The Impact of Script Concordance Testing on Clinical Decision-Making in Paramedic Education.

This study investigates the effectiveness of the Script Concordance Test (SCT) in enhancing clinical reasoning skills within paramedic education. Focusing on the Medical University of Lublin, we evaluated the SCT's application across two cohorts of paramedic students, aiming to understand its potential to improve decision-making skills in emergency scenarios. Our approach, informed by Van der Vleuten's assessment framework, revealed that while the SCT's correlation with traditional methods like multiple-choice questions (MCQs) was limited, its formative nature significantly contributed to improved performance in summative assessments. These findings suggest that the SCT can be an effective tool in paramedic training, particularly in strengthening cognitive abilities critical for emergency responses. The study underscores the importance of incorporating innovative assessment tools like SCTs in paramedic curricula, not only to enhance clinical reasoning but also to prepare students for effective emergency responses. Our research contributes to the ongoing efforts in refining paramedic education and highlights the need for versatile assessment strategies in preparing future healthcare professionals for diverse clinical challenges.

'Being and becoming a practice educator': An AHP online programme.

BACKGROUND: Five higher education institutions (HEIs) in Scotland with qualifying allied health professional (AHP) programmes developed an online programme in practice education. This paper focuses on the design, development and evaluation of this programme. APPROACH: The programme was developed using the ADDIE approach for instructional design and was launched on TURAS (NHS e-learning platform) in November 2020. In November 2021, an online questionnaire was distributed to evaluate the e-learning programme and AHPs' preferences for future practice education training. EVALUATION: Of the 407 responses, 95% (n = 388) were working in the NHS. There was no preference for online or face-to-face format of training. For the majority, having flexibility of time and place was deemed to be important to manage learning particularly given high workloads and staff shortages. Out of the 29% (n = 118) who answered questions regarding the programme, more than 60% (n > 75) of respondents reported it was well organised, the content relevant and would support their learning. Free text comments suggested a desire for networking opportunities to discuss learning. IMPLICATIONS: An e-learning programme for new and existing AHP practice educators in Scotland was developed and launched in November 2020. Key feedback from participants was that they wanted to have opportunities for interaction with other learners to discuss and share their learning whether this was online or face-to-face. The programme now forms the foundation education in practice education for AHPs in Scotland and is supplemented with networking opportunities through synchronous online training with HEIs and via NHS Education for Scotland's virtual community.

Minimum Wear Duration for the activPAL Professional Activity Monitor in Adolescent Females.

OBJECTIVES: This study aims to determine the minimum number of days of monitoring required to reliably predict sitting/lying time, standing time, light intensity physical activity (LIPA), moderate-to-vigorous intensity physical activity (MVPA) and steps in adolescent females. METHOD: 195 adolescent females (mean age = 15.7 years; SD = 0.9) participated in the study. Participants wore the activPAL activity monitor for a seven day protocol. The amount of time spent sitting/lying, standing, in LIPA and in MVPA and the number of steps per day were quantified. Spearman-Brown Prophecy formulae were used to predict the number of days of data required to achieve an intraclass correlation coefficient of both 0.7 and 0.8. RESULTS: For the percentage of the waking day spent sitting/lying, standing, in LIPA and in MVPA, a minimum of 9 days of accelerometer recording is required to achieve a reliability of ≥ 0.7, while a minimum of 15 days is required to achieve a reliability of ≥ 0.8. For steps, a minimum of 12 days of recording is required to achieve a reliability of ≥ 0.7, with 21 days to achieve a reliability of ≥ 0.8. CONCLUSION: Future research in adolescent females should collect a minimum of 9 days of accelerometer data to reliably estimate sitting/lying time, standing time, LIPA and MVPA, while 12 days is required to reliably estimate steps.

Validity of wrist worn accelerometers and comparability between hip and wrist placement sites in estimating physical activity behaviour in preschool children.

Wrist-worn accelerometers can increase compliance with wearing accelerometers, however, several large scale studies continue to use hip-worn accelerometers and it is unclear how comparable data is from the two sites. The study aims were: to investigate agreement between wrist- and hip- worn accelerometers and to determine the validity of Johansson et al cut-points for wrist worn accelerometers in preschool children. A sample of 32 preschool children (21 boys, 4.2 (0.5) years, BMI 16.6 (1.1)) were videoed wearing GT3X+ accelerometers on their wrist and hip while they engaged in 1 h of free-play in their nursery. Children's activity were coded using, the children's activity rating scale (CARS): with CARS, level 1 'sedentary' and levels 2-5 were classified as time spent in total physical activity (TPA). Accelerometry data were processed using Johansson et al cut-points for the wrist data and Evenson et al cut-points for the hip data, into time spent in different intensities of physical activity (PA). The mean counts per minute (cpm) from the hip and wrist were compared. There was a strong correlation between the hip and wrist cpm (r = 0.81, p < 0.01) and total count data (r = 0.83 p < 0.01), however there was a large systematic bias with wide limits of agreement. Good agreement (mean difference (LOA) 1.1 (-9.9, 12.1) was found between the CARS estimate of TPA (29.5 (10.4) mins) and the wrist estimate, using the Johansson et al cut points (28.4 (9.8) mins). There was also a reasonable agreement between the hip estimates with the Evenson et al cut-points and Johansson et al estimate (mean difference (LOA):6.3 (-8.8, 21.4) mins. In conclusion, the findings suggest that the Johansson et al (2013 Pediatr. Obes. 10 1-6) cut-points applied to wrist worn accelerometers provides a valid estimate of TPA in preschool children and have reasonable agreement with Evenson et al cut-points applied to hip accelerometers.

An investigation into the minimum accelerometry wear time for reliable estimates of habitual physical activity and definition of a standard measurement day in pre-school children.

The purpose of this study was to determine the number of hours and days of accelerometry data necessary to provide a reliable estimate of habitual physical activity in pre-school children. The impact of a weekend day on reliability estimates was also determined and standard measurement days were defined for weekend and weekdays.Accelerometry data were collected from 112 children (60 males, 52 females, mean (SD) 3.7 (0.7)yr) over 7 d. The Spearman-Brown Prophecy formula (S-B prophecy formula) was used to predict the number of days and hours of data required to achieve an intraclass correlation coefficient (ICC) of 0.7. The impact of including a weekend day was evaluated by comparing the reliability coefficient (r) for any 4 d of data with data for 4 d including one weekend day.Our observations indicate that 3 d of accelerometry monitoring, regardless of whether it includes a weekend day, for at least 7 h d(-1) offers sufficient reliability to characterise total physical activity and sedentary behaviour of pre-school children. These findings offer an approach that addresses the underlying tension in epidemiologic surveillance studies between the need to maintain acceptable measurement rigour and retention of a representatively meaningful sample size.

Comparison of accelerometry cut points for physical activity and sedentary behavior in preschool children: a validation study.

This study compared accelerometry cut points for sedentary behavior, light and moderate to vigorous intensity activity (MVPA) against a criterion measure, the Children's Activity Rating Scale (CARS), in preschool children. Actigraph accelerometry data were collected from 31 children (4.4 ± 0.8 yrs) during one hour of free-play. Video data were coded using the CARS. Cut points by Pate et al., van Cauwenberghe et al., Sirard et al. and Puyau et al. were applied to calculate time spent in sedentary, light and MVPA. Repeated-measures ANOVA and paired t tests tested differences between the cut points and the CARS. Bland and Altman plots tested agreement between the cut points and the CARS. No significant difference was found between the CARS and the Puyau et al. cut points for sedentary, light and MVPA or between the CARS and the Sirard et al. cut point for MVPA. The present study suggests that the Sirard et al. and Puyau et al. cut points provide accurate group-level estimates of MVPA in preschool children.

Comparison of epoch and uniaxial versus triaxial accelerometers in the measurement of physical activity in preschool children: a validation study.

The objectives of this study were to explore whether triaxial is more accurate than uniaxial accelerometry and whether shorter sampling periods (epochs) are more accurate than longer epochs. Physical activity data from uniaxial and triaxial (RT3) devices were collected in 1-s epochs from 31 preschool children (15 males, 16 females, 4.4 ± 0.8 yrs) who were videoed while they engaged in 1-hr of free-play. Video data were coded using the Children's Activity Rating Scale (CARS). A significant difference (p < .001) in the number of minutes classified as moderate to vigorous physical activity (MVPA) was found between the RT3 and the CARS (p < .002) using the cut point of relaxed walk. No significant difference was found between the GT1M and the CARS or between the RT3 and the CARS using the cut point for light jog. Shorter epochs resulted in significantly greater overestimation of MVPA, with the bias increasing from 0.7 mins at 15-s to 3.2 mins at 60-s epochs for the GT1M and 0 mins to 1.7 mins for the RT3. Results suggest that there was no advantage of a triaxial accelerometer over a uniaxial model. Shorter epochs result in significantly higher number of minutes of MVPA with smaller bias relative to direct observation.