Unfamiliar Situations Research Articles

Medical student-led simulation in COVID-19 crisis.

BackgroundSimulation training is an effective tool for improving confidence in healthcare workers. During the recent COVID‐19 pandemic, large numbers of staff required re‐training to manage unfamiliar situations. We present a set of medical student‐led clinical simulation sessions and evaluate their effects on (i) confidence among redeployed healthcare workers managing COVID‐19 patients and (ii) medical students’ confidence as educators.MethodsHalf‐day simulation training sessions consisting of three COVID‐related clinical scenarios were devised by senior medical students and delivered to a group of approximately 150 healthcare workers over six repeated sessions prior to redeployment to COVID‐19 wards. We distributed an anonymous pre‐ and post‐simulation questionnaire to 36 participants in the final group exploring their experiences. The confidence scores were analysed using the Wilcoxon signed‐rank test. Following the delivery of teaching, medical students completed a questionnaire assessing their personal experiences of designing and delivering the exercises.ResultsData are available for 35/36 participants approached. Respondents reported being significantly more confident after the training in all aspects of managing COVID‐19 patients, including triage, complex discharge, recognising deterioration, initiating basic life support, managing symptoms and advising on visiting policies (p < 0.001); 97% of respondents rated the training as useful. Thematic analysis of medical students’ responses demonstrated mutual benefit.DiscussionThis study demonstrates the strengths of simulation training in helping to build staff confidence in a rapidly evolving situation and highlights the value of medical students in supporting a hospital’s response to an outbreak. We recommend further studies of student‐led simulation exercises, including longer‐term follow‐up.

Qualitative Study of Experiences of Cooperation Among Healthcare Workers Participating in COVID-19 Aid Mission in China and Its Implications for Offsite Pandemic Response Planning

Background: Most recent studies on the coronavirus disease (COVID-19) have focused on its epidemiology and on frontline healthcare workers’ (HCWs’) physio-psychological experiences, with few studies examining their experiences of cooperation. To assist future offsite planning for pandemics, we documented lived experiences of cooperation among HCWs during the COVID-19 pandemic.Methods: We conducted an empirical phenomenological investigation among 25 HCWs (17 nurses and eight physicians), selected through convenient and purposive sampling, who participated in a medical aid mission in China during the COVID-19 pandemic. Data were collected via semi-structured online video interviews, and the interview transcripts were analyzed using Colaizzi's phenomenological method.Findings: (1) The government-organized multi-level and multi-departmental management structure ensured appropriate arrangements of human and material resources. (2) High morale among voluntarily recruited HCWs and a supportive context entailing mutual learning encouraged cooperation among team members. (3) A continuous, streamlined workflow and communication was crucial. Adequate communication enabled HCWs, confronting shock and unfamiliar situations, to adjust quickly by drawing on their rich prior professional experience. (4) Nurse managers, who were the core internal and external team coordinators, juggling multiple roles and tasks, experienced severe stress. (5) A comprehensive person-centered care model and cooperation within multidisciplinary teams of HCWs were needed to balance infection management and patient-centered care.Interpretations: Planning for a pandemic aid mission is challenging, given the unpredictable nature of the circumstances and the political context within a specific region. We offer the following recommendations for future pandemic planning.Funding Statement: No external funding.Declaration of Interests: The authors declare no conflict of interest.Ethics Approval Statement: The study was approved by the Institutional Review Board at the researchers’ institute (IRB number: 202025).

Defamiliarization in the Novel Charlie and the Chocolate Factory

Language used in literary works is commonly dif erent from language used in daily or ordinary language. Therefore, Russian Formalists introduced defamiliarization, in which it is known to be a technique to create or to see dif erences of literary languages and ordinary languages. In this study, researcher defined the technique of defamiliarization in the novel Charlie and the Chocolate Factory by Roald Dahl, with the intention to find the ef ects of defamiliarization in the novel. In conducting the study, researcher used qualitative method, because the researcher collected the data from sentences which showed strange or unfamiliar ideas, objects, and situations in the story of the novel. The result of this study showed that defamiliarization is used in the novel and it gave the ef ects of defamiliarization to the novel, especially at the level of perception, language, narrative structure, genre, as well as the literariness and aesthetic quality of the language in the novel.&#x0D;

Systemic Functional Grammar and its Usefulness in English-Korean Translation

This paper is to demonstrate the usefulness of Systemic Functional Grammar in English-Korean translation in the absence of explicit macro- and micro–level translation education. To this end, this paper explains the main four functions of Systemic Functional Grammar such as experiential, logical, interpersonal and textual functions and shows good and bad translations with translation materials in accordance with the four functions. In addition, the merits of Systemic Functional Grammar in translation are stated in considering translation strategies, delivering accurate meaning and using language shifts depending on genre, culture, readers’ expectations and writers’ purposes. This paper is meaningful in that it dealt with the usefulness of Systemic Functional Grammar in English-Korean translation in detail under the unfamiliar situation of Systemic Functional Grammar in Korea.

Older persons and relatives' experience of coordinated care planning via a video meeting.

AimThe study aimed to describe coordinated care planning via a video meeting from the perspective of older persons and their relatives.DesignA qualitative inductive research design was used to describe older persons and relatives’ experience of care planning via video meeting.MethodsEight unstructured interviews were conducted. Purposive sampling resulted in a sample of four older persons and four relatives. The material was analysed by qualitative content analysis.ResultsThe theme being excluded illustrates how the older persons and their relatives experienced care planning via a video meeting as lack of a personal relationship, meaninglessness and lack of participation. The older persons and their relatives had a feeling of being excluded and in an unfamiliar situation. Lack of information about the meeting's structure and content impaired their ability to prepare for it beforehand, which led to uncertainty.

Covid-19 Impact: Indonesia Tourism in New Normal Era

This study examines the problem of the impact of Covid-19 on the Tourism Industry in the New Normal Era, which is a previously unusual or unfamiliar situation which is then made into a standard of habit or expectation. This research is expected to be able to further explain the impact of Pandemic Covid-19 on the tourism industry which must recover immediately from the slump in Post Covid-19 or in the New Normal Era, able to explain where the tourism industry is going, how governance and how the tourism industry will be able to adapt with the dramatic restructuring of the economic and social order in business and society. The method in this research is a qualitative method with case studies to describe the complete picture of the events under study. Data obtained from various sources, documents, and other written data. The findings of this study explain that all components of the tourism industry both government, hospitality, travel businesses, tourism objects and various other supporting institutions as a whole must be able to have protocols as a standard that must be adhered to in providing services and services in all sectors of the tourism industry. Meanwhile the governance of the tourism industry must be able to optimize marketing strategies by making full use of the various advantages of information communication technology that will be very dominant in all sectors of activity which will thus be able to adapt to various global economic and business restructuring.

Exploring potential differential relationships between social anxiety and emotional eating amongst normative vs. academically gifted students

ABSTRACT The social environment, which plays a critical role, is an important factor for self-development during adolescence. On the other hand, gifted adolescents may be relatively at risk in social relationships. Therefore, the first objective of the current research is to examine the relationship between social anxiety and emotional eating in normative adolescents. The second objective is to examine whether this relationship would be different for academically gifted adolescents. For both groups, three constructs of social anxiety were examined: fear of negative evaluation, social avoidance and distress for new or unfamiliar situations, and social avoidance and distress for general situations. In total, 429 Dutch high school students completed measures of emotional eating and social anxiety (normative = 246, gifted = 83). The results from a confirmatory factor analysis showed that for normative adolescents only fear of negative evaluation was positively related to emotional eating (p < .001). For academically gifted adolescents, there were no significant relationships between any of the three constructs of social anxiety and emotional eating. Results and implications for future research directions are discussed. Future research projects would benefit from the exploration and addition of coping mechanisms to such studies. This could allow researchers to investigate the potential mediational effects of coping strategies between anxiety and emotional eating in these two groups.

A new experience of online education under the COVID-19 pandemic for occupational therapy students in Palestine

ABSTRACT There are circumstances and conditions that stimulate thinking and research in a scientific and practical way. These conditions fit into our reality under the COVID-19 pandemic. This experience related to myself and my field of work as an instructor of occupational therapy at the Arab American University in Palestine. There are students that I teach that have not been accustomed to distance learning through online courses using social media, especially zoom. This unfamiliar situation provided an opportunity for my students and myself to re-think the cases we deal with and the methods that we typically use, especially those people with spinal cord injuries. Here, I started creating an educational unit for students, in order to answer the questions posed by students. How can we provide an occupational therapy service under quarantine because of the COVID-19 pandemic? In what ways are patients suffering in the same way that we are suffering from the coronavirus pandemic? How can I adapt my teaching strategies methods to achieve the goals that I previously set for my students’ education before the pandemic?

The Preparation, Delivery and Outcome of COVID-19 Pandemic Training Program among the Emergency Healthcare Frontliners (EHFs): The Malaysian Teaching Hospital Experience

One of the strategies in strengthening the healthcare providers in mitigating the impact of COVID-19 pandemic is through training. Safety and disease unfamiliarity with COVID-19 was the main reason for developing this dedicated specialized training modules in order to address the issue. The training modules were developed based on three strategies that are learning from experience, design suitable dedicated module and identify weakness and vulnerability. The training modules created were donning-doffing of Personal Protective Equipment (PPE), airway management and cardiopulmonary resuscitation of suspected COVID-19 patients which were delivered through immersive life simulation technique. A total of 178 Emergency Healthcare Frontliners (EHFs) were trained. Each module was guided with a checklist that the participants found to be very useful. None of the participants reported developing symptoms of infection after undergoing the face-to-face simulation training even after two weeks of post-training periods. Seven important steps were found to be crucial that contributed to these findings which included room space, participants number per group, COVID-19 screening, taking of temperature, hand sanitization, PPE, and equipment sanitization before and after training. Hands-on training with guided-checklist was found to be very useful to the EHFs in managing an unfamiliar situation of COVID-19. In time-constraint-resource-limited conditions, training modules should be focused on addressing the pressing problem at hand. In conducting a face-to-face training, precautionary safety measures should be strictly adhered to prevent the spread of the disease.

Expectations of technology use during meetings: An experimental test of manager policy, device use, and task-acknowledgment

In organizational meetings, mobile media are commonly used to hold multiple simultaneous conversations (i.e., multicommunication). This experiment uses video vignettes to test how manager policy (no policy, pro-technology, anti-technology), device use (notepad, laptop, cell phone) and task-acknowledgment (no task-acknowledgment, task-acknowledgment) affect perceptions of meeting multicommunication behavior. US workers ( N = 243) who worked at least 30 hours per week and attended at least one weekly meeting rated relevant outcomes: expectancy violation, communicator evaluation, perceived competence, and meeting effectiveness. Results reveal manager policy and device use both affect multicommunication perceptions, with mobile phones generating the highest expectancy violation and lowest evaluation of the communicator and meeting effectiveness. Surprisingly, there was no effect for task-acknowledgment; however, a match between manager policy and task-acknowledgment affected evaluations. This paper unifies past evidence about multicommunication under the expectancy violations framework, extends theoretical understandings of mobile media use at work, and suggests practical implications for technology use in unfamiliar workplace situations.

Cholinergic Stress Signals Accompany MicroRNA-Associated Stereotypic Behavior and Glutamatergic Neuromodulation in the Prefrontal Cortex.

Stereotypic behavior (SB) is common in emotional stress-involved psychiatric disorders and is often attributed to glutamatergic impairments, but the underlying molecular mechanisms are unknown. Given the neuro-modulatory role of acetylcholine, we sought behavioral-transcriptomic links in SB using TgR transgenic mice with impaired cholinergic transmission due to over-expression of the stress-inducible soluble ‘readthrough’ acetylcholinesterase-R splice variant AChE-R. TgR mice showed impaired organization of behavior, performance errors in a serial maze test, escape-like locomotion, intensified reaction to pilocarpine and reduced rearing in unfamiliar situations. Small-RNA sequencing revealed 36 differentially expressed (DE) microRNAs in TgR mice hippocampi, 8 of which target more than 5 cholinergic transcripts. Moreover, compared to FVB/N mice, TgR prefrontal cortices displayed individually variable changes in over 400 DE mRNA transcripts, primarily acetylcholine and glutamate-related. Furthermore, TgR brains presented c-fos over-expression in motor behavior-regulating brain regions and immune-labeled AChE-R excess in the basal ganglia, limbic brain nuclei and the brain stem, indicating a link with the observed behavioral phenotypes. Our findings demonstrate association of stress-induced SB to previously unknown microRNA-mediated perturbations of cholinergic/glutamatergic networks and underscore new therapeutic strategies for correcting stereotypic behaviors.

Cognitive States Matter: Design Guidelines for Driving Situation Awareness in Smart Vehicles.

Situation awareness (SA) is crucial for safe driving. It is all about perception, comprehension of current situations and projection of the future status. It is demanding for drivers to constantly maintain SA by checking for potential hazards while performing the primary driving tasks. As vehicles in the future will be equipped with more sensors, it is likely that an SA aiding system will present complex situational information to drivers. Although drivers have difficulty to process a variety of complex situational information due to limited cognitive capabilities and perceive the information differently depending upon their cognitive states, the well-known SA design principles by Endsley only provide general guidelines. The principles lack detailed guidelines for dealing with limited human cognitive capabilities. Cognitive capability is a mental capability including planning, complex idea comprehension, and learning from experience. A cognitive state can be regarded as a condition of being (e.g., the state of being aware of the situation). In this paper, we investigate the key cognitive attributes related to SA in driving contexts (i.e., attention focus, mental model, workload, and memory). Endsley proposed that those key cognitive attributes are the main factors that influence SA. In those with higher levels of attributes, we found eight cognitive states which mainly influence a human driver in achieving SA. These are the focused attention state, inattentional blindness state, unfamiliar situation state, familiar situation state, insufficient mental resource state, sufficient mental resource state, high time pressure state, and low time pressure state. We then propose cognitive state aware SA design guidelines that can help designers to effectively convey situation information to drivers. As a case study, we demonstrated the usefulness of our cognitive state aware SA design guidelines by conducting controlled experiments where an existing SA interface is compared with a new SA interface designed following the key guidelines. We used the Situation Awareness Global Assessment Technique (SAGAT) and Decision-Making Questionnaire (DMQ) to measure the SA and decision-making style scores, respectively. Our results show that the new guidelines allowed participants to achieve significantly higher SA and exhibit better decision making performance.

Humility Versus Humiliation: The Fine Line of Student Discomfort.

To the Editor: Caruso Brown1 acknowledges the important role discomfort plays in fostering humility within medicine. However, we do not believe there is a threatened loss of humility in medicine and we fear potential confusion between the innate discomfort of learning and practicing medicine and something more serious—medical student humiliation. It is important to identify what is meant by discomfort. On one hand, there is the discomfort felt in an unfamiliar situation, illustrated when Caruso Brown visited a Kenyan children’s hospital. This discomfort, from an internal source, stems from uncertainty and self-doubt, which is all too familiar to students. As medical students ourselves, we recognize the internal embarrassment of identifying a gap in our knowledge.2 With an overwhelming wealth of information to learn, medical students are burdened by fear of failure, worrying that their knowledge will never be enough. In reality, medicine is a career of lifelong learning and patients rarely present as “textbook” cases. Clinicians are frequently challenged by the discomfort of unfamiliar situations in which they do not know the answers. This form of discomfort in itself promotes a humility that is inherent within medicine. However, there is a fine line between this internal discomfort and the intentional discomfort created by teachers, which may be regarded as humiliation.2 Worse still is public humiliation, when teachers actively criticize students in front of other students, patients, or clinicians. This merely highlights a lack of knowledge, rather than utilizing the potential learning opportunity. While effective in the short term, research shows that scaring students into studying can lead to students missing teaching sessions, reduced motivation and self-esteem, burnout, psychiatric issues, and career change.3 Medical students are extremely impressionable; teachers are not only responsible for imparting their medical knowledge but also for acting as role models, shaping the types of doctors these students will become. Thus far, this power imbalance has perpetuated a vicious cycle of mistreatment and humiliation, which will only be interrupted by acknowledgment of the issue and evolution of new teaching styles. We must not reject the pursuit of a healthier teaching culture for fear of a loss of humility. Ruhi ShahFifth-year student, GKT School of Medical Education, King’s College London, London, United Kingdom; [email protected]Amirali FernandesFourth-year student, GKT School of Medical Education, King’s College London, London, United Kingdom.Sparsh ShahThird-year student, Barts and The London School of Medicine and Dentistry, London, United Kingdom.

Anaesthesia simulation training during coronavirus pandemic: an experience to share

Since the WHO declared covid-19 pandemic on 11 March 2020, Hamad Medical Corporation (HMC), the leading healthcare provider in Qatar, has taken unprecedented measures to streamline service provision, to prevent...

Infant behavioral inhibition predicts personality and social outcomes three decades later

Does infant temperament predict adult personality and life-course patterns? To date, there is scant evidence examining relations between child temperament and adult outcomes, and extant research has relied on limited methods for measuring temperament such as maternal report. This prospective longitudinal study followed a cohort of infants (n = 165) for three decades to examine whether infant behavioral inhibition, a temperament characterized by cautious and fearful behaviors to unfamiliar situations, shapes long-term personality, social relationships, vocational/education, and mental health outcomes in adulthood. At age 14 mo, behavioral inhibition was assessed using an observation paradigm. In adolescence (15 y; n = 115), error monitoring event-related potentials were measured in a flanker task. In adulthood (26 y; n = 109), personality, psychopathology, and sociodemographics were self-reported using questionnaires. We found that infants with higher levels of behavioral inhibition at 14 mo grew up to become more reserved and introverted adults (β = 0.34) with lower social functioning with friends and family (β = -0.23) at age 26. Infant behavioral inhibition was also a specific risk factor for adult internalizing (i.e., anxiety and depression, β = 0.20) psychopathology, rather than a transdiagnostic risk for general and externalizing psychopathology. We identified a neurophysiologic mechanism underlying risk and resilience for later psychopathology. Heightened error monitoring in adolescence moderated higher levels of adult internalizing psychopathology among behaviorally inhibited individuals. These findings suggest meaningful continuity between infant temperament and the development of adult personality. They provide the earliest evidence suggesting that the foundation of long-term well-being is rooted in individual differences in temperament observed in infancy.

Navigators’ Errors in a Ship Collision via Simulation Experiment in South Korea

A very significant number of marine accidents occur because of human errors. This study aimed to prevent ship collisions by identifying types of navigators’ errors. Based on Reason’s classification theory, the possible human errors are classified into skill-based slips (SBSs) (errors caused by the lack of skills), rule-based mistakes (RBMs) (errors caused by the misapplication of rules), and knowledge-based mistakes (KBMs) (errors caused by the lack of navigator’s knowledge). For this study, a scenario-based experiment using a ship-handling simulator was conducted with 50 recruited student navigators. The results revealed two primary human errors of accidents, namely lack of knowledge and misapplication of rules. The results suggest that a collision can be minimized when a navigator has sufficient knowledge of an appropriate course of action and a deep understanding of safety rules. Accidents cannot be prevented by identifying errors, but steps can be taken to narrow the knowledge gap. Based on the results, we proposed a simulation training on navigator error in an unfamiliar situation. The results are expected to reduce errors in the maritime sector using a human-centric work system.

RELEARNING HOW TO DRIVE

AbstractThe author notes that one trait that successful leaders have in common is the ability to save and honor face for others. “Saving Face” is a universal concept, beyond its origins in China, and it is a key factor in leadership for building positive relationships, motivating and rewarding others. Leaders can navigate through a new or unfamiliar situation and still manage to save and protect face; an ability the author calls, “Relearning how to drive.” For instance, working in a new environment is a lot like driving in a foreign country for the first time. Go on autopilot too quickly can lead to a loss of face, whether it's a new team or a new country you're working in. A detailed corporate example is provided about a videoconference with managers from a factory in Dongguan, China, illustrating a concept the author refers to as The Cultural Iceberg. The BUILD model is also outlined, with five keys that are crucial building blocks to forming strong, productive business relationships: Benevolence and Accountability, Understanding, Interacting, Learning, and Delivery. Leaders can view complex issues in a multicultural business environment from four different perspectives: first person, second person, meta position, and helicopter.

Perception of Saudi EFL Learners and Teachers towards the Use of Listening Transcript in the Listening Lessons

Undergraduate learners learning English in the Kingdom of Saudi Arabia often complain that they face problems in understanding audios played in their listening skills’ classroom. Audio materials are recorded by native English speakers at a speedy pace with challenging linguistic or content input in unfamiliar or less familiar contexts or situations. As it is observed in classes of listening skills, listening materials are more focused on teaching test instead of teaching listening acquisition. Teachers play the audios, students do a variety of exercises and activities (fill-in-the-blanks, multiple-choice, short writing questions, matching and pronunciation practice), and conclude the lesson with ‘right/wrong’ feedbacks or shift to teaching another skill. In both cases, listening lessons provide insufficient internalization of comprehensible input. The present study explored perceptions of Saudi English as a Foreign Language (EFL) undergraduates and EFL teachers towards the use of ‘Listening Transcript’ (LT) in lessons of listening skills. It investigates if LT help students in overcoming the difficulties that they face in bottom-up processing and top-down processing and what EFL teachers think about the pedagogical value of LT and ways of using it in the lessons of listening skills. It is a mixed method of research. It employs survey to collect quantitative data in the form of a 15-item questionnaire of 60 female Saudi undergraduates and a semi-structured interview of 10 EFL teachers in King Khalid University (KKU), Abha, Saudi Arabia to gather qualitative data. The result of the study shows that LT plays a more decisive role in developing bottom-up skills like identifying segmental suprasegmental features of speech, recognizing words, recalling information, relating with real life, selecting words, restating and explaining the content than developing top-down skills (high order skills) like distinguishing information, comparing and contrasting, judging, and formulating your learning. The study finds there is a need for designing strategies to use LT more creatively and powerfully.

Sensemaking support system (S3) for manufacturing process improvement

Production management teams often face unfamiliar situations where each team member must understand new phenomena individually before the team can make mutually understandable and acceptable decisions. Contradicting subjective judgments can distort the group’s decision-making process because team members understand situations differently and are generally prone to behavioural biases. This paper presents the development of a sensemaking support system (S3,S cube) for selecting improvement projects in a complex,small-volume batch production system of a premium car manufacturer. All phases of the sensemaking process are facilitated by making various sources of information available to a team of managers and experts to reduce conflicts regarding the selection of improvement projects. S3 is based on a lens model which combines judgments of the management team with discrete event simulation and provides visual representations of the differences and misjudgements related to various improvement options. The results – that can easily be generalised to many similar settings – indicate different understanding and lack of coherence within the management team which prevents them from defining mutually acceptable actions. This is countered with the creation of an action proposal,summarising and visualising causal relationships,and connecting them to improvement options to improve performance of the production system.

Brief Report: Autistic Adults Assign Less Weight to Affective Cues When Judging Others' Ambiguous Emotional States.

Understanding other people's emotional states involves integrating multiple sources of information, such as someone's smile (affective cue) with our knowledge that they have passed an exam (situational cue). We explored whether autistic adults display differences in how they integrate these cues by showing participants videos of students receiving their exams results. Our results suggest autistic adults generally perform as neurotypical participants when identifying and integrating affective and situational cues. It was only in certain unfamiliar and ambiguous social situations that autistic adults assigned less weight to affective cues compared to situational cues when judging other people's emotional states.