Annotation is a valuable tool to enhance learning and assessment in student essays.

UNLABELLED: As a United Kingdom (UK) wide organisation, the Quality Assurance Agencies ensure that best standards in higher education are reached. Following an institutional audit within a UK University, it was recommended that annotation be introduced to promote good practice in the management and implementation of giving feedback to students on assessed work. Annotation is a handwritten comment or mark written directly onto the page of the students' script. METHODS: A review of current literature, policy and practice in relation to annotation. Random sample of student scripts analysed for versions of annotation such as content, difference, length, approach and clarity. Questionnaires distributed to staff (n=74) and students n=249), analysed using SPSS and thematic analysis. OUTCOMES: For both staff and students, interpretations of annotation in terms of transparency of style and legibility were an issue. Both respondents agreed or strongly agreed that annotation enhances a student-centered approach to learning. For the student sample, there was an agreement or strong agreement that annotation helped inform the next assignment (82.2%). There was a recognition that annotation can convey a tone and the student survey indicated that the tone of some annotation undermines confidence. Findings show annotation is considered important by students but is different from other forms of feedback. Because annotation is written on the page it requires greater sensitivity towards students' work. Recommendations disseminate findings to develop health professional education. DISCUSSION: The annotator's presence can influence the student's interaction with their script causing them to evaluate their original writing differently. Ramage and Bean [Ramage, J.D., Bean, J.C., 1995. Writing Arguments, third ed. Allyn and Bacon, Needham Heights, MA.], use two different annotated versions of the same essay to model and contrast ''reading as a believer" and ''reading as a doubter" (cited in Wolfe [Wolfe, J.L., 2002. Marginal pedagogy: how annotated texts affects writing-from-source text. Written Communication 19 (2), 297-333.]). Multiple readings can be made of one text, but how the essay is read by the lecturer has the greater impact on the student. Annotation defies any stable definition precisely because it can be practiced in so many ways. It is vital that annotation is used and received appropriately so that negative effects of annotation are minimised and the positive effects emphasised. There are a number of ways of improving annotation, and good practice guidelines are offered in the conclusion to this paper.

Baptism of fire: New Brunswick's public health movement and the 1918 influenza epidemic.

In the fall of 1918 when war-weary New Brunswickers were hit by the influenza pandemic, theirs was the only Canadian province with a Minister of Health, the first to be appointed anywhere in the British Empire. But it was a new position and a controversial one. This paper traces the growth of a public health movement in New Brunswick in the late 19th and early 20th centuries, the campaign for the establishment of a provincial Department of Health, and the role played by the 1918 influenza epidemic in legitimizing and consolidating the newly minted Department, masthead of the public health movement.

Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department.

This study examined the emergency nurse practitioner candidate (ENPC) scope of practice in a Victorian emergency department (ED). The emergency nurse practitioner (ENP) role is relatively new in Victoria and the scope of the ENP(C) practice is yet to be defined. International research literature regarding the ENP role has focused on outcomes such as patient satisfaction, waiting times and/or ED length of stay, accuracy and adequacy of documentation, use of radiography, and patient education, health promotion and communication issues. A prospective exploratory design was used to conduct this cohort study. There were 476 ENPC-managed patients between 14 July 2004 and 31 March 2005 with an average age of 29 years. The majority (77.2%) of ENPC-managed patients were discharged from the ED. The majority of the ENPC time was devoted to clinical practice (55%) and development of clinical practice guidelines (25%). Of patients managed by the ENPC, 49.6% required medications, 51% required diagnostic imaging and 8.6% required pathology testing during their ED stay. The most common discharge referrals were made to local medical officers (73.5%) and the most common referrals made for patients requiring admission were made to the plastic surgery (37.3%) and orthopaedic (35.5%) units. Extensions to the current scope of emergency nursing practice are pivotal to effective management of specific patient groups by ENP. The ENP model of care is an important strategy for the management of increased service demands in Victoria; however, little is known about the scope of the ENPC practice and many outcomes of the ENP care are yet to be defined. Further research to better understand the relationships between ENP outcomes is required if the contribution that ENPs make to emergency care is to be accurately quantified.

Emergency nurse practitioner care and emergency department patient flow: case-control study.

OBJECTIVE: The present study aimed to compare ED waiting times (for medical assessment and treatment), treatment times and length of stay (LOS) for patients managed by an emergency nurse practitioner candidate (ENPC) with patients managed via traditional ED care. METHODS: A case-control design was used. Patients were selected using the three most common ED discharge diagnoses for ENPC managed patients: hand/wrist wounds, hand/wrist fractures and removal of plaster of Paris. The ENPC group (n = 102) consisted of patients managed by the ENPC who had ED discharge diagnoses as mentioned above. The control group (n = 623) consisted of patients with the same ED discharge diagnoses who were managed via traditional ED care. RESULTS: There were no significant differences in median waiting times, treatment times and ED LOS between ENPC managed patients and patients managed via traditional ED processes. There appeared to be some variability between diagnostic subgroups in terms of treatment times and ED LOS. CONCLUSION: Patient flow outcomes for ENPC managed patients are comparable with those of patients managed via usual ED processes.