Vocational rehabilitation in persons with mental illness in India: A scoping review

BACKGROUND

Employment has a therapeutic impact, enhances community integration and improves the quality of life of persons with mental illness (PwMI). Vocational rehabilitation (VR) models must be sensitive to existing needs and resources. Several VR models have been tested in high income countries. Mapping different VR models in India would help both practitioners and policymakers.

AIM

The study aimed to comprehensively review VR models tested among PwMI in India.

METHODS

We adhered to the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews. We included interventional studies, case studies and grey literature carried out for the VR of PwMI in India. The search was done in PubMed, PsychInfo, worldwide science and Web of Science. Google Scholar was used to supplement the search. A Boolean search using MeSH terms was carried out for the period January 2000 to December 2022.

RESULTS

A total of twelve studies (one feasibility study, four case studies, four institute-based intervention studies and two studies reporting NGOs' role) were included in the final synthesis. The studies included in the review were either quasi-experimental studies or case based. Types of VR included supported employment or place and train or train and place models, case management and prevocational skills training.

CONCLUSION

Limited studies exist on VR in PwMI from India. Most studies assessed a restricted set of outcomes. The experiences of NGOs should be published so that practical challenges can be understood. There is a need for public-private partnerships in designing and testing services and should involve all the stakeholders.

Predictors of batting and pitching performance in the USA baseball prospect development pipeline

This study examined the relationship between psychomotor abilities and baseball performance by analysing data from 379 athletes who participated in the USA Baseball, Prospect Development Pipeline (PDP). Hit and pitch metrics were generated during practice sessions using the RapsodoTM System. Data were compared through exploratory factor analysis and hierarchical regression. Factor analysis grouped batter's PDP evaluations into four latent variables accounting for 63% of variance. Pitcher performance grouped into three factors accounting for 51% of variance. Regression on batter data revealed a significant demographic/anthropometric base model with height, weight, and age that accounted for 58% of the batted ball speed (R2 = 0.581). Player position explained 2% of the variance (R2 = 0.604), and PDP evaluation scores contributed an additional 3% (R2 = 0.631). Regression of pitcher data showed a significant base demographic/anthropometric model accounting for 36% of fastball pitch speeds (R2 = 0.363), with the PDP evaluation scores adding 6% additional variance (R2 = 0.424). Uniformly, assessments of lower body strength added the greatest predictive information. Hand grip strength did not correlate with pitch metrics. While demographics/anthropometrics are major contributors to batted and pitched ball speed, position and psychomotor variables add statistically significant contributions and may be of practical value for player selection.

An unexpected shift in constant year effects in female elite handball

One of the most convincing studies about the importance of the cutoff date in relative age effects was when Helsen et al. (2000) showed that a shift in the date directly resulted in a change of birth month distributions in soccer. Over the past four decades, the role of the birth year has also been associated with relative age effects (as reflected in constant year effects). In this investigation, two studies attempted to replicate the shift of birth year distributions caused by a change in birth years in international female handball. In Study 1, the results from the female handball world championship 2017 showed a significant within-year effect overall and a constant year effect for players born 1988 and after. A second study was conducted with female players from world championships in 2009, 2011, 2013, and 2015. Results demonstrated small effect sizes for most tests. However, there was an unexpected trend toward a constant year effect shift at the age of 28 years. Several hypotheses are presented as an explanation for this trend.

Analysis of learning the bimanual control of (tele)operating joint space controlled robotic arms with 4 degrees of freedom using the two-timescales power law of learning

Training costs for operators of robotic arms in forestry and construction are high. A systematic analysis of skill development can help to make training more efficient. This research focuses on motor skill development by investigating the bimanual control of a four-DoF robotic arm. The two-time scale power law of learning was used to identify difficulties in control learning. Ten participants acquired the control of the robotic arm in a simulator over ten sessions within seven weeks. Eight movement targets were presented in each of six blocks per session, comprising 432 robotic arm movements. The results suggest that learning varies for each joystick axis, with control of the elbow joint showing the highest learning gain. The base and shoulder joints showed similar learning gains. The wrist joint showed mixed results in terms of use or disuse. Performance increased with retention, suggesting that a longer period of consolidation aided skill acquisition.Practitioner summary: A shortage of skilled operators, costly, and extensive training of heavy machine operators in robotic arm control requires to revisit control skill learning. This study showed that focus of training ought to be shifted to specific joints and training requires to emphasise longer resting periods between training sessions.

Relationships of Contact Technique in Training and Matches With Performance and Injury Outcomes in Male Rugby Union

The aims of this study were 3-fold: (1) to compare technical proficiency scores between training and matches for tackling, ball-carrying, and rucking outcomes; (2) to determine the relationship between technique in training and technique in matches for tackling, ball carrying, and rucking; and (3) to determine how contact technique (in training and matches) relates to match performance and injury outcomes. Twenty-four male players from an amateur rugby union club participated in the study. At the beginning of the season, players' contact technique proficiency was assessed in a training drill. Contact technique in matches was assessed during 14 competitive matches. The technique proficiency was assessed using standardized criteria, and the outcomes of each tackle, ball carry, and ruck were recorded. In training and matches, positive performance outcomes were associated with higher contact technique proficiency scores. For instance, in both settings, tackle technique was significantly lower in missed tackles when compared to effective and ineffective tackles. Players' contact technique scores in matches also had a positive effect on their tackle performance in matches. Ball-carry technique was associated with tackle breaks in matches (P < .05, r2 = .31). In training and match environments, tackler, ball-carrier, and ruck technique scores were significantly associated with effective tackles, ball carries, and rucks. Despite the relationship between technical proficiency scores and performance, there were small to moderately higher scores in training compared with matches. The current study highlights the importance of contact skill training, in different environments and conditions, to ensure that skills developed in training are transferred to match performance.

Learning analytics for lifelong career development: a framework to support sustainable formative assessment and self-reflection in programs developing career self-efficacy

Among myriad complex challenges facing educational institutions in this era of a rapidly evolving job marketplace is the development of career self-efficacy among students. Self-efficacy has traditionally been understood to be developed through the direct experience of competence, the vicarious experience of competence, social persuasion, and physiological cues. These four factors, and particularly the first two, are difficult to build into education and training programs in a context where changing skills make the specific meaning of graduate competence largely unknown and, notwithstanding the other contributions in this collection, largely unknowable. In response, in this paper we argue for a working metacognitive model of career self-efficacy that will prepare students with the skills needed to evaluate their skills, attitudes and values and then adapt and develop them as their career context evolves around them. The model we will present is one of evolving complex sub-systems within an emergent milieu. In identifying various contributing factors, the model provides specific cognitive and affective constructs as important targets for actionable learning analytics for career development.

Implementation of a Student-Teacher-Based Blended Curriculum for the Training of Medical Students for Nasopharyngeal Swab and Intramuscular Injection: Mixed Methods Pre-Post and Satisfaction Surveys

BACKGROUND

The COVID-19 pandemic caused a major disruption in the health care sector with increased workload and the need for new staff to assist with screening and vaccination tasks. Within this context, teaching medical students to perform intramuscular injections and nasal swabs could help address workforce needs. Although several recent studies discuss medical students' role and integration in clinical activities during the pandemic, knowledge gaps exist concerning their role and potential benefit in designing and leading teaching activities during this period.

OBJECTIVE

The aim of our study was to prospectively assess the impact in terms of confidence, cognitive knowledge, and perceived satisfaction of a student-teacher-designed educational activity consisting of nasopharyngeal swabs and intramuscular injections for the training of second-year medical students in the Faculty of Medicine, University of Geneva, Switzerland.

METHODS

This was a mixed methods pre-post surveys and satisfaction survey study. Activities were designed using evidence-based teaching methodologies based on the SMART (specific, measurable, achievable, realistic, and timely) criteria. All second-year medical students who did not participate in the activity's old format were recruited unless they explicitly stated that they wanted to opt out. Pre-post activity surveys were designed to assess perception of confidence and cognitive knowledge. An additional survey was designed to assess satisfaction in the mentioned activities. Instructional design was blended with a presession e-learning activity and a 2-hour practice session with simulators.

RESULTS

Between December 13, 2021, and January 25, 2022, a total of 108 second-year medical students were recruited; 82 (75.9%) students participated in the preactivity survey and 73 (67.6%) in the postactivity survey. Students' confidence in performing intramuscular injections and nasal swabs significantly increased on a 5-point Likert scale for both procedures-from 3.31 (SD 1.23) and 3.59 (SD 1.13) before the activity to 4.45 (SD 0.62) and 4.32 (SD 0.76) after the activity (P<.001), respectively. Perceptions of cognitive knowledge acquisition also significantly increased for both activities. For the nasopharyngeal swab, knowledge acquisition concerning indications increased from 2.7 (SD 1.24) to 4.15 (SD 0.83), and for the intramuscular injection, knowledge acquisition concerning indications increased from 2.64 (SD 1.1) to 4.34 (SD 0.65) (P<.001). Knowledge of contraindications for both activities increased from 2.43 (SD 1.1) to 3.71 (SD 1.12) and from 2.49 (SD 1.13) to 4.19 (SD 0.63), respectively (P<.001). High satisfaction rates were reported for both activities.

CONCLUSIONS

Student-teacher-based blended activities for training novice medical students in commonly performed procedural skills seem effective for increasing their confidence and cognitive knowledge and should be further integrated within a medical school curriculum. Blended learning instructional design increases students' satisfaction about clinical competency activities. Future research should elucidate the impact of student-teacher-designed and student-teacher-led educational activities.

Understanding strengths and challenges of people with autism: insights from parents and practitioners

This study is an attempt to bridge the gap between the understanding of strengths and challenges of people with autism to operationalize a strength-based approach to serve people with autism effectively. By virtue of being based on firsthand accounts by parents and practitioners the people who spend prolonged periods with people with autism in natural settings, and are privy to direct observation of abilities and challenges, the study yields in-depth information that addresses a continued gap in the existing literature on the subject. Twenty participants (13 parents and seven practitioners) took part in the study through a semi-structured questionnaire and face-to-face interviews. Data were analyzed following qualitative thematic analysis methodology. Strengths and related challenges experienced were extracted as the broad themes, based on which support needs were derived and future directions recommended. The paper recommends strategic home-school collaborations with crucial, concurrent roles played by parents and practitioners.

Development of a veterinary emergency open standard competency framework using a competency-based model of medical education

OBJECTIVE

To address the shortage of emergency veterinarians, the profession is exploring accelerated training pathways. We sought to contribute to the solution by developing the foundation for an open standard, competency-based veterinary emergency training curriculum for use by any program. We also developed a curricular delivery, tracking, and assessment system to demonstrate how the framework can be integrated into training programs.  DESIGN: Hybrid Delphi method.  SETTING: Academia and referral practice.  ANIMALS: None.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

An emergency veterinary competency framework was developed by adapting the human Model of the Clinical Practice of Emergency Medicine, which aligns with the Competency-Based Veterinary Education framework, to produce 4 areas of core competency: Patient Care, Interpersonal/Communication, Professionalism, and Practice-based Learning/Improvement. A comprehensive list of veterinary emergency skills was generated and organized within the framework utilizing the hybrid Delphi method. An initial survey completed by 133 emergency and critical care specialists and emergency room clinicians produced data regarding the value of specific skills. An 11-member focus group consisting of survey participants iterated upon the survey results to produce a master library of skills and cases, including 56 Patient Care, 43 Interpersonal/Communication, 11 Practice-based Learning/Improvement, and 20 Professionalism skills, as well as 155 case types. The curricular delivery system tracks and assesses case management proficiency and development of knowledge and professional skills using a patient care eLearning program and simulation training environment.  CONCLUSIONS: The increasing need for emergency veterinarians is a shared industry-wide challenge. To contribute toward a collective solution, we have undergone an evidence-based process to create the foundation for an open standard competency framework composed of a library of skills and cases. We offer this open standard framework to the veterinary profession and hope it continues to grow and evolve as we drive toward developing competency-based training programs that address the shortage of emergency veterinarians.

Scaling junior sport competition: A body-scaling approach?

The design of the junior sport competition environment plays a critical role in attracting and retaining children as life-long participants. Critically, however, the guidelines governing the design of junior sport are rarely scrutinized. With this in mind, our aim is to offer sports authorities a method to systematically assess the suitability of guidelines. The most popular junior ball sport competitions in Australia were assessed in relation to the scaling of task constraints and compared to children's corresponding physical maturation and/or performance measures. This assessment enabled the calculation of pi ratios, which were then used to categorise constraints as either (1) undersized, (2) appropriately sized or (3) oversized. Results revealed that most sports' ask children to play in oversized conditions, particularly in the under 9 to under 12 age groups and in boys' competitions. The task constraints that had the highest percentage of pi ratios appropriately sized were match duration and goal size. Comparatively, ball size and field length had the highest percentage of pi ratios classified as oversized. We contend that the systematic approach applied in this article should be used by sports authorities to understand the extent of scaling constraints in junior sport.

Effects of biofeedback on whole lower limb joint kinematics and external kinetics

Biofeedback (BFb) is a useful tool to accelerate the skill development process. Limited research has applied BFb to the whole lower-limb in a complex skill therefore the aim of this research was to assess the effectiveness of a biofeedback intervention targeting whole lower limb kinematics. Thirty-two healthy participants were randomized to a BFb (n = 16) and a Control group (n = 16). Participants visited a motion capture laboratory on three occasions during one week, and returned for retention testing at 4-6 weeks. Following introduction to a novel lunge-touch task, visual BFb on lower limb joint kinematic extension angular velocities (ω) and timing were provided following each lunge. BFb was effective in increasing Hipω (F = 3.746, p = 0.03) and Kneeω (F = 10.241, p = 0.01). Peak Ankle_ω remained unchanged (F = 1.537, p = 0.23, η² = 0.05), however Peak Ankle_θ (F = 10.915, p < 0.001, η² = 0.27) and Ankle_ROM (F = 9.543, p < 0.001, η² = 0.24) significantly increased. Despite kinematic changes, there were no significant changes in any external kinetics. No significant correlations were found between Hipω, Kneeω or Ankleω and horizontal impulse (Impulse_Y: r = 0.20, p = 0.26; r = -0.11, p = 0.24; and r = 0.22, p = 0.28, respectively). Findings demonstrate that BFb can be used to alter multiple kinematic variables in a complex skill, but do not necessarily alter associated kinetic variables not directly targeted by BFb.

From a crisis to an opportunity: Eight insights for doing science in the COVID-19 era and beyond

The COVID-19 crisis has forced researchers in Ecology to change the way we work almost overnight. Nonetheless, the pandemic has provided us with several novel components for a new way of conducting science. In this perspective piece, we summarize eight central insights that are helping us, as early career researchers, navigate the uncertainties, fears, and challenges of advancing science during the COVID-19 pandemic. We highlight how innovative, collaborative, and often Open Science-driven developments that have arisen from this crisis can form a blueprint for a community reinvention in academia. Our insights include personal approaches to managing our new reality, maintaining capacity to focus and resilience in our projects, and a variety of tools that facilitate remote collaboration. We also highlight how, at a community level, we can take advantage of online communication platforms for gaining accessibility to conferences and meetings, and for maintaining research networks and community engagement while promoting a more diverse and inclusive community. Overall, we are confident that these practices can support a more inclusive and kinder scientific culture for the longer term.

School-Based Health Education Research: Charting the Course for the Future

SHAPE America has identified four goals as part of the 50 Million Strong by 2029 initiative; one of these goals is healthy behavior. School-based health education is uniquely positioned to be a primary route through which this goal can be achieved. Health education is an academic subject included in a well-rounded education, based on health behavior and learning theory, research-based and taught by licensed and trained health educators with adequate instructional time. Health education helps students acquire functional knowledge about a variety of topics and develop health-related skills resulting in personal competence and self-efficacy. The purpose of this paper is to provide an overview of the existing evidence examining school-based health education and to articulate future directions for research that will solidify school-based health education as a necessary and efficacious strategy for improving the health and wellness of youth.

Design of a Game-Based Training Environment to Enhance Health Care Professionals' E-Mental Health Skills: Protocol for a User Requirements Analysis

BACKGROUND

E-mental health (EMH) offers various possibilities for mental health care delivery, with many studies demonstrating its clinical efficacy. However, the uptake of EMH technologies by mental health care professionals remains to be low. One of the reasons for this is the lack of knowledge and skills in using these technologies. Skill enhancement by means of serious gaming has been shown to be effective in other areas but has not yet been applied to the development of EMH skills of mental health care professionals.

OBJECTIVE

The aim of this paper is to describe a study protocol for the user requirements analysis for the design of a game-based training environment for mental health care professionals to enhance their skills in EMH.

METHODS

The user requirements are formulated using three complementary outputs: personas (lively descriptions of potential users), scenarios (situations that require EMH skills), and prerequisites (required technical and organizational conditions). We collected the data using a questionnaire, co-design sessions, and interviews. The questionnaire was used to determine mental health care professionals' characteristics, attitudes, and skill levels regarding EMH and was distributed among mental health care professionals in the Netherlands. This led to a number of recognizable subuser groups as the basis for personas. Co-design sessions with mental health care professionals resulted in further specification of the personas and an identification of different user scenarios for the game-based training environment. Interviews with mental health care professionals helped to determine the preferences of mental health care professionals regarding training in EMH and the technical and organizational conditions required for the prospective game-based training environment to be used in practice. This combination of requirement elicitation methods allows for a good representation of the target population in terms of both a broad view of user needs (through the large N questionnaire) and an in-depth understanding of specific design requirements (through interviews and co-design).

RESULTS

The questionnaire was filled by 432 respondents; three co-design sessions with mental health care professionals and 17 interviews were conducted. The data have been analyzed, and a full paper on the results is expected to be submitted in the first half of 2021.

CONCLUSIONS

To develop an environment that can effectively support professionals' EMH skill development, it is important to offer training possibilities that address the specific needs of mental health care professionals. The approach described in this protocol incorporates elements that enable the design of a playful training environment that is user driven and flexible and considers the technical and organizational prerequisites that influence its implementation in practice. It describes a protocol that is replicable and provides a methodology for user requirements analyses in other projects and health care areas.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR1-10.2196/18815.

Teaching psychomotor skills online: exploring the implications of novel coronavirus on health professions education

CONTEXT

The safe and effective application of psychomotor skills in the clinical environment is a central pillar of the health professions. The current global coronavirus pandemic has significantly impacted health professions education (HPE) and has been of particular consequence for routine face-to-face (F2F) skill education for health professionals and clinical students worldwide. What is being experienced on an unprecedented scale parallels a problem familiar to regional, rural and remote health professionals and students: the learners are willing, and the educational expertise exists, but the two are separated by the tyranny of distance. This article considers how the problem of physical distance might be overcome, so that quality skill education might continue.

ISSUES

Psychomotor skills are undeniably easier to teach and learn F2F, and training schedules in tertiary, in-service and accredited professional courses reflect this. This aspect of HPE is therefore at significant risk in the context of social distancing and physical isolation. Psychomotor skills are much more complex than the physical motor outputs alone might suggest, and an F2F skill session is only one way to build the complementary aspects of new skill performance. This article argues that educators and course designers can progress with psychomotor skill education from a physical distance.

LESSONS LEARNED

Videos can be used to either passively present content to learners or actively engage them. It is the design of the educational activity, rather than the resource medium itself, that enables active engagement. Furthermore, while many training schedules have been adapted to accommodate intensive F2F skill training once it is safe to do so, distributed practice and the need for reflection during the acquisition and development of new skills may challenge the pedagogical effectiveness of this approach. Skill development can be fostered in the absence of F2F teaching, and in the absence of a shared physical space. Embracing the creative licence to do so will improve equitable access to regional, rural and remote clinicians and students well beyond the resolution of the current pandemic.

Longitudinal Effects of the Home Learning Environment and Parental Difficulties on Reading and Math Development Across Grades 1-9

This study focuses on parental reading and mathematical difficulties, the home literacy environment, and the home numeracy environment as well as their predictive role in Finnish children’s reading and mathematical development through Grades 1–9. We examined if parental reading and mathematical difficulties directly predict children’s academic performance and/or if they are mediated by the home learning environment. Mothers (n = 1590) and fathers (n = 1507) reported on their reading and mathematical difficulties as well as on the home environment (shared reading, teaching literacy, and numeracy) when their children were in kindergarten. Tests for reading fluency, reading comprehension, and arithmetic fluency were administered to children in Grades 1, 2, 3, 4, 7, and 9. Parental reading difficulties predicted children’s reading fluency, whereas parental mathematical difficulties predicted their reading comprehension and arithmetic fluency. Familial risk was associated with neither formal nor informal home environment factors, whereas maternal education had a significant relationship with both, with higher levels of education among mothers predicting less time spent on teaching activities and more time spent on shared reading. In addition, shared reading was significantly associated with the development of reading comprehension up to Grades 3 and 4, whereas other components of the home learning environment were not associated with any assessed skills. Our study highlights that taken together, familial risk, parental education, and the home learning environment form a complex pattern of associations with children’s mathematical and reading skills.

Coaches' perspective towards skill acquisition in swimming: What practice approaches are typically applied in training?

This study aimed to explore the experiential knowledge and preferred training approaches of elite swimming coaches in regards to general skill development and then looking specifically at the freestyle stroke. A qualitative thematic analysis approach was employed to identify, analyse and report themes within the content of the collected data. Twenty elite swimming coaches participated in semi-structured interviews. Several themes revealed that the most common training practices employed to improve skill learning included the use of task decomposition (part-task) techniques. The findings also indicated that swimming coaches believe practice should be specific/representative to the intended performance outcomes. It is believed that such viewpoints may have been influenced by coaches' interaction with skill acquisition consultants and may have also shaped some coaches use of variants of constraints manipulation in their practice design. While swimming coaches seem to mix both traditional and contemporary skill acquisition theories in their training prescriptions, the traditional approach is dominant as evidenced by coaches seeking to reinforce "perfect" swimming technique and mechanical consistency. Considering coaches' experiential knowledge and training prescriptions may benefit future research protocols and better facilitate the transfer of empirical findings to coaching practice.

Impact of Simulated Patients on Physiotherapy Students' Skill Performance in Cardiorespiratory Practice Classes: A Pilot Study

Purpose: To date, no evidence exists that high-fidelity simulation improves skill development among physiotherapy students in the university setting. With pressures to reduce costs and maintain or improve the quality of the learning experience, and with pressures on clinical placement, it is essential to investigate methods that might improve students' skill performance before they undertake clinical practice. Our study set out to investigate (1) the impact of using simulated patients (SPs) in a practical class on physiotherapy students' skill acquisition and (2) the students' reflections on the intervention. Method: We devised a pilot study using a single-centre randomized controlled trial. A total of 28 undergraduate physiotherapy students, matched using previous practical examination grades, undertook a 2-hour practical class in which they practised their core cardiorespiratory skills. Pre-session resources were identical. The control group practised on peers; the intervention group practised on SPs. The students' skill performance was assessed 2 weeks later using the Mini-Clinical Evaluation Exercise (MiniCEX), including gathering qualitative data from the students' reflections. Twenty-eight students undertook the practical class and subsequent MiniCEX assessment. Results: A statistically significant difference was found for all aspects of the MiniCEX except medical interview (p = 0.07) and physical interview (p = 0.69), and a large effect size was found for all areas except physical interview (0.154) and medical interview (0.378). The students' reflections focused on three key themes: behaviours and attitudes, teaching the active cycle of breathing technique, and feedback. Conclusions: Our findings suggest that interacting with SPs improves student skill performance, but further research using a larger sample size and an outcome measure validated for this population is required to confirm this.

Enhancing Operative Feedback: A Descriptive Trajectory for Surgical Development in Otolaryngology

OBJECTIVE

Developmental frameworks are narrative descriptions of learner performance that may be useful to provide operative feedback tools in surgical education. The authors previously proposed the Technician, Anatomist, Anticipator, Strategist, Executive (TAASE) framework utilizing data collected from general surgeons and conjectured its applicability in other surgical specialties. Here, we construct a developmental framework in otolaryngology using similar techniques, then compare the results to TAASE.

DESIGN

Ten otolaryngology educators participated in semi-structured, audio-recorded interviews, to explore how otolaryngology faculty characterize surgical learning at different levels of training. Researchers analyzed the transcripts using a thematic analysis approach to build a developmental framework. Results were then qualitatively compared to the TAASE trajectory.

SETTING

Single tertiary academic medical center.

PARTICIPANTS

Faculty within the Department of Otolaryngology-Head and Neck Surgery.

RESULTS

Otolaryngology faculty characterized surgical development as an integrated trajectory of technical and cognitive skills progressing from specific operative tasks to a global understanding of patients and procedures largely consistent with stages outlined in the Technician, Anatomist, Anticipator, Strategist, and Executive model. A new theme identified was learner emotions, which may impact learning and hinder or enhance progression along the trajectory.

CONCLUSIONS

Otolaryngology and general surgeons agree upon a common arc to operative maturity reflected by the TAASE trajectory. The TAASE framework may be useful as a tool for intraoperative assessment in otolaryngology to help promote quality feedback. Further research is needed to understand how emotions may influence operative skill development.

Skill Development Versus Performativity Among Beginners in Aerial Practice: An Embodied and Meaningful Learning Experience

The purpose of this quasi-experimental, phenomenological study was to use embodied cognition in understanding learning experiences in skill development and performativity (e.g., storytelling and emotional expression) among 17 beginners in aerial practice (M_age = 20.59 ± 1.37 years old). Eight people were in the treatment-group class (skill development and performativity) and nine individuals participated in the control-group class (only skill development). Four themes emerged from the analysis: linking other exercises to aerial (e.g., cheerleading, dancing, and gymnastics) and uniqueness of aerial (e.g., artistic aspect while in the air); success in meeting aerial goals (at the posttest, performativity was valued more in the treatment group than the control group); exercise changes due to aerial, such as enhanced upper-body strengthening activities and stretches; and lessons learned, including importance of conditioning and small class size, switching Teaching Assistants (TAs), and silk awareness. Practitioners in community-based movement education programs like dancing and physical theater should recognize the need for embodied knowledge by emphasizing not only skill development but also performativity for enhanced learning experiences within supportive class settings. Although adding performative qualities to skill learning is more challenging than skill development alone, it can lead to enhanced performance, joy, and meaning of movement.

A Golden Age for Motor Skill Learning? Learning of an Unfamiliar Motor Task in 10-Year-Olds, Young Adults, and Adults, When Starting From Similar Baselines

It is often argued within sports circles that the age span of around 6–12 years is a golden age for motor skill learning, and this period is often described as sensitive, or even critical, for learning such skills. Consequently, skill development programmes target this age span for teaching technical and coordinative skills. In the scientific literature, however, the term golden age is scarcely seen, and few studies have even attempted to test this hypothesis. When comparing motor learning between children and adults, studies have typically found little difference or differences favoring adults. Studies that have reported precocious learning within the golden age seem not to have controlled all relevant variables. Typically, the different age groups have not started from similar baselines and have tested tasks that have not been scaled according to physical differences between individuals belonging to the various groups. The present study tested 10-year-olds, 18-year-olds, and 40-year-olds on dart throwing with their non-dominant hands. They each completed 200 throws over 2 days, with 1 day in between. All participants performed at similar levels at the pre-test, and the task was scaled according to each participant’s individual size. No difference was found between the groups after practice in terms of change in absolute error, or with respect to the slopes of their learning curves. The 10-year-olds’ learning curves were more variable compared with the other groups. Thus, the present study found no evidence that the 10-year-olds belonged to a golden age for motor learning, and we would argue that previous findings of differences might well be artefacts due to lack of control of relevant variables.

Implementation of a modified sport programme to increase participation: Key stakeholder perspectives

Modified sports, whereby equipment and rules are manipulated to facilitate skill performance, have been shown to promote skill learning and potentially increase participation. However, it is currently unexplored how key stakeholders - coaches and key figures working in National associations - who are critical stakeholders in implementing and delivering sport programmes, perceive modified sport. This study explored how tennis coaches and key figures working within tennis National associations perceived the impact of implementing a modified tennis campaign on participation and skill development in children and adults. Key figures and coaches around the world completed an online questionnaire. Both groups considered that modified tennis was positively associated with increasing and sustaining participation, skill learning, talent development and people's attitude towards tennis. Furthermore, participants thought that a rule change (i.e., use of a low-compression ball in children competitions) and the campaign's core messages (i.e., "serve, rally, score" and "easy, fun, and healthy") have been critical for the success of the campaign. These results support previous research on the positive impact of modified tennis on skill development and provide a further impetus on implementing modified sports to increase participation. Other sports can adopt similar strategies to improve their modified programmes.

Assessing the Co-Curriculum by Mapping Student Organization Involvement to Curricular Outcomes Using Mixed Methods

Objective. To use institution-specific curricular outcomes as a framework to map skill development opportunities available through cocurricular involvement in pharmacy student organizations. Methods. Participants completed a modified Extracurricular Involvement Inventory individually to measure the intensity of their involvement in each student organization. Participants also completed the Co-Curriculum Outcomes Assessment Mapping Survey (COAMS) instrument as a group to indicate what skills (ie, curricular outcomes) they developed through involvement in a student organization and student organization activities, programs, and events, and to provide examples of these skills. Data sources were triangulated to map skill development opportunities in the co-curriculum to curricular outcomes. Results. The COAMS identified all curricular outcomes as skills students have the opportunity to develop through student organization involvement in the co-curriculum. Communication was the most common skill identified. Other common skills included professionalism and ethical behavior, collaboration and influence, and in-depth knowledge and proficient skills. A co-curriculum heat map was used to illustrate the degree to which students reported these skills were emphasized through student organization involvement in the co-curriculum. Conclusion. Evaluation of activities in the context of curricular outcomes can provide a more comprehensive understanding of how the co-curriculum complements the curriculum, thereby complying with accreditation expectations. Cocurricular mapping provides valuable information regarding student skill development opportunities to multiple stakeholders (eg, students, faculty, curriculum leadership). This process can be applied to diverse programs, adapted to measure institution-specific experiences, and measure various constructs of interest.

The PreOp Program: Intensive Preclinical Surgical Exposure is Associated With Increased Medical Student Surgical Interest and Competency

OBJECTIVE

As medical students' interest in surgical fields wanes, we investigated the impact of a preclinical surgical exposure program on students' attitudes toward pursuing surgical careers.

DESIGN

This is a prospective longitudinal study of PreOp, a preclinical rotation-based surgical exposure program for first-year medical students, from 2013 to 2017. Surveys assessed PreOp rotation quality, students' surgical interest, and students' self-reported preparedness for the surgical clerkship. Surgery clerkship grades were obtained as a measure of surgical competency and compared to class-wide peers. Match data was collected and compared to class-wide peers as well as historical norms.

SETTING

NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY; tertiary care center.

PARTICIPANTS

Fifty-four PreOp students from 2013 to 2017.

RESULTS

Fifty-four PreOp participants were recruited. After completing the PreOp program, 66.7% of PreOp students reported being very likely to apply into a surgical field compared to 29.4% when they started medical school. Ultimately, 71.4% of PreOp students versus 21.7% of non-PreOp class-wide peers matched into surgical fields (p < 0.001). From the preceding 5 match years before PreOp implementation, 21.4% of all students matched into surgical fields compared to 25.6% of all students after PreOp was started (p = 0.26). In terms of preparedness, 75% of PreOp students reported feeling more prepared for the third-year surgery clerkship than their non-PreOp peers after the second year of medical school. PreOp students were significantly more likely than non-PreOp class-wide peers to receive honors in the surgery clerkship when controlling for cumulative clerkship GPA (p = 0.012, adjusted odds ratio = 5.5 [95% confidence interval 1.5-22.1]).

CONCLUSIONS

Hands-on preclinical surgical exposure was associated with student-reported increased surgical interest that was maintained longitudinally and reflected in significantly increased surgical matches relative to non-PreOp class-wide peers. This study uniquely demonstrates that participation in PreOp was also associated with increased self-reported surgical preparedness and significantly higher surgery clerkship grades relative to overall academic performance.

Implementing a skill development program among food handlers in tertiary care hospital to improve their personal hygiene: A pilot study

INTRODUCTION

Food handlers with poor personal hygiene and lack of awareness in preventing foodborne diseases working in hospitality sectors or hospitals could spread foodborne infections.

OBJECTIVE

Our study objective was to ascertain the impact of a video-based educational intervention program and administrative measures on improvement in personal hygiene of food handlers in hospital.

METHODOLOGY

We conducted this pilot study among all 103 food handlers who were working in a tertiary care hospital. A checklist-based scoring and physical examination were conducted by the investigator for the food handlers. After baseline scoring S1, intervention 1 and 2 was implemented, and score was obtained as S2 and S3, respectively. Descriptive statistics was calculated, and score was compared by repeated measures ANOVA test using SPSS-22 software.

RESULTS

Our study revealed that a total of 19.2% of food handlers had health complaints. More than half (54.8%) admitted that they had suffered from any kind of illness since last 6 months. Common illness was viral fever (40.3%) followed by typhoid (5.7%), dengue (4.8%) and urinary tract infection (3.8%). Most of the food handlers had long hair (62.5%) followed by long nail (57.69%). Nearly, one-fifth (20.1%) of food handlers nail was infected with fungus. Worm was found in 14.4% cases by stool examination. Statistically significant (P < 0.05) improvement in score was observed after each intervention.

DISCUSSION

Poor hygiene (Score-1 = 23.76) was observed at baseline study although there was a mechanism in place for a yearly health checkup and regular (6 monthly) hygiene training. After interventions (video-based training and administrative measures), the score was improved to Score-3 (42.57). Statistically significant (P < 0.05) differences in hygiene score were observed for variables such as state of residence, education level, and working experiences (inside or outside the hospital).

CONCLUSION

It is possible to improve personal hygiene among food handlers using video-based interactive training methods and administrative measures with no extra or minimal cost.

RECOMMENDATIONS

This "piggyback" approach of training can be imparted in addition to routine training measures among the food handlers for improving their personal hygiene in the hospital setting.

Identifying and Mapping Skill Development Opportunities Through Pharmacy Student Organization Involvement

Objective. To describe a process for identifying skills that students can gain through co-curricular involvement and to map these skills to curricular outcomes. Methods. This pilot study used a mixed-methods approach involving document reviews, student involvement surveys, and focus groups/interviews to evaluate skill development opportunities in three pharmacy student organizations. Investigators reviewed key documents (eg, student organization websites, annual review forms) to identify skills emphasized by the organization. Student participants completed modified Extracurricular Involvement Inventory surveys to measure the intensity of their student organization involvement. Two student focus groups, one student leader focus group and one general student member focus group, were held for each student organization. Interviews were conducted with each student organization's faculty advisor. Data sources were triangulated to identify and map skill development opportunities to program core competencies. Results. Six of nine core competencies were identified as skills pharmacy students can develop through involvement in the pilot student organizations. All three organizations provided opportunities for members to develop communication skills and in-depth knowledge and proficient skills of the discipline of pharmacy. Two organizations provided opportunities for students to develop collaboration skills. Conclusion. A mixed-methods approach can be used to identify and map skills that students can develop through co-curricular involvement. This approach provides several advantages: objective evaluation and triangulation of skill development opportunities, evaluation of students' involvement, and identification of linkages between the co-curriculum and curriculum in the context of curricular outcomes.

Exploring the Role and Application of the Deliberate Practice Concept in Radiation Therapy

The concept of deliberate practice (DP) has been extensively applied to the development of skill and expert performance in many domains of professional practice. Although it has been widely reviewed in other health professions, there is a lack of evidence on its application in radiation therapy practice. This article aims to explore the concept of DP and how it can be applied to radiation therapy practice. The authors define DP, why it is essential, and how it can be implemented in radiation therapy. Evidence from the DP literature in the health professions was used to clarify the guiding principles for successful DP implementation within both the clinical and educational contexts. While the authors encourage radiation therapy practitioners to engage in DP approaches, every profession utilizing DP will develop strategies unique to the individual discipline. Hence, rather than imitating other professions, it is essential that radiation therapists engage evidence-based approaches that will generate empirical evidence to model radiation therapy-specific DP approaches.

An Evaluation of an eHealth Tool Designed to Improve College Students' Label-Reading Skills and Feelings of Empowerment to Choose Healthful Foods

Objective

College students are at risk for poor dietary choices. New skills can empower individuals to adopt healthful behaviors, yet eHealth tools designed to develop food-choice skills, such as label-reading skills, are uncommon. We investigated the effects of web-based label-reading training on college students’ perceptions of healthful food-choice empowerment.

Methods

Students completed label-reading training in which they practiced selecting the more healthful food using nutrition labels. We examined improvements in label-reading accuracy (correct healthfulness decisions) and perceptions of empowerment, using a 6-item scale. Repeated measures ANOVAs and paired-samples t-tests were used to examine changes in accuracy and empowerment across the training session.

Results

In addition to increases in label-reading accuracy with training, we found increases in healthful food-choice empowerment scores. Specifically, the proportion of correct (i.e., more healthful) food choices increased across the three blocks of practice (p = 0.04) and food-choice empowerment scores were about 7.5% higher on average after training (p < 0.001).

Conclusion and implications

Label-reading training was associated with increased feelings of empowerment associated with making healthful food choices. Skill focused eHealth tools may offer an important avenue for motivating behavior change through skill development.

Training the Next Generation: Developing Health Education Skills in Undergraduate Public Health Students at a Historically Black College and University

With the looming workforce crisis, undergraduate public health students could be an important link in filling this demand. As public health continues to face challenges in the future, it is important that the future workforce is not only diverse but also trained in a manner that exposes them to real-world experiences that give them an opportunity to apply coursework to solve problems. This article outlines how a health program planning course was taught at a Historically Black College and University using assignments that promote active learning. Students were assessed on their ability to plan and implement a health activity based on a developed metric. Student and instructor reflections were collected from final assessments of the health programs by both groups. All elements of the course are discussed from course design, structure, assignments, and outcomes along with student and instructor reflections and lessons learned. Results suggest that including assignments focused on active learning are beneficial to helping students learn course material. As public health continues to change, more work needs to focus on teaching pedagogies that better prepare students to address future public health issues.

The Role of Postural Support in Young Adults' Control of Stationary Kicking

PURPOSE

The requirement for postural stability during the performance of motor skills has been clearly demonstrated in infants, but the necessity for such a postural substrate is not well documented in adults. The present study investigated the role of postural stability during a ballistic ball-kicking task in adults by providing varying degrees of external postural support.

METHOD

In the 1st experiment, 30 participants performed 20 maximal-velocity kicks under each of 3 conditions: grasping a rigid stable handle, light fingertip touch, and grasping a suspended elastic tube. A 2nd experiment with 16 participants varied the position of the stable handle to examine if the handle position in Experiment 1 might simply act as a fulcrum to enhance torque generation.

RESULTS

In Experiment 1, ball velocity was significantly higher in the stable-grasp condition in both men and women with the men showing greater improvement relative to the other conditions. Experiment 2 showed that the position of the stable handle did not significantly affect kicking velocity, indicating that the handle was not simply acting as a fulcrum during the kick.

CONCLUSION

Together, the findings suggest that postural stability may be a rate limiter in the performance of dynamic motor tasks in adults.

Challenges to developing diabetes self-management skills in a low-income sample in North Carolina, USA

High rates of diabetes diagnosis and poor diabetes outcomes are particularly significant in low-income, socially disadvantaged populations. Although many social and economic predictors of poor self-management outcomes are known, few studies have examined how these elements impact the ability to develop self-management capacities in low-income populations. This article presents new insights into low-income women's challenges and successes to becoming more adept self-managers. Interview data were collected in 2012 with a sample of low-income, middle-age women with type II diabetes recruited from a non-profit medical clinic serving low-income clients in North Carolina, United States. Data were analysed using a grounded theory approach. Developing self-management skills within disadvantaged life contexts involved negotiating three related, overlapping sub-processes: negotiating access to care systems, negotiating disruptions to diabetes self-management patterns, and negotiating self-care knowledge. Developing diabetes self-management skills is a long and arduous process. Data and analysis presented here help explain how disadvantaged life contexts can impact self-managers' efforts to develop self-management skills and why continued support is important for reducing and preventing future problems. These initial findings suggest that future studies and intervention development on the topic are warranted.

State-of-the-Art Pediatric Hypnosis Training: Remodeling Curriculum and Refining Faculty Development

Training in pediatric hypnosis has been part of clinical hypnosis education in the United States since 1976. Workshops expanded over time and are now taught by highly experienced pediatric clinicians across the globe. In 1987, a small vanguard of North American faculty, academic pediatricians, and pediatric psychologists taught a 3-day pediatric hypnosis workshop at the national meeting of the Society for Developmental and Behavioral Pediatrics (SDBP). This model of annual tri-level concurrent workshops (introductory, intermediate, and advanced) was sponsored by the SDBP for 24 years. In 2009, the National Pediatric Hypnosis Training Institute (NPHTI) assembled, and in 2010, offered its first annual workshops. This article documents this history of pediatric hypnosis education and describes NPHTI's remodeling and ongoing refinement toward a state-of-the-art curriculum with innovative methodology based upon (1) current research about adult experiential and small group learning; (2) design principles for presentations that maximize adult learning and memory; and (3) evaluations by participants and faculty. These underpinnings-including clinical training videos, individualized learning choices, emphasis on personalized, goal-oriented sessions, and advances in faculty selection, and ongoing development-are applicable to adult training models. Integration of developmental and self-regulation strategies may be more unique to pediatric hypnosis skills training programs. The conclusion proposes expansion of pediatric hypnosis education and elimination of related barriers toward goals that all children learn self-hypnosis (SH) for mind-body health.

Scaling Tennis Racquets During PE in Primary School to Enhance Motor Skill Acquisition

PURPOSE

Research supporting the skill acquisition benefits of scaling sports equipment for children in a real-world setting where child-to-coach ratios are high is scarce. Thus, the aim of this study was to examine the influence of scaling the tennis racquet on children's skill acquisition in a primary school setting.

METHOD

Children aged 6 to 7 years old practiced for 5 weeks during physical education classes using either a small racquet (SR group; n = 23) or a large racquet (LR group; n = 23). Measures of hitting technique, hitting performance, and general hand-eye coordination were administered before and after the practice period.

RESULTS

The high child-to-coach ratio (22:2) seemingly led to a small number of practice opportunities for children. Despite this finding, children in the SR group displayed greater improvements in hitting technique for the forehand and backhand. This finding did not translate to better hitting performance (i.e., skill outcome), however, with similar results found for both groups during the pretest and posttest. Conversely, the LR group showed greater improvements in the hand-eye coordination measure of bouncing the ball on the ground.

CONCLUSION

Scaling equipment for children enhanced the acquisition of a more desirable technique in a real-world setting. We speculate that this technique acquisition would also lead to improved hitting performance following a longer practice period, whereby children are exposed to more practice opportunities.

Widely Assumed but Thinly Tested: Do Employee Volunteers' Self-Reported Skill Improvements Reflect the Nature of Their Volunteering Experiences?

An increasing number of companies use corporate volunteering programs (CVPs) to support and coordinate their employees' efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers' self-reported skill development reflects the characteristics of the volunteers and their volunteering experiences. Study participants were 74 employee volunteers who completed a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit's records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of 10 work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were moderated by the employee volunteers' self-efficacy about improving their work-related skills on all 10 skills as hypothesized. I discuss the implications of these findings for theory and research, and provide suggestions for designing volunteer experiences that encourage service commitments from companies and their employees, and ultimately create tangible value for them and meaningful social value for their communities.

Cognitive Expertise: An ALE Meta-Analysis

Expert performance constitutes the endpoint of skill acquisition and is accompanied by widespread neuroplastic changes. To reveal common mechanisms of reorganization associated with long-term expertise in a cognitive domain (mental calculation, chess, language, memory, music without motor involvement), we used activation likelihood estimation meta-analysis and compared brain activation of experts to nonexperts. Twenty-six studies matched inclusion criteria, most of which reported an increase and not a decrease of activation foci in experts. Increased activation occurred in the left rolandic operculum (OP 4) and left primary auditory cortex and in bilateral premotor cortex in studies that used auditory stimulation. In studies with visual stimulation, experts showed enhanced activation in the right inferior parietal cortex (area PGp) and the right lingual gyrus. Experts' brain activation patterns seem to be characterized by enhanced or additional activity in domain-specific primary, association, and motor structures, confirming that learning is localized and very specialized.

Monitoring the Veterinary Medical Student Experience: An Institutional Pilot Study

Veterinary medical school challenges students academically and personally, and some students report depression and anxiety at rates higher than the general population and other medical students. This study describes changes in veterinary medical student self-esteem (SE) over four years of professional education, attending to differences between high and low SE students and the characteristics specific to low SE veterinary medical students. The study population was students enrolled at the Michigan State University College of Veterinary Medicine from 2006 to 2012. We used data from the annual anonymous survey administered college-wide that is used to monitor the curriculum and learning environment. The survey asked respondents to rate their knowledge and skill development, learning environment, perceptions of stress, skill development, and SE. Participants also provided information on their academic performance and demographics. A contrasting groups design was used: high and low SE students were compared using logistic regression to identify factors associated with low SE. A total of 1,653 respondents met inclusion criteria: 789 low SE and 864 high SE students. The proportion of high and low SE students varied over time, with the greatest proportion of low SE students during the second-year of the program. Perceived stress was associated with low SE, whereas perceived supportive learning environment and skill development were associated with high SE. These data have provided impetus for curricular and learning environment changes to enhance student support. They also provide guidance for additional research to better understand various student academic trajectories and their implications for success.

A Methodology for Assessing Skill-Based Educational Outcomes in a Pharmacy Course

Objective. To develop a methodology for assessing skill development in a course while providing objective evidence of success and actionable data to improve instructional effectiveness. Design. Course objectives were recast as skills to be demonstrated. Confidence in these skills was surveyed before and after the course. Student skills were demonstrated using 4 work products and a multiple-choice examination. Assessment. The change from precourse survey to postcourse survey was analyzed with a paired t test. Quality of the student work product was assessed using scoring guides. All students demonstrated skill mastery by scoring 70% or above on the work product, and 87/88 demonstrated individual progress on the surveyed skills during the 15-week course. Conclusion. This assessment strategy is based on sound design principles and provides robust multi-modal evidence of student achievement in skill development, which is not currently available using traditional student course evaluation surveys.

Views from academia and industry on skills needed for the modern research environment

Reports from employers of higher education graduates indicate the existence of a considerable gap between the skills required by employers and those possessed by recent graduates. As a first step toward closing this gap, this study aims to determine its origin. Interviews with nine research-active biochemistry professionals were used to identify the most important skills for biochemistry students to succeed in research positions postgraduation. The results of these interviews were used to develop a survey, which was then administered to a larger group of biochemistry faculty and industry professionals. The output of the survey was a list of 52 skills valued by biochemistry professionals and rated by perceived importance. Importantly, the survey results also afford a comparative look at the prioritization of skills by two key populations: the academic faculty training students and the industry professionals hiring them. While there are many areas of agreement between these two populations, the survey also reveals areas were priorities diverge. The discrepancies found here suggest that the skills gap manifest at the point of employment may stem directly from differences in prioritization between the academic and industrial environments. This article aims to provide insight into the needs and requirements of the modern biochemical research environment, and invites debate concerning the preparation students receive in academia. Moreover, the results presented herein point to a need for further exploration of the possible misalignment of these two critical environments for young scientists.

Another day, another tennis coaching intervention, but does this one do what coaches purport?

A proficient serve is critical to successful tennis performance, and consequently coaches and players devote considerable time refining this stroke. In so doing, a wide variety of interventions are used or trialled, generally with very little empirical support. This study examined the efficacy of a commonly used service intervention, where players focus on exaggerating their finish (arabesque) position to promote specific changes in lower limb and trunk kinematics. The kinematics of eight high-performance junior players hitting flat serves were compared to the acute changes in kinematics elicited by the arabesque follow through position on serves using a 10-camera VICON MX motion analysis system. The significantly greater front (landing leg) hip flexion (p < 0.05) and forward trunk flexion (p < 0.05) confirmed the more exaggerated arabesque landing position following the arabesque instruction. The arabesque instruction resulted in increased frontal plane trunk range of motion and peak angular velocity in the forward swing, and increased leg drive during the drive phase. Practically, the results support the use of the arabesque instruction, effectively promoting the desired acute changes in trunk kinematics (i.e. increased frontal plane trunk rotation angular velocity) and leg drive (i.e. increased back knee extension angular velocity and front/back vertical hip velocity).

Performance factors related to the different tennis backhand groundstrokes: a review

The backhand is one of the two basic groundstrokes in tennis and can be played both with one or two hands, with topspin or backspin. Despite its variety of derivatives, the scientific literature describing the backhand groundstroke production has not been reviewed as extensively as with the serve and the forehand. The purpose of this article is to review the research describing the mechanics of one and two-handed backhands, with a critical focus on its application to clinicians and coaches. One hundred and thirty four articles satisfied a key word search (tennis, backhand) in relevant databases and manual search, with only 61 of those articles considered directly relevant to our review. The consensus of this research supports major differences between both the one- and two-handed strokes, chiefly about their respective contributions of trunk rotation and the role of the non-dominant upper extremity. Two-handed backhand strokes rely more on trunk rotation for the generation of racquet velocity, while the one-handed backhands utilize segmental rotations of the upper limb to develop comparable racquet speeds. There remains considerable scope for future research to examine expertise, age and/or gender-related kinematic differences to strengthen the practitioner's understanding of the key mechanical considerations that may shape the development of proficient backhand strokes. Key pointsOne-and two-handed backhands require different motor coordinationTwo-handed backhand strokes rely more on trunk rotation for racquet velocity generation, whereas one-handed backhand strokes rely more on segmental rotations of the upper limbPlayers using a two-handed backhand should learn early a slice one-handed backhand because of the different co-ordination pattern involvedEquipment scaling is a great tool for coaches to learn early proper one-handed backhand strokesFuture research related to the interaction between backhand technique, gender and skill level is needed.

E-mentoring for violence and injury prevention: early lessons from a global programme

To address the growing burden of violence and injuries, especially in low- and middle-income countries, in 2007 the World Health Organization launched MENTOR-VIP, a global violence and injury prevention (VIP)-mentoring programme. The programme aims to develop human resource capacity through 12-month mentoring arrangements between individual VIP experts (mentors) and less-experienced injury practitioners (mentees). In this paper, we review the first five years of the programme (2007-2011) using a systems analysis and SWOT (Strengths, Weaknesses, Opportunities and Threats) frameworks, discuss programme findings and make recommendations. A well-defined programme with clear instructions, successful matching of mentorship pairs with similar interests and language, a formal accord agreement, institutional support and effective communication were identified as programme strengths. Overambitious projects, lack of funds and difficulties with communications were identified as programme weaknesses. Mentorship projects that require institutional permissions or resources could be potential threats to the success of mentorship. The study resulted in the four following recommendations to strengthen the programme: (1) institute additional steps in selection and matching mentor-mentee pair; (2) train mentors on e-mentoring; (3) conduct special orientation for mentees to the programme; and (4) maintain effective and open communication throughout the programme.

Training to use a commercial brain-computer interface as access technology: a case study

PURPOSE

This case study describes how an individual with spastic quadriplegic cerebral palsy was trained over a period of four weeks to use a commercial electroencephalography (EEG)-based brain-computer interface (BCI).

METHOD

The participant spent three sessions exploring the system, and seven sessions playing a game focused on EEG feedback training of left and right arm motor imagery and a customised, training game paradigm was employed.

RESULTS

The participant showed improvement in the production of two distinct EEG patterns. The participant's performance was influenced by motivation, fatigue and concentration. Six weeks post-training the participant could still control the BCI and used this to type a sentence using an augmentative and alternative communication application on a wirelessly linked device.

CONCLUSIONS

The results from this case study highlight the importance of creating a dynamic, relevant and engaging training environment for BCIs. Implications for Rehabilitation Customising a training paradigm to suit the users' interests can influence adherence to assistive technology training. Mood, fatigue, physical illness and motivation influence the usability of a brain-computer interface. Commercial brain-computer interfaces, which require little set up time, may be used as access technology for individuals with severe disabilities.

Mechanics and learning practices associated with the tennis forehand: a review

The forehand ranks closely behind the serve in importance in the sport of tennis. Yet, while the serve has been the focus of a litany of research reviews, the literature describing forehand stroke production has not been reviewed as extensively. The purposes of this article are therefore to review the research describing the mechanics of the forehand and then to appraise that research alongside the coach-led development of the stroke. The consensus of this research supports the importance of axial rotation of the pelvis, trunk, shoulder horizontal adduction and internal rotation as the primary contributors to the development of racket speed in the forehand. The relationship between grip style and racket velocity is similarly well established. However, it is also clear that there remains considerable scope for future research to longitudinally examine the inter-relationships between different teaching methodologies, equipment scaling and forehand mechanics. Key PointsSports biomechanics has played a key role in assisting tennis coaches to understand the mechanical characteristics of the forehand.Research has confirmed the largely positive role of modified courts and balls in increasing the technical proficiency, number and success of forehand shots of beginner children.Suggested research directions include prospective or longitudinal studies into the inter-relationships of different teaching methodologies, equipment scaling and forehand mechanics.

Visual search of experts in medical image reading: the effect of training, target prevalence, and expert knowledge

The aims of this study are (a) To determine the effect of training on the multiple-target lesion search performance; and (b) To examine the effect of target prevalence on the performance of radiologists and novices. We conducted four sessions of 500 trials in a lesion search on a medical image task in which participants searched for three different target lesions. Participants were 10 radiologists and novices. In each session, the prevalence of the different target lesions varied from low (2%) to high (40%). The sensitivity of novices was higher in the later sessions than in the first session, whereas there were no differences among sessions in radiologists. The improvement on sensitivity of novices was largely due to attenuations of false alarm (FA) errors. In addition, miss rates of the three targets did not differ in data of novices, whereas radiologists produced a higher miss rate for the highest prevalence target lesion (non-serious lesion) than for the other two lesions (serious lesions). The conclusions are (a) The training for the multiple-target lesion search task can be effective to reduce FA errors; and (b) The prevalence effect on lesion search can be attenuated by the multiple-target identification and the knowledge about seriousness of lesions. This suggests that acquired knowledge about normal cases and serious lesions is an important aspect of a radiologists' skill in searching for medical lesions and their high performance levels.

Medical students as medical educators: opportunities for skill development in the absence of formal training programs

All physicians, at some point in their career, are responsible for the education of their peers and junior colleagues. Although medical students are expected to develop clinical and research skills in preparation for residency, it is becoming clear that a student should also be expected to develop abilities as a teacher. A handful of institutions have student-as-teacher programs to train medical students in education, but most students graduate from medical school without formal training in this area. When such a program does not exist, medical students can gain experience in education through participation in peer teaching, course design, educational committees, and medical education scholarship. In doing so, they attain important skills in the development, implementation, and evaluation of educational programs. These skills will serve them in their capacity as medical educators as they advance in their careers and gain increasing teaching responsibility as residents, fellows, and attending physicians.