Placement Quality Research Articles

Expanding clinical placement opportunities: Exploring night shift experiences for nursing students

Academic programs grapple with the daunting task of managing a growing influx of nursing students while ensuring the quality and accessibility of clinical placements, and simultaneously engaging in competition among themselves to secure diverse clinical sites. This article delves into the innovative approach of integrating night shift clinical placements for nursing students to address the challenges posed by growing competition for day shift opportunities in acute care hospital settings. With pressure mounting on academic programs to accommodate a rising number of qualified nursing students while ensuring sufficient clinical placements, this initiative aims to alleviate strain on day shift nursing staff, mitigate teaching fatigue, and provide students with diverse learning experiences. Drawing upon a comprehensive review of literature and practical considerations, this article presents a detailed exploration of the benefits, planning processes, implementation strategies, and evaluation methods associated with night shift clinical placements in prelicensure nursing programs.

Employment Skills in Tertiary Work-Based Learning: A Multiple-Stakeholder Investigation into China’s “3 + 1” Programs

Rapid economic development and globalization have reshaped the labor market, demanding a highly skilled and adaptable workforce. Tertiary education institutions worldwide have increasingly incorporated work-based learning into their curricula to close the gap between academic knowledge and practical skills. In China, the “3 + 1” programs, combining three years of academic study with one year of practical training, have emerged as a prominent work-based learning model. Despite the strategic importance of these programs, critical gap in consensus remains regarding the specific employment skills that should be imparted, leading to unemployment or underemployment of graduates and employer dissatisfaction. This qualitative study explores the employment skills expected from students in China’s “3 + 1” programs and identifies factors contributing to effective program organization. Through insights gathered from in-depth interviews with multiple stakeholders, including 28 students, educators, and employers, the study highlights the importance of industry-academia collaboration, curriculum relevance and flexibility, professional development for educators, enhanced work placement quality, and effective feedback mechanisms. The findings suggest that these strategies can promote effective work-based learning, equipping graduates with the essential skills emphasized by multiple stakeholders in the study, such as technical proficiency, problem solving, effective communication, teamwork and cooperation, adaptability and agility, digital literacy and technological skills, innovation and creativity, and initiative and proactivity. The study offers implications for both educational institutions and policymakers aiming to improve graduate employability, particularly by enhancing the quality of the “3 + 1” programs through the effective integration of academic studies and industrial training.

FP6.1 - Core Surgical Training in Northern Ireland: Regional Compliance with Quality Indicators

Abstract Aims Standards for training programmes are set by the GMC, with the Joint Committee for Surgical Training developing a curriculum and quality indicators (QIs) specific to Core Surgical Training. To ensure local training fits within these guidelines, placement quality is evaluated by NIMDTA, using specialty specific surveys sent to all Core Trainees in the region. Methods A survey, related to their current post, was sent to all Core Trainees in Northern Ireland. The responses were collated and cross-referenced against the 14 generic QIs for Core Surgery in order to assess compliance with published standards. Results Response rate from trainees was 70%. Compliance with the quality indicators was generally poor; 24% of trainees reported receiving the recommended 2 hours per week of formal teaching, 59% were able to complete a quality improvement project, 83% of trainees completed a learning agreement within the recommended 6 weeks from post commencement, 21% reported adequate exposure to simulation training and only 11% reported attending the expected one or more MDT meetings per week. Conclusions The level of adherence to the QIs for core surgery in Northern Ireland could be significantly improved. Despite some themes achieving a majority response in line with the QIs, overall alignment is poor. Subsequently we have developed key recommendations for focused improvement in the local Core Training programme in NI in an effort to better align our training with the JCST QI framework. A further survey will be conducted to assess the effect of these recommendations on compliance with JCST QIs.

Factors influencing nursing student satisfaction in aged care placements: An Australian cross-sectional study

AimThis study aimed to investigate factors influencing nursing students’ satisfaction with aged care placements. BackgroundProviding positive clinical experiences in aged care is crucial for students to learn safe, quality care and to foster a sustainable workforce. DesignCross-sectional study MethodsNursing students in nursing degrees participated in the national placement evaluation survey. A total of 2378 responses were extracted from the national clinical placement evaluation survey in 2023. Using multinomial logistic regression, demographics, academic, placement characteristics and placement education quality (clinical environment and learning support) were investigated in relation to three different levels of students' overall satisfaction (low, moderate, high). ResultsStudents reported overall satisfaction with their clinical placement, with a mean score of 7.9 (SD=2.1) on a 10-point scale. While most students agreed that they had achieved their learning objectives (90.0 %), they reported limited opportunities to interact with the multidisciplinary team (80.0 %). Further, students reported a relatively negative experience with staff, such as willingness to work with students (78.9 %) and being positive role models (78.9 %). Comparing the low satisfaction group to the moderate satisfaction group, male gender, identifying as an indigenous student and higher academic years increased the odds of being ‘least satisfied’, whereas international students, whose first language was not English and those with higher perceived placement education quality scores had lower odds of low satisfaction group membership. Conversely, compared with the moderate satisfaction group, those with the highest satisfaction with their clinical placement had a greater odds of being older, an international student and having higher scores in placement quality for the clinical environment and learning support. This model predicted 58.7 % of students' overall satisfaction. ConclusionsPositive learning experiences in aged care may promote the importance of practice in this area to new graduates. Despite students’ overall positive satisfaction with aged care placements, it is clear there are areas to address: a need to develop a structured approach to enhance aged care clinical experiences, progressive development of learning objectives, enhancing student career preparation and increasing participation in interprofessional collaboration may be useful approaches.

A Review Paper on the Crucial Factors that Influencing RMC Delivery Operation

The delivery process of ready-mix concrete (RMC) is a critical component in construction projects, influencing the quality, efficiency, and timeliness of concrete placement. This abstract explores the various factors that impact the RMC delivery process, ranging from logistical considerations to concrete properties and customer requirements. Key factors affecting RMC delivery include the distance to the construction site, traffic conditions, weather, regulatory constraints, batching plant operations, order volume, customer specifications, concrete mix design, truck capacity, and communication channels among stakeholders. Each of these factors can significantly influence the success of RMC delivery, posing challenges and opportunities for optimization.

Paramedic student and preceptor experiences of a clinical facilitator model during ambulance clinical placements: A qualitative study

Introduction: Ambulance service clinical placements are fundamental to paramedicine student education, but the quality and safety of these placements can be highly variable. Inspired by positive results from a nursing facilitator model, this study reports on a collaboration between an Australian university and ambulance service that introduced a paramedic clinical facilitator for undergraduate paramedic students during their ambulance clinical placements. This article describes the experiences of a clinical facilitator model for paramedicine students and their preceptors during the study period. Methods: This study follows an exploratory qualitative research methodology. After implementation of the paramedic clinical facilitator model, two focus groups with paramedicine student participants and two semi-structured interviews with their paramedic preceptors were conducted. Intimate observations were recorded in a reflexive logbook by the facilitator, which was kept for data analysis. Purposive sampling was used to recruit participants, and thematic analysis was used to code data and conceptualise themes. Results: Three broad overarching themes were conceptualised from the data: 1) increased educational opportunities, 2) improved clinical placement management and 3) greater student support and welfare. Both paramedicine students and paramedic preceptors felt that the paramedic clinical facilitator model improved the quality of ambulance clinical placements for undergraduate paramedicine students. Conclusion: This study suggests that a paramedic clinical facilitator model improved the safety and quality of ambulance clinical placement experience for paramedicine students and preceptors. Universities and ambulance services could consider implementing a paramedic facilitator model for ambulance clinical placements in their local contexts.

Development of the Clinical Placement Quality Survey – Educator (CPQS-E) Tool to Evaluate the Quality of Physiotherapy Clinical Placements

Background: Increasing demand for entry-level clinical education placements has resulted in changes to traditional models. In this evolving landscape, the ability to effectively assess clinical placement quality is critical. However, existing tools are not specific to physiotherapy and/or have focused on student’s perspectives. Purpose: To design a tool that can be utilised by clinical education providers to measure the quality of physiotherapy clinical placements. Methods: A survey was developed based on published recommendations for quality indicators in clinical education. Content and face validity were established using an expert panel of clinical educators (n=18). Test-retest reliability was tested via physiotherapy clinical educators (n=62) completing the survey twice over a two-week period. Reliability of the survey was assessed using intraclass correlation coefficients (ICC), test-retest percentage agreement, and Cronbach’s alpha. Results: The ICC of 0.87 indicated minimal measurement error. The majority (98%, n=62) of test items met criteria for close agreement. The correlation coefficient of reliability ranged from 0.73 to 0.87 across four defined constructs. Conclusion: Initial assessment of the Clinical Placement Quality Survey - Educator (CPQS-E) tool indicates that its properties provide a valid and reliable measure of entry-level physiotherapy placement quality from the perspective of the clinical educator.

A clinical study of HoloSight Orthopaedic Trauma Surgery Robot-assisted infra-acetabular screw placement for acetabular fractures

To investigate the effectiveness of HoloSight Orthopaedic Trauma Surgery Robot-assisted infra-acetabular screw placement for treatment of acetabular fractures. The clinical data of 23 patients with acetabular fractures treated with open reduction and internal fixation and infra-acetabular screw placement in two medical centers between June 2022 and October 2023 were retrospectively analyzed. According to the the method of infra-acetabular screw placement, the patients were divided into navigation group (10 cases, using HoloSight Orthopaedic Trauma Surgery Robot-assisted screw placement) and freehand group (13 cases, using traditional X-ray fluoroscopy to guide screw placement). There was no significant difference in gender, age, body mass index, cause of injury, time from injury to operation, and Judet-Letournel classification between the two groups ( P>0.05). The time of infra-acetabular screw placement, the fluoroscopy frequency, the guide pin adjustment times, the quality of screw placement, the quality of fracture reduction, and the function of hip joint were compared between the two groups. All patients completed the operation successfully. The time of screw placement, the fluoroscopy frequency, and guide pin adjustment times in the navigation group were significantly less than those in the freehand group ( P<0.05). The quality of screw placement in the navigation group was significantly better than that in the freehand group ( P<0.05). Patients in both groups were followed up 6-11 months, with an average of 7.7 months. There were 9 and 9 cases in the navigation group and the freehand group who achieved excellent and good fracture reduction quality at 1 week after operation, and 12 and 12 cases with excellent and good hip joint function at last follow-up, respectively, and there was no significant difference between the two groups ( P>0.05). The fractures in both groups healed well, and there was no significant difference in healing time ( P>0.05). During the follow-up, there was no complication related to screw placement, such as failure of internal fixation, vascular and nerve injury, incisional hernia. In the treatment of acetabular fractures, compared with the traditional freehand screw placement, the HoloSight Orthopaedic Trauma Surgery Robot-assisted screw placement can reduce the time of screw placement, improve the accuracy of screw placement, and reduce the amount of radiation, which is an efficient, accurate, and safe surgical method.

Improving the quality of allied health placements: student, educator and organisational preparedness

ABSTRACT Work Integrated Learning is essential for healthcare degrees where students learn to become healthcare professionals. As a complex form of learning the quality of student placement experiences are variable, impacting student wellbeing and development of professional competencies. Getting it right, students enter the workforce ready to practice. Getting it wrong can have deleterious effects on all stakeholders. Although research has examined placement quality for students, less is known about the experiences of other stakeholder groups (e.g. placement educators, university academics and professional support staff). Our research addresses this gap. Using narrative interviewing methods, underpinned by social constructionism, we interviewed fifty-one participants: 19 allied healthcare students, 15 placement educators, 12 university academics and 5 professional staff from a large Australian university. We identified four preparedness themes impacting on placement quality, namely: University, Placement Site, Placement educator and Student preparedness. Within these themes, good practice is highlighted alongside examples of unsettling experiences. Curricula should be reviewed to ensure students are prepared as agentic learners for the complexities of the workplace. Furthermore, universities should co-design placements in partnership with healthcare organisations and educators to enable students to optimise their learning and contribution to patient/client care.

Radiographic assessment of dental post and core placement at different educational levels in an undergraduate student clinic: a 4-year retrospective study.

Dental post and core is one of the common procedures performed after endodontic treatment. The aim of this study was to radiographically assess the quality of post and core procedures performed by dental students at different education levels in addition to determining the most critical errors encountered during their clinical practice. A retrospective cross-sectional study design was conducted in the College of Dentistry, Imam Abdulrahman Bin Faisal University. A total of 550 periapical radiographs (PAs) of cemented posts were retrieved from the records of patients treated by dental students. Parameters and guidelines for assessing the quality of post treatment have been determined and statistically analyzed. A P value <0.05 was considered statistically significant. The study included 502 students and most of them were females (66.5%). Data were obtained from 502 patients (62% females) with fiber posts used in 98.2% of the cases. About 50% of the posts were inserted in premolars, 62.9% in the upper arch, and 66.7% were restored with crowns as a final restoration. Regarding the quality of posts, 98.4% showed good preparation quality and 98% showed good radiographic quality. The post diameter was equal to 1/3 of the root diameter in 31.9% of the cases; post length was equal to 2/3 of root length in 5% of the cases and equal to or more than crown height in all cases (100%). Length of the remaining gutta percha (GP) was between 3-5 mm in 38.8%, and there was no gap between the post and remaining GP in 95.6% of the cases. There were no statistically significant differences between dental students at different clinical educational levels regarding the quality of post placement. The quality of post and core procedures performed by students showed acceptable radiographic quality and were within the recommended standards.

Fundamental and Practical Feasibility of Electrocardiogram Reconstruction from Photoplethysmogram.

Electrocardiogram (ECG) reconstruction from contact photoplethysmogram (PPG) would be transformative for cardiac monitoring. We investigated the fundamental and practical feasibility of such reconstruction by first replicating pioneering work in the field, with the aim of assessing the methods and evaluation metrics used. We then expanded existing research by investigating different cycle segmentation methods and different evaluation scenarios to robustly verify both fundamental feasibility, as well as practical potential. We found that reconstruction using the discrete cosine transform (DCT) and a linear ridge regression model shows good results when PPG and ECG cycles are semantically aligned-the ECG R peak and PPG systolic peak are aligned-before training the model. Such reconstruction can be useful from a morphological perspective, but loses important physiological information (precise R peak location) due to cycle alignment. We also found better performance when personalization was used in training, while a general model in a leave-one-subject-out evaluation performed poorly, showing that a general mapping between PPG and ECG is difficult to derive. While such reconstruction is valuable, as the ECG contains more fine-grained information about the cardiac activity as well as offers a different modality (electrical signal) compared to the PPG (optical signal), our findings show that the usefulness of such reconstruction depends on the application, with a trade-off between morphological quality of QRS complexes and precise temporal placement of the R peak. Finally, we highlight future directions that may resolve existing problems and allow for reliable and robust cross-modal physiological monitoring using just PPG.

PreRoutGNN for Timing Prediction with Order Preserving Partition: Global Circuit Pre-training, Local Delay Learning and Attentional Cell Modeling

Pre-routing timing prediction has been recently studied for evaluating the quality of a candidate cell placement in chip design. It involves directly estimating the timing metrics for both pin-level (slack, slew) and edge-level (net delay, cell delay), without time-consuming routing. However, it often suffers from signal decay and error accumulation due to the long timing paths in large-scale industrial circuits. To address these challenges, we propose a two-stage approach. First, we propose global circuit training to pre-train a graph auto-encoder that learns the global graph embedding from circuit netlist. Second, we use a novel node updating scheme for message passing on GCN, following the topological sorting sequence of the learned graph embedding and circuit graph. This scheme residually models the local time delay between two adjacent pins in the updating sequence, and extracts the lookup table information inside each cell via a new attention mechanism. To handle large-scale circuits efficiently, we introduce an order preserving partition scheme that reduces memory consumption while maintaining the topological dependencies. Experiments on 21 real world circuits achieve a new SOTA R2 of 0.93 for slack prediction, which is significantly surpasses 0.59 by previous SOTA method. Code will be available at: https://github.com/Thinklab-SJTU/EDA-AI.

An MPI-based parallel genetic algorithm for multiple geographical feature label placement based on the hybrid of fixed-sliding models

ABSTRACT Multiple Geographical Feature Label Placement (MGFLP) has been a fundamental problem in geographic information visualization for decades. Moreover, the nature of label positioning has proven to be an Nondeterministic polynomial-time hard (NP-hard) problem. Although advances in computer technology and robust approaches have addressed the problem of label positioning, the lengthy running time of MGFLP has not been a major focus of recent studies. Based on a hybrid of the fixed-position and sliding models, a Message Passing Interface (MPI) parallel genetic algorithm is proposed in the present study for MGFLP to label mixed types of geographical features. To evaluate the quality of label placement, a quality function is defined based on four quality metrics: label-feature conflict; label-label conflict; label association with the corresponding feature; label position priority for all three types of features. The experimental results show that the proposed algorithm outperforms the DDEGA, DDEGA-NM, and Parallel-MS in both label placement quality and computation time efficiency. Across three datasets, compared to Parallel-MS, running times decreased from 118.45 to 8.34, 45.98 to 3.51, and 20.01 to 0.43 min, with further reductions in label-label and label-feature conflicts.

GAN-Place: Advancing Open Source Placers to Commercial-quality Using Generative Adversarial Networks and Transfer Learning

Recently, GPU-accelerated placers such as DREAMPlace and Xplace have demonstrated their superiority over traditional CPU-reliant placers by achieving orders of magnitude speed up in placement runtime. However, due to their limited focus in placement objectives (e.g., wirelength and density), the placement quality achieved by DREAMPlace or Xplace is not comparable to that of commercial tools. In this article, to bridge the gap between open source and commercial placers, we present a novel placement optimization framework named GAN-Place that employs generative adversarial learning to transfer the placement quality of the industry-leading commercial placer, Synopsys ICC2, to existing open source GPU-accelerated placers (DREAMPlace and Xplace). Without the knowledge of the underlying proprietary algorithms or constraints used by the commercial tools, our framework facilitates transfer learning to directly enhance the open source placers by optimizing the proposed differentiable loss that denotes the “similarity” between DREAMPlace- or Xplace-generated placements and those in commercial databases. Experimental results on seven industrial designs not only show that our GAN-Place immediately improves the Power, Performance, and Area metrics at the placement stage but also demonstrates that these improvements last firmly to the post-route stage, where we observe improvements by up to 8.3% in wirelength, 7.4% in power, and 37.6% in Total Negative Slack on a commercial CPU benchmark.

An Efficient and Autonomous Planning Scheme for Deploying IoT Services in Fog Computing: A Metaheuristic-Based Approach

The fog computing paradigm is a promising concept to overcome the exponential increase in data volume in Internet of Things (IoT) applications. This paradigm can support delay-sensitive IoT applications by extending cloud services to the network edge. However, fog computing faces challenges such as resource allocation for applications at the network edge due to limited resources as well as its heterogeneous and distributed nature. This is in line with the goals of microservice architecture and develops the placement of microservice-based IoT applications. The IoT service placement problem (SPP) on fog nodes is known as non-deterministic polynomial-time (NP)-hard. In this study, we introduce a meta-heuristic approach named SPP-differential evolution algorithm (DEA) to handle SPP, which originates from the DEA with a shared parallel architecture. The proposed method takes advantage of the scalable and deployable nature of microservices to minimize the resource utilization and delay as much as possible. SPP-DEA is developed based on monitoring, analysis, decision-making, and execution with knowledge bas (MADE-k) autonomous planning model with the aim of compromise between service cost, response time, resource utilization, and throughput. In order to address the computational complexity of the problem, we consider the resource consumption distribution and service deployment priority in the placement process. In order to evaluate the quality of placement in SPP-DEA, extensive experiments have been performed on a synthetic fog environment. The simulation results show that compared to the state-of-the-art approaches, SPP-DEA reduces the service cost and waiting time by 16% and 11%, respectively.

Inefficiencies and bias in first job placement: The case of professional Asian nationals in the United States

We study whether the quality of the first job is lower for professional Asian nationals than for non-Asian nationals in the USA. With over a million professionals from Asia entering the US labor market in the past decade, a potential under placement may be both inefficient and discriminatory. We collected data on all newly hired assistant professors of management in research-intensive (R1) universities in the USA between 2010 and 2021. We focus on the quality of the university into which first hires are placed and examine whether first-job placement quality is lower for individuals who were born in East, South and Southeast Asia. We find that the quality and quantity of publication record are positively related to the quality of the placement and that Asian nationals have higher performance. However, Asian nationals are placed at lower-quality universities relative to their peers. Further, Asian nationals require a strong performance signal, in the form of first or second authorship on a publication to narrow the placement gap. Our results are explained by a combination of direct bias against applicants of Asian nationality and a requirement of a higher performance “burden of proof” from these applicants, compared to peers who are non-Asian nationals.

Reflection in Professional Practice and Education in Engineering, Nursing, and Teaching

Background: Critical reflection is an essential curricular component for learning from experience that determines placement quality in postsecondary experiential learning placements. However, there are poor empirical connections between the use of critically reflective processes and learning outcomes. Purpose: This research explored reflective processes professionals use in their practice and how these processes compare with the reflective activities postsecondary instructors in professional faculties use during experiential learning. Methodology/Approach: This collective case study used focus group interviews, field notes, and professional grey literature to examine the research questions. Findings/Conclusions: Professional training programs must align their reflective practices with more integrated and holistic models of reflective practice to better mirror the professional skills demanded in professional practice contexts. Professionals in context-laden professional environments should integrate reflective activities into their practice based on emergent, iterative, and cocreative models that are more like their lived realities at work. Reflective practices which better fit and mirror these lived realities may lead to better connections between reflective activities and work outcomes. Implications: Professional environments are complex, dynamic, and affected by contextual factors. New integrated and holistic models of reflective experience should replace the separated, stepwise, or automatic models that have guided reflective practices in the past.

Students’ evaluation of professional experience placement quality in a pre-registration nursing programme: A cross-sectional survey

AimTo evaluate the quality of student nurses' experiences and overall satisfaction with professional experience placements at a regional Australian University. BackgroundProfessional experience placements are a crucial component of pre-registration nursing programs. However, the absence of standardised approaches to assess placement quality has created uncertainty on what constitutes a high-quality placement from a student’s perspective. DesignCross-sectional survey. MethodsA descriptive cross-sectional survey was administered online to 800 second and third year undergraduate nursing students at an Australian university. The survey contains demographic questions (e.g., year of study, placement specialty, duration, setting and geographic location), a validated Placement Evaluation Tool and free-text comments. The Placement Evaluation Tool is a 20-item questionnaire that measures two key factors: clinical environment (factor 1), learning support (factor 2) and overall satisfaction of students’ learning experiences during a professional experience placement. A descriptive analysis was conducted to evaluate the student’s overall experience and satisfaction. Multivariate linear regression was used to assess the relationship between the quality of the student experience and demographics and presented as beta coefficient (β) and confidence interval (CI). Free-text comments were thematically analysed. ResultsA total of 1104 survey responses were received (as students may rate more than one placement), with an estimated 71% response rate. Most responses (60.3%) were third-year students. Most students experienced high-quality placements, reflected in the overall positive placement experience (PET item 1–19 score: mean 85.9 out of 95) and high student satisfaction (PET item 20: mean 8.53 out of 10). Multiple linear regression analyses revealed that the third year of study and public facilities were independent predictors of positive student experiences (β: 2.61, 95% CI: 0.75, 4.47 and β: 3.72, CI: 0.90, 6.55, respectively). Further analysis of PET items related to factor 1 and factor 2 revealed that high positive experiences in public facilities may be due to the higher learning support (β: 2.54, CI: 0.80, 4.27). Three main themes were perceived to be important to students' professional experience: (i) staff and facilitator attitudes, (ii) learning opportunities and (iii) a team-based learning environment. ConclusionsMost students reported high-quality placement experience and high satisfaction; however, a lack of learning support may contribute to less positive student experiences. This finding emphasises the importance of collaboration between clinical facilities and educational institutions to enhance the student’s placement experience.

Enhancing Placements in Educational Institutes: A Novel Approach

Abstract—The ABC analysis is an established inventory control technique in the industry wherein the available inventory is divided into three categories. It is similar to the Pareto principle and provides a mechanism to segregate the material into different categories based on their values to the industries. This study presents a novel approach of extending the concept of ABC analysis to the companies visiting the institutes for conducting the campus interview. The primary objective of this study was to enhance the quality and number of placements in the institute by classifying the industries as per the ABC analysis. The data of 268 companies visiting the institute over a period of eight years was documented and analyzed. After careful deliberations, a formula was established to determine the value of each company offering placements. The percentage value obtained for every company was used to segregate the companies into A, B and C categories. For calculations, the study has considered only the number of placements and average package offered by the visiting companies. Thereafter certain initiatives were undertaken by the institute for engaging with the industries. The motive was to enhance the quality of placements and to increase the industry-institute interactions in the institute. It was observed that the implementation of various initiatives led to an increase in the number of placements, average and maximum package. Within a year, the placements increased by 121 while the maximum package increased to 4.6 Lakhs. Pro-active engagement with the ‘A’ category companies have also resulted in additional benefits such as scholarships for needy students, increase in internships for students and increase in footfall of the industry experts and establishment of Centre of Excellence. The present study is a unique attempt to enhance the quality and number of placements in educational institutions. It represents a logical extension of a simple and commonly used technique in a different domain. This approach can be applied to any educational institute with suitable modifications for increasing the industry-institute interactions. Keywords: ABC Analysis, Educational Institutes, Engineering Graduates, Internships, Pareto Principle, Placements.

Functional Outcomes of Patients Who Underwent Anorectal Malformation Repair Using MRI Guidance

BackgroundDespite the initiation of minimally invasive laparoscopic techniques, the majority of patients who undergo anorectal malformation repair still experience functional bowel issues in childhood, including constipation and fecal incontinence. In this study, we evaluate the functional outcomes of a procedure in which magnetic resonance imaging guidance is used during initial laparoscopic repair to better locate the epicenter of the sphincter muscle complex and pelvic floor with the goal of more accurate placement of the neoanus and improved functional outcomes. MethodsA retrospective chart review evaluated demographic, operative, and outcome details for patients who underwent this procedure. A telephone survey was employed to determine levels of social continence using the validated Baylor Continence Scale and to determine what type of bowel management is used. ResultsTwenty-six patients were included. Median age at operation was 7 months, and median age at follow-up was 4 years old, with a range of 1–9. Bowel management regimen results revealed that 19 % (n = 5) use no bowel management regimen, 58 % (n = 15) use laxatives only, and 23 % (n = 6) use enemas. Enema use was not associated with different spine or sacral anomalies (p = 0.77). Fifteen patients (58 %) answered the Baylor Continence Scale questions and had a median score of 14. No difference was found in scores when accounting for lesion level (p = 0.43), quality of needle placement (p = 0.46), or quality of sphincter muscles (p = 0.75). ConclusionsUsing MRI guidance in the repair of anorectal malformations shows promise in both the qualitative and quantitative functional outcomes of this complex patient population. Level of EvidenceLevel III.