Enhancing the learning and transfer of preprocedural communication skills during clerkship using audio-visual material: a prospective case-controlled study over 2 years

Objective/design/settingThis study aims to develop preprocedural communication-specific framework that emphasises the use of audiovisual materials and compares its acceptability by trainees with a regular module.TraineesBetween October 2018 and July 2021, 96 medical clerks were enrolled and randomly divided into regular and intervention groups. Another 48 trainees whose did not join the framework-based training but complete self-assessments were enrolled as the control group.InterventionsIn the intervention training module, the key steps of preprocedural communication-specific skills were structuralised into a framework using the acronym of OSCAR.Primary and secondary outcome measuresThis study compared the acceptability of trainees for two modules by measuring the degree of increase in the end-of-rotation and follow up (4 weeks later) competency from baseline by trainees’ self-assessments and physician assessments after serial trainings.ResultsIn comparison with regular group trainees, greater degree of improvements (framework-1 statement: 111%±13% vs 27%±5%, p<0.001; framework-2 statement: 77%±9% vs 48%±2%, p<0.05; skill-1 statement: 105%±9% vs 48%±3%, p<0.001); skill-2 statement: 71%±11% vs 50%±9%, p<0.05) were noted in the framework-related and skill-related statement 1–2 (the familiarity and confidence to use the framework and skills) than those of intervention group. At the end-of-rotation stage, the trainees ability to use the ‘A-step: using audiovisual materials’ of the OSCAR was significantly improved (229%±13%, p<0.001), compared with other steps. In the intervention group, the degree of improvement of the end-of-rotation data of trainees’ self-assessment from baseline was significantly correlated with the degree of the improvement in physicians’ assessment data in the aspects of skills, framework and steps in framework (R=0.872, p<0.01; R=0.813, p<0.001; R=0.914, p<0.001).ConclusionsThe OSCAR framework-based intervention module is well accepted by medical clerks and motivates them to integrate the acquired skills in clinical practice, which leads to trainees’ primary care patients being satisfied with their preprocedural communication.

Influence of Price and Distributive Fairness on Micro Finance Customers’ Relationship Commitment: PLS-SEM Analysis

Bangladeshi Micro Finance Institution (MFI) sector is highly competitive in financial industry. Due to strong multifaceted competition customer drop out (exit/switching) is taking place. In fact, to achieve sustainability, MFIs need to reduce the dropout rate and to retain customer by developing relationship commitment (RC). Hence, the aim of the empirical study is to find out how the clients drop out from the MFI can be prevented through developing relationship commitment in the relational exchange context. The study focuses on the price fairness and distributive fairness as an antecedent of relationship commitment. The PLS-SEM technique is utilized for the analysis of data collected from 409 consumers of different MFI’s of Bangladesh. The study employed survey method for getting responses from MFI consumers about price fairness, distributive fairness and relationship commitment related statement. The study explores that price fairness, distributive fairness, has significant effect on relationship commitment. Hence, the findings of this model may be applied by the policy makers and the practitioners as an approach to enhance relationship commitment in the MFI’s in developing economy context.

United States Resists Efforts to Have the Arctic Council Make Climate-Related Statement

The Arctic Council convened for the eleventh time in early May 2019 in Rovaniemi, Finland, for a two-day conference. On May 7, the Arctic Council released a Joint Ministerial Statement that affirmed the desire of the eight member states to work together to face upcoming challenges but made no substantive commitments and no mention of climate change. In remarks to the Council, Secretary of State Mike Pompeo expressed wariness about collective decision making and warned against potential effects of Chinese activity in the Arctic.

Juridical Review Of Nominee Agreement In Land Of Tenure Property Rights Under The Book Of Civil Law And Agraria

Nominee agreement is an agreement made between someone who by law can not be the subject of rights to certain lands (property rights), in this case that foreigners (WNA) and Indonesian Citizen (citizen), with the intention that the foreigners can master land de facto property rights, but legal-formal (de jure) land property rights are assigned to his Indonesian citizen. The purpose of this paper isto assess the position of the nominee agreement in Indonesia's legal system and the legal consequences arising in terms of the draft Civil Code and the Law on Agrarian. Agreement is an agreement unnamed nominee made based on the principle of freedom of contract and good faith of the parties. However, it should be noted that the law prohibits foreigners make agreements / related statement stock wealth / property (land) for and on behalf of others, sehingga the legal consequences of the agreement is the nominee of the agreement is not legally enforceable because the agreement was made on a false causa.Keywords: Nominee Agreement; Property Rights; Foreigners.

The artist speaks: the interview as documentation

Nearly every exhibition catalogue now contains an interview with, or related statement by, the artist. How and why did this become the norm? The increasing popularity of the artist’s words is traced back in this article to its roots in Romanticism, the rise of the mass media and the cult of the avant-garde artist. The value and reliability of the transcribed and printed words is questioned and a bibliography of published interviews with artists follows.