A feasibility study on a novel well-being intervention for university students.

OBJECTIVES: Challenging transitions, increased stress and mental ill health can affect students' academic performance and their capacity to remain in higher education. Prevention and early treatment of mental health problems in college students is therefore a key public health priority, nationally and internationally. Developing a range of evidence-based interventions targeting the mental health of students is critical. We examined the feasibility and acceptability of a new universal time use and well-being intervention, the 'Everyday Matters: Healthy Habits for University Life' digital badge (EMDB), a co-curricular micro-credential for first-year college students. METHODS: This study used a single-arm, pre-post design for first-year undergraduate students. The EMDB comprised eight 1-hour lunchtime sessions on brain development and time-use habits across the 24 hours of the day including sleep, self-care, leisure, study and work. Validated measures of occupational competence and value, mental well-being, sleep health, mindset, self-compassion and gratitude were completed, along with an evaluation questionnaire. RESULTS: Eight first-year undergraduate students completed the demographic questionnaire and pre- and post- measures, with one additional student completing only the evaluation questionnaire. There was significantly improved levels of well-being, self-compassion and growth mindset following the intervention. Many of the challenges reported by participants related to occupational issues such as managing finances and having a satisfying routine. Participants appreciated the practical relevance and scientific underpinnings of the programme content. The sense of belonging within the group and having insightful conversations with other group members were particularly valued by participants. CONCLUSIONS: This study offers preliminary evidence that an occupational therapy based universal time-use and well-being intervention was feasible to deliver and acceptable to first-year undergraduate students. The results of this study and the participant acceptability support further development and evaluation of the EMDB intervention.

Enhancing validity, reliability and participation in self-reported health outcome measurement for children and young people: a systematic review of recall period, response scale format, and administration modality.

INTRODUCTION: Self-report is the gold standard for measuring children's health-related outcomes. Design of such measures is complex and challenging. This review aims to systematically appraise the evidence on recall period, response scale format, mode of administration and approaches needed to enable children and young people < 19 years to participate in valid and reliable self-reporting of their health outcomes. METHOD: PsycInfo, Medline, CINAHL and Embase were searched from 1 January 1990 to 15 March 2020, and citation searching undertaken in Scopus. Articles were included if they were primary research or case reports of ≥ 3 participants reporting the following: recall period, response scale selection, administration modality. Quality was assessed using QualSyst, and results synthesised narratively. This review was conducted and reported according to PRISMA guidelines. RESULTS: 81 of 13,215 retrieved articles met the inclusion criteria. Children < 5 years old cannot validly and reliably self-report health outcomes. Face scales demonstrate better psychometric properties than visual analogue or Likert scales. Computerised and paper scales generally show equivalent construct validity. Children prefer computerised measures. Children ≤ 7 years old think dichotomously so need two response options. Those > 8 years old can reliably use a 3-point scale. CONCLUSION: The results of this review have both clinical and research implications. They can be used to inform appropriate choice of PROM for use with CYP in the clinical setting. We also give eight recommendations for future development of self-reported outcome measures for children and young people.

Parental alcohol intoxication and adverse health outcomes among offspring. A 4-year follow up HUNT study among 2399 Norwegian adolescents.

This study aimed to investigate whether experience of parental alcohol intoxication was associated with adverse health outcomes among adolescents four years later. A population-based Norwegian cohort study of 2399 adolescents who participated in the Young-HUNT1 Survey 1995-97 (T1, 13-15 years old) was followed up four years later (T2) in 2000 (Young-HUNT2, 17-19 years old). Measures were based on adolescent self-report of exposure to parental alcohol intoxication, self-rated general health, mental distress (SCL-5) and lifetime hospital admission. Multivariable logistic regression analyses, adjusted for gender, age and parental education were applied. Results show that half of the adolescents (51%) had seen parents intoxicated at age 13-15 years. Four years later, those who had reported parental alcohol intoxication at T1 had increased odds of admission to hospital with odds ratios ranging from OR1.3; CI 1.0-1.7 to OR 2.2; CI 1.3-3.9, poorer self-rated health (odds ratio ranging from 1.8;1.2-2.6 to 2.0;1.1-3.7) and more mental distress (odds ratio ranging from 1.7;1.1-2.5 to 1.9;1.0-3.6). Furthermore, the increased frequency of experience of parental alcohol intoxication are associated with higher prevalence of admission to hospital and mental distress and lower levels of self-rated health. Findings from this large, representative population of Norwegian adolescents indicate that adverse health outcomes among adolescents in a general population are related to relatively common heavy drinking behaviours among parents.

Progress testing in undergraduate dental education: the Peninsula experience and future opportunities.

BACKGROUND: Progress testing is well established as a longitudinal form of assessment in undergraduate medical programmes to measure growth in knowledge. Peninsula Dental School is the first school to use progress testing and remains the only one to do so. AIMS: To share the experience of developing progress testing in an undergraduate dental programme as a major summative assessment tool at a newly established dental school in the United Kingdom. METHODS: Data were collected for progress tests conducted from 2007 to 14. The tests were formative in the first 2 years of the programme and summative in subsequent years. Each test was based on 100 single best answer multiple-choice items with an appropriate vignette. The students chose their answer from 5 options. A score 1 mark is awarded for each correct answer, minus 0.25 for an incorrect answer and 0 for 'don't know' (DK). The standard setting for each sitting was carried out using Angoff and Hofstee methods. RESULTS: There were two tests per year with each cohort undertaking eight tests in their 4 years of study providing a total 14 test occasions. The reliability of each test for each student cohort tests was measured using Cronbach's alpha. The average reliability over 42 test/cohort combinations was 0.753 (±SD 0.08). Data analyses show growth in knowledge of dental students across successive years with the largest increase in knowledge observed between tests 1 and 5 and concomitant reduction in DK responses. CONCLUSION: This is the first study to report the establishment and use of progress testing as the principle form of written summative testing in an undergraduate dental curriculum. Progress testing is a valid and reliable tool to assess growth in knowledge longitudinally over the duration of a dental programme. Although a labour-intensive process, progress testing merits more widespread use in dental programmes.

Key Points to Facilitate the Adoption of Computer-Based Assessments.

There are strong pedagogical arguments in favor of adopting computer-based assessment. The risks of technical failure can be managed and are offset by improvements in cost-effectiveness and quality assurance capability. Academic, administrative, and technical leads at an appropriately senior level within an institution need to be identified, so that they can act as effective advocates. All stakeholder groups need to be represented in undertaking a detailed appraisal of requirements and shortlisting software based on core functionality, summative assessment life cycle needs, external compatibility, security, and usability. Any software that is a candidate for adoption should be trialed under simulated summative conditions, with all stakeholders having a voice in agreeing the optimum solution. Transfer to a new system should be carefully planned and communicated, with a programme of training established to maximize the success of adoption.

Use of peer assessment in tooth extraction competency.

INTRODUCTION: Peer assessment is a widely recognised practice in higher education and is being increasingly utilised in healthcare education. It offers multiple advantages and may play a useful role in enhancing students' learning experience. This study was carried out to evaluate the utility of peer assessment in tooth extraction competency in simulated dental learning environment (SDLE). METHODS: Year 2 dental students were invited to participate in a formative, peer assessment exercise on forceps tooth extraction in SDLE. The ratings made by peers in the formative assessment were compared with the ratings made by academic supervisors in an equivalent summative assessment. RESULTS: One hundred and twenty-two students participated in both the formative and summative assessments. Descriptive statistics demonstrated that the majority of students were given the same rating in both assessments. However, there were a number of students who were rated as 'Competent' in one assessment and 'Not Competent' in the other assessment. Spearman's Rho correlations showed that there were weak relationships between the formative and summative assessments. There was also weak inter-rater reliability for the ratings of the peers and academic supervisors, as measured by the intraclass correlation coefficient. Feedback from the students and academic supervisors showed unanimously positive perceptions about the peer assessment experience, and they expressed the desire for incorporating peer assessment in other competencies. CONCLUSIONS: This study shows mixed results with regard to the value of the peer assessment. Given the potential utility of peer assessment as a tool to augment and enrich students' learning experience, further work needs to be done to evaluate the use of peer assessment in operative competencies in dentistry.

Management of impacted wisdom teeth: teaching of undergraduate students in UK dental schools.

INTRODUCTION: Wisdom tooth removal is one of the most common oral surgical procedures performed across the world. The aim of this study was to gauge the teaching and training of impacted wisdom teeth in undergraduate dental programmes across the UK. The objectives were to identify consistencies and variations in theoretical instructions and clinical training as well as approaches to management of impacted wisdom teeth. METHODS: This was a cross-sectional survey utilising an online questionnaire. A purposefully designed pro forma with open- as well as closed-ended questions was used. The questionnaire was hosted online on the school's blackboard academic suite (Emily). Prior to conducting the study, approval was gained from the Research and Ethics Committee, and all the ethical principles pertaining to data protection were strictly followed. E-mail invitations were sent to oral surgery leads in all dental schools in the UK. The participants were provided with an information sheet, and an informed consent was obtained. The participants were invited by e-mail to complete the questionnaire online voluntarily. RESULTS: A total of 16 dental schools offering an undergraduate course in dentistry in the UK, 13 responded positively. (response rate = 81.25%). In majority of dental schools, this subject is taught in the 4th and 5th years. A pre-clinical competency on phantom heads is a requirement in six schools, whilst only one school requires the students to pass a clinical competency. The clinical exposure of students to wisdom tooth surgery is quite variable. Although the dental schools are fairly consistent in their teaching with regard to the indications for surgical intervention, diagnostic/treatment modalities as well as the post-operative care, interesting variations were also observed. CONCLUSIONS: This study, perhaps the first of its kind, provides useful insights into management of impacted wisdom teeth, as taught in the undergraduate dental programmes across the UK.

Academic environment in a newly established dental school with an enquiry-based curriculum: perceptions of students from the inaugural cohorts.

INTRODUCTION: Established in 2007, Peninsula Dental School offers a highly innovative, enquiry-based, student-led, patient-centred curriculum. It is one of the first dental schools in UK to be based exclusively in a primary care setting. This study was carried out to evaluate the academic environment at Peninsula Dental School and to identify differences between expectations of new entrants and perceptions of senior cohorts. METHODS: This was a cross-sectional survey utilising an online questionnaire based on Dundee Ready Educational Environment Measure (DREEM). The subjects were 234 dental students from all years in this enquiry-based Bachelor of Dental Surgery programme. RESULTS: The response rate to the questionnaire was 56.42% with an equal gender distribution of the participants. The overall mean DREEM score of the four cohorts was 143.58 (SD ± 20.84), and the mean score for individual items was 2.87 (SD ± 0.41). The reliability of the DREEM data as a whole was strong (α = 0.93). The difference in questionnaire means for the new entrants and the senior cohorts was not significant (P > 0.05). The ANOVA results showed that there were no significant effects of age, gender or ethnicity on the mean DREEM scores. The MANOVA results showed a significant effect of ethnicity with regard to perceptions of teachers and atmosphere. CONCLUSIONS: An enquiry-based, student-centred curriculum at the Peninsula Dental School provides a positive academic environment for the students.

Students' engagement with their group in a problem-based learning curriculum.

INTRODUCTION: In a new enquiry-based learning dental curriculum, problem-based learning (PBL) was chosen as a central methodology because it promotes a collaborative and constructive approach to learning. However, inevitably, some groups function worse than others. This study explores the relationship between group functionality and individuals' results on knowledge-based assessment. It also sought to establish whether using the Belbin team role theory could improve group functionality. METHODS: Students completed the Belbin team role inventory that assigns individuals to a team role type and were allocated to either an ideal Belbin group or a control group. To evaluate the functionality of the groups, Macgowan's group engagement measure was completed after 18 and 31 weeks for each student by their group facilitator. The scores were summed and averaged giving a group engagement score for each group. Relationships between group engagement, individual performance in assessment in weeks 18 and 31 and Belbin and non-Belbin teams were investigated. RESULTS: Individual group engagement scores and performance in the knowledge tests had a statistically significant positive relationship despite the small number of students involved (62). However, no correlation was shown between Belbin groups and group engagement scores. CONCLUSIONS: Those students who engaged most with the PBL process performed markedly better in assessments of knowledge. Using Belbin's team role theory to place students in PBL groups in an effort to increase group functionality had no effect when compared with non-Belbin control groups.

Evidence-informed dental student recruitment techniques.

The aim of the study described was to measure the performance of potential dental students in an evidence-based, objective, structured admission interview, and to compare that performance to student achievement in aptitude tests, tests of scientific knowledge, and tests of ability to apply knowledge to dentistry. A list of desirable attributes of dental professionals was drawn from the literature, omitting those which were considered to be learnt within the dental school curriculum. Possession of these attributes were then measured by objectively scoring responses to questions framed around a challenging clinical scenario. The interview scores were then correlated against student performance in an MCQ science for dentistry examination, an applied dental knowledge test, and the Graduate Australian Medical student aptitude test. The literature review revealed that sensitivity to others, professionalism, and ethical behaviour were deemed almost as important as academic and technical competency. Correlations of scores from an interview which sought to measure the attributes described in the literature with scores in scientific knowledge tests, aptitude tests and applied dental knowledge tests were low, and did not reach statistical significance. The results suggest that an interview process has been devised which measures the importance of characteristics not readily captured in more traditional selection strategies. Because the literature demonstrates that these characteristics are important to the public and the profession, this objective interview is a useful selection tool.

The lived experience of community mental health nurses working with people who have dual diagnosis: a phenomenological study.

Dual diagnosis (the combination of mental health and substance misuse problems) is a significant facing mental health nurses in the UK. The purpose of the study was to describe the lived experience of community mental health nurses working with people who have a dual diagnosis. A phenomenological approach was us and a purposive sample of seven community mental health nurses with experience of working with people with a dual diagnosis was selected. Data were collected through audiotaped, semi-structured interviews lasting approximately 1 h in duration and analysed using Colaizzi's (1978) method. Thirteen theme clusters relating to three major themes were identified: (1) difficulties in understanding the concept of dual diagnosis; (2) feeling deskilled when working with people who have a dual diagnosis; (3) struggling to work in a system which seeks to avoid people with dual diagnosis. Recommendations regarding the need for increased joint working between professionals, improved education and further research are made.

The impact of a practice development project on the quality of in-patient small group therapy.

In 1993 a mental health service in South-east England initiated a practice development project that aimed at continuously improving the quality of in-patient small group therapy provided within its four acute wards. From the outset it was intended that the project and the practice it focused on should be robust and research based. In support of this an evaluative study was carried out in 1998. The evaluation covered a 6-month period and coincided with concerns being reported elsewhere about the adequacy of therapeutic activity within acute psychiatric settings across the country. Data collected for the evaluation focused on the quality dimensions of effectiveness, relevance to need, social acceptability, accessibility, efficiency and economy, and equity. Quantitative and qualitative methods were deployed and data were collected at three points in time over the evaluation period to provide a picture of change within each ward. The quantitative data gathered were mainly obtained through two self-report questionnaires that were developed specifically for the study. Both instruments were tested and found to have a high degree of internal consistency. The qualitative data gathered were collected using semistructured interviews. Analysis of the qualitative and quantitative data sets indicated that practice quality diminished rather than improved during the 6-month study period. Factors that emerged from the data as having influenced this outcome were: increases in ward team's overall workload, inadequate staffing levels and changes in expectations placed on those providing small group therapy. The findings are consistent with a national trend of deteriorating quality in in-patient care and point to some of the limitations of action learning as a practice development method. They also point to service factors that work against effective practice development.

Von Wille-brand's disease in UK dobermanns: possible correlation of a polymorphic DNA marker with disease status.

Ninety-one dobermanns have been typed for a polymorphic microsatellite DNA marker situated within an intron of the von Willebrand factor gene and the alleles correlated with von Wille-brand's disease status. Two alleles were identified, one associated only with the normal gene and the other with both normal and disease genes.

Vitamin K-dependent coagulopathy in a British Devon rex cat.

Deficiencies of the vitamin K-dependent coagulation factors were identified in a Devon rex cat which had bled after castration. Haemorrhage was controlled by plasma transfusion. Clotting times were normalised by oral administration of vitamin K. This report confirms the existence of this bleeding disorder in a Devon rex cat in the United Kingdom.

Student nurse appraisal of placement (SNAP): an attempt to provide objective measures of the learning environment based on qualitative and quantitative evaluations.

Many nurse researchers have emphasised the importance of good clinical learning environments for student nurses. However, there is less emphasis on how measures of the learning environment can be communicated clearly and objectively to educationalists and clinical staff. This paper attempts to show how the findings of a self-administered student nurse appraisal of placement (SNAP) form can be presented in both qualitative and quantitative terms. A questionnaire was specially designed to provide objective and valid feedback from students, and the learning environments of three wards were compared.