Optimising frontline learning and engagement between consultant-led neonatal teams in the West Midlands: a survey on the utility of an augmented simulation training technique

Background In England, neonatal care is delivered in operational delivery networks, comprising a combination of the Neonatal Intensive Care (NICU), Local-Neonatal (LNU) or Special-Care Units (SCU), based on their ability to care for babies with different degrees of illness or prematurity. With the development of network care pathways, the most premature and sickest are mostly triaged for delivery in services linked to NICU. This has created anxiety for teams in LNU and SCU. Less exposure to sicker babies has resulted in limited opportunities to maintain expertise for when these babies unexpectedly deliver at their centre and thereafter require transfer for care, to NICU. Simultaneously, LNU and SCU teams develop skills in the care of the less ill and premature baby which would also be of benefit to NICU teams. A need for mutual learning through inter-unit multidirectional collaborative learning and engagement (hereafter also called neonatal networking) between teams of different designations emerged. Here, neonatal networking is defined as collaboration, shared clinical learning and developing an understanding of local systems strengths and challenges between units of different and similar designations. We describe the responses to the development of a clinical and systems focussed platform for this engagement between different teams within our neonatal ODN. Method An interactive 1-day programme was developed in the West Midlands, focussing on a non-hierarchical, equal partnership between neonatal teams from different unit designations. It utilised simulation around clinical scenarios, with a slant towards consultant engagement. Four groups rotating through four clinical simulation scenarios were developed. Each group participated in a clinical simulation scenario, led by a consultant and supported by nurses and doctors in training together with facilitators, with a further ~two consultants, as observers within the group. All were considered learners. Consultant candidates took turns to be participants and observers in the simulation scenarios so that at the end of the day all had led a scenario. Each simulation-clinical debrief session was lengthened by a further ~ 20 min, during which freestyle discussion with all learners occurred. This was to promote further bonding, through multidirectional sharing, and with a systems focus on understanding the strengths and challenges of practices in different units. A consultant focus was adopted to promote a long-term engagement between units around shared care. There were four time points for this neonatal networking during the course of the day. Qualitative assessment and a Likert scale were used to assess this initiative over 4 years. Results One hundred fifty-five individuals involved in frontline neonatal care participated. Seventy-seven were consultants, supported by neonatal trainees, staff grade doctors, clinical fellows, advanced neonatal nurse practitioners and nurses in training. All were invited to participate in the survey. The survey response rate was 80.6%. Seventy-nine percent felt that this learning strategy was highly relevant; 96% agreed that for consultants this was appropriate adult learning. Ninety-eight percent agreed that consultant training encompassed more than bedside clinical management, including forging communication links between teams. Thematic responses suggested that this was a highly useful method for multi-directional learning around shared care between neonatal units. Conclusion Simulation, enhanced with systems focussed debrief, appeared to be an acceptable method of promoting multidirectional learning within neonatal teams of differing designations within the WMNODN.

Promoting inter-organisational knowledge sharing: A qualitative evaluation of England’s Global Digital Exemplar and Fast Follower Programme

Background The Global Digital Exemplar (GDE) Programme was designed to promote the digitisation of hospital services in England. Selected provider organisations that were reasonably digitally-mature were funded with the expectation that they would achieve internationally recognised levels of excellence and act as exemplars (‘GDE sites’) and share their learning with somewhat less digitally-mature Fast Follower (FF) sites. Aims This paper explores how partnerships between GDE and FF sites have promoted knowledge sharing and learning between organisations. Methods We conducted an independent qualitative longitudinal evaluation of the GDE Programme, collecting data across 36 provider organisations (including acute, mental health and speciality), 12 of which we studied as in-depth ethnographic case studies. We used a combination of semi-structured interviews with programme leads, vendors and national policy leads, non-participant observations of meetings and workshops, and analysed national and local documents. This allowed us to explore both how inter-organisational learning and knowledge sharing was planned, and how it played out in practice. Thematic qualitative analysis, combining findings from diverse data sources, was facilitated by NVivo 11 and drew on sociotechnical systems theory. Results Formally established GDE and FF partnerships were perceived to enhance learning and accelerate adoption of technologies in most pairings. They were seen to be most successful where they had encouraged, and were supported by, informal knowledge networking, driven by the mutual benefits of information sharing. Informal networking was enhanced where the benefits were maximised (for example where paired sites had implemented the same technological system) and networking costs minimised (for example by geographical proximity, prior links and institutional alignment). Although the intervention anticipated uni-directional learning between exemplar sites and ‘followers’, in most cases we observed a two-way flow of information, with GDEs also learning from FFs, through informal networking which also extended to other health service providers outside the Programme. The efforts of the GDE Programme to establish a learning ecosystem has enhanced the profile of shared learning within the NHS. Conclusions Inter-organisational partnerships have produced significant gains for both follower (FF) and exemplar (GDE) sites. Formal linkages were most effective where they had facilitated, and were supported by, informal networking. Informal networking was driven by the mutual benefits of information sharing and was optimised where sites were well aligned in terms of technology, geography and culture. Misalignments that created barriers to networking between organisations in a few cases were attributed to inappropriate choice of partners. Policy makers seeking to promote learning through centrally directed mechanisms need to create a framework that enables networking and informal knowledge transfer, allowing local organisations to develop bottom-up collaboration and exchanges, where they are productive, in an organic manner.

PointLIE: Locally Invertible Embedding for Point Cloud Sampling and Recovery

Point Cloud Sampling and Recovery (PCSR) is critical for massive real-time point cloud collection and processing since raw data usually requires large storage and computation. This paper addresses a fundamental problem in PCSR: How to downsample the dense point cloud with arbitrary scales while preserving the local topology of discarded points in a case-agnostic manner (i.e., without additional storage for point relationships)? We propose a novel Locally Invertible Embedding (PointLIE) framework to unify the point cloud sampling and upsampling into one single framework through bi-directional learning. Specifically, PointLIE decouples the local geometric relationships between discarded points from the sampled points by progressively encoding the neighboring offsets to a latent variable. Once the latent variable is forced to obey a pre-defined distribution in the forward sampling path, the recovery can be achieved effectively through inverse operations. Taking the recover-pleasing sampled points and a latent embedding randomly drawn from the specified distribution as inputs, PointLIE can theoretically guarantee the fidelity of reconstruction and outperform state-of-the-arts quantitatively and qualitatively.

Towards decolonising research methods training: the development of a locally responsive online learning course on research methods for mental health in war and conflict for researchers and practitioners in the Gaza Strip

Background Concerns exist that online learning directed at non-Western settings to strengthen research capacity imposes Western-centric epistemology, provides unidirectional transfer of knowledge, and neglects local paradigms and expertise. We argue that a plurality of voices, histories and epistemologies are essential to strengthen research capacity. We share our experience developing and teaching an online course for mental health professionals and researchers in the Gaza Strip. Methods Birzeit University and King's College London developed and delivered the course equally, focusing on the intersection between qualitative research methods, mental health and conflict, and addressing local research needs. We incorporated local case studies and expertise, encouraged interaction in English and Arabic, and stimulated critique of Western theories. Seventeen participated, 12 completed the pre-course questionnaire, 15 completed the post-course questionnaire and four undertook semi-structured interviews. Results Our pre-course survey showed participants most needed coding and qualitative data analysis skills. Post-course findings showed improved qualitative research skills. Most agreed the course was comprehensive and well delivered, with relevant case studies. Three themes were identified: (1) the course was locally contextualised and met students' needs; (2) the course fostered dialogic and multi-directional learning and (3) suggestions for improvements. Several participants wanted some topics in greater depth and further specialised training. A few suggested the course be in Arabic. Conclusion Fostering multi-directional learning is key for non-Western knowledge, epistemologies, and languages to gain prominence in Western academia. A social transformation would see local researchers and educators engage with and use local methods and paradigms in mental health in war and conflict.

Adaptive learning under strategic and structural uncertainty: the case of auction games

In games of incomplete information individual players make decisions facing a combination of structural uncertainty about the underlying parameters of the environment, and strategic uncertainty about the actions undertaken by their partners. How well are human actors able to cope with these uncertainties, and what models best describe their learning in such environments? We use a double auction task with different competitive and informational environments to characterize learning abilities of the single human participants (buyers) in a range of adaptive learning models covering reinforcement learning, directional learning and belief learning. Results show that real behaviour is best described using simple models of directional learning type with minimal knowledge assumptions about information efficiency of prices. This behavior is consistent with bounded rationality and risk aversion: human subjects try to maximize their chance for transaction, and do so using the simplest learning rule.

Meningkatkan Aktivitas Belajar Peserta Didik pada Mata Pelajaran PAI dan Budi Pekerti Melalui Pembelajaran Kooperatif Model Mind Mapping dalam Bentuk Peta Konsep Kreatif di SMP Negeri 1 Pemenang

The purpose of this study is to improve student learning activities through cooperative learning Mind Mapping models in the form of creative concept maps. This research method uses classroom action research. The subjects of this study were students of class VII.2 students of SMPN 1 Pemenang with a total of 17 people. This research instrument uses observation. Research data analysis techniques using qualitative and quantitative descriptive analysis. The results of this study indicate that an increase in student learning activities is an average of 12.06 obtained from the average activity of students in the first cycle was 69.06 and then increased in the second cycle to 81.17. So it can be concluded that (1) The application of Mind Mapping learning models in the form of creative concept maps is one of the best alternatives in PAI and Budi Pekerti learning, (2) The application of Mind Mapping learning models in the form of creative concept maps can create participatory and multi-directional learning , (3) Through the application of Mind Mapping learning methods in the form of creative concept maps can increase the learning activities of students. The results also showed changes in classroom atmosphere that tended to be democratic and changes in teacher attitudes to care more about the atmosphere of learning in the classroom.

Pembelajaran Interaktif Pendidikan Kewarganegaraan Melalui Mobile Learning di Era Industri 4.0

Abstrak: Tuntutan pembelajaran era milenial adalah mengoptimalkan pemanfaatan teknologi. Revolusi industri 4.0 sangat mempengaruhi aspek kehidupan baik pendidikan, sosial, politik, budaya, dan ekonomi. Dibidang pendidikan teknologi dimanfaatkan beragam baik pra-pembelajaran, proses pembelajaran maupun pasca pembelajaran berlangsung. Tujuan penelitian adalah untuk menganalisis dan mendeskripsikan pembelajaran interaktif pendidikan kewarganegaraan melalui mobile learning di era industri 4.0. Metode dan pendekatan penelitian yang digunakan adalah library research. Pengumpulan data menggunakan dokumentasi, yakni dari buku, makalah, artikel, jurnal dan sebagainya yang relevan. Analisis data menggunakan content analysis, guna mendapatkan invensi yang kredibel dan dapat digunakan atau diteliti ulang berdasarkan konteksnya. Untuk menjaga ketepatan hal yang dikaji dan guna mencegah kesalahan informasi yang diungkap dalam analisis data, maka dilakukan pengecekan antar pustaka dari referensi-referensi yang digunakan. Selain itu membaca ulang pustaka-pustaka yang digunakan juga sangat penting serta memperhatikan komentar teman sejawat. Hasil pengkajian menunjukkan bahwa peran teknologi dalam pembelajaran PKn sangat membantu proses pembelajaran, menjadi sarana kreasi, inovasi, dan pengembangan diri untuk belajar mandiri dan terarah. Pembelajaran Interaktif PKn di Era Revolusi Industri 4.0 membantu mempercepat proses belajar jika digunakan dengan bijak sesuai kebutuhan materi pembelajaran. Penggunaan Mobile Learning dalam pembelajaran PKn mampu mengoptimalkan ketepatan dalam menangkap materi pembelajaran, sarana sumber pembanding dalam materi pembelajaran, dan mampu membangkitkan motivasi pembelajaran.Abstract: The demands of millennial learning are optimizing technology utilization. The 4.0 Industrial Revolution greatly affects the life aspects of both education, social, political, cultural, and economic. The field of technology education is used to vary both pre-learning, learning process, and post-learning. The research aims to analyze and describe the interactive learning of citizenship education through mobile learning in the 4.0 industrial era. The method and approach of the research used is library research. Collection of data using documentation, i.e. from books, papers, articles, journals and so on relevant. Data analysis uses content analysis, to obtain credible inventions that can be used or researched based on context. To maintain the accuracy of the assessed and to prevent misinformation disclosed in the analysis of data, it is checked between libraries from the references used. In addition to rereading the libraries used are also very important as well as paying attention to peer comments. The results showed that the technological role in PKn-learning is very helpful to the learning process, becoming a means of creation, innovation, and self-development for independent and directional learning. PKn Interactive Learning in the Era of Industrial Revolution 4.0 helps accelerate the learning process if used wisely according to learning material needs. The use of Mobile Learning in PKn learning can optimize accuracy in capturing learning materials, comparative source means in learning materials, and able to inspire learning motivation.

Bi-Directional Learning: Identifying Contaminants on the Yurok Indian Reservation

The Yurok Tribe partnered with the University of California Davis (UC Davis) Superfund Research Program to identify and address contaminants in the Klamath watershed that may be impairing human and ecosystem health. We draw on a community-based participatory research approach that begins with community concerns, includes shared duties across the research process, and collaborative interpretation of results. A primary challenge facing University and Tribal researchers on this project is the complexity of the relationship(s) between the identity and concentrations of contaminants and the diversity of illnesses plaguing community members. The framework of bi-directional learning includes Yurok-led river sampling, Yurok traditional ecological knowledge, University lab analysis, and collaborative interpretation of results. Yurok staff and community members share their unique exposure pathways, their knowledge of the landscape, their past scientific studies, and the history of landscape management, and University researchers use both specific and broad scope chemical screening techniques to attempt to identify contaminants and their sources. Both university and tribal knowledge are crucial to understanding the relationship between human and environmental health. This paper examines University and Tribal researchers’ shared learning, progress, and challenges at the end of the second year of a five-year Superfund Research Program (SRP) grant to identify and remediate toxins in the lower Klamath River watershed. Our water quality research is framed within a larger question of how to best build university–Tribal collaboration to address contamination and associated human health impacts.