Thesis (M.S. in Management)--Naval Postgraduate School, March 2009. / Thesis Advisor(s): Hatch, William ; Roberts, Benjamin ; Cahill, Maureen. "March 2009." Description based on title screen as viewed on April 23, 2009. Author(s) subject terms: Training Officer, HR Community, Milestones, Lateral Transfer. Includes bibliographical references (p. 51). Also available in print.

Background: Competency based medical education will move training programs away from a time based standard to a model of competence and milestones. Assessment, observation and feedback are key ingredients to successful implementation. Work based assessment tools will be an important part of a multi-modal programmatic assessment for learners. Purpose: The purpose of the study was: 1) to facilitate the development and implement a pilot competency-based curriculum into the general pediatric component of the PGY 1 year at McMaster University, pediatric residency program, 2) to develop a tool, the Mini Milestones Assessment (Mini-MAS) to assess six medical competencies and progression through milestones using the Dreyfus Developmental Model and to pilot the tool in the general pediatric rotations for the PGY 1 and 4 residents and 3) to test the reliability, validity, acceptability and feasibility of the Mini-MAS tool. Method: Twelve PGY 1 residents at McMaster Children’s Hospital were required to complete 40 observations (10 history taking, 10 physical exam, 5 clinical reasoning, 5 communication with families, 5 communication with staff and 5 collaboration) during their general pediatric component of the 2013-2014 academic year. These same competencies were also observed for 9 PGY 4 residents over the same competencies over the same time period although this group was required to complete only 15-20 encounters. Following the study period, a survey was administered to the residents and faculty to assess acceptability and feasibility of the Mini-MAS tool. Kane’s validity framework, which is divided into four components (scoring, generalization, extrapolation and decision), was used to evaluate the Mini-MAS tool. Results: PGY 1 and PGY 4 residents had an average of 36 and 16 observations completed, respectively, across a wide variety of settings and clinical problems with multiple assessors. The scale of the Mini-MAS tool was used appropriately. The tool was able to differentiate between the PGY 1 and PGY 4 learners and showed progress of the PGY 1 learners through the academic year. The G coefficient overall for the Mini-MAS tool was 0.8 for the PGY1 residents and 0.5 for the PGY 4 residents. Correlation between the six competencies assessed was low, achieved by only one competency being observed and having grounded anchors. Learners and faculty were satisfied with the tool. The tool allowed learners to be observed more frequently and receive timely valuable feedback. Conclusion: A pilot competency based curriculum for PGY 1 residents was successfully implemented. The Mini-MAS tool added, as a formative assessment mode to a multi-modal assessment program will benefit the trainee, by increasing their observations and providing residents with valuable feedback. The assessment will inform residents where they stand with respect to their level of training, what competencies they can improve on and how they can make such improvements. / Thesis / Master of Science (MSc)

The CBI Facilitator Assessment tool is what the Case-based Instruction faciliatators use to assess the three of the six behavioral competencies for first year medical students.

The thesis deals with the milestones in the development of accounting and auditing. In four chapters, which are sorted chronologically, the thesis tries to identify the most significant events that contributed to the current form of these disciplines. The work not only shows which events occurred, and thus answers to the question "what", but also looks for the causes of these events and answers the question "why". Developmental line is examined primarily in the area of UK.

Literature (Beck, 1986:96; Beaver & Brewster, 2002:132; Piaget et al., 2009:1) indicates that the first two years of a baby’s life is a critical period for development. This period is seen as windows of opportunity for development. There is still controversy in the literature regarding if baby stimulation helps babies to reach their neuro-motor development milestones faster, and which type of stimulation is the most advantageous, namely group stimulation or individual stimulation. The first objective of this study was to determine the effect of different methods of stimulation on the motor development of babies between the ages of 3 – 9 months, and secondly to determine what the effect of stimulation administered by a primary caregiver have on the motor development of babies between the ages of 3 – 9 months. A pretest-posttest design was used based on an available random sample where the effect of motor stimulation in different stimulation groups was tested. For objective 1 the babies (N=42) was divided into three different groups and exposed to informal stimulation (n=14), group stimulation as part of a day care program (n=15) and individual stimulation (n=13) administered by a primary caregiver. A nonstandardised checklist was designed by the researcher, refined in a pilot study and completed by the facilitators of the group and individual stimulation programs in which the content of the motor stimulation program was described. During the pretesting phase the babies were tested by the researcher in order to determine their motor milestone developmental status by means of the Peabody Developmental Motor Scales-2-measuring instrument (PDMS-2). This measuring instrument consists of five sub-scales that are converted to a gross motor, fine motor and total motor quotient. After applying the stimulation programs for 12 weeks on a daily basis in the group stimulation and the formal individual stimulation programs, the same aspects of the babies’ motor development was tested again by the PDMS-2. The results showed that after 3 – 9 months old babies were exposed to formal stimulation programs and the data was adjusted for age in months, gender, other activities and pretest results, they did not reach their neuro-motor developmental milestones faster than the babies that were exposed to informal stimulation. The results also show that babies that received individual stimulation administered by a primary caregiver did not reach their milestones faster than babies that only received informal stimulation. However, it seems that individual stimulation administered by a primary caregiver is more beneficial than group stimulation. For objective 2 the subjects (N=27) was divided into two groups and were exposed to informal stimulation (n=14) and individual stimulation (n=13) administered by a primary caregiver. A co-variance of analysis was used and effect sizes were determined for the differences that occurred. The results showed that 3 – 9 months old babies that were exposed to a formal stimulation program did not reach their neuro-motor development milestones faster than babies that were exposed to informal stimulation, because the informal stimulation groups achieved significant (d > 0.2) higher scores for the gross motor (d > 0.24), fine motor (d > 0.27) and total motor quotient (d > 0.33). Individual stimulation showed nonsignificant higher mean values for the reflex (ẋ = 10.30), locomotion (ẋ = 9.16) and visual-motor integration sub-scales (ẋ = 9.45), while informal stimulation showed higher mean values for static balance (ẋ = 11.46) and grasping skills (ẋ = 10.21). The conclusion can be made that simulation whether informal, formal or in a group is beneficial to babies, but the baby must be ready for the specific stimulation. The success of informal stimulation depends on the parents’ knowledge and educational levels. Consequently the same results will not necessarily be achieved by parents that are from a less wealthy environment and that have fewer opportunities to obtain knowledge about the optimal stimulation of babies. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2011

Literature (Beck, 1986:96; Beaver & Brewster, 2002:132; Piaget et al., 2009:1) indicates that the first two years of a baby’s life is a critical period for development. This period is seen as windows of opportunity for development. There is still controversy in the literature regarding if baby stimulation helps babies to reach their neuro-motor development milestones faster, and which type of stimulation is the most advantageous, namely group stimulation or individual stimulation. The first objective of this study was to determine the effect of different methods of stimulation on the motor development of babies between the ages of 3 – 9 months, and secondly to determine what the effect of stimulation administered by a primary caregiver have on the motor development of babies between the ages of 3 – 9 months. A pretest-posttest design was used based on an available random sample where the effect of motor stimulation in different stimulation groups was tested. For objective 1 the babies (N=42) was divided into three different groups and exposed to informal stimulation (n=14), group stimulation as part of a day care program (n=15) and individual stimulation (n=13) administered by a primary caregiver. A nonstandardised checklist was designed by the researcher, refined in a pilot study and completed by the facilitators of the group and individual stimulation programs in which the content of the motor stimulation program was described. During the pretesting phase the babies were tested by the researcher in order to determine their motor milestone developmental status by means of the Peabody Developmental Motor Scales-2-measuring instrument (PDMS-2). This measuring instrument consists of five sub-scales that are converted to a gross motor, fine motor and total motor quotient. After applying the stimulation programs for 12 weeks on a daily basis in the group stimulation and the formal individual stimulation programs, the same aspects of the babies’ motor development was tested again by the PDMS-2. The results showed that after 3 – 9 months old babies were exposed to formal stimulation programs and the data was adjusted for age in months, gender, other activities and pretest results, they did not reach their neuro-motor developmental milestones faster than the babies that were exposed to informal stimulation. The results also show that babies that received individual stimulation administered by a primary caregiver did not reach their milestones faster than babies that only received informal stimulation. However, it seems that individual stimulation administered by a primary caregiver is more beneficial than group stimulation. For objective 2 the subjects (N=27) was divided into two groups and were exposed to informal stimulation (n=14) and individual stimulation (n=13) administered by a primary caregiver. A co-variance of analysis was used and effect sizes were determined for the differences that occurred. The results showed that 3 – 9 months old babies that were exposed to a formal stimulation program did not reach their neuro-motor development milestones faster than babies that were exposed to informal stimulation, because the informal stimulation groups achieved significant (d > 0.2) higher scores for the gross motor (d > 0.24), fine motor (d > 0.27) and total motor quotient (d > 0.33). Individual stimulation showed nonsignificant higher mean values for the reflex (ẋ = 10.30), locomotion (ẋ = 9.16) and visual-motor integration sub-scales (ẋ = 9.45), while informal stimulation showed higher mean values for static balance (ẋ = 11.46) and grasping skills (ẋ = 10.21). The conclusion can be made that simulation whether informal, formal or in a group is beneficial to babies, but the baby must be ready for the specific stimulation. The success of informal stimulation depends on the parents’ knowledge and educational levels. Consequently the same results will not necessarily be achieved by parents that are from a less wealthy environment and that have fewer opportunities to obtain knowledge about the optimal stimulation of babies. / Thesis (M.A. (Kinderkinetics))--North-West University, Potchefstroom Campus, 2011

Musculoskeletal complaints account for 15-30% of all patient visits to primary care physicians, yet many providers express a lack of confidence in their ability to perform a satisfactory musculoskeletal exam (Day and Yeh, 2008). Deficiencies in knowledge often stem from inadequate training during medical school or residency and continue as physicians become immersed in practice. Numerous researchers have called for improvement in the musculoskeletal education of medical students and residents. We suggest a novel curriculum-based upon the family medicine milestones that will assist educators and clinicians in developing competence and confidence in their knee and shoulder examinations and enhance the training of students and residents. Upon completion of this session, participants should be able to: Perform a complete examination of the knee and shoulder joints Implement the knee and shoulder exam musculoskeletal milestones in their practices or programs Present the knee and shoulder exams using visual, auditory, read/write, and kinesthetic modes.

In this workshop, the STFM Group on Musculoskeletal Education will facilitate participants incorporating the ACGME milestones into a musculoskeletal curriculum. Participants will submit prior to the workshop perceived barriers in implementing the milestones. During the workshop, participants will engage in a hands-on curriculum that promotes milestone progression in residents, including concepts such as self-learning and leadership while learning core musculoskeletal medicine concepts, such as shoulder/knee exams and concussion management. Participants will apply these skills while training to administer a SMART (Sideline Management Assessment Response Techniques) course and thus learn how to assess resident competence in providing medical coverage at sporting events where these key concepts and skills such as spinal immobilization are necessary. The workshop will conclude with a discussion on collaboration and methods that promote interdisciplinary education in musculoskeletal medicine. Objectives: After attending this workshop, participants will be able to: 1. Apply the ACGME milestones to key portions of a musculoskeletal curriculum, including joint exams, joint injections, casting/splinting, and sideline management 2. Reproduce hands-on skill stations in a residency setting, form the foundation for residency competence, and promote muscle memory in key musculoskeletal procedures. 3. Lead a SMART (Sideline Management Assessment Response Techniques) course in their residency setting.

No description available.

Computer applications can be described as largely rigid structures within which an information seeker must navigate in search of information - each screen, each transaction having underlying unique code. The larger the application, the higher the number of lines of code and the larger the size of the application executable. This study suggests an alternative pattern based approach, an approach driven by the information seeker. This alternative approach makes use of value embedded in intelligent patterns to assemble rules and logic constituents, numerous patterns aggregating to form a "virtual screen" based on the need of the information seeker. Once the information need is satisfied, the atomic rules and logic constituents dissipate and return to a base state. These same constituents are available, are reassembled and form the succeeding "virtual screen" to satisfy the following request. Metaphors are used to introduce current information solutions, where events are initiated and driven by physical constructs built using monolithic instruction sets. The metaphor approach is then expanded, illustrating how metaphors can be used to communicate an understanding between two likeminded intellects - this illustrates how spatial artifacts are used to carry intellectual value across the intellectual divide, from the one (intellectual source) to the other (intellectual target). At this point, the pattern based concept is introduced. This is where value, an intellectual appreciation hidden within spatiality, can be exploited towards the delivery of information. The pattern based approach makes use of multiple pattern "instances" to deliver functionality - each pattern instance has a specific embedded value. Numbers of these patterns aggregate to drive the formation of a "virtual screen" built using patterns, each pattern referencing and associating (physical) atomic logic and spatial constituents. This is analogous to painting a picture using removable dots. The dots can be used to describe a fish, and then, once appreciation has been completed, the image is destroyed and the dots are returned to the palette. These same dots can later be reapplied to present the picture of a dog, if that is requested by the information seeker. In both pictures the same "dots" are applied and reused. The form of the fish and dog are retained as value embedded within the patterns, the dots are building blocks aligned using instructions within the patterns. This study classifies existing application solutions as belonging to the Artifact-Pattern-Artifact (APA) group, and the pattern based approach belonging to the Pattern-Artifact-Pattern (PAP) group. An overview and the characteristics of each are presented. The document concludes by presenting the results obtained when using a prototype developed using the PAP approach. / Thesis (M.Sc. (Information Technology))--North-West University, Vaal Triangle Campus, 2008.