By E. Tempeck. Allegheny College. 2018.

To be specific: 161 use structured written feedback on essays; provide immediate feedback on technical buy lipitor 5mg with mastercard, interperso- nal purchase 20mg lipitor visa, or oral skills as an outcome of direct observations generic 10 mg lipitor amex, orals or practical assessments; and use self-assessment which includes feedback as part of the process order 20 mg lipitor with amex. Some guidelines for giving feedback include the following: keep the time short between what students do and the feedback; balance the positive with the negative; indicate how the student can improve in specific ways; encourage students to evaluate themselves and give feedback to each other; and make the criteria clear when setting work and relate feedback to the criteria buy 20mg lipitor with visa. REPORTING THE RESULTS OF ASSESSMENT In many major examinations you will be required to report the results as a final mark or grade based on a number of different assessment methods. What usually happens is that marks from these different assessments are simply added or averaged and the final mark or grade awarded, Simple though this approach may be, it can introduce serious distortions. Factors contributing to this problem may be different distributions of marks in each subtest; varying numbers of questions; differing levels of difficulty; and a failure to appropriately weight each component. This is not the place to do more than alert you to the need to do so and refer you to a text on educational measurement or to advise you to enlist the aid of an educational statistician, who can usually be found by contacting the teaching unit in your institution. GUIDED READING There are many useful general texts on educational measurement. Linn’s Measurement and Evaluation in Teaching, Merril Press, Bellevue, Washington, 2000. Most will have useful discus- sions of broad assessment considerations such as objec- tives, planning, reliability, validity and scoring, and also 162 will provide a wide range of examples of test items that you could use as models for your own tests. Glasner, SRHE and Open University Press, Buckingham, 1999 is another general overview text that we recommend because of the many examples relevant to higher education. Cox, Kogan Page, London, 1998, Assessing Student Learning in Higher Education by G. Brown and others, Routledge, London, 1997 and Chapter 9 in Teaching for Quality Learning at University by J. A useful adjunct to this chapter is Assessing Clinical Competence at the Undergraduate Level by D. Constructing Written Test Questions for the Basic and Clinical Sciences, 2nd edition, National Board of Medical Examiners, Philadelphia. Assessment of medical competence using an objective structured clinical exam- ination (OSCE) Medical Education, 13, 41-54. The reasons for this are not hard to understand – there is now such rapid development in the application of computers and information communication technologies in higher education that much of what is said today is out-of-date tomorrow! On the other hand, it is fair to judge that as one looks around our campuses, for much of the time most teaching can still be described as‘traditional’with student groups of varying sizes meeting with a teacher for a set period of instruction. While we would not wish to see all of traditional teaching preserved for its own sake, it is nevertheless the case that it is in these settings, as well as in more contemporary approaches to learning and teaching, that we find a continuing need for assistance with such fundamental issues as using an overhead projector properly and preparing well-designed handouts. First, from the previous edition we have updated material on some of the more basic technologies and retained a focus in this chapter on materials and technologies rather than on approaches to teaching. Teaching approaches are pre- sented elsewhere in this book, for example, in the chapters on small groups and problem-based learning. Second, we have provided introductory ideas on using information technologies, and finally, we have distilled some principles of good practice that we believe apply to the use of all technologies and that provide a benchmark against which to evaluate what you are doing with your students. BASIC PRINCIPLES IN PREPARING LEARNING AND TEACHING MATERIALS In your teaching career you will use quite a wide range of teaching materials and technologies. The fundamental criterion for judging the effectiveness of your teaching material is its audibility and/or visibility. If that seems too obvious to warrant mention, have a look at some of the materials used by others: overheads and slides with excessive amounts of tiny detail that cannot be read on the screen; complicated Web pages that look like art shows and take for ever to load on your computer; and faded handouts that cannot be read. When it does, it seriously interferes with the effectiveness of learning. Attention to the way in which the material is produced and how it is used in teaching will eliminate many of these problems. Whether you are preparing a simple handout or multi- media materials, there are some basic principles that can be incorporated into your design and preparation that will enhance the quality and effectiveness of the material. Relevance Materials should be relevant to the purpose for which they were created and to the students’ level of understanding of the topic. Complex handouts distributed at the end of a lecture and never referred to by the teacher are classic offenders of this principle. Linkage An introduction is usually required to establish the purpose of the material and to link it with what it is reasonable to expect students to know already. Simplicity Simplicity in the use of language and design, the avoidance of needless qualifications and the use of suitable abstrac- tions of complex situations can be positive aids to understanding.

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To disseminate research Reader increases knowledge of evi­ dence base and applies findings to practice Journals will be particularly interested in the results of your research and their implications for clinical practice generic 5 mg lipitor otc. For example purchase lipitor 40mg online, you might want to write about the implications of a new piece of legislation for clinical practice buy 5mg lipitor. To entertain Reader enjoys Some journals accept items that are purely for the entertainment of the reader rather than for any academic or professional reason generic 5mg lipitor with visa. A humorous piece buy 5mg lipitor free shipping, a collec­ tion of anecdotes or a historical piece, are just some examples. Once you are sure of this yourself it will be much easier to communicate it to your reader. Redraft it until you think you have a clear and succinct statement, for example, ‘to explain the signs and symptoms of depression, its causes, traditional classifications and manage­ ment options’. Answering these questions is particularly important if you are writing an article for members of another discipline. For example, an occupational therapist writing an article on poor hand–eye co-ordination for teachers will need to think carefully about the knowledge base of his or her readers. Add your target audience to your statement of purpose, for example, ‘explain to district nurses the signs and symptoms of depression, its causes, traditional classifications and management options’. Decide on the content Your statement of purpose or your objective forms the starting point for drafting the content of your article. Brainstorming using the keywords from your objective is a useful way of developing ideas. It may help this JOURNAL ARTICLES 281 process if you set yourself a series of questions. In the above example, you might want to ask some of the following questions. The key areas or concepts identified through this process will form your section headings. Even if these are not used as titles in the final article, they can act as markers for how you will organise your material. Creating a structure Forming a structure early on in your planning will help in refining your search for information. Here are some examples of different formats for presenting material in articles. Research papers Research articles or research papers are always written using the traditional scientific approach discussed in Chapter 13 ‘Research Projects’. An abstract consists of a short paragraph that summarises the research paper for the reader. Most are 200 to 250 words in length, although some journals may accept longer ones. A reader can use the abstract to quickly make a decision about whether the research findings are of relevance to him or her and therefore worth reading. On a database, an abstract may be the only information available to the searcher on the contents of a paper. Abstracts contain: ° a statement about the purpose of your research ° your hypothesis or your research question ° a description of your research design ° your rationale for choosing that design ° a statement about your methods and procedures that includes details of any special equipment and the selection and number of subjects ° a description of your data analysis ° your major findings ° your conclusions 282 WRITING SKILLS IN PRACTICE ° implications for further research or applications to practice. The organisation of the abstract very much reflects the structure of the re­ search paper, the standard format being: ° Introduction (this contains information about relevant literature, the purpose and rationale for your research and your hypothesis) ° Methods ° Results ° Discussion of results ° Conclusion. Other formats Example of a literature review: ° Introduction (reason for or objectives in conducting the review) ° Rationale for literature selection ° Critical analysis of the literature ° Results of your review ° Conclusions ° Implications for further research ° Applications to clinical practice. Example of a clinical update on skin diseases: ° Incidence of skin diseases ° Description of skin ° Effect on client (psychological aspects, physical factors, quality of life) ° Assessment (including a description of different skin diseases) ° Treatment ° Summary (a position statement). Example of a debate on clinical supervision: ° Introduction (definition of clinical supervision, statement on the purpose and terms of reference of the article) JOURNAL ARTICLES 283 ° Overview of the models of supervision ° Comparison of models of delivery ° Discussion of the benefits of supervision (supported by references to research). Example of a continuing professional development article on ‘depression’: ° Statement about the aims and intended learning outcomes for the reader, for example: ° describe the signs and symptoms of depression ° list common causes of depression ° differentiate between the four classifications of depression ° describe four treatments for depression ° Introduction ° Definition of depression ° Common causes ° Signs and symptoms ° Classification of depression ° Treatments ° Conclusion (applications to practice). A teaching article of this sort might suggest other complementary forms of study. In the above example, the reader might be asked to reflect on his or her own experience of depression, complete a self-assessment question­ naire on the basic facts, and make a list of symptoms noted in a client diag­ nosed with depression. A well-structured article will be organised and logical, and will only include information that is necessary to meet your aims. Researching your article Your next step is to carry out a thorough literature review of your intended subject area.

This is best achieved by placing your hand on the patient’s upper forehead and exerting pressure to tilt the head generic lipitor 5 mg amex. Remove any obvious obstruction from the mouth; leave well fitting dentures in place generic lipitor 10mg mastercard. Place two fingertips under the point of the chin to lift it Are you forwards 40mg lipitor with visa. Look discount lipitor 5mg with visa, listen order lipitor 20mg without prescription, and feel for breathing: look for chest movement, listen close to the mouth for breath sounds, and feel for air with your cheek. Look, listen, and feel for 10 seconds before deciding that breathing is absent. Recovery position If the patient is unconscious but is breathing, place him or her in the recovery position. In this position the tongue will fall away from the pharyngeal wall and any vomit or secretion will dribble out of the corner of the mouth rather than obstruct the airway or, later on, cause aspiration. Establishing responsiveness 1 ABC of Resuscitation Breathing If breathing is absent, send a bystander to telephone for an ambulance. The exception to this rule is when the patient is a child or the cause of the patient’s collapse is near drowning, drug or alcohol intoxication, trauma, or choking. Under these circumstances it is likely that you are dealing with a primary respiratory arrest and appropriate resuscitation should be given for about one minute before seeking help. Return to the patient and maintain an airway by tilting the head and lifting the chin. Take a breath, seal your lips firmly around those of the patient, and breathe out until you see the patient’s chest clearly rising. Lift your head away, watching the patient’s chest fall, and take another breath of air. The chest should rise as you blow in and fall when you take your mouth away. Each breath should expand the patient’s chest visibly but not cause overinflation as this will allow air to Head tilt and jaw lift enter the oesophagus and stomach. Subsequent gastric distension causes not only vomiting but also passive regurgitation into the lungs, which often goes undetected. If the patient is still not breathing after two rescue breaths (or after five attempts at ventilation, even if unsuccessful), check for signs of a circulation. Look and listen for any The best pulse to feel in an emergency is the movement, breathing (other than an occasional gasp), or carotid pulse, but if the neck is injured the femoral pulse may be felt at the groin coughing. Turning casualty into the recovery position Expired air resuscitation 2 Basic life support If you are a healthcare provider, and have been trained to do so, feel for a pulse as part of your check for signs of a circulation. If no signs of a circulation are present continue with rescue breaths but recheck the circulation after every 10 breaths or about every minute. Circulation If there are no signs of a circulation (cardiac arrest) it is unlikely that the patient will recover as a result of CPR alone, so defibrillation and other advanced life support are urgently required. Ensure that the patient is on his or her back and lying on a firm, flat surface, then start chest compressions. The correct place to compress is in the centre of the lower half of the sternum. To find this, and to ensure that the risk of damaging intra-abdominal organs is minimised, feel along the rib margin until you come to the xiphisternum. Place your middle finger on the xiphisternum and your index finger on the bony sternum above, then slide the heel of your other hand down to these fingers and leave it there. In an adult compress about 4-5cm, keeping the pressure firm, controlled, and applied vertically. Try to spend about the same amount of time in the compressed phase as in the released phase and aim for a rate of 100 compressions/min (a little less than two compressions per second). After every 15 compressions tilt the head, lift the chin, and give two rescue breaths. Return your hands immediately to the sternum and give 15 further compressions, continuing compressions and rescue breaths in a ratio of 15:2. It may help to get the right rate and ratio by counting: “One, two, three, four. The compression rate should remain at Hand position for chest compression 100/min, but there should be a pause after every 15 compressions that is just long enough to allow two rescue breaths to be given, lasting two seconds each. Provided the patient’s airway is maintained it is not necessary to wait for exhalation before resuming chest compressions. The precordial thump is taught as a standard part of advanced life support Precordial thump Studies have shown that an initial precordial (chest) thump may restart the recently arrested heart.

We recently developed a metal cast of grafted bone that is used to confirm the direction and depth of the bony gutter in the femoral head by fluoroscopy during VIBG to secure graft position buy lipitor 20 mg cheap. Little is known about factors affecting the clinical results of VIBG except for the position of the grafted bone order 10 mg lipitor with visa. Our previous study concluded that risk factors for VIBG were female sex purchase 40mg lipitor free shipping, systemic lupus erythematosis (SLE) buy lipitor 10mg mastercard, steroid administration cheap lipitor 5mg overnight delivery, and bilateral cases by investigating unsuccessful cases after VIBG. However, the present study demonstrated that female sex and steroids did not always affect JOA score and survival rate after VIBG. The other risk factor that we should further con- sider is preoperative collapse, which affects JOA score and survival rate. Once collapse occurs, the vascularized iliac bone cannot support the destroyed bone structure in the femoral head. Male sex and abuse of alcohol were also found to be risk factors for survival rate after VIBG. This finding might be explained by the fact that most osteo- necrosis-affected patients with abuse of alcohol are men. Vascularized Iliac Bone Graft for Femoral Head Necrosis 133 Taken together, VIBG should be indicated in limited cases with early-stage ION. However, we found that patients with pain in the affected hip always showed a certain degree of collapse of the femoral head. In addi- tion, VIBG cannot always prevent progress of femoral head collapse or advancement of osteoarthritic changes, even though the femoral head shows no collapse. We con- clude that VIBG for ION should be indicated for (1) joints without or with little col- lapse of the femoral head and (2) joints with a wide lesion for which transtrochanteric rotational osteotomies are never indicated. VIBG is a time-saving surgery for young patients to postpone total hip arthroplasty or hemiarthroplasty. VIBG cannot always prevent stage progression of the femoral head after ION. Preoperative collapse, sex, total curettage of the necrotic lesion for bone grafts, and bilateral ION reduce JOA score after VIBG. Total curettage of the necrotic lesion, operative age over 30 years, precollapse, and abuse of alcohol reduce survival rate of ION when the endpoint is set at progress of femoral head collapse. VIBG is a “time-saving surgery” for young patients with ION to postpone perfor- mance of total hip arthroplasty or hemiarthroplasty. Solonen KA, Rindell K, Paavilainen T (1990) Vascularized pedicled bone graft into the femoral head: treatment of aseptic necrosis of the femoral head. Cheung HS, Stewart IE, Ho KC, Leung PC, Metreweli C (1993) Vascularized iliac crest grafts: evaluation of viability status with marrow scintigraphy. Sugano N, Atsumi T, Ohzono K, Kubo T, Hotokebuchi T, Takaoka K (2003) The 2001 revised criteria for diagnosis, classification, and staging of idiopathic osteonecrosis of the femoral head. Hasegawa Y, Iwata H, Mizuno M, Genda E, Sato S, Miura T (1992) The natural course of osteoarthritis of the hip due to subluxation or acetabular dysplasia. Pavlovcic V, Dolinar D, Arnez Z (1999) Femoral head necrosis treated with vascular- ized iliac crest graft. Eisenschenk A, Lautenbach M, Schwetlick G, Weber U (2001) Treatment of femoral head necrosis with vascularized iliac crest transplants. Feng CK, Yu JK, Chang MC, Chen TH, Lo WH (1998) Vascularized iliac bone graft for treating avascular necrosis of the femoral head. Nagoya S, Nagao M, Takada J, Kuwabara H, Wada T, Kukita Y, Yamashita T (2004) Predictive factors for vascularized iliac bone graft for nontraumatic osteonecrosis of the femoral head. Hasegawa Y, Iwata H, Torii S, Iwase T, Kawamoto K, Iwasada S (1997) Vascularized pedicle bone-grafting for nontraumatic avascular necrosis of the femoral head. Norman D, Reis D, Zinman C, Misselevich I, Boss JH (1998) Vascular deprivation- induced necrosis of the femoral head of the rat. An experimental model of avascular osteonecrosis in the skeletally immature individual or Legg–Perthes disease. Noguchi M, Kawakami T, Yamamoto H (2001) Use of vascularized pedicle iliac bone graft in the treatment of avascular necrosis of the femoral head. Sugioka Y (1978) Transtrochanteric anterior rotational osteotomy of the femoral head in the treatment of osteonecrosis affecting the hip: a new osteotomy operation.

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