinicians chiefly displayed what was presumed to be Type 1 processing. Here we further explored a dual-process model by examining whether less experienced clinicians displayed both types of processing when assessing illness severity across a series of cases. Consistent with the model, a dissociation between Type 1 and Type 2 processing was observed through resident reports of deliberation, response times, and three eye tracking metrics associated with diagnostic expertise. We conclude by discussing potential implications for the training of this enigmatic diagnostic skill.

Using concept mapping to understand motivational interviewing practice

PurposeMotivational interviewing (MI) has developed considerably since its inception, which may have led to diverse practice across contexts and differential understanding of core principles. Concept mapping is one potential method for offering insight into practitioner awareness, understanding and application of MI. The paper aims to discuss this issue.Design/methodology/approachIn total, 29 professionals from a range of disciplines, including counselling, education and health, completed concept maps about MI, following brief training at the UK regional MI interest network. In total, 17 completed maps were submitted for analysis using quantitative and qualitative methods.FindingsA total of 186 concepts and 175 propositional links were found within the 17 maps. The most commonly identified concepts were: change, empathy, collaboration, open-ended questions, affirmations, reflections, summaries (OARS), client centred and compassion. The concept maps also suggested differing levels of expertise across network members using concept mapping morphology classification.Research limitations/implicationsThe sample was small scale and located in one region of the UK. Maps were submitted anonymously meaning that participant data could not be matched to the maps.Practical implicationsConcept mapping is a potentially useful method for auditing practice and developing skills in MI, as well as exploring participants’ understanding of related concepts and therapeutic mechanisms.Social implicationsMI has a strong evidence-based across a variety of disciplines and contexts. Refining practitioner skills in MI has implications for the integrity of delivery, and improved client outcomes in areas such as substance use, health promotion and educational disaffection.Originality/valueThis is the first study to investigate concept mapping as a means of understanding MI practice. It has potential implications for training, monitoring, supervision and development in MI practice.

The influence of ‘High’ vs. ‘Low’ rape myth acceptance on police officers' judgements of victim and perpetrator responsibility, and rape authenticity

PurposePrevious studies suggest that officers' level of rape myth acceptance (RMA) is predictive of their case decision making and judgements towards victim-survivors. However, few studies have directly assessed the relationship between RMA and responsibility and authenticity judgments. Methods808 UK police officers categorised as ‘high’ or ‘low’ in rape myth acceptance made judgements of victim and perpetrator responsibility, and case authenticity, towards one of 16 vignettes depicting a hypothetical rape scenario varying on victim-perpetrator relationship, victim reputation, and initial point of resistance. ResultsOfficers categorised as ‘high’ in RMA rated victims as more responsible, perpetrators as less responsible, and cases as less authentic than those deemed to be ‘low’ in RMA. When rape-myth related factors were present, both individually and in combination, judgements by officers ‘high’ in RMA were more negative than those ‘low’ in RMA. ConclusionsResults suggest that officers ‘high’ in RMA may judge victims of rape differently to those ‘low’ in RMA, particularly when rape myth-related extra-legal case factors are present. The potential implications for training and selection are discussed.

Psychologically Informed Practice for Management of Low Back Pain: Future Directions in Practice and Research

In this perspective article, a number of conclusions and recommendations are offered based on the articles in this special issue of PTJ. In this special issue, a new approach to physical therapy, termed "psychologically informed practice," is offered as a "middle way" between narrowly focused standard physical therapist practice based on biomedical principles and the more cognitive-behavioral approaches developed originally for the treatment of mental illness. This new approach uses the "flags" framework, with psychologically informed practice requiring routine and specific consideration of "yellow flags" and "blue flags" (depending on clinical setting) for determining risk of poor outcome and identifying the potential for treatment modification-but with cognizance of the overall environment or context in which the clinician must operate. This context includes professional culture, health care policy, and insurance reimbursement (potential "black flags"). The primary goal of this approach is to prevent the development of unnecessary pain-associated activity limitations. The approach is based on the identification of normal psychological processes that affect the perception of pain and the response to it as an expected and normal part of the musculoskeletal pain experience and that are potentially modifiable. The potential for linking risk identification with targeted treatment has been discussed, this article focuses on the potential implications for training and implementation, drawing on experience in developing training programs in which the trainees have welcomed this new approach, viewing it as a helpful extension of their basic professional training. Indeed, this new approach can be viewed as evolutionary rather than revolutionary, in that it builds upon the established professional expertise of physical therapists, but incorporates systematic attention to the psychosocial factors that are associated with outcome of treatment.

Social identity is key to human resources development

PurposeThe aims of this paper is to reviews the latest management development across the globe and pinpoint practical implications from cutting‐edge research and case studies.Design/methodology/approachThis briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context.FindingsThe paper finds that, despite being overlooked in the literature on training and development, social identity is a critical factor influencing learning and performance in organizations. Social identity is important because it provides insights about individual behavior in groups and the group dynamics that affect individual learning and performance. There is a gap in human resources development to provide training at a group level. Although the individual is usually placed at the centre of the organization, it is essential to recognize identity‐related constraints beyond the individual level to ensure continuous individual learning. This article reviews social identity theory and looks at its potential implications for training and development.Practical implicationsThe paper provides strategic insights and practical thinking that have influenced some of the world's leading organizations.Originality/valueThe briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy‐to‐digest format.