Individual Skills Research Articles

Tailoring Education: A Comprehensive Review of Personalized Learning Approaches Based on Individual Strengths, Needs, Skills, and Interests

Background and Aims: Personalized learning is important because it tailors educational experiences to each student's needs and strengths, resulting in more effective and engaging learning. This approach not only improves academic performance but also accommodates students' learning styles and interests, resulting in increased motivation and success. This paper investigates Tailoring Education: A Comprehensive Review of Personalized Learning Approaches Based on Individual Strengths, Needs, Skills, and Interests. Methodology: This paper conducted a thorough analysis of various personalized learning approaches, such as adaptive learning technologies, differentiated instruction, and project-based learning. It combined findings from empirical studies, case studies, and theoretical frameworks to assess the efficacy and impact of these approaches on individual student needs and academic outcomes. Results: The finding found that personalized learning approaches demonstrate their significant potential for meeting individual student needs and improving educational outcomes. Adaptive learning technologies and differentiated instruction have successfully tailored learning experiences to students' strengths, whereas competency-based and project-based learning provides flexible, student-centered pathways for meaningful engagement and academic progress. Collectively, these methodologies help to create a more individualized and responsive educational environment. Conclusion: The findings show that personalized learning approaches effectively meet individual student needs while improving educational outcomes. These methodologies foster a more responsive and personalized learning environment by tailoring experiences to students' strengths and providing flexible, student-centered pathways.

Effects of Perceptual-motor Exercises Based on Multi-sensory Therapy on Sensory Processing of Older Adults

Objectives Aging is one of the stages of the life cycle that is accompanied by sensory changes and bodily awareness. This study aims to investigate the effectiveness of perceptual-motor exercises based on multi-sensory therapy on body image and sensory processing in elderly individuals with cognitive impairments. Methods & Materials The present study is a clinical trial with a pre-test-post-test design with an experimental and a control group, conducted in a double-blind manner. The samples were selected using the available sampling method and were randomly assigned to the control and experimental groups (15 participants in each group). The interventions were performed individually for each participant in 8 treatment sessions, 2 days a week, for a duration of 1 month. The assessment tools included the multidimensional body-self relations questionnaire (MBSRQ) and the sensory profile questionnaire. Results The results showed that the perceptual-motor exercises based on multi-sensory therapy had a significant difference in all cases of the MBSRQ (except for body satisfaction and preoccupation with excess body) and the sensory profile questionnaire in both groups (P<0.05). Additionally, the analysis of covariance in both questionnaires and in both groups was calculated to be less than 0.05 and significant. Conclusion The findings of this study showed that perceptual-motor exercises based on multi-sensory methods can improve body image and enhance sensory processing skills in elderly individuals with cognitive impairments. Therefore, educating and repeating these exercises can greatly assist therapists and clients in achieving more beneficial results.

Targeted feedback for Indonesian-speaking classrooms in higher education context: A perspective from educators’ lens

In today's interconnected world, excellent communication is essential to develop relationships and cooperate with people from various cultural backgrounds. Therefore, individuals with strong speaking abilities can explain their views clearly, negotiate successfully, and develop rapport across borders. However, many students are still facing difficulties and anxiety in producing spoken context in English classrooms. In terms of speaking skills in the EFL context, targeted feedback is a sort of instruction that is particular and focused, given to an individual based on their performance, activities, or habits. In educational settings, it is intended to specifically address specific parts of an individual's work or skill development in a precise manner. This qualitative study that involved 10 lecturers at college levels aimed to reveal their perspectives on the targeted feedback for speaking proficiency. The multiple-case study was applied here to identify and analyze the issue in speaking classrooms. Focus Group Discussion was conducted as a research instrument and analyzed using verbatim techniques. Findings revealed teachers are still facing challenges, yet they are exploring good chances to nurture students’ speaking skills at the same time. Additionally, the perspectives also figured out the principles of targeted feedback practised by the lecturers in speaking classes.

Manual wheelchair training approaches and intended training outcomes for adults who are new to wheelchair use: A scoping review.

Wheelchair training is pivotal for safety, independence, and occupational engagement in the community, yet adults coming into wheelchair use often receive insufficient or untailored training. This research aimed to understand the range and type of manual wheelchair training approaches that exist for adults commencing wheelchair use. A systematic scoping review involved searching eight electronic databases and grey literature up to September 2023. Papers relating to manual wheelchair training for adults and their caregivers were included for data extraction. Eighty-seven articles were included in this review. The International Classification of Functioning (ICF) was used to organise and analyse data related to intended training outcomes. Consumer consultation was not included in this review; however, the outcomes suggest that involving consumers in future wheelchair training research is critical to assure community participation outcomes. Data were extracted from 87 papers. Manual wheelchair training was delivered across diverse contexts encompassing varied support structures, trainer backgrounds, and technology and was commonly directed towards wheelchair users with spinal cord injury. Intended training outcomes most frequently mapped to the activity and participation component of the ICF (n= 39), followed by personal factors (n= 27), body structures and functions (n= 18), and environmental factors (n= 3), with limited focus on longer term occupational engagement outcomes. Most existing manual wheelchair training focussed on the acquisition of individual wheelchair skill and may not facilitate generalised and long-term occupational participation outcomes. Further exploration into the contexts that support occupational engagement, particularly for older adults with progressive conditions, is required to support service provision. We looked at what manual wheelchair training approaches exist for adults who need to use a manual wheelchair and what training helps people to do/achieve. We did a scoping review that looked at literature about manual wheelchair training programs for adult wheelchair users. We found 87 research papers and training programs that we included in our review. We recorded and analysed information from all the papers about the wheelchair training programs and outcomes for people who do these programs. We found that manual wheelchair training can be done in structured or ad hoc ways, can have different amounts of training, can be provided face-to-face or online, and can be given by different allied health professionals and other wheelchair users. Most training programs had short-term outcomes like learning manual wheelchair skills, being able to use the wheelchair properly, and feeling confident about using a wheelchair. Some had longer term outcomes about being able to use the manual wheelchair in everyday activities. Most people who did the training programs that we looked at in this review were manual wheelchair users with spinal cord injury. Because not many wheelchair programs have been tried with people who do not have a spinal cord injury, it is hard for occupational therapists to make recommendations about training for other people who use a manual wheelchair. Manual wheelchair training that is done in the community and made to meet the needs of individuals may help people with using their wheelchair for their everyday activities and participate in their community.

Diagnostic accuracy of the lactate stress test for detecting mitochondrial disorders: Systematic review and meta-analysis

Due to their variable phenotypes, mitochondrial disorders (MDs) can be difficult to diagnose. The absolute load lactate stress test (LSTA) and the relative load lactate stress test (LSTR) have been shown to be useful screening tools for the detection of MDs. In this study, we aimed to perform a meta-analysis to evaluate the diagnostic accuracy of these tests in detecting MDs. The study protocol was registered with PROSPERO (no. CRD42022331710). We performed a comprehensive search of PubMed, Web of Science and Scopus from January 10th, 2022 to July 27th, 2022 and included case-control and cohort diagnostic studies that targeted participants with MDs and used LSTA and/or LSTR as index tests. Two reviewers worked separately to compile information from selected articles. Risk of bias and applicability were assessed using the QUADAS-2 tool. Sensitivity and specificity, as well as diagnostic odds ratios (DORs) and area under the curve (AUC) were calculated using Meta-DiSc 2.0 and Stata software. The analysis included 14 studies with a total of 1064 participants, divided into six studies with 793 participants for LSTA and eight studies with 271 participants for LSTR. For LSTA the meta-analysis gave a pooled sensitivity of 0.67 (95 % CI 0.62, 0.72), a specificity of 0.93 (95 % CI 0.85, 0.97), DOR of 26.63 (95 % CI 10.99, 64.52), and AUC of 0.70 (95 % CI 0.66, 0.74). For LSTR, the pooled sensitivity was 0.52 (95 % CI 0.33, 0.70), specificity 0.94 (95 % CI 0.79, 0.99), DOR 18.14 (95 % CI 2.99, 109.85), and the AUC 0.80 (95 % CI 0.76, 0.83). LSTA and LSTR showed as screening tests moderate sensitivity and high specificity for MD diagnosis, particularly for LSTR. The choice of test may depend on the patient's individual aerobic capacity and motor skills and the availability of equipment.

Losing Top Talent: How Organizations Can Alienate Their Most Valuable Employees

Retaining top talent is crucial for organizational success but many firms unknowingly drive away their best employees. This article examines the major reasons outstanding performers seek opportunities elsewhere when their needs are overlooked. Through a review of relevant literature and analyses of industry examples, key factors are identified that alienate top contributors, such as focusing solely on tasks while neglecting human well-being, lacking career growth pathways, not acknowledging great work, and poor communication practices. Practical strategies are then presented for cultivating an environment where top performers want to stay long-term, such as building relationships, balancing work and life, providing learning opportunities, regularly expressing appreciation, fostering transparency, and empowering skilled individuals. The consulting industry example highlights retention challenges overcome by firms attending to human needs like mentorship and flexibility. Overall, leadership must recognize talent retention as dependent on fulfilling innate human needs within the workplace.

Ratio of accelerations to decelerations in Women’s division I lacrosse

This study analyzed the differences by position in acceleration, deceleration, and the ratio of accelerations to decelerations in drills and quarters of games (Q1-Q4). Data were collected in 23 female collegiate lacrosse athletes (20.8 ± 1.5 years, 168.3 ± 6.1 cm), consisting of ten midfielders, five defenders, and eight attackers. Drills were categorized as: stickwork (SW), small-sided games (SSG), warm-up (WU), active recovery (AR), individual skills (IS), scrimmage, and conditioning. AR (0.31 ± 0.09 accelerations/min) and WU (0.47 ± 0.07 accelerations/min) showed the lowest number of accelerations, and conditioning and SW were the highest (>1.0 accelerations/min). Conditioning showed the highest demand for decelerations (0.37 ± 0.14 decelerations/min) and AR and WU had the fewest (0.10 ± 0.04 decelerations/min). AR, IS, SW, and WU all had higher acceleration/deceleration ratios (4:1 to 5.7:1) than the remaining drill types (p = .000 - .050, 3:1-4:1). Q1 had a higher acceleration demand (0.72 ± 0.52 accelerations/minute) than the remaining three quarters (0.57 - 0.67 accelerations/min). The game demand in decelerations was approximately 0.20 decelerations/minute across all quarters and the acceleration/deceleration ratio was approximately 4:1, with the exception of defenders in Q1 who had 6:1 ratio. There is a large demand for accelerations in field lacrosse with no positional differences, and training should be devoted towards this skill.

Digital learning: Differentiated teaching models using ICT in a Greek context – Good Practices "We give money, we buy things"

The importance of money in people's lives today is an important and useful skill for individuals in a transactional society. Money management is a communication, transaction, and socialization skill. People with special educational needs and especially people with mental retardation with the right training can develop the skill of recognizing and using money. Differentiated teaching with the help of ICTs is an educational approach to knowledge suitable for teaching people without or with special educational needs.

Mindfulness-Based Interventions for People with Autism Spectrum Disorder: A Systematic Literature Review.

Mindfulness-based interventions (MBIs) have emerged in recent years as a strong candidate for the treatment of a range of difficulties faced by individuals with autism spectrum disorder (ASD), including cognitive, emotional, and social aspects. Therefore, we aimed to conduct a review that systematically examined the efficacy of MBIs for individuals with ASD and their caregivers. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our literature search was conducted within the MEDLINE database. We included in the review only longitudinal or intervention studies focusing mainly on mindfulness principles, while we excluded mixed intervention studies. We only included studies that explicitly utilized quantitative methodologies for evaluating the outcomes of the interventions, including mental health indices (e.g., stress, anxiety, depression) and assessments of cognitive and social skills (e.g., attention, prosociality). We conducted also a risk of bias assessment through the method of the Cochrane risk of bias tool for intervention studies ROBINS-I. Thirty-seven studies were included in the review, and we grouped the studies by the targets of the interventions, i.e., adults (n = 12), children and adolescents (n = 9), caregivers and medical staff (n = 13), and combined intervention for both children/adolescents and their parents/caregivers (n = 5). The reviewed papers seem to support the feasibility and utility of mindfulness interventions for persons with ASD and their caregivers, but any recommendations based on this body of evidence should be made with caution due to the overall low quality of the studies conducted so far. The review reveals a positive outcome, including the alleviation of psychological distress, reduced behavioral problems, and enhanced cognitive and social skills in individuals with ASD. Despite such promising results, the review notes a limitation in the scarcity of MBIs for young patients, emphasizing caution in universally endorsing the existing literature. Moreover, the results underline the urgency of the exploration of tailored interventions for different ASD subgroups, considering varying levels of autism, and expanding support to teachers in educational settings.

INTERVENTIONS POUR PROMOUVOIR LE DEVELOPPEMENT EXECUTIF CHEZ LES ENFANTS ET ADOLESCENTS (CHAPITRE 24)

Researchers and developers of tests of executive functioning and behavior rating scales designed to assess executive skills have all organized andcategorized executive skills somewhat differently. For instance, the developers of the Behavior Rating Inventory of Executive Function (Gioia, Isquith, Guy, & Kenworthy, 2000 have defined two broad categories of skills, those involved in behavior regulation (e.g., impulse control, emotion control) and those that are more metacognitive in nature (e.g., working memory, task initiation, planning/organization). More recently, Barkley (2011), in developing the Barkley Deficits in Executive Functioning Scale, identified five broad categories of executive functioning (e.g., self-regulation of emotion, time management, organization/problem solving). In our work with parents and teachers, we have identified 11 individual executive skills that we believe figure prominently in understanding why some children tackle activities of daily living, including schoolwork, homework, chores, and daily routines, more successfully than others. Table 24.1 lists these skills, along with brief definitions, and a description of the most common exemplars of problems associated with each executive skill.

The effects of cooperative learning on self-reported peer relations, peer support, and classroom engagement among students with disabilities

Students with disabilities are at an increased risk of experiencing poorer quality peer relationships than those without disabilities. Previous school-based efforts to promote positive peer interactions among students with and without disabilities have included individual skill development and broader initiatives such as inclusive school practices. In the current study, we investigate the effects of cooperative learning (CL) on peer relationships, peer academic supports, and classroom engagement of middle school students with and without disabilities over two years. Using 4 waves of data from a cluster randomized trial of middle schools, we hypothesized that CL would create positive gains in study outcomes among all students, but we anticipated that effects would be more pronounced among students with disabilities. Results confirmed these hypotheses and highlighted the potential role of CL in creating greater social integration among students with and without disabilities. The implications of these findings for practitioners and policymakers are discussed.

Combining low-technology augmentative and alternative communication with regular aphasia treatment: interim findings of a hospital-based RCT in post-stroke patients

ABSTRACT Background Previous research indicates that low-technology (low-tech) augmentative and alternative communication interventions (AACT) can enhance communication skills in individuals with post-stroke aphasia in China. However, there is limited evidence for low-tech AACT in inpatient settings. Aim This study aims to evaluate the impact of low-tech AACT combined with speech-language therapy (SLT) on communication skills related to basic needs, quality of life, and spoken language function among individuals with post-stroke aphasia in an inpatient setting. Methods & Procedures Twelve participants with aphasia having difficulty in daily communication were randomly assigned to an experimental group, receiving 30 minutes of SLT and 30 minutes of low-tech AACT per session (AACT + SLT), or a control group, receiving 60 minutes of SLT per session (SLT), over ten sessions in two weeks. Primary outcomes were measured using the basic needs (CBN) domain of the functional assessment of communication skills for adults (FACS). Secondary outcomes included scores from the Chinese version of the stroke-specific quality of life scale (SS-QOL) and subtests of spoken language production and comprehension from the aphasia battery of Chinese (ABC). The study was registered in the Chinese clinical trial registry (ChiCTR2000028870). Results The results indicated a significant improvement in the CBN domain of FACS in the AACT + SLT group, with larger clinically significant changes compared to the SLT group. The AACT+ SLT group also showed significantly higher overall scores on the SS-QOL and more significant improvements in the content of spontaneous speech than the SLT group after intervention. Comparable improvements were observed in other subtests of the ABC between the two groups. Conclusions Incorporating low-tech AACT into regular SLT in inpatient settings can improve communication for basic needs in an in-patient setting, facilitate language recovery, and potentially support the overall quality of life, compared to SLT alone, for people with post-stroke aphasia. This combined approach demonstrates preliminary feasibility in hospital settings, suggesting the value of low-tech AACT in aphasia rehabilitation.

A cluster approach to matching the competences of data specialists with skills in demand on the labour market

This paper addresses the challenge of aligning the competences of data specialists with skills in demand on the labour market in the rapidly evolving field of data science. Using an open dataset of 3,744 IT job postings, the study applies K-means clustering to identify key skill groupings for data specialist positions. The optimal number of clusters is determined using the elbow method, resulting in four distinct clusters: Data Analyst & Engineer, Data Platform Engineer, Data Science & Engineering Specialist, and Cloud Data Engineer. The research methodology employs unsupervised learning techniques, specifically K-means clustering, to analyze the distribution of skills across job postings. The clusters are visualized using t-distributed Stochastic Neighbor Embedding (t-SNE), providing insights into the relationships between different skill sets. The study reveals that job titles do not always unambiguously define the required skills, emphasizing the importance of focusing on specific skill sets rather than job titles alone. To bridge the gap between specific subject competences academic programs and industry requirements, the paper proposes a novel approach for comparing the proportion of skills in job clusters with the proportion of professional competencies in academic programs. This method is demonstrated using the Information Systems and Technologies Master's program at Kherson State University as a case study. The chi-square test is applied to confirm the statistical similarity between the skill structure of the Data Science & Engineering Specialist cluster and the competency structure of the academic program. The findings highlight the importance of continuous adaptation of profile of academic program to meet evolving industry needs. The proposed approach provides a data-driven framework for universities to align their programs with labor market demands, potentially improving graduate employability in the data science field. The study also underscores the need for personalized learning paths that can be tailored to individual career goals and skill gaps. Future research directions include the development of an artificial intelligence system to form individualized educational trajectories based on the skills required for specific job clusters. This could further enhance the alignment between education and industry needs, preparing students more effectively for the dynamic data science job market.

Mentorship in health research institutions in Africa: A systematic review of approaches, benefits, successes, gaps and challenges.

In Africa, where the burden of diseases is disproportionately high, significant challenges arise from a shortage of skilled researchers, lack of research funding, and limited mentorship opportunities. The continent faces a substantial gap in research output largely attributed to the dearth of mentorship opportunities for early career researchers. To explore existing mentorship approaches, identify challenges, gaps, successes, and benefits, and provide insights for strengthening mentorship programs in African health research institutions. We registered the review protocol on the International Prospective Register of Systematic Reviews [CRD42021285018] and searched six electronic databases-EMBASE, AJOL, Web of Science, PubMed, DOAJ, and JSTOR from inception to 10 November 2023, for studies published in English reporting on approaches of mentorship in health research in African countries. We also searched grey literature repositories, institutional websites, and reference lists of included studies for additional literature. Two independent reviewers conducted screening of titles and abstracts of identified studies, full-text screening, assessment of methodological quality, and data extraction. We assessed study quality against the Mixed Methods Appraisal Tool (MMAT). We resolved any disagreements through discussion and consensus. We employed a narrative approach to synthesize the findings. We retrieved 1799 articles and after screening, included 21 studies in the review. The reviewers identified 20 mentorship programs for health researchers (N = 1198) in 12 African countries mostly focusing on early-career researchers and junior faculty members. A few included mid-career and senior researchers. We categorized the programs under three key mentoring approaches: international collaborative programs, regional and in-country collaborations, and specialized capacity-building initiatives. Our review highlighted the following successes and benefits of health research mentorship programs: the establishment of collaborations and partnerships, development of research programs and capacities, improvement of individual skills and confidence, increased publications, and successful grant applications. The gaps identified were limited funding, lack of a mentorship culture, negative attitudes towards research careers, and lack of prioritization of research mentorship. Our review highlights a diverse landscape of health research mentorship aspects predominantly targeting early career researchers and heavily driven by the North. There is a need for locally driven mentorship initiatives in Africa to strengthen mentorship to advance health research in the region. PROSPERO registration number: CRD42021285018.

FMB: A functional manipulation benchmark for generalizable robotic learning

In this paper, we propose a real-world benchmark for studying robotic learning in the context of functional manipulation: a robot needs to accomplish complex long-horizon behaviors by composing individual manipulation skills in functionally relevant ways. The core design principles of our Functional Manipulation Benchmark (FMB) emphasize a harmonious balance between complexity and accessibility. Tasks are deliberately scoped to be narrow, ensuring that models and datasets of manageable scale can be utilized effectively to track progress. Simultaneously, they are diverse enough to pose a significant generalization challenge. Furthermore, the benchmark is designed to be easily replicable, encompassing all essential hardware and software components. To achieve this goal, FMB consists of a variety of 3D-printed objects designed for easy and accurate replication by other researchers. The objects are procedurally generated, providing a principled framework to study generalization in a controlled fashion. We focus on fundamental manipulation skills, including grasping, repositioning, and a range of assembly behaviors. The FMB can be used to evaluate methods for acquiring individual skills, as well as methods for effectively combining and ordering such skills in order to solve complex, multi-stage manipulation tasks. We also offer an imitation learning framework that includes a suite of policies trained to solve the proposed tasks. This enables researchers to utilize our tasks as a versatile toolkit for examining various parts of the pipeline. For example, researchers could propose a better design for a grasping controller and evaluate it in combination with our baseline reorientation and assembly policies as part of a pipeline for solving multi-stage tasks. Our dataset, object CAD files, code, and evaluation videos can be found on our project website: https://functional-manipulation-benchmark.github.io .

Cognitive defusion as a mediator in the autobiographical memory and metacognitive awareness pathway to problem-solving in borderline personality disorder

BackgroundProblem-solving ability is influenced by numerous cognitive factors. However, a significant research gap exists regarding the mediating role of cognitive defusion in the relationship between autobiographical memory (AM) and metacognitive awareness with problem-solving. Given the critical role of problem-solving, this study aimed to model the relationship between AM and metacognitive awareness with problem-solving, considering the mediating role of cognitive defusion in individuals with borderline personality disorder (BPD). MethodThe study population comprised all individuals with BPD referred to counseling centers and psychiatric clinics in Kurdistan province. A sample of 300 individuals diagnosed with BPD according to the DSM-V and willing to participate was selected. All data were collected using self-report questionnaires. ResultsPath analysis results indicated that AM and metacognitive awareness had a significant positive direct effect on both problem-solving and cognitive defusion. Additionally, cognitive defusion significantly mediated the relationships between AM and metacognitive awareness with problem-solving. ConclusionsThese findings provide evidence for the significant roles of AM and metacognitive awareness in problem-solving, with cognitive defusion acting as a crucial mediating factor in individuals with BPD. these results offer valuable insights for both theoretical understanding and clinical interventions, which could enhance problem-solving skills in individuals with BPD by strengthening cognitive defusion.

On the use of hindcast skill for merging NMME seasonal forecasts across the western U.S.

Abstract Multi-model ensemble forecasts have gained widespread use over the past decade. A yet unresolved issue is whether forecast skill benefits from the use of prior skill from each model in providing a weighted combination. Here we use the available seasonal ensemble forecasts of six models from the North American Multi-Model Ensemble (NMME) to study various aspects of prior skill-based weighting schemes and explore ways to merge multi-model forecasts. First, we post-process each NMME model through quantile mapping and a simple spread error adjustment. Then, using an equal weighted combination as the baseline forecast, we test merging the models together through skill-based weights by varying the prior skill metric and varying how the metrics are aggregated across the different subbasins and time of year. Results confirm prior work that the combined forecasts do outperform individual models. When evaluating prior skill, equal weighting generally performed as well or slightly better than all weighting schemes tried. The skill of the weighting scheme was not found to be strongly dependent on prior metric but did improve when aggregating all forecasted months and subbasins together to provide one overall weight to each model. Also, we found that including an offset to the prior metric that nudged the weights closer to equal weighting improves skill especially at longer leads where individual model skill is low. Results also show that the weighting schemes performed better than regression-based techniques including multiple linear regression and random forest.

Using simulation scenarios and a debriefing structure to promote feedback skills among interprofessional team members in clinical practice

BackgroundTeam reflexivity and peer feedback in daily clinical work can improve patient safety. However, teams do not always engage in reflection after patient care. A reason could be that team members may lack skills in engaging in team reflection. This study explores the use of interprofessional team-based simulations to encourage and equip teams for reflective conversations in the real-world clinical practice.MethodsThis was a prospective, explorative study of team members’ perceptions of the use of in situ simulation-based scenarios with critically ill patient cases to train team-based reflections and peer feedback. The study took place in two neurological wards. Prior to the intervention, a 1-day observation in each ward and semi-structured short interviews with physicians and nurses were conducted.ResultsA total of 94 staff members, 57 nurses, 8 nurse assistants and 29 physicians participated in the in situ simulation scenarios. All team members showed appreciation of the safe learning environment. The authors found that the simulations and the debriefing structure provided an opportunity for training of team reflexivity and feedback. The team members evaluated the simulation-based training very positively, and their initial reaction indicated that they found peer feedback useful for the individual and the team. This approach allowed them to reflect on their own clinical practice.ConclusionThe simulation-based training scenarios and the debriefing structure promoted team members’ team reflexivity and peer feedback skills. The method is feasible and could be used in other specialties and situations.The team members’ reactions to feedback were positive, and based on their reflections, there is a potential to increase both individual and team skills as well as improve patient treatment.

Safety and efficacy of the Tao facemask for positive pressure ventilation in morbidly obese patients

Purpose: Positive-pressure mask ventilation is an essential skill for individuals providing basic and advanced airway interventions in a variety of clinical settings. The C-E grip technique is most commonly used with standard facemasks to provide an effective seal that allows for positive pressure ventilation. The Tao mask is a novel facemask that utilises an ergonomic grip by using downwards pressure of the palm of the hand accompanied by midline jaw lift. Specifically, the technique to create a seal involves downwards pressure of the palm centred on the mask accompanied by a jaw lift with four fingers centred under the mandible. A previous comparison between the Tao and standard masks revealed superior performance across a cross-section of average patients. The purpose of this study was to evaluate the safety and effectiveness of the Tao mask compared to the standard mask in a subset of patients with morbid obesity as defined by a body mass index (BMI) greater than or equal to 40 kg/m2. Methods: This prospective crossover trial included 156 patients aged ⩾18 years at the Medical University of South Carolina who were scheduled for elective surgery under general endotracheal anaesthesia with a BMI of ⩾40 kg/m2 at the time of surgery. After the induction of general anaesthesia, but prior to the administration of a neuromuscular blocking drug (NMBD), each patient was ventilated with both the standard and Tao masks, and effectiveness was measured using both the Han and Warters scales. The process was repeated after the administration of an NMBD. Results: Data were collected and analysed from 153 individuals. The mean BMI was 50.7 ± 9.3 kg/m2. The Tao mask ventilation scores were significantly lower (more effective) than the standard mask scores on both the Han and Warters Scales before pre-NMBD ( p = 0.0002 and p < 0.001, respectively) and after post-NMBD ( p = 0.002 and p < 0.001, respectively). On the Warters Scale, it was significantly easier to ventilate with the Tao Mask pre-NMBD ( p = 0.0001). On the Han Scale, the Tao mask was significantly easier than the standard mask post-NMBD ( p = 0.03). With regard to mask sequence, the mean Warters scores were lower for the Tao mask pre-NMBD only when the standard mask was used first ( p = 0.002). Similarly, the difference in the mean Warters scores post-NBMD was significant only when the standard mask was used first ( p = 0.02). Conclusion: The Tao mask demonstrated equivalent safety and superior effectiveness in ventilating morbidly obese surgical patients despite a trial design that favoured the standard mask owing to anaesthetist experience. The use of the Tao mask may be particularly beneficial in clinical situations involving inexperienced operators or in patients for whom mask ventilation is likely to be difficult. ClinicalTrials.gov registration number: NCT03473366

Teaching patient safety in remote consulting

ABSTRACT A significant proportion of primary care consultations now happen remotely. Although the vast majority occur safely, a recent study highlighted areas of risk which may be compounded by the limited training many GPs have received in remote consulting. To provide safe remote services, consideration needs to be given to adapting practice workflow to optimise remote care. Patients less suitable for remote consulting, either due to disease, extremes of age, disability or for social reasons should be identified and prioritised for face-to-face encounters. Training supports both the development of individual communication skills for remote care, and effective team working. Practice-based group learning events can be used to share experiences, identify resources, and consider the risks in remote care and how they can be mitigated. The paper presents some fictionalised cases, illustrating where patients came to harm, as a result of a remote consultation, and where harm was averted due to actions taken by practice teams. These can be used to support critical thinking and discussion within practice development meetings and tutorials with trainee GPs and other practice staff. Using the paper as a basis for reflection, teaching and action can facilitate the delivery of safer remote care.