When intercepting moving targets, mid-movement error corrections reflect distinct responses to visual and haptic perturbations.

We examined a key aspect of sensorimotor skill: the capability to correct performance errors that arise mid-movement. Participants grasped the handle of a robot that imposed a nominal viscous resistance to hand movement. They watched a target move pseudo-randomly just above the horizontal plane of hand motion and initiated quick interception movements when cued. On some trials, the robot's viscosity or the target's speed changed without warning coincident with the GO cue. We fit a sum-of-Gaussians model to mechanical power measured at the handle to determine the number, magnitude, and relative timing of submovements occurring in each interception attempt. When a single submovement successfully intercepted the target, capture times averaged 410 ms. Sometimes, two or more submovements were required. Initial error corrections typically occurred before feedback could indicate the target had been captured or missed. Error corrections occurred sooner after movement onset in response to mechanical viscosity increases (at 154 ms) than to unprovoked errors on control trials (215 ms). Corrections occurred later (272 ms) in response to viscosity decreases. The latency of corrections for target speed changes did not differ from those in control trials. Remarkably, these early error corrections accommodated the altered testing conditions; speed/viscosity increases elicited more vigorous corrections than in control trials with unprovoked errors; speed/viscosity decreases elicited less vigorous corrections. These results suggest that the brain monitors and predicts the outcome of evolving movements, rapidly infers causes of mid-movement errors, and plans and executes corrections-all within 300 ms of movement onset.

Developing a research community within an online healthcare feedback platform.

INTRODUCTION: Care Opinion is an online feedback platform supporting patients to author stories about their care. It is not known whether authors would be willing to be involved in improving care through research. The aims of this study were to explore the views and preferences of Care Opinion authors about joining an online research community and to pilot new research community functionality. METHODS: Five hundred and nine Care Opinion authors were invited to take part in an online survey in June 2019. Survey items included questions about participants' willingness to take part in research and their preferences for supporting processes. Data were analysed descriptively. Authors were invited to consent to join a research community and were asked to participate in three pilot studies. RESULTS: One hundred and sixty-three people consented to take part in the survey (32%). Participants indicated they would like to know the time commitment to the project (146, 90%), details about the organization carrying out the research (124, 76%) and safeguarding information (124, 76%). Over half indicated that they did not know how to get involved in healthcare research (87, 53%). Subsequently, 667 authors were invited to join the research community, 183 (27%) accepted, and three studies were matched to their expressed preferences for project attributes or organization type. CONCLUSION: Many people who leave online feedback about their experiences of healthcare are also willing to join a research community via that platform. They have strong preferences for supporting University and NHS research. Eligibility and acceptance rates to join pilot research studies varied. Further work is needed to grow the research community, increase its diversity, and create relevant and varied opportunities to support research. PATIENT OR PUBLIC CONTRIBUTION: Four members of the Safety In Numbers patient and public involvement and engagement (PPIE) group advised about survey development.

Online patient feedback as a safety valve: An automated language analysis of unnoticed and unresolved safety incidents.

Safety reporting systems are widely used in healthcare to identify risks to patient safety. But, their effectiveness is undermined if staff do not notice or report incidents. Patients, however, might observe and report these overlooked incidents because they experience the consequences, are highly motivated, and independent of the organization. Online patient feedback may be especially valuable because it is a channel of reporting that allows patients to report without fear of consequence (e.g., anonymously). Harnessing this potential is challenging because online feedback is unstructured and lacks demonstrable validity and added value. Accordingly, we developed an automated language analysis method for measuring the likelihood of patient-reported safety incidents in online patient feedback. Feedback from patients and families (n = 146,685, words = 22,191,427, years = 2013-2019) about acute NHS trusts (hospital conglomerates; n = 134) in England were analyzed. The automated measure had good precision (0.69) and excellent recall (0.98) in identifying incidents; was independent of staff-reported incidents (r = -0.04 to 0.19); and was associated with hospital-level mortality rates (z = 3.87; p < 0.001). The identified safety incidents were often reported as unnoticed (89%) or unresolved (21%), suggesting that patients use online platforms to give visibility to safety concerns they believe have been missed or ignored. Online stakeholder feedback is akin to a safety valve; being independent and unconstrained it provides an outlet for reporting safety issues that may have been unnoticed or unresolved within formal channels.

How different online self-presentations relate to life satisfaction differently in college students: The role of positive online feedback and self-esteem.

In the Internet age, some online factors, such as online self-presentation, related to life satisfaction have received much attention. However, it is unclear whether and how different strategies of online self-presentation are linked to an individual's life satisfaction differently. Accordingly, the present study examined the possible different relationships between different online self-presentations and life satisfaction with a sample of 460 Chinese college students. Using a series of questionnaires, a moderated mediation model was built in which positive online feedback was a mediator and self-esteem was a moderator. The results indicated that: (1) positive self-presentation was negatively associated with college students' life satisfaction, whereas honest self-presentation was positively related to it; (2) positive online feedback was a significant mediator in such relationships; (3) the mediation process was moderated by self-esteem. Specifically, positive self-presentation was negatively related to positive online feedback only for high self-esteem college students, but negatively associated with life satisfaction only for low self-esteem ones. By contrast, honest self-presentation was positively associated with positive online feedback despite the level of self-esteem, but positively linked with life satisfaction only for those with low self-esteem. The findings suggest that honest rather than positive online self-presentation should be conducive to college students' life satisfaction, particularly for those with low self-esteem. The implications were discussed.

Online modification of goal-directed control in human reaching movements.

Humans are able to perform very sophisticated reaching movements in a myriad of contexts based on flexible control strategies influenced by the task goal and environmental constraints such as obstacles. However, it remains unknown whether these control strategies can be adjusted online. The objective of this study was to determine whether the factors that determine control strategies during planning also modify the execution of an ongoing movement following sudden changes in task demand. More precisely, we investigated whether, and at which latency, feedback responses to perturbation loads followed the change in the structure of the goal target or environment. We changed the target width (square or rectangle) to alter the task redundancy, or the presence of obstacles to induce different constraints on the reach path, and assessed based on surface electromyography (EMG) recordings when the change in visual display altered the feedback response to mechanical perturbations. Task-related EMG responses were detected within 150 ms of a change in target shape. Considering visuomotor delays of ∼ 100 ms, these results suggest that it takes 50 ms to change control policy within a trial. An additional 30-ms delay was observed when the change in context involved sudden appearance or disappearance of obstacles. Overall, our results demonstrate that the control policy within a reaching movement is not static: contextual factors that influence movement planning also influence movement execution at surprisingly short latencies. Moreover, the additional 30 ms associated with obstacles suggests that these two types of changes may be mediated via distinct processes.NEW & NOTEWORTHY The present work demonstrates that the control strategies used to perform reaching movements are adjusted online when the structure of the target or the presence of obstacles are altered during movements. Thus, the properties of goal-directed reaching control are not simply selected during the planning stage of a movement prior to execution. Rather, they are dynamically and rapidly adjusted online, within ∼150 ms, according to changes in environment.

An online discussion between students and teachers: a way forward for meaningful teacher feedback?

BACKGROUND: Student evaluation is an essential component in feedback processes in faculty and learner development. Ease of use and low cost have made paper evaluation forms a popular method within teaching programmes, but they are often seen as a formality, offering variable value towards the improvement of teaching. Students report poor motivation to engage with existing feedback tools whilst teachers describe receiving vague, contradicting, or irrelevant information. We believe that feedback for teachers needs to be a two-way process, similar to feedback for students, for it to be effective. An online feedback tool has been implemented for third-year medical students from Imperial College London to promote open discussion between teachers and students. The feedback tool is accessible throughout students' clinical attachment with the option of maintaining anonymity. We aim to explore the benefits and challenges of this online feedback tool and assess its value as a method for teacher feedback. METHODS: Qualitative data was obtained from both volunteer third-year medical students of Imperial College London and Clinical Teaching Fellows using three focus groups and a questionnaire. Data was analysed through iterative coding and thematic analysis to provide over-arching analytical themes. RESULTS: Twenty-nine students trialled this feedback tool with 17 responding to the evaluative questionnaire. Four over-arching themes were identified: reasons for poor participation with traditional feedback tools; student motivators to engage with 'open feedback'; evaluative benefits from open feedback; concerns and barriers with open feedback. CONCLUSION: This feedback tool provides a platform for two-way feedback by encouraging open, transparent discussion between teachers and learners. It gives a unique insight into both teachers and peers' perspectives. Students engage better when their responses are acknowledged by the teachers. We elaborate on the benefits and challenges of public open feedback and approaches to consider in addressing the self-censorship of critical comments.

Vestibular modulation of visuomotor feedback gains in reaching.

Humans quickly and sophisticatedly correct their movements in response to changes in the world, such as when reaching to a target that abruptly changes its location. The vigor of these movement corrections is time-dependent, increasing if the time left to make the correction decreases, which can be explained by optimal feedback control (OFC) theory as an increase of optimal feedback gains. It is unknown whether corrections for changes in the world are as sophisticated under full-body motion. For successful visually probed motor corrections during full-body motion, not only the motion of the hand relative to the body needs to be taken into account, but also the motion of the hand in the world should be considered, because their relative positions are changing. Here, in two experiments, we show that visuomotor feedback corrections in response to target jumps are more vigorous for faster passive full-body translational acceleration than for slower acceleration, suggesting that vestibular information modulates visuomotor feedback gains. Interestingly, these corrections do not demonstrate the time-dependent characteristics that body-stationary visuomotor feedback gains typically show, such that an optimal feedback control model fell short to explain them. We further show that the vigor of corrections generally decreased over the course of trials within the experiment, suggesting that the sensorimotor system adjusted its gains when learning to integrate the vestibular input into hand motor control.NEW & NOTEWORTHY Vestibular information is used in the control of reaching movements to world-stationary visual targets, while the body moves. Here, we show that vestibular information also modulates the corrective reach responses when the target changes position during the body motion: visuomotor feedback gains increase for faster body acceleration. Our results suggest that vestibular information is integrated into fast visuomotor control of reaching movements.

Task-dependent responses to muscle vibration during reaching.

Feedback corrections in reaching have been shown to be task-dependent for proprioceptive, visual and vestibular perturbations, in line with predictions from optimal feedback control theory. Mechanical perturbations have been used to elicit proprioceptive errors, but have the drawback to actively alter the limb's trajectory, making it nontrivial to dissociate the subject's compensatory response from the perturbation itself. In contrast, muscle vibration provides an alternative tool to perturb the muscle afferents without changing the hands trajectory, inducing only changes in the estimated, but not the actual, limb position and velocity. Here, we investigate whether upper-arm muscle vibration is sufficient to evoke task-dependent feedback corrections during goal-directed reaching to a narrow versus a wide target. Our main result is that for vibration of biceps and triceps, compensatory responses were down-regulated for the wide compared to the narrow target. The earliest detectable difference between these target-specific corrections is at about 100 ms, likely reflecting a task-dependent feedback control policy rather than a voluntary response.

Learning from patient experiences of projection imaging through the use of online feedback platforms.

INTRODUCTION & BACKGROUND: Projection radiography remains a well-used diagnostic tool in healthcare, and its use is continually increasing. The volume of feedback collected from patients has grown exponentially but is rarely analysed within the service to meaningfully underpin change. Professions such as nursing currently make use of patient feedback during training yet there is comparatively little use in diagnostic radiography. Research exists into the use of social media during radiotherapy treatment, highlighting how it could be embraced in future research. However, there remains a sparsity of publications discussing the experiences of patients with projection radiography despite its prominence within diagnostic imaging. Online platforms for feedback are available to most industries and readily embraced and used. They are also becoming increasingly available to healthcare providers. This study aimed to assess and analyse the patient experience of projection radiography using the stories of patients via an online platform. METHODOLOGY: Recognising that humans do not experience healthcare in a binary way, the authors selected a narrative method as the most appropriate qualitative methodology to analyse and understand 181 patient stories relating to projection radiography from the Care Opinion UK website. Each story was read three times to establish codes and themes and to ensure author familiarity with the patient's words & descriptions. This resulted in 30 empirical codes with the most frequently used being split into three major themes for discussion RESULTS & CONCLUSION: The three major themes considered the radiography experience, the encounter with professionals and service provision. Online sources of feedback provide valuable data for health researchers and provide access to insights which might otherwise go unconsidered. Patients instinctively perceive radiological examinations to result in delays to their care and report surprise when discovering examinations are delivered swiftly, though it remains that innovations such as radiographer-led discharge could be better utilised to enhance the patient experience. In addition, it is evident that administrative functions in diagnostic radiology departments are considered poor and from the descriptions given in the study by patients, the administrative side of the service does not meet their needs. Patient stories demonstrate that radiography is not perceived as vital to patient care and is frequently devalued through the notion that health professions are limited to medical doctor and nurse. The work of radiographers is not valueless to the patient evidenced by their desire to thank staff for their work, but its value is poorly understood and could be further enhanced by embracing online feedback as part of continuing professional and service development.

An online feedback system for laparoscopic training during the COVID-19 pandemic: evaluation from the trainer perspective.

Objective: A system to provide feedback for laparoscopic training using an online conferencing system during the COVID-19 pandemic was developed. The purpose of this study is to evaluate this system from the trainer perspective. Design: A procedural feedback system using an online conferencing system was devised. Setting: Surgical training was observed using an online conferencing system (Zoom). Feedback was provided while viewing suture videos which are, as a feature of this system, pre-recorded. Feedback was then recorded. Trainer comments were then converted into text, summarized as feedback items, and sorted by suture phase which facilitates reflection. Trainers completed a questionnaire concerning the usability of the online feedback session. Results: Eleven trainers were selected. Physicians had an average experience of 21.9 ± 5.9 years (mean ± standard deviation). The total number of feedback items obtained by classifying each phase was 32. Based on questionnaire results, 91% of trainers were accustomed to the use of Zoom, and 100% felt that online procedural education was useful. In questions regarding system effectiveness, more than 70% of trainers answered positively to all questions, and in questions about efficiency, more than 70% of trainers answered positively. Only 55% of the trainers felt that this system was easy to use, but 91% were satisfied as trainers. Conclusions: The results of the questionnaire suggest that this system has high usability for training. This online system could be a useful tool for providing feedback in situations where face-to-face education is difficult.

Continuous Tracking of Task Parameters Tunes Reaching Control Online.

A hallmark of human reaching movements is that they are appropriately tuned to the task goal and to the environmental context. This was demonstrated by the way humans flexibly respond to mechanical and visual perturbations that happen during movement. Furthermore, it was previously showed that the properties of goal-directed control can change within a movement, following abrupt changes in the goal structure. Such online adjustment was characterized by a modulation of feedback gains following switches in target shape. However, it remains unknown whether the underlying mechanism merely switches between prespecified policies, or whether it results from continuous and potentially dynamic adjustments. Here, we address this question by investigating participants' feedback control strategies in presence of various changes in target width during reaching. More specifically, we studied whether the feedback responses to mechanical perturbations were sensitive to the rate of change in target width, which would be inconsistent with the hypothesis of a single, discrete switch. Based on movement kinematics and surface EMG data, we observed a modulation of feedback response clearly dependent on dynamical changes in target width. Together, our results demonstrate a continuous and online transformation of task-related parameters into suitable control policies.

An Action Research Investigation of the Impact of Using Online Feedback Videos to Promote Self-Reflection on the Microteaching of Preservice EFL Teachers.

A growing number of researchers have investigated the potential of using video recordings to foster greater self-reflection in pre-service teacher preparation programs. However, at present, few investigations have explored secondary-level pre-service teachers' perceptions of in-the-moment video recorded feedback on their teaching. Thus, pre-service teachers taught video recorded microteaching lessons and were given video recorded feedback from their course instructor. The lessons were conducted during the Covid-19 lockdown so it was not possible for the course instructor to conduct more interactive face-to-face lessons. Each participant's lesson with instructor feedback was shared with their classmates. Qualitative data were collected and analyzed regarding their experiences and perceptions of the microteaching and feedback they received. Findings revealed that they learned general teaching principles, and identified several specific teaching practices (e.g., lesson planning). They also felt that the feedback was extensive and detailed and offered an objective perspective on their teaching that they could review many times. Some drawbacks of the video feedback included their nervousness about sharing it, some reservations they had regarding the authenticity of the process, and their requests for greater interaction with peers about the feedback.

'Using humanity to change systems' - understanding the work of online feedback moderation: A case study of Care Opinion Scotland.

OBJECTIVE: To gain a deeper understanding of online patient feedback moderation through the organisation of Care Opinion in Scotland. METHODS: An ethnographic study, initially using in-person participant observations, switching to remote methods due to the pandemic. This involved the use of remote observations and interviews. Interviews were carried out with the whole Scottish team (n = 8). RESULTS: Our results identify three major themes of work found in online patient feedback moderation. The first is process work, where moderators make decisions on how to edit and publish stories. The second is emotional labour from working with healthcare experiences and with NHS staff. The third is the brokering/mediation role of Care Opinion, where they must manage the relationships between authors, subscribing healthcare providers and Scottish Government. Our results also capture that these different themes are not independent and can at times influence the others. CONCLUSION: Our results build on previous literature on Care Opinion and provide novel insights into the emotional and brokering/mediation work they undertake. Care Opinion holds a unique position, where they must balance the interests of the key stakeholders. Care Opinion holds the power to amplify authors' voices but the power to make changes to services lies with NHS staff and services. Online moderation work is complex, and moderators require support to carry out their work especially given the emotional impact. Further research is planned to understand how patient stories are used by NHS Scotland, and the emotional labour involved with stories, from both the author and NHS staff perspective.

Learners' perceived advantages and social-affective dispositions toward online peer feedback in academic writing.

Peer feedback is widely acknowledged for its advantages and benefits in improving students' learning in writing classes. Although the integration of online platforms has been found to impact peer feedback, research on second language learners' perceived advantages of social affective disposition to using multiple platforms for delivering peer feedback is limited. To address the aforementioned research gap, we conducted this 12-week action research to explore how 12 doctoral students at a university in Macau perceived their experience of using multiple online feedbacks in an academic writing course. To integrate the various advantages of different online platforms, we adopted three tools including Moodle, Rain Classroom, and WeChat for the delivery of peer feedback. The results demonstrated learners' perceived advantages and disadvantages of online peer feedback and how the different online peer feedback can be combined to magnify their benefits for academic writing. It also revealed that the use of emojis, memes, and one-to-one conversation window on WeChat can foster students' positive emotions. However, the ubiquitous connection by WeChat Moments increased their emotional load and undermined peer trust.

Views of Care at End of Life: A Secondary Analysis of Online Feedback Using Care Opinion.

Although there are studies on the use of social media and palliative and end-of-life care (PEOLC), there are no studies specifically investigating the content of online public feedback about PEOLC services. This study sought to understand experiences of end-of-life care provided in hospitals in the West of Scotland by exploring the main themes within the content of stories posted on a nationally endorsed nonprofit feedback online platform, Care Opinion, within a 2-year period. We used "Appreciative Inquiry" as a theoretical framework for this study to determine what works well in end-of-life care, while also identifying areas for further improvement. Of the 1428 stories published on "Care Opinion" from March 2019 to 2021 regarding hospitals in the West of Scotland, 48 (3.36%) were related to end-of-life care, of which all were included in data analysis. Using the software package NVivo and thematic analysis, we identified 4 key themes. We found that people overwhelmingly posted positive feedback about their experiences with end-of-life care. People reported positively about staff professionalism in providing compassionate and person-centered care to meet their loved ones needs at end of life. Other experiences of care related to challenges facing healthcare services, particularly during the COVID-19 pandemic. Quality appraisal of staff responses highlighted areas for improving feedback. This study can add to the aim of improving staff response to people's concerns about end-of-life care. This study has provided a novel perspective of patients' experiences of end-of-life care in hospitals in the West of Scotland. Novel insights were the appreciation of quality of care, staff professionalism, effective communication, and meeting patient's needs at end-of-life particularly by nursing staff.

Caring for care: Online feedback in the context of public healthcare services.

People increasingly provide feedback about healthcare services online. These practices have been lauded for enhancing patient power, choice and control, encouraging greater transparency and accountability, and contributing to healthcare service improvement. Online feedback has also been critiqued for being unrepresentative, spreading inaccurate information, undermining care relations, and jeopardising professional autonomy. Through a thematic analysis of 37 qualitative interviews, this paper explores the relationship between online feedback and care improvement as articulated by healthcare service users (patients and family members) who provided feedback across different online platforms and social media in the UK. Online feedback was framed by interviewees as, ideally, a public and, in many cases, anonymous 'conversation' between service users and healthcare providers. These 'conversations' were thought of not merely as having the potential to bring about tangible improvements to healthcare, but as in themselves constituting an improvement in care. Vital to this was the premise that providing feedback was an enactment of care - care for other patients, certainly, but also care for healthcare as such and even for healthcare professionals. Ultimately, feedback was understood as an enactment of care for the National Health Service (NHS), as symbolically encompassing all of the above. Putting these findings in dialogue with STS scholarship on care, we argue that, in this context, the provision of online feedback can be understood as a form of care that is, simultaneously, both directed at healthcare (in the round, including patients, professionals, services, organisations, and, of course, health itself) and part of healthcare. We conceptualise this as 'caring for care'. This conceptualization moves beyond dominant framings of online feedback in terms of 'choice' and 'voice'. It embeds online feedback within pre-existing healthcare systems, relations and moral commitments, foregrounds the mutuality of care relations, and draws attention to the affective labour of feedback practices.

Anonymity, veracity and power in online patient feedback: A quantitative and qualitative analysis of staff responses to patient comments on the 'Care Opinion' platform in Scotland.

OBJECTIVE: To analyse how staff in one Scottish hospital respond to anonymised patient feedback posted on the nationally endorsed feedback platform Care Opinion; and to understand staff experiences of, and attitudes towards, engaging with Care Opinion data. METHODS: This was a multi-method study comprising: (a) numerical and thematic analysis of stories posted during a six-month period, using a published framework; (b) thematic analysis of interviews with a range of 10 hospital staff responsible for organisational responses to feedback. RESULTS: Seventy-seven stories were published during the six-month period. All received a response, with a mean response time of 3.9 days. Ninety-six responses were made in total, from 20 staff members. Personalisation and tailoring was mostly assessed as performing well against the published framework. Only two 'changes made' were reported. While staff interviewed were mostly understanding of why patients might prefer giving anonymised feedback, some found it uncomfortable and challenging. Participants described instances where they might seek to de-anonymise the individual, in order to pass on personal thanks to the relevant staff member, or to investigate the issue raised and seek resolution offline. Patients did not always want to identify themselves; this could sometimes lead staff to query the veracity or importance of issues raised. Sometimes staff could identify individuals anyway, including one described as 'our regular person'. CONCLUSIONS: Staff used to engaging directly with patients and families, both clinically and in dealing with feedback, need support in dealing with anonymous feedback, and the uncomfortable situation of unequal power it may create.

Fully Automated Targeted Confocal and Single-Molecule Localization Microscopy.

Single-molecule localization microscopy (SMLM) enables imaging of biological structures in the nanometre range. Long measurement times are the consequence of this kind of microscopy due to the need of acquiring thousands of images. We built a setup that automatically detects target structures using confocal microscopy and images them with SMLM. Utilizing the Konstanz Information Miner (KNIME), we were able to connect a confocal microscope with an SMLM unit for targeted screening. In this process, we developed KNIME plugins to communicate with the microscope components and combined them to a workflow. Thus, measuring biological nanometre-sized structures in a sufficient number to get statistical significance becomes feasible. For proof of principle HIV-1 assembly complexes in HeLa cells derived from transfection of replication deficient viral construct were imaged by a fully automated screen.

The impact of aging on the spatial accuracy of quick corrective arm movements in response to sudden target displacement during reaching.

Age-related declines in visuomotor processing speed can have a large impact on motor performance in elderly individuals. Contrary to previous findings, however, recent studies revealed that elderly individuals are able to quickly react to displacement of a visual target during reaching. Here, we investigated the influence of aging on quick, corrective responses to perturbations during reaching in the terms of their functional contribution to accuracy. Elderly and young adults performed reaching movements to a visual target that could be displaced during reaching, and they were requested to move their hand to reach the final target location as quickly as possible. Results showed that, for the younger group, the variance in the directional error of the corrective response correlated with the variance in the reaching trajectory at the halfway point of the reach, but the correlation decreased at the end of the reaching. On the other hand, such correlations were not significant in elderly participants, although the variance of the directional error did not show a significant difference between age groups. Thus, the quick, corrective response seems to play an important role in decreasing variability, especially before the end of reaching, and aging can impair this process.