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Guan Hui Tricia Lim, Ritika Devendra Gera, Fady Hany Kamel, Vikram Ajit Rajan Thirupathirajan, Somar Albani, Rima Chakrabarti UCL Medical School, University College London, London, UKCorrespondence: Rima Chakrabarti, Email r.chakrabarti@ucl.ac.ukBackground: Feedback collated at University College London Medical School (UCLMS) during the COVID pandemic identified how many students felt unprepared for their summative Objective Structured Clinical Examinations (OSCEs) despite attending mock face-to-face OSCEs. The aim of this study was to explore the role of virtual mock OSCES for improving student’s sense of preparedness and confidence levels for their summative OSCEs.Methods: All Year 5 students (n=354) were eligible to participate in the virtual mock OSCEs and were sent a pre- and post-survey for completion. Hosted on Zoom in June 2021, each circuit comprised six stations, assessing history taking and communication skills only, in Care of the Older Person, Dermatology, Gynaecology, Paediatrics, Psychiatry and Urology.Results: Two hundred and sixty-six Year 5 students (n=354) participated in the virtual mock OSCEs, with 84 (32%) students completing both surveys. While a statistically significant increase in preparedness was demonstrated, there was no difference in overall confidence levels. In contrast, between specialties, a statistically significant increase in confidence levels was seen in all specialties barring Psychiatry. Despite half of the participants highlighting how the format did not sufficiently represent the summative OSCEs, all expressed interest in having virtual mock OSCEs incorporated into the undergraduate programme.Conclusion: The findings of this study suggest that virtual mock OSCEs have a role in preparing medical students for their summative exams. While this was not reflected in their overall confidence levels, this may be due to a lack of clinical exposure and higher anxiety levels among this cohort of students. Although virtual OSCEs cannot replicate the “in-person” experience, considering the logistical advantages, further research is required on how these sessions can be developed, to support the traditional format of face-to-face mock OSCEs within the undergraduate programme.Keywords: virtual mock OSCEs, undergraduate medical education, history taking & communication skills

Changing climate conditions affect dust emissions and the global dust cycle, which in turn affects climate and biogeochemistry. In this study we use observationally constrained model reconstructions of the global dust cycle since the Last Glacial Maximum, combined with different simplified assumptions of atmospheric and sea ice processing of dust-borne iron, to provide estimates of soluble iron deposition to the oceans. For different climate conditions, we discuss uncertainties in model-based estimates of atmospheric processing and dust deposition to key oceanic regions, highlighting the large degree of uncertainty of this important variable for ocean biogeochemistry and the global carbon cycle. We also show the role of sea ice acting as a time buffer and processing agent, which results in a delayed and pulse-like soluble iron release into the ocean during the melting season, with monthly peaks up to ~17 Gg/month released into the Southern Oceans during the Last Glacial Maximum (LGM).

Trace element deposition from desert dust has important impacts on ocean primary productivity, the quantification of which could be useful in determining the magnitude and sign of the biogeochemical feedback on radiative forcing. However, the impact of elemental deposition to remote ocean regions is not well understood and is not currently included in global climate models. In this study, emission inventories for eight elements primarily of soil origin, Mg, P, Ca, Mn, Fe, K, Al, and Si are determined based on a global mineral data set and a soil data set. The resulting elemental fractions are used to drive the desert dust model in the Community Earth System Model (CESM) in order to simulate the elemental concentrations of atmospheric dust. Spatial variability of mineral dust elemental fractions is evident on a global scale, particularly for Ca. Simulations of global variations in the Ca / Al ratio, which typically range from around 0.1 to 5.0 in soils, are consistent with observations, suggesting that this ratio is a good signature for dust source regions. The simulated variable fractions of chemical elements are sufficiently different; estimates of deposition should include elemental variations, especially for Ca, Al and Fe. The model results have been evaluated with observations of elemental aerosol concentrations from desert regions and dust events in non-dust regions, providing insights into uncertainties in the modeling approach. The ratios between modeled and observed elemental fractions range from 0.7 to 1.6, except for Mg and Mn (3.4 and 3.5, respectively). Using the soil database improves the correspondence of the spatial heterogeneity in the modeling of several elements (Ca, Al and Fe) compared to observations. Total and soluble dust element fluxes to different ocean basins and ice sheet regions have been estimated, based on the model results. The annual inputs of soluble Mg, P, Ca, Mn, Fe and K associated with dust using the mineral data set are 0.30 Tg, 16.89 Gg, 1.32 Tg, 22.84 Gg, 0.068 Tg, and 0.15 Tg to global oceans and ice sheets.

Aerosol-climate interactions constitute one of the major sources of uncertainty in assessing changes in aerosol forcing in the anthropocene as well as understanding glacial-interglacial cycles. Here we focus on improving the representation of mineral dust in the Community Atmosphere Model and assessing the impacts of the improvements in terms of direct effects on the radiative balance of the atmosphere. We simulated the dust cycle using different parameterization sets for dust emission, size distribution, and optical properties. Comparing the results of these simulations with observations of concentration, deposition, and aerosol optical depth allows us to refine the representation of the dust cycle and its climate impacts. We propose a tuning method for dust parameterizations to allow the dust module to work across the wide variety of parameter settings which can be used within the Community Atmosphere Model. Our results include a better representation of the dust cycle, most notably for the improved size distribution. The estimated net top of atmosphere direct dust radiative forcing is -0.23 ± 0.14 W/m2 for present day and -0.32 ± 0.20 W/m2 at the Last Glacial Maximum. From our study and sensitivity tests, we also derive some general relevant findings, supporting the concept that the magnitude of the modeled dust cycle is sensitive to the observational data sets and size distribution chosen to constrain the model as well as the meteorological forcing data, even within the same modeling framework, and that the direct radiative forcing of dust is strongly sensitive to the optical properties and size distribution used.

The mineralogy of desert dust is important due to its effect on radiation, clouds and biogeochemical cycling of trace nutrients. This study presents the simulation of dust radiative forcing as a function of both mineral composition and size at the global scale, using mineral soil maps for estimating emissions. Externally mixed mineral aerosols in the bulk aerosol module in the Community Atmosphere Model version 4 (CAM4) and internally mixed mineral aerosols in the modal aerosol module in the Community Atmosphere Model version 5.1 (CAM5) embedded in the Community Earth System Model version 1.0.5 (CESM) are speciated into common mineral components in place of total dust. The simulations with mineralogy are compared to available observations of mineral atmospheric distribution and deposition along with observations of clear-sky radiative forcing efficiency. Based on these simulations, we estimate the all-sky direct radiative forcing at the top of the atmosphere as + 0.05 Wm−2 for both CAM4 and CAM5 simulations with mineralogy. We compare this to the radiative forcing from simulations of dust in release versions of CAM4 and CAM5 (+0.08 and +0.17 Wm−2) and of dust with optimized optical properties, wet scavenging and particle size distribution in CAM4 and CAM5, −0.05 and −0.17 Wm−2, respectively. The ability to correctly include the mineralogy of dust in climate models is hindered by its spatial and temporal variability as well as insufficient global in situ observations, incomplete and uncertain source mineralogies and the uncertainties associated with data retrieved from remote sensing methods.

The mineralogy of desert dust is important due to its effect on radiation, clouds and biogeochemical cycling of trace nutrients. This study presents the simulation of dust radiative forcing as a function of both mineral composition and size at the global scale, using mineral soil maps for estimating emissions. Externally mixed mineral aerosols in the bulk aerosol module in the Community Atmosphere Model version 4 (CAM4) and internally mixed mineral aerosols in the modal aerosol module in the Community Atmosphere Model version 5.1 (CAM5) embedded in the Community Earth System Model version 1.0.5 (CESM) are speciated into common mineral components in place of total dust. The simulations with mineralogy are compared to available observations of mineral atmospheric distribution and deposition along with observations of clear-sky radiative forcing efficiency. Based on these simulations, we estimate the all-sky direct radiative forcing at the top of the atmosphere as + 0.05 Wm-2 for both CAM4 and CAM5 simulations with mineralogy. We compare this to the radiative forcing from simulations of dust in release versions of CAM4 and CAM5 (+0.08 and +0.17 Wm-2) and of dust with optimized optical properties, wet scavenging and particle size distribution in CAM4 and CAM5, -0.05 and -0.17 Wm-2, respectively. The ability to correctly include the mineralogy of dust in climate models is hindered by its spatial and temporal variability as well as insufficient global in situ observations, incomplete and uncertain source mineralogies and the uncertainties associated with data retrieved from remote sensing methods.

The complex nature of mineral dust aerosol emission makes it a difficult process to represent accurately in weather and climate models. Indeed, results in the companion paper indicate that many large-scale models underestimate the dust flux's sensitivity to the soil's threshold friction velocity for erosion. We hypothesize that this finding explains why many dust cycle simulations are improved by using an empirical dust source function that shifts emissions towards the world's most erodible regions. Here, we both test this hypothesis and evaluate the performance of the new dust emission parameterization presented in the companion paper. We do so by implementing the new emission scheme into the Community Earth System Model (CESM) and comparing the resulting dust cycle simulations against an array of measurements. We find that the new scheme shifts emissions towards the world's most erodible regions in a manner that is strikingly similar to the effect of implementing a widely used source function based on satellite observations of dust source regions. Furthermore, model comparisons against aerosol optical depth measurements show that the new physically based scheme produces a statistically significant improvement in CESM's representation of dust emission, which exceeds the improvement produced by implementing a source function. These results indicate that the need to use an empirical source function is eliminated, at least in CESM, by the additional physics in the new scheme, and in particular by its increased sensitivity to the soil's threshold friction velocity. Since the threshold friction velocity is affected by climate changes, our results further suggest that many large-scale models underestimate the global dust cycle's climate sensitivity.

Aerosol-climate interactions constitute one of the major sources of uncertainty in assessing changes in aerosol forcing in the anthropocene as well as understanding glacial-interglacial cycles. Here we focus on improving the representation of mineral dust in the Community Atmosphere Model and assessing the impacts of the improvements in terms of direct effects on the radiative balance of the atmosphere. We simulated the dust cycle using different parameterization sets for dust emission, size distribution, and optical properties. Comparing the results of these simulations with observations of concentration, deposition, and aerosol optical depth allows us to refine the representation of the dust cycle and its climate impacts. We propose a tuning method for dust parameterizations to allow the dust module to work across the wide variety of parameter settings which can be used within the Community Atmosphere Model. Our results include a better representation of the dust cycle, most notably for the improved size distribution. The estimated net top of atmosphere direct dust radiative forcing is -0.23 ± 0.14 W/m2 for present day and -0.32 ± 0.20 W/m2 at the Last Glacial Maximum. From our study and sensitivity tests, we also derive some general relevant findings, supporting the concept that the magnitude of the modeled dust cycle is sensitive to the observational data sets and size distribution chosen to constrain the model as well as the meteorological forcing data, even within the same modeling framework, and that the direct radiative forcing of dust is strongly sensitive to the optical properties and size distribution used.

The global cycle of desert dust aerosols responds strongly to climate and human perturbations, and, in turn, impacts climate and biogeochemistry. Here we focus on desert dust size distributions, how these are characterized, emitted from the surface, evolve in the atmosphere, and impact climate and biogeochemistry. Observations, theory and global model results are synthesized to highlight the evolution and impact of dust sizes. Individual particles sizes are, to a large extent, set by the soil properties and the mobilization process. The lifetime of different particle sizes controls the evolution of the size distribution as the particles move downwind, as larger particles fall out more quickly. The dust size distribution strongly controls the radiative impact of the aerosols, as well as their interactions with clouds. The size of particles controls how far downwind they travel, and thus their ability to impact biogeochemistry downwind of the source region. © 2013 The Authors.

Desert dust perturbs climate by directly and indirectly interacting with incoming solar and outgoing long wave radiation, thereby changing precipitation and temperature, in addition to modifying ocean and land biogeochemistry. While we know that desert dust is sensitive to perturbations in climate and human land use, previous studies have been unable to determine whether humans were increasing or decreasing desert dust in the global average. Here we present observational estimates of desert dust based on paleodata proxies showing a doubling of desert dust during the 20th century over much, but not all the globe. Large uncertainties remain in estimates of desert dust variability over 20th century due to limited data. Using these observational estimates of desert dust change in combination with ocean, atmosphere and land models, we calculate the net radiative effect of these observed changes (top of atmosphere) over the 20th century to be −0.14 ± 0.11 W/m2 (1990–1999 vs. 1905–1914). The estimated radiative change due to dust is especially strong between the heavily loaded 1980–1989 and the less heavily loaded 1955–1964 time periods (−0.57 ± 0.46 W/m2), which model simulations suggest may have reduced the rate of temperature increase between these time periods by 0.11 °C. Model simulations also indicate strong regional shifts in precipitation and temperature from desert dust changes, causing 6 ppm (12 PgC) reduction in model carbon uptake by the terrestrial biosphere over the 20th century. Desert dust carries iron, an important micronutrient for ocean biogeochemistry that can modulate ocean carbon storage; here we show that dust deposition trends increase ocean productivity by an estimated 6% over the 20th century, drawing down an additional 4 ppm (8 PgC) of carbon dioxide into the oceans. Thus, perturbations to desert dust over the 20th century inferred from observations are potentially important for climate and biogeochemistry, and our understanding of these changes and their impacts should continue to be refined.