Evaluation of a formative peer assessment in research methods teaching using an online platform: A mixed methods pre-post study

BACKGROUND

In higher education settings, there are increasing calls to shift away from traditional summative assessment practices, such end of term written tests, to explore methods of assessing learning in alternative ways. Peer assessment has been advocated as a means of formative assessment to enhance student engagement, empowering students to take responsibility for their own learning. While there is accumulating evidence for the value of peer assessment in higher education, one cannot assume peer feedback will translate appropriately to all settings and educational contexts.

OBJECTIVES

This study evaluated the implementation of formative online peer assessment in a nursing and midwifery research methods module. We explored students' expectations, experiences, and ultimately the acceptability of this approach.

DESIGN

A quantitative descriptive study.

SETTING

Ireland.

METHODS

An online survey to collate expectations and experiences of engagement in peer assessment. Scales were drawn from previous research and non-parametric tests explored changes in perceptions over time. Qualitative content analysis explored patterns evident in open-text responses.

RESULTS

The response rate was 28% (n = 74) at baseline and 31% at follow-up (n = 81). Peer assessment was a new experience for 95% of respondents. Students initially expressed apprehension, perceiving the task as daunting, and doubting their ability to provide feedback to peers. However, through providing instruction and tools to support students in the activity, high levels of satisfaction with the process and the experience were reported. Significant differences in perceptions of peer assessment were evident over time, including an enhanced belief that respondents had the requisite skills to appraise the work of their peers.

CONCLUSIONS

In sum, nursing and midwifery students agreed that peer assessment was a valuable learning experience as part of research methods training and critical skills development.

ICD-11 PTSD and complex PTSD amongst Syrian refugees in Lebanon: the factor structure and the clinical utility of the International Trauma Questionnaire

OBJECTIVE

Support for ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD) is growing; however, few studies include refugees or examine the clinical utility of PTSD/CPTSD classifications. This study sought to provide the first evaluations of (i) the factor structure of ICD-11 PTSD/CPTSD amongst refugees in the Middle East; and (ii) the clinical utility of the International Trauma Questionnaire (ITQ) to identify PTSD/CPTSD in a humanitarian context.

METHOD

Participants were 112 treatment-seeking Syrian refugees living in Lebanon. Factorial validity was assessed using confirmatory factor analysis (CFA) based on responses to the ITQ. Clinical utility of the ITQ was assessed through semi-structured interviews with six Lebanese psychotherapists.

RESULTS

Complex PTSD (36.1%) was more common than PTSD (25.2%), and no sex or age differences were observed at the prevalence or symptomatic levels. CFA results supported a two-factor higher-order model consistent with ICD-11 PTSD/CPTSD. Qualitative findings indicated that the ITQ is generally positively regarded, with some limitations and suggested modifications noted.

CONCLUSION

This is the first study to support the ICD-11 PTSD/CPTSD amongst refugees in the Middle East and the clinical utility of the ITQ in a humanitarian context. Findings support the growing evidence for the cross-cultural applicability of ICD-11 PTSD/CPTSD.

Serial bedside emergency ultrasound in a case of pediatric blunt abdominal trauma with severe abdominal pain

We present a case of a teenager with isolated left renal laceration with perirenal hematoma. The patient had presented with severe left upper quadrant (LUQ) pain following blunt abdominal trauma (BAT) sustained during a sledding accident. A screening bedside focused abdominal sonogram for trauma (FAST) rapidly excluded free fluid on two serial examinations, 30 minutes apart. It provided the pediatric emergency physician with a measure of diagnostic confidence that the patient could be safely transported to the CT suite for detailed delineation of his injury. Moreover, narcotic analgesia was liberally administered early in his illness course, without the fear of unmasking potential hypovolemia when it was known that he did not have gross intra-abdominal bleeding on his bedside ultrasound (US). It also provided a working diagnosis of the primary organ of injury. Our hospital, like many pediatric hospitals around the nation, does not have in-house 24-hour radiology support. We suggest that the use of the bedside US be extended to the stable pediatric patient in severe abdominal pain following BAT. It can serve as a valuable, rapid, noninvasive, bedside, easily repeated, fairly accurate triage tool to evaluate pediatric BAT with severe pain.

Determination of systolic blood pressure via pulse oximeter in transported pediatric patients

OBJECTIVE

To compare pulse oximetry waveform systolic blood pressure measurements (POWSBP) to measurements obtained by noninvasive blood pressure measurement (NIBPM) during the transport of children.

DESIGN

A prospective, convenience sample.

SETTING AND PARTICIPANTS

All patients transported by a dedicated Pediatric Critical Care Transport Team were eligible for inclusion. Senior transport nurses with over 3 years of transport experience who had been instructed by the principal investigator (PI) in the technique, obtained the measurements and recorded the results. A convenience sample was obtained based on the presence or absence of one of the senior nurses on the transport team.

METHODS

Measurements of blood pressure were obtained by POWSBP and NIBPM (PROPAQ@; Protocol Systems, Beaverton, OR) on pediatric patients during transport in moving ambulances or fixed wing aircraft. Measurement of systolic blood pressure by pulse oximetry (POWSBP) was obtained on all patients by observing the return of the plethysmographic waveform of the pulse oximeter as the blood pressure cuff deflated. The patients were divided into two groups; in group A POWSBP measurements were obtained by using the automated BP cuff from the PROPAQ@ and in group B by a manual BP cuff. These measurements were compared to NIBPM readings obtained at the same time. Between 3 and 13 paired readings were obtained for each patient. The actual transport time determined the number of measurements obtained.

RESULTS

A total of 24 patients were enrolled in the study. Multiple matched pair readings (both POWSBP and NIBPM) were obtained from each patient for a total of 180 data points. A two variable linear regression model was run which identified a significant correlation between POWSBP and NIBPM. Group A, r = 0.7592 and r = 0.9477 for group B significant at P< 0.000001. Further, a corrective equation was developed for use with an automated BP cuff.

CONCLUSIONS

The use of pulse oximetry waveform systolic blood pressure measurement is a quick and easy method with which to obtain systolic blood pressure in children during transport and shows a close correlation to the standard noninvasive blood pressure measurement. If an automated blood pressure cuff is used, then a corrective equation [NIBP-S = 41.686 + 0.7377(POBPS)] is required. Further validation in a larger group of patients is recommended.

Proficiency test performance and experience with College of American Pathologists' programs

We examined rates of unacceptable results in a large interlaboratory proficiency test program, which is designed for small hospitals, clinics, and physician offices. The objective was to see whether rates of unacceptable results decrease as laboratories gain experience in interlaboratory comparison programs. We examined data from the College of American Pathologists' Excel Surveys, 1987 through 1993, in the areas of chemistry, hematology, immunology, and blood bank. The data for laboratories with consistent participation show consistent and statistically significant improvement in performance for the first 3 to 4 years of proficiency testing. The data for all participants also suggest that laboratories with more experience with proficiency testing have lower rates of unacceptable results, and that these rates tend to decrease with each year of experience. These conclusions support the findings of other researchers who have documented the benefits of interlaboratory comparison programs and proficiency testing.

An investigation of the magnitude and causes of count loss artifacts in SPECT imaging

A quantitative evaluation and an investigation of the mechanism of the count losses that can occur in SPECT imaging is described. The most common clinical example of the artifacts which result from this is encountered when sections are taken through the femoral heads in skeletal studies of the pelvis. From some simple phantom studies, it was identified that the count losses were associated with the presence of a high dynamic range in the projection data. Further information was obtained from simulation studies. It was found that the count loss phenomenon is caused by the combined effects of the presence of a high count density area and a structure with a relatively high attenuation level. An appreciation of the presence, magnitude, and mechanism of this effect is important if erroneous clinical findings are to be avoided. This is particularly relevant because of the existence of a variety of techniques that can be used to remove the resulting artifacts.

College of American Pathologists-Centers for Disease Control collaborative study for evaluating reference materials for total serum cholesterol measurements

Several recent studies to evaluate the performance of laboratory instruments have shown that with some instrument systems processed (lyophilized, frozen, and stabilized) materials exhibit matrix effects that cause the assay for cholesterol to respond differently for them than for patient specimens. To understand this phenomenon better the College of American Pathologists, Northfield, III, and the Centers for Disease Control, Atlanta, Ga, have conducted a collaborative study with 44 laboratories where 16 instruments manufactured by nine companies are evaluated. The purposes were to assess measurement variation on several reference materials used for standardizing total cholesterol measurements and to evaluate a new stabilized liquid serum as a potential reference material. Lypophilized, frozen, fresh-frozen, and stabilized materials at three concentrations were measured for total cholesterol. The results show that the average coefficient of variation of measured total cholesterol for all instruments, laboratories, vials, and replicates is 3.6% to 4.1% for each of the materials measured (excluding the results for one instrument). For one instrument, however, significant bias was found on the stabilized liquid serum material. Results from the fresh-frozen materials indicate that the instrument systems evaluated allow laboratories to attain the National Cholesterol Education Program analytical performance goals.

Supraglottitis in young adults

Supraglottitis is a disorder with the potential for significant morbidity and mortality in adults. Of the 25 patients we reviewed, 18 were black, representing the largest series of black adults with this condition reported in the medical literature. The mean age for black men was 14 years younger than previously described adults with supraglottitis. The index of suspicion for supraglottitis should be high in young adults with odynophagia out of proportion to findings on oropharyngeal examination. Indirect laryngoscopy will confirm the diagnosis and allow prompt initiation of treatment. Early recognition and treatment will avoid complications.

Quality control of agar diffusion susceptibility tests: data from the Quality Assurance Service Microbiology program of the College of American Pathologists

Over a 12-month period, between July 1981 and June 1982, 115 active participants in the Microbiology program of the College of American Pathologists Quality Assurance Service (QAS) submitted a total of 555,619 individual determinations on three quality control reference strains using the NCCLS standardized disc diffusion procedure. Data is presented for those antimicrobic agent/reference strain combinations for which NCCLS control limits have been changed since the last report of QAS microbiology data or that continue to show discrepancies with current NCCLS individual daily test control guidelines. Data for Escherichia coli versus cefoxitin, doxycycline, and nalidixic acid and for Staphylococcus aureus versus cefoxitin, nafcillin, and oxacillin show good compliance with the new NCCLS guidelines and distributions that are all approximately Gaussian. Significant discrepancies were noted for six combinations; cefamandole, cephalothin, neomycin, and nitrofurantoin versus E. coli and amikacin and clindamycin versus S. aureus. Of these discrepancies, only neomycin/E. coli and amikacin/S. aureus can be accounted for by a subpopulation of laboratories, which, when removed, corrects the data.