Background: Experienced assessors show good intra-rater reproducibility (within-session and between-session agreement and reliability) when using an algometer to determine pressure pain thresholds (PPT). However, it is unknown whether novice assessors perform equally well. This study aimed to determine within and between-session agreement and reliability of PPT measurements performed by novice assessors and explored whether these parameters differed per assessor and algometer type.Methods: Ten novice assessors measured PPTs over four test locations (tibialis anterior muscle, rectus femoris muscle, extensor carpi radialis brevis muscle and paraspinal muscles C5-C6) in 178 healthy participants, using either a Somedic Type II digital algometer (10 raters; 88 participants) or a Wagner Force Ten FDX 25 digital algometer (nine raters; 90 participants). Prior to the experiment, the novice assessors practiced PPTs for 3 h per algometer. Each assessor measured a different subsample of ~9 participants. For both the individual assessor and for all assessors combined (i.e., the group representing novice assessors), the standard error of measurement (SEM) and coefficient of variation (CV) were calculated to reflect within and between-session agreement. Reliability was assessed using intraclass correlation coefficients (ICC1,1).Results: Within-session agreement expressed as SEM ranged from 42 to 74 kPa, depending on the test location and device. Between-session agreement, expressed as SEM, ranged from 36 to 76 kPa and the CV ranged from 9-16% per body location. Individual assessors differed from the mean group results, ranging from -55 to +32 kPa or from -9.5 to +6.6 percentage points. Reliability was good to excellent (ICC1,1: 0.87 to 0.95). Results were similar for both types of algometers.Conclusions: Following 3 h of algometer practice, there were slight differences between assessors, but reproducibility in determining PPTs was overall good.
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One challenge novice nurses face at the start of their career is coming to grips with the tumultuous working environment and its social dynamics. Assertive behavior and interprofessional communication play a key role in maintaining one’s health throughout this process: skills which novice nurses feel they lacked in their education. Within their education, clinical placements providea true-to-life working environment to train these skills. However, studies show that assertive behavior and interprofessional communication skills are not structurally addressed within this learning environment. To alleviate this theory-practice gap, our study focused on developing a digital tool together with nursing students that helps them structurally reflect upon and monitor these skills. Our main question was: How do students want to reflect upon their assertive behavior and interprofessional communication during their clinical placement using a digital tool?
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OBJECTIVES: To demonstrate that novice dosimetry planners efficiently create clinically acceptable IMRT plans for head and neck cancer (HNC) patients using a commercially available multicriteria optimization (MCO) system.METHODS: Twenty HNC patients were enrolled in this in-silico comparative planning study. Per patient, novice planners with less experience in dosimetry planning created an IMRT plan using an MCO system (RayStation). Furthermore, a conventionally planned clinical IMRT plan was available (Pinnacle(3)). All conventional IMRT and MCO-plans were blind-rated by two expert radiation-oncologists in HNC, using a 5-point scale (1-5 with 5 the highest score) assessment form comprising 10 questions. Additionally, plan quality was reported in terms of planning time, dosimetric and normal tissue complication probability (NTCP) comparisons. Inter-rater reliability was derived using the intra-class correlation coefficient (ICC).RESULTS: In total, the radiation-oncologists rated 800 items on plan quality. The overall plan score indicated no differences between both planning techniques (conventional IMRT: 3.8 ± 1.2 vs. MCO: 3.6 ± 1.1, p = 0.29). The inter-rater reliability of all ratings was 0.65 (95% CI: 0.57-0.71), indicating substantial agreement between the radiation-oncologists. In 93% of cases, the scoring difference of the conventional IMRT and MCO-plans was one point or less. Furthermore, MCO-plans led to slightly higher dose uniformity in the therapeutic planning target volume, to a lower integral body dose (13.9 ± 4.5 Gy vs. 12.9 ± 4.0 Gy, p < 0.001), and to reduced dose to the contra-lateral parotid gland (28.1 ± 11.8 Gy vs. 23.0 ± 11.2 Gy, p < 0.002). Consequently, NTCP estimates for xerostomia reduced by 8.4 ± 7.4% (p < 0.003). The hands-on time of the conventional IMRT planning was approximately 205 min. The time to create an MCO-plan was on average 43 ± 12 min.CONCLUSIONS: MCO planning enables novice treatment planners to create high quality IMRT plans for HNC patients. Plans were created with vastly reduced planning times, requiring less resources and a short learning curve.
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Many studies have shown that experts possess better perceptual-cognitive skills than novices (e.g., in anticipation, decision making, pattern recall), but it remains unclear whether a relationship exists between performance on those tests of perceptual-cognitive skill and actual on-field performance. In this study, we assessed the in situ performance of skilled soccer players and related the outcomes to measures of anticipation, decision making, and pattern recall. In addition, we examined gaze behaviour when performing the perceptual-cognitive tests to better understand whether the underlying processes were related when those perceptual-cognitive tasks were performed. The results revealed that on-field performance could not be predicted on the basis of performance on the perceptual-cognitive tests. Moreover, there were no strong correlations between the level of performance on the different tests. The analysis of gaze behaviour revealed differences in search rate, fixation duration, fixation order, gaze entropy, and percentage viewing time when performing the test of pattern recall, suggesting that it is driven by different processes to those used for anticipation and decision making. Altogether, the results suggest that the perceptual-cognitive tests may not be as strong determinants of actual performance as may have previously been assumed.
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ObjectiveRepeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review.MethodsWe systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration’s risk of bias assessment tool. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics.ResultsThe searches yielded 1662 unique publications. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes.ConclusionSpacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. The overall number and quality of available studies were only moderate, limiting the validity and generalizability of our findings.
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In this paper we describe our work in progress on the development of a set of criteria to predict text difficulty in Sign Language of the Netherlands (NGT). These texts are used in a four year bachelor program, which is being brought in line with the Common European Framework of Reference for Languages (Council of Europe, 2001). Production and interaction proficiency are assessed through the NGT Functional Assessment instrument, adapted from the Sign Language Proficiency Interview (Caccamise & Samar, 2009). With this test we were able to determine that after one year of NGT-study students produce NGT at CEFR-level A2, after two years they sign at level B1, and after four years they are proficient in NGT on CEFR-level B2. As a result of that we were able to identify NGT texts that were matched to the level of students at certain stages in their studies with a CEFR-level. These texts were then analysed for sign familiarity, morpheme-sign rate, use of space and use of non-manual signals. All of these elements appear to be relevant for the determination of a good alignment between the difficulty of NGT signed texts and the targeted CEFR level, although only the morpheme-sign rate appears to be a decisive indicator
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We investigated to what extent correctional officers were able to apply skills from their self-defence training in reality-based scenarios. Performance of nine self-defence skills were tested in different scenarios at three moments: before starting the self-defence training programme (Pre-test), halfway through (Post-test 1), and after (Post-test 2). Repeated measures analyses showed that performance on skills improved after the self-defence training. For each skill, however, there was a considerable number of correctional officers (range 4–73%) that showed insufficient performance on Post-test 2, indicating that after training they were not able to properly apply their skills in reality-based scenarios. Reality-based scenarios may be used to achieve fidelity in assessment of self-defence skills of correctional officers.Practitioner summary: Self-defence training for correctional officers must be representative for the work field. By including reality-based scenarios in assessment, this study determined that correctional officers were not able to properly apply their learned skills in realistic contexts. Reality-based scenarios seem fit to detect discrepancies between training and the work field. Abbreviations: DJI: Dutch National Agency for Correctional Insitutes; ICC: Intraclass Correlation Coefficient.
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In the context of developing mentor teachers' use of supervisory skills, two consecutive studies were conducted, using stimulated recall. Firstly, with eight participants, an instrument was developed to categorize contents of interactive cognitions. Secondly, with 30 participants, the instrument was applied to uncover contents of mentor teachers' interactive cognitions, before and after training in supervisory skills. After training, mentor teachers demonstrate an increased awareness of their use of supervisory skills. This indicates that mentor teachers not only seem to emphasize pupil learning and needs when conducting a mentoring dialogue, but simultaneously focus on their own supervisory behaviour.
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This paper presents a mixed methods study in which 77 students and 3 teachers took part, that investigated the practice of Learning by Design (LBD). The study is part of a series of studies, funded by the Netherlands Organisation for Scientific Research (NWO), that aims to improve student learning, teaching skills and teacher training. LBD uses the context of design challenges to learn, among other things, science. Previous research showed that this approach to subject integration is quite successful but provides little profit regarding scientific concept learning. Perhaps, when the process of concept learning is better understood, LBD is a suitable method for integration. Through pre- and post-exams we measured, like others, a medium gain in the mastery of scientific concepts. Qualitative data revealed important focus-related issues that impede concept learning. As a result, mainly implicit learning of loose facts and incomplete concepts occurs. More transparency of the learning situation and a stronger focus on underlying concepts should make concept learning more explicit and coherent.
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Competent practice in sport psychology is of utmost importance for the professional status of the field, and hence proper assessment of competence for sport psychology practice is needed. We describe three cycles of action research to improve the assessment of competence in a sport psychology education program. The cycles were directed at (a) empowering supervisors in their assessing role, (b) improving the assessment checklist, and (c) investigating an alternative assessment method. Although challenges remain (e.g., improve the still low interrater reliability), the action research has contributed to an improved quality and higher acceptability of the assessment in the education program.
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