Regular Peer Research Articles

Caesarean Section Rate Reduced

The Caesarean section rate in consecutive years was decreased from 20.5% to 11.1% of total public deliveries (p < 0.0001). On retrospective analysis the emergency Caesarean section rate decreased from 10.9% to 6.0% (p < 0.0001) and elective Caesarean section rate from 9.6% to 5.1% (p < 0.0001) in consecutive years. Interventions which have accounted for the decrease were 3-fold. Firstly, vaginal birth after Caesarean delivery was encouraged, secondly, the active management of labour and thirdly, extensive, regular peer review were introduced as unit policy. The decrease in the Caesarean section rate was not achieved at the expense of the fetus as judged by perinatal mortality rates and 5-minute Apgar scores of less than 7.

Today I placed my father...

The aim of this study is to take a longitudinal approach to assess the value of an in-house program developed in a Singapore hospital over a two year period.Radiographers (n = 48) consented to take part in the study. The control group (CG: n = 40) continued with normal working practice whilst the remaining ‘additional training group’ (ATG: n = 8) participated in the hospital's in-house image interpretation program. Upon completion, all participants were assessed using a RadBench® test bank. All participants then continued to work in their normal clinical practice; however the ATG received regular peer support to reinforce learning and aid further development. One year later, the same populations were invited to sit another RadBench® assessment.The mean accuracy of both groups was very similar at phase one (70v71%). The ATG demonstrated higher mean sensitivity (83v72%) but the CG higher mean specificity (68v56%). One year later, with continued mentor support, the ATG demonstrated a marked improvement in mean accuracy over CG (86v70%) largely driven by a marked increase in mean specificity from 56 to 87%. 43% of the ATG could deliver exceptional standards for accuracy, sensitivity and specificity, ready and able to provide reliable preliminary clinical evaluation, versus none of the CG.In-house programmes could be a cost effective approach to skills development and ideally suited to preceptorship and new employee orientation in order to assess, develop and monitor image interpretation performance.

Quality assurance and clinical indicators in emergency medicine

Quality assurance and clinical indicators in emergency medicine

NAFE in Practice ‐ Implications for Staff Development

Abstract In 1987 Her Majesty's Inspectorate (HMI) published the findings of an inspecton of Non‐Advanced Further Education (NAFE) in England and Wales (HMSO, 1987). The inspection involved 11 curriculum areas and 34 colleges. This paper examines the implications for staff development of the findings of the HMI survey. It argues that more attention should be given to the quality of teaching skills and that regular peer review within colleges should have an important role in this respect. It considers the acquisition of new knowledge, opportunities for personal development and for some management training and development. It concludes by commenting on the link between staff development and institutional development.

Generalization and Adaptation of Learning Strategies to Natural Environments

This article is the second of a twopart series designed to review the critical features of facilitating generalization and adaptation of learning strategies. In Part 1, a model of generalization was presented along with research supportive of the model and identification of research needs. Essentially, the model views instruction for generalization not as something that comes at the end of an instructional sequence, but rather as consisting of four levels of generalization that transverse instruction—antecedent, concurrent, subsequent, and independent. The purpose of this article is to consolidate a number of studies that describe a unified set of specific instructional techniques that can be used while addressing generalization and to present them as part of an overall instructional approach for learning strategies. Within each level, specific procedures mediated by the special (or remedial) education teacher, regular content teacher, peer, and/or student are illustrated. Each category is followed by a synthesis of related teaching practices. The procedures identified here should not be considered definitive because demonstration of efficacy awaits additional validation; however, they do serve as a basis for planning instruction consistent with what has been learned about generalization to date.