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Undergraduate students have been shown to spontaneously form communities of practice and social networks that support their learning and identity development. This study considers the translation of this participatory learning into professional employment following graduation. Thirteen former biological sciences students from a single UK university were interviewed following their successful transition into graduate level scientific employment. A thematic analysis of the interview transcripts revealed that these students did not learn new workplace practices from more experienced peers "de novo," rather they negotiated changes to their existing university practices and hence were able to participate as newcomers to the joint enterprise of their workplace community of practice. Hence, students' capacity for "know how" and "know who" knowledge has important implications for their employability, and this should be encouraged by maximising students' exposure to co-participatory learning both within the university and in collaboration with local community projects.

Background: Proper diagnosis in primary care is crucial due to the large number of skin cancer diagnoses each year and its associated growing economic burden. Understanding how primary care providers can be best trained in dermoscopy is instrumental in helping primary care providers differentiate benign and malignant cutaneous lesions so that appropriate action can be taken (eg, biopsy/referral to dermatology or reassurance). Objective: To assess the success of concise dermoscopy training among primary care providers. Design: A cohort study was conducted in primary care at Mayo Clinic, Rochester, including primary care physicians, nurse practitioners, and physician assistants in internal medicine and family medicine. Diagnostic accuracy was measured on standardized testing through image-based recognition and in clinical practice through observation of referral and biopsy patterns both before and after dermoscopy education, focused on the TADA plus method. Results: Forty-three primary care providers completed the image-based recognition tests, with significant improvement in mean score measured after dermoscopy training workshop (20%). Among the thirteen primary care providers who continued to use dermoscopy in clinical practice, a significant improvement (31%) in mean clinical diagnostic accuracy was observed comparing 1 year of practice data before versus after dermoscopy training. Conclusion: Improvement in diagnostic accuracy with utilization of the TADA plus method translates into clinical practice. Therefore, training primary care providers in dermoscopy may improve the dermatologic care patients receive in primary care, especially in rural or medically underserved areas where access to dermatology is limited. [ABSTRACT FROM AUTHOR]

Our work concerned the socio-cultural practices of tutors from diverse higher education institutes. The tutors were practising lecturers who had contributed to peer assessment studies published in refereed academic journals. Analysis of interview data considered the relational interdependency of tutors' and students' activity in the socially and culturally structured world of peer assessment. Undertaking peer assessment led to changes in: (1) relational learning between tutors and students, and (2) tutors' and students' perceived identities. The findings are discussed in terms of: (a) learning in communities of practice through boundary interactions with other communities, and (b) the participatory and acquisition metaphors of learning. The wider role of peer assessment in terms of interactions, communications and the balance of learning metaphors in higher education is considered.

This article uses situated learning theory to consider current tutor assessment and feedback practices in relation to learning practices employed by students outside the overt curriculum. The case is made that an emphasis on constructive alignment and explicitly articulating assessment requirements within curricula may be misplaced. Outside of the overt curriculum students appear to be interdependent learners, participating in communities of practice and learning networks, where sense-making occurs through negotiation and there is identity development. Such negotiation may translate curriculum requirements articulated by tutors into unexpected meanings. Hence, tutors' efforts might be better placed on developing students' ability to self-assess and to effectively evaluate and negotiate information, rather than primarily on their own delivery of the curriculum content and feedback. Tutors cannot be fully effective if they fail to consider students' learning outside the overt curriculum, and ways to facilitate such learning processes are suggested together with future research directions.

Context: Integral to the location of health resources is the distance decay of utilization observed in a population. In rural Peru, a nongovernmental organization planning to increase the availability of health services needed this information. Purpose: To determine variables associated with utilization of a central medical clinic and determine whether, because of the mountainous topography, travel time (TT) would be a better predictor of utilization than distance. Methods: A door-to-door survey of all available households (81% of total), using a Spanish translation of questions excerpted from the Behavioral Risk Factor Surveillance System Survey, was conducted in the summer of 2008 to determine variables associated with self-reported history of clinic utilization. Results: Utilization was inversely related to TT and distance. Of those living within 5 minutes of the clinic, 61% had been to the clinic whereas only 25% of those living 30 or more minutes away had sought care. Female gender and fever predicted increased odds of clinic utilization. Having a disability reduced one's odds (OR 0.55) of visiting the clinic, after adjusting for gender, TT, and fever. The inverse correlation of utilization with travel distance and TT was not significantly different, thus failing to demonstrate that TT is a better predictor of utilization than distance. Conclusion: In health service planning, care for common conditions should be available within 5 minutes' TT or a few kilometers' distance from each person's home in order to improve health care access and reduce health care disparities worsened by disability.

Tutors' intentions when providing feedback may not be accurately perceived and acted on by students. In this study, 19 biological sciences students and six tutors were interviewed concerning the tutor's intentions when providing specific feedback and the students' perceptions and usage of that feedback. A phenomenological approach was used to analyse the interview data. Additionally, copies of the documented feedback were examined and the feedback style was classified. Student conceptions of the role of feedback included providing guidance, identifying what the tutor wants and giving meaning to the work to develop learning. Analysis of tutor feedback styles indicates that tutors were focussed on giving praise and correcting misunderstandings in the present assignment. Since developmental aspects of students' learning were rarely addressed in tutor feedback, these findings suggest some misalignment in feedback provision. Tutors need to provide more guidance to students regarding the use of feedback, possibly by introducing better scaffolding and variation into their feedback. (Contains 2 tables.)

Context: Risks for poor self-rated overall health in rural areas of developing nations have not been thoroughly investigated. Purpose: The objective of this study was to assess potential risk factors for poor self-rated health among rural villagers in Peru. Methods: A door-to-door survey of villagers residing in the Pampas Grande region in Peru, which is in the Andes Mountains, yielded complete data for 337 adults. Findings: Adjusting for age and gender using multiple logistic regression analysis revealed that having self-reported disabilities was inversely and independently related to good self-rated health (OR 0.48 [95% CI, 0.26-0.88]). Joint pain also was related to self-rated health (OR 0.23 [95% CI, 0.13-0.41]). Conclusions: Increasing access to affordable, effective analgesics may reduce this disparity. Health agencies should consider these actions as possible planning priorities for the region.

This study explores students' attitudes to the provision of formative feedback on academic work using audio files together with the ways in which students implement such feedback within their learning. Fifteen students received audio file feedback on written work and were subsequently interviewed regarding their utilisation of that feedback within their learning. The written work provided by twelve of the students was also conventionally marked and this feedback was quantitatively compared with the audio feedback comments following classification of individual comments. The students responded very positively to the audio file feedback judging it to be good quality because it was easier to understand, had more depth and was more personal. Most students annotated their work as they listened and stated that they would use the audio feedback to improve their work for other tutors. Pitfalls of this form of feedback included the large size of the audio files (up to 11Mb) being incompatible with some e-mail systems. Comment classification showed a greater emphasis on developmental aspects of learning within audio file feedback. Guidance is provided for tutors concerning the effective use of audio file feedback. As feedback is integral to all learning this project has wide applicability across the disciplines. (Contains 1 figure.)

Learning outcomes are statements of intended learning within a module. In practice, students may consider various options when undertaking assessments. They may feel they can meet the stated learning outcomes by demonstrating other aspects of study which are termed "distractions." Thirty-three undergraduate students' constructed scientific posters and completed questionnaires prior to and on the day of poster submission. Additionally, ten of these students were interviewed. Analysis of questionnaire data using principle components analysis and interview data by clustering units of relevant meaning revealed that students did not differentiate between learning outcomes and distractions, both of which steered their learning during the assessment. These results are discussed within the context of assessment tasks and implications for practice.

Ramaprasad (1983) defined feedback as information about the gap between actual performance level and the reference level, which is subsequently used to alter that gap. Feedback, therefore, needs to be meaningful, understood and correctly acted upon. Tutors not only have to give feedback; they should really evaluate how effective their feedback has been. This study reports the findings of semi-structured interviews with third year biology students on their utilization of tutor feedback. We show that students use feedback in six ways. Four specific uses were (a) to enhance motivation; (b) to enhance learning; (c) to encourage reflection; and (d) to clarify understanding. Two further forms of usage were, firstly, to enrich their learning environment and, secondly, to engage in mechanistic enquiries into their study. The findings are discussed in the context of current literature and specific recommendations are given as to how the impact of tutors' feedback could be enhanced.

Students' perceptions of their skills development and the overall value of their undergraduate project work were evaluated using data derived from questionnaires. Thirty-nine students completing their second year of study (i.e. prior to the commencement of project work) and 42 students completing their third-year project work took part. Thirteen tutors also completed questionnaires. They were asked to give their perceptions as to what skills project students developed and what attributes of project work enhanced both students' personal development and students' assessment grades. Results showed a shift in students' perceptions of the types of skills reinforced, developed and assessed within project work during the course of their third-year project. Their perceived views did not fully coincide with tutors' perceptions of student skills development, although evaluation of both the assessment and personal importance of particular aspects of project work showed some interesting relationships between students and tutors. The diversity of opinion shown in these results may be due to lack of clarification of assessment criteria rather than a "hidden curriculum". For example, the distinction between presentation of work and scientific writing may not be clear from an initial reading of the criteria. The outcomes of this study, with particular reference to the relationship between scientific writing and thinking, have implications regarding tutor and student discussion, the development of marking criteria and the use of plenary project support sessions. (Contains 3 figures and 4 tables.)

This paper reports a study designed to enhance students' ability to implement assessment marking criteria and to develop the role of dialogue in student learning. Pairs or trios of undergraduate biology students were asked to complete a poster on the theme of histology using student/tutor-constructed marking criteria. The study showed: (1) students can effectively implement a variety of marking criteria after formative discussion with tutors and peers; (2) there is a distinction between students being able to implement marking criteria and being able to transfer that understanding of marking criteria to written comments; and (3) formative assessment models allow discussion to focus on student learning and for feedback to be given within the same or different modules or courses. The study supports previous work which showed peer and self-assessment are extremely useful in helping students reach their learning goals.

Examined a method of student self- and peer assessment involving student construction of grading criteria using exemplars. Found that the use of exemplars can help students demonstrate greater understanding of both grading criteria and subject standards, and that the use of exemplars forms a focus for meaningful formative feedback. (EV)

Compared student self and tutor, student self and peer, and student and tutor grading using student constructed or tutor provided grading criteria at a British university for a total of 85 first-year biology students. Findings suggest that allowing students to construct their own grading criteria may lead to different learning outcomes compared to having marking criteria imposed on them. (Author/DB)

Reports on a study of a student self-assessment method in college biology, comparing students' self-evaluation, students' peer evaluation, and the teacher's evaluation criteria. Results illustrate potential problems in making assumptions about student ability to self-evaluate but also support previous findings about the instructional usefulness of self-evaluation. (Author/MSE)

OBJECTIVE: To examine the educational benefits of international elective rotations during graduate medical education. PARTICIPANTS AND METHODS: We studied Mayo International Health Program (MIHP) participants from April 1, 2001, through [...]

A study was conducted to examine patients' preferences for the collection of bodily fluids. Patients' preferences for the collection of saliva, blood, and urine were assessed. Findings indicate that patients regarded the donation of saliva as more comfortable and convenient than that of urine or blood at the doctor's office. It was reported that saliva and urine are the easiest to collect at home.