NPCs in video games: a reflective resource for sports coaches and participant engagement.

This perspective article explores the potential of non-player characters (NPCs) in video games as a reflective tool for coaches to enhance participant engagement in sports. While coaches traditionally focus on movement skill instruction, their role extends to fostering young people's immersion in sports contexts and potentially contribute to the possibility of lifelong participation. However, challenges persist in translating coaching theory in coach education programs into practice, including the awareness of roles and how to make young people immersion in sports. Integrating elements from video games, where NPCs play pivotal roles in shaping player experiences, presents a possible avenue for re-thinking the role of coach, especially in participation. By drawing parallels between NPCs and coaches, this article advocates for a new reflection tool for coaching roles. Future research should investigate the effectiveness of leveraging NPCs to enhance athlete engagement and motivation, ultimately creating dynamic and inclusive coaching environments that cater to the evolving needs of participants.

Self-assessment, and not continuous training, improves basic open suturing skills.

BACKGROUND: To develop and maintain suturing skills, clinical exposure is important. When clinical exposure cannot be guaranteed, an adequate training schedule for suturing skills is required. This study evaluates the effect of continuous training, 'reflection before practice' and self-assessment on basic open suturing skills. METHODS: Medical students performed four basic suturing tasks on a simulation set up before ('pre-test') and after their surgical rotation ('after-test'). Participants were divided in three groups; the 'clinical exposure group' (n = 44) had clinical exposure during their rotation only, the 'continuous training group' (n = 16) completed a suturing interval training during their rotation and the 'self-assessment group' (n = 16) also completed a suturing interval training, but with the use of reflection before practice and self-assessment. Parameters measured by a tracking system during the suturing tasks and a calculated 'composite score' were compared between groups and test-moments. RESULTS: A significantly better composite score was found at the after-test compared to the pre-test for all groups for all basic suturing tasks (0.001 ≤ p ≤ 0.049). The self-assessment group scored better at the pre-test than the other two groups for all tasks, except for 'knot tying by hand' (0.004 ≤ p ≤ 0.063). However, this group did not score better at the after-test for all tasks, compared to the other two groups. This resulted in a smaller delta of time ('transcutaneous suture', p = 0.013), distance ('Donati suture' and 'intracutaneous suture', 0.005 ≤ p ≤ 0.009) or composite score (all tasks, except for knot tying by hand, 0.007 ≤ p ≤ 0.061) in the self-assessment group. CONCLUSION: Reflection before practice and self-assessment during continuous training of basic open suturing tasks, may improve surgical skills at the start of the learning curve.

Critical Self-reflection on Racism by Hospital Physicians in Large German Cities. A Qualitative Reconstructive Study Using Episodic Interviews.

Racism permeates healthcare institutions and interpersonal interactions, impacting both staff and patients. The role of doctors, given their influential position in the healthcare system, is particularly crucial in this context. Despite this, there is a scarcity of evidence regarding the manifestation of racism among healthcare professionals in Germany. Critical whiteness studies emphasize the importance of white* individuals engaging in critical self-reflection to mitigate racism. This study aimed to explore the attitudes of white* physicians in hospitals in major German cities towards racism and their critical reflection on personal attitudes and actions concerning racism in interactions with staff members and patients. Data was collected through six episodic interviews with physicians, analyzed using the reconstructive qualitative procedure of the documentary method, leading to a sense-genetic typology. The sense-genetic typology revealed three distinct attitudes towards racism: acknowledging, individualistic, and ignoring. Four types emerged concerning the self-reflection of white doctors: self-critical, socially critical, worried, and defensive. The most promising potential for interventions to reduce racism lies within the self-critical and socially critical types, both demonstrating an acknowledging attitude. Conversely, the worrying and defensive types may present challenges in deconstruction. This suggests that interventions aimed at reducing racism should be tailored and implemented with a nuanced approach.

Comfort Care.

Description Death does not thrill me anymore. I am a trauma surgeon extraordinaire! The patient had suffered a traumatic brain injury and has struggled for weeks. He is only 16. Today, the family decided to make him "comfort care." I was at the end of my call, exhausted, drained of all energy. I looked out of the ICU window and saw the fading rain and the city lights. It somehow reminded me of a precious life ebbing away, and I burst into a silent scream. I am still human.

The alternative fairytale: how personal history shapes identity and resilience in medicine.

In "The Alternative Fairytale," I explore my journey as a cardiology registrar/fellow, a path influenced deeply by my early displacement from war-torn Sudan. This piece reflects on the interplay between my professional choices and personal identity amidst the backdrop of a male-dominated field and societal expectations. It examines how my roots in a family that once fled conflict have shaped my approach to medicine-emphasizing community, empathy, and a leadership style that diverges from traditional norms. Through this narrative, I aim to redefine and help others to reflect on what success looks like in cardiology and medicine; advocating for diversity in leadership styles and highlight the importance of personal background in shaping professional paths.

Utility of the Jefferson teamwork observation guide for measuring collaborative practice competencies virtually, in-person, and across health professions: A Rasch Analysis.

Modern healthcare increasingly requires interprofessional teams to collaborate both in person and virtually to effectively achieve common goals. To prepare students for interprofessional collaborative practice (CP) universities need evaluation tools that can validly and reliably measure students' CP competencies after online and in-person interprofessional education. The Jefferson Teamwork Observation Guide® (JTOG) is a 360-degree evaluation tool previously validated to measure nationally-defined CP competencies. The psychometrics of the Individual JTOG have been examined in a sample of interprofessional healthcare students after online interprofessional education. The present study examined the psychometric properties of the Individual JTOG in 709 students after in-person interprofessional education using Rasch Modeling and compared results across collaborative settings and student professions. Results indicated that item and person statistics, unidimensionality, scaling performance, and local independence of the Individual JTOG were comparable between online and in-person samples, suggesting it is consistent in its measurement of CP competencies across collaborative settings. Psychometric properties were strong, but ceiling effects were present. Minor deviations were found in the Individual JTOG's unidimensionality between professional groups. The Values and Ethics construct was more strongly separated from others for nursing than other health professions. Recommendations for future research and possible adaptations to the instrument are discussed.

Día de Muertos: A confluence of gross anatomy, culture, and spirituality.

Is there room for spirituality and reflection in gross anatomy? While Jesuit institutions have incorporated contemplation and reflection into their curricula for centuries; the integration of reflective practices into the gross anatomy curriculum has gained traction in recent years. Additionally, more emphasis has been placed on diversity, equity, inclusion, and belonging within health professions education. As a Jesuit, Catholic university that is simultaneously classified as a Hispanic-Serving Institute (HSI), Regis University was well-positioned to integrate reflective and celebratory activities in honor of Día de Muertos (the Day of the Dead) into a graduate level anatomy course for Doctor of Physical Therapy students. From a communal ofrenda (altar) to a celebration during a lecture to a reflective ceremony honoring body donors in the laboratory, students and faculty constructed a learning environment that incorporated spirituality and culture into anatomy in a thoughtful manner. Furthermore, by seeking student input on the design of this innovative educational experience, each of these activities aided in fostering a sense of cultural and spiritual belonging for Hispanic and Latine students who are historically marginalized in health professions, thereby promoting diversity, equity, inclusion, and belonging through a gross anatomy course.

In Parkinson's disease dopaminergic medication and deep brain stimulation of the subthalamic nucleus increase motor, but not reflection and cognitive impulsivity.

Background: Parkinson's disease is associated with increased impulsivity, which can be divided into several domains: motor (consisting of proactive and reactive subdomains), reflection, and cognitive impulsivity. Evidence suggests that both dopaminergic medication and subthalamic nucleus deep brain stimulation can affect impulsivity. Therefore, we set out to investigate the effects of dopaminergic medication and subthalamic nucleus deep brain stimulation on motor, reflection, and cognitive impulsivity in Parkinson's disease patients. Methods: Twenty Parkinson's disease patients who underwent subthalamic nucleus deep brain stimulation were tested ON and OFF dopaminergic medication and ON and OFF subthalamic nucleus deep brain stimulation. They performed three different impulsivity tasks: the AX continuous performance task (AX-CPT) to test for motor impulsivity, the Beads task for reflection impulsivity, and the Delay discounting task for cognitive impulsivity. Results: The combination of subthalamic nucleus deep brain stimulation and dopaminergic medication led to an increase in motor impulsivity (p = 0.036), both proactive (p = 0.045) and reactive (p = 0.006). There was no effect of either dopaminergic medication or subthalamic nucleus deep brain stimulation on reflection and cognitive impulsivity. Conclusion: The combination of dopaminergic medication and subthalamic nucleus deep brain stimulation leads to increased motor, but not cognitive or reflection, impulsivity in patients with Parkinson's disease. Both proactive and reactive motor impulsivity were impaired by the combination of dopaminergic medication and subthalamic nucleus deep brain stimulation.

Applying process dissociation to self-sacrificial moral dilemmas: Extending the dual-process model.

There is considerable evidence linking cognitive reflection with utilitarian judgments in dilemmas that involve sacrificing someone else for the greater good. However, the evidence is mixed on the question of whether cognitive reflection is associated with utilitarian judgments in self-sacrificial dilemmas. We employed process dissociation to extract a self-sacrificial utilitarian (SU) parameter, an altruism (A) parameter, an other-sacrificial (OU) utilitarian parameter, and a deontology (D) parameter. In Study 1, the cognitive reflection test (CRT) positively correlated with both SU and OU (replicated in Studies 2 and 4, pre-registered). In Study 2, we found that instructing participants to rely on reason increased SU and OU (replicated in Study 4, pre-registered). In Study 3, we found that SU and OU positively correlated with giving in the single-game version of the public goods game (replicated in Study 4, pre-registered), which provides behavioral validation that they are genuine moral tendencies. Together, these studies constitute strong cumulative evidence that SU and OU are both valid measures that are associated with reliance on cognitive reflection.

Resident Feedback on Incorporating Reflection Rounds Into a Family Medicine Residency Wellness Curriculum: A Brief Report.

Background: We sought to understand well-being from the perspectives of residents in a family medicine residency program and to assess the residents' opinions on implementing "Reflection Rounds" (RR) to promote wellness and combat burnout through self-reflection. These aims were achieved through descriptive qualitative analysis of a focus group of family medicine residents. Methods: Participation was voluntary and open to all 45 residents in the program. The final participant sample consisted of 14 residents who shared similar characteristics, including level of training and being exposed to similar training stressors. Both a priori and open coding were used for this analysis. Results: An iterative process identified themes based on focus group responses. The residents were in favor of initiating RR and recommended discussion topics unique to family medicine residency. They also identified logistical preferences for this intervention, such as conducting confidential and unrecorded groups, splitting rounds by training year, offering RRs led by a trained facilitator, providing snacks if feasible, and making the RRs available on a regular basis during protected didactic time. Conclusion: This project elucidates how residents are identifying and managing wellness and burnout as well as informs effective ways that family medicine residency programs can incorporate RR into their wellness curriculum.

The essence of students' vitality in the context of its reflexive determination.

OBJECTIVE: Aim: Theoretical analysis of the problem of the individual's vitality in the context of its reflective determination, an empirical study of the formation of its components, and the proof of correlations with various types of reflection. PATIENTS AND METHODS: Materials and Methods: The following psychodiagnostic methods were used in the empirical study: "Methodology of vitality diagnosis" by S. Maddi in an adaptation by D. Leontiev; test for determining the reflection of interpersonal interaction T. Pushkar in the modification of N. Senchyna; the method of research of reflexivity of thinking (T. Pashukova, A. Dopira, G. Dyakonov); the technique "Determining the level of reflection" (O. Anisimov); method "Determining the level of reflexivity" (A. Karpov, V. Ponomaryova). RESULTS: Results: It was established that the majority of students in both the first and fourth years have an average and low level of vitality. Vitality is directly connected to intellectual, personal, and situational reflection on a temporal basis; that is, the specified types of reflection are the leading determinants of vitality, which is statistically proven. CONCLUSION: Conclusions: The study showed the high importance of resilience for the full functioning of student youth in modern complex life conditions and its determination by the level of development of various types of reflection.

Reflective practice is a prerequisite for One Health development.

One Health is being promoted as a transformative approach in health, conservation, and environmental sustainability. The polycrisis of climate change, pandemics, food insecurity, biodiversity loss, pollution and inequity is creating an urgency to evolve the epistemology and methods of One Health. However, the amount of effort placed into critical and systematic reflection on One Health is outweighed by advocacy for its use, or for expanding its scope of practice. This paper advocates for reflective One Health practice to foster new ways of knowing and doing that are helpful in the face of a rapidly narrowing window of opportunity to preserve the social and environmental factors that secure health and resilience for all species and generations. We propose six areas for reflection; (1) how to moderate conformity so that One Health does not become its own silo; (2) finding the moral purpose of One Health to align actions with desired outcomes; (3) coping with the problem of too many interacting problems; (4) the strategic trajectory of growth to accelerate action on root causes and ensure One Health is future-ready; (5) how to identify priorities across a vast array of problems, values, and needs and (6) how to know if we are making the world healthier and safer and for whom. Reflective practice requires investment in ongoing conversation to guard against over-confidence that we have captured the "one right way" to meet changing expectations and circumstances in a fair and effective way. Our intention is to stimulate thinking and discussion within the One Health community to ensure that "doing is shaped by knowing". We hope One Health will continue to be an emergent and highly variable set of ever more effective practices that constantly changes in response to the complex, interconnected and changing problems facing the health of people, animals, and the environment.

Optical discrimination of pathological red blood cells.

Fast diagnostic methods are crucial to reduce the burden on healthcare systems. Currently, detection of diabetes complications such as neuropathy requires time-consuming approaches to observe the correlated red blood cells (RBCs) morphological changes. To tackle this issue, an optical analysis of RBCs in air was conducted in the 250-2500 nm range. The distinct oscillations present in the scattered and direct transmittance spectra have been analyzed with both Mie theory and anomalous diffraction approximation. The results provide information about the swelling at the ends of RBCs and directly relate the optical data to RBCs morphology and deformability. Both models agree on a reduction in the size and deformability of RBCs in diabetic patients, thus opening the way to diabetes diagnosis and disease progression assessment.

Fostering reflective impact orientation in transdisciplinary research-A multi-method workshop format.

The primary objective of transdisciplinary research (TDR) is to contribute to the solution of complex 'real-world' problems by integrating heterogeneous knowledge and achieving societal effects. However, establishing a continuous impact orientation during TDR processes remains a challenge, as the necessary tools are not yet sufficiently available. We developed and tested a half-day workshop format for strengthening the impact-oriented project management and research activities of seven TDR projects. Our findings indicate that the reflective impact workshops supported participants in pursuing societal effects systematically. Applying the methodological approach also fosters TDR process qualities such as knowledge integration. Conducted at different project stages, the results can serve as a basis for monitoring and adapting the project design. The reflective approach•includes scientific and non-scientific TDR project team members,•draws on Theory of Change as a conceptual framework and motivates participants to reflect on plausible impact pathways and make implicit assumptions about interlinkages between different forms of societal effects explicit, and•provides results which enable project partners to adjust their project design for greater societal effectiveness.

Bicolor Tuning and Hyper-Reflective Color Switching Based on Two Stacked Cholesteric Liquid Crystal Cells with Asymmetric Electrothermal Optical Responses.

We propose a double-cell cholesteric liquid crystal (CLC) device composed of a left-handed (LH) CLC cell with a pair of sheet electrodes and a right-handed (RH) CLC cell with a tri-electrode configuration characterized by a sheet electrode on the top and an interdigitated electrode on the bottom substrates. Bi-reflected color tuning and hyper-reflective color switching are revealed from this cell stack via the electrothermal control of the central wavelengths of the LH- and RH-bandgaps by voltage-induced pseudo-dielectric heating. The two CLCs are thermally sensitive and exhibit overlapped bandgaps in the field-off state with nearly identical temperature dependence, resulting in a hyper-reflective color at 720 nm at 23.4 °C and 380 nm at 29.8 °C. Upon the application of 4 Vrms at 2 MHz across the stacked device to induce pseudo-dielectric heating, two reflective colors can be resolved due to asymmetrical temperature elevations. Accordingly, the difference in wavelength between the two colors increases with increasing voltage through a series cell connection, while maintaining approximately constant via a parallel connection. This study provides a feasible pathway to developing a multifunctional device with electrothermally tunable bi-reflected and hyper-reflective states based on two conventional cell geometries, which is promising for lasers and color-related display applications.

Dichroic switching of core-shell plasmonic nanoparticles on reflective surfaces.

Plasmonic metal nanostructures can simultaneously scatter and absorb light, with resonance wavelength and strength depending on their morphology and composition. This work demonstrates that unique dichroic effects and high-contrast colour-switching can be achieved by leveraging the resonant scattering and absorption of light by plasmonic nanostructures and the specular reflection of the resulting transmitted light. Using core/shell nanostructures comprising a metal core and a dielectric shell, we show that their spray coating on reflective substrates produces dichroic films that can display colour switching at different viewing angles. The high-contrast colour switching, high flexibility in designing multicolour patterns, and convenience for large-scale production promise their wide range of applications, including anticounterfeiting, mechanochromic sensing, colour display, and printing.

Automated spectrometer alignment via machine learning.

During beam time at a research facility, alignment and optimization of instrumentation, such as spectrometers, is a time-intensive task and often needs to be performed multiple times throughout the operation of an experiment. Despite the motorization of individual components, automated alignment solutions are not always available. In this study, a novel approach that combines optimisers with neural network surrogate models to significantly reduce the alignment overhead for a mobile soft X-ray spectrometer is proposed. Neural networks were trained exclusively using simulated ray-tracing data, and the disparity between experiment and simulation was obtained through parameter optimization. Real-time validation of this process was performed using experimental data collected at the beamline. The results demonstrate the ability to reduce alignment time from one hour to approximately five minutes. This method can also be generalized beyond spectrometers, for example, towards the alignment of optical elements at beamlines, making it applicable to a broad spectrum of research facilities.

Ensuring robust OSCE assessments: A reflective account from a Scottish school of nursing.

AIM: This paper reflects on the experience of one Scottish University in conducting a face-to-face Objective Structured Examination (OSCE) for large cohorts of student nurses. It outlines the challenges experienced and learning gained. Borton's model of reflection frames this work due to its simplicity, ease of application and cyclical nature. BACKGROUND: The theoretical framework for the OSCE is critical thinking, enabling students to apply those skills authentically. OSCE's are designed to transfer classroom knowledge to clinical practice and offer an authentic work-based assessment. DESIGN: Validity and robustness are key considerations in any assessment and in OSCE, the number of stations that students encounter is important and debated. We used a case-study based OSCE approach initially over four stations and following reflection, changed to one long station with four phases. RESULTS: In OSCE examinations, interrater reliability is a necessity, and students expect equity of approach. We identified that despite clear marking criteria, marks were polarised, with students achieving high or low marks with little middle ground. Review of examination papers highlighted that although students' overall performance was good, some had failed in at least one station, suggesting a four-station approach may skew results. On reflection we hypothesised that using a one station case study-based, phased approach enabled the examiner to build up a more holistic picture of student knowledge and skills. It also provided the student opportunity to develop a rapport with the examiner and standardised patient, thereby putting them more at ease. We argue that this approach is holistic, authentic and student centred. CONCLUSIONS: Our experience highlights that a single station, four phase OSCE is preferrable, enabling students to integrate all aspects of the assessment and provides a holistic view of clinical skills and knowledge.

Analysis of Gloss Unevenness and Bidirectional Reflectance Distribution Function in Specular Reflection.

Gloss is associated significantly with material appearance, and observers often focus on gloss unevenness. Gloss unevenness is the intensity distribution of reflected light observed within a highlight area, that is, the variability. However, it cannot be analyzed easily because it exists only within the highlight area and varies in appearance across the reflection angles. In recent years, gloss has been analyzed in terms of the intensity of specular reflection and its angular spread, or the bidirectional reflectance distribution function (BRDF). In this study, we develop an apparatus to measure gloss unevenness that can alter the angle with an angular resolution of 0.02°. Additionally, we analyze the gloss unevenness and BRDF in terms of specular reflection. Using a high angular resolution, we measure and analyze high-gloss materials, such as mirrors and plastics, and glossy materials, such as photo-like inkjet paper and coated paper. Our results show that the magnitude of gloss unevenness is the largest at angles marginally off the center of the specular reflection angle. We discuss an approach for physically defining gloss unevenness based on the BRDF.