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BackgroundOpen-ended questions eliciting free-text comments have been widely adopted in surveys of patient experience. Analysis of free text comments can provide deeper or new insight, identify areas for action, and initiate further investigation. Also, they may be a promising way to progress from documentation of patient experience to achieving quality improvement. The usual methods of analyzing free-text comments are known to be time and resource intensive. To efficiently deal with a large amount of free-text, new methods of rapidly summarizing and characterizing the text are being explored. ObjectiveThe aim of this study was to investigate the feasibility of using freely available Web-based text processing tools (text clouds, distinctive word extraction, key words in context) for extracting useful information from large amounts of free-text commentary about patient experience, as an alternative to more resource intensive analytic methods. MethodsWe collected free-text responses to a broad, open-ended question on patients’ experience of primary care in a cross-sectional postal survey of patients recently consulting doctors in 25 English general practices. We encoded the responses to text files which were then uploaded to three Web-based textual processing tools. The tools we used were two text cloud creators: TagCrowd for unigrams, and Many Eyes for bigrams; and Voyant Tools, a Web-based reading tool that can extract distinctive words and perform Keyword in Context (KWIC) analysis. The association of patients’ experience scores with the occurrence of certain words was tested with logistic regression analysis. KWIC analysis was also performed to gain insight into the use of a significant word. ResultsIn total, 3426 free-text responses were received from 7721 patients (comment rate: 44.4%). The five most frequent words in the patients’ comments were “doctor”, “appointment”, “surgery”, “practice”, and “time”. The three most frequent two-word combinations were “reception staff”, “excellent service”, and “two weeks”. The regression analysis showed that the occurrence of the word “excellent” in the comments was significantly associated with a better patient experience (OR=1.96, 95%CI=1.63-2.34), while “rude” was significantly associated with a worse experience (OR=0.53, 95%CI=0.46-0.60). The KWIC results revealed that 49 of the 78 (63%) occurrences of the word “rude” in the comments were related to receptionists and 17(22%) were related to doctors. ConclusionsWeb-based text processing tools can extract useful information from free-text comments and the output may serve as a springboard for further investigation. Text clouds, distinctive words extraction and KWIC analysis show promise in quick evaluation of unstructured patient feedback. The results are easily understandable, but may require further probing such as KWIC analysis to establish the context. Future research should explore whether more sophisticated methods of textual analysis (eg, sentiment analysis, natural language processing) could add additional levels of understanding.

The objective of this study is to identify the factors which have a significant impact on the performance of students on an undergraduate accounting degree course. Previous research in this area has taken place over many years and has considered a number of factors which might influence performance such as: prior academic achievement, gender, age and numeracy. The findings of these studies have been quite mixed, perhaps reflecting differences in the institutions being considered, the courses analysed and the research methods adopted. This study follows a cohort of students who commenced an undergraduate accounting degree course at a UK University through to their graduation. It unites and tests all the key findings of the other previous studies in this area to determine the key factors affecting student performance. The results can inform universities in terms of their policies on admissions, teaching and retention and also inform students in deciding whether to apply for or continue with an accounting course. The results will also be of interest to academics delivering accounting courses and those with an interest in accounting education.

Processes for moderating assessments are much debated in higher education. The myriad approaches to the task vary in their demands on staff time and expertise, and also in how valid, reliable and fair to students they appear. Medical education, with its diverse range of assessments and assessors across clinical and academic domains presents additional challenges to moderation. The current review focuses on medical education, considering double-marking and benchmarking as two broad classes of moderation procedure, and argues that it is the process more than the type of procedure which is crucial for successful moderation. The advantages and disadvantages of each class of procedure are discussed in the light of our medical school's current practices, and with respect to the limited empirical evidence within medical education assessment. Consideration of implementation is central to ensuring valid and reliable moderation. The reliability of assessor judgements depends more on the consistency of assessment formats and the application of clear and agreed assessment criteria than on the moderation process itself. This article considers these factors in relation to their impact on the reliability of moderation, and aims to help assessors and students appreciate the diversity of these factors by facilitating their consideration in the assessment process.

This research contributes to helping educational establishments across the world develop self-efficacy techniques to improve communication skills within an accounting course design and other disciplines. This paper asks the research question: Does self-efficacy enhances accounting students' communication ability? Previous research has identified the business community requiring accountants to display high levels of communication ability. However, despite many deliberate pedagogical interventions over the years, communication skills are lacking in graduating accounting students. This paper describes a new approach of deliberate self-efficacy interventions in one UK university's undergraduate accounting curriculum to improve accounting students' communication ability. In addition, a self-efficacy framework of Stone and Bailey [(2007). Team conflict self-efficacy and outcome expectancy of business students. Journal of Education for Business, 82(5), 258–266. https://doi.org/10.3200/JOEB.82.5.258-266.] is developed to model communication self-efficacy, outcome expectancy and behavioral intentions of the students. The data consists of the results of 131 first-year accounting students, and this paper contributes by helping to pinpoint two self-efficacy techniques to improving students' communication skills: 'personal mastery' and 'mentor support'. [ABSTRACT FROM AUTHOR]

The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an important opportunity to examine applicants' reactions to acute stress. In the context of multi-station selection centres for recruitment to anaesthesia training programmes, we investigated the factors influencing candidates' pre-station challenge/threat evaluations and the extent to which their evaluations predicted subsequent station performance. Candidates evaluated the perceived stress of upcoming stations using a measure of challenge/threat evaluation--the cognitive appraisal ratio (CAR)--and consented to release their demographic details and station scores. Using regression analyses we determined which candidate and station factors predicted variation in the CAR and whether, after accounting for these factors, the CAR predicted candidate performance in the station. The CAR was affected by the nature of the station and candidate gender, but not age, ethnicity, country of training or clinical experience. Candidates perceived stations involving work related tasks as more threatening. After controlling for candidates' demographic and professional profiles, the CAR significantly predicted station performance: "challenge" evaluations were associated with better performance, though the effect was weak. Our selection centre model can help recruit prospective anaesthetists who are able to rise to the challenge of performing in stressful situations but results do not support the direct use of challenge/threat data for recruitment decisions.

The practice of medicine involves inherent ambiguity, arising from limitations of knowledge, diagnostic problems, complexities of treatment and outcome and unpredictability of patient response. Research into doctors' tolerance of ambiguity is hampered by poor conceptual clarity and inadequate measurement scales. We aimed to create and pilot a measurement scale for tolerance of ambiguity in medical students and junior doctors that addresses the limitations of existing scales. After defining tolerance of ambiguity, scale items were generated by literature review and expert consultation. Feedback on the draft scale was sought and incorporated. 411 medical students and 75 foundation doctors in Exeter, UK were asked to complete the scale. Psychometric analysis enabled further scale refinement and comparison of scale scores across subgroups. The pilot study achieved a 64% response rate. The final 29 item version of the Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale had good internal reliability (Cronbach's a 0.80). Tolerance of ambiguity was higher in foundation year 2 doctors than first, third and fourth year medical students (-5.23, P = 0.012; -5.98, P = 0.013; -4.62, P = 0.035, for each year group respectively). The TAMSAD scale offers a valid and reliable alternative to existing scales. Further work is required in different settings and in longitudinal studies but this study offers intriguing provisional insights.

Introduction: Multisource feedback (MSF) ratings provided by patients and colleagues are often poorly correlated with doctors' self-assessments. Doctors' reactions to feedback depend on its agreement with their own perceptions, but factors influencing self-other agreement in doctors' MSF ratings have received little attention. We aimed to identify the characteristics of doctors and their rater groups that affect self-other agreement in MSF ratings. Methods: We invited 2454 doctors to obtain patient and colleague feedback using the UK General Medical Council's MSF questionnaires and to self-assess on core items from both patient (PQ) and colleague (CQ) questionnaires. Correlations and differences between doctor, patient and colleague mean feedback scores were examined. Regression analyses identified the characteristics of doctors and their rater groups that influenced self-other score agreement. Results: 1065 (43%) doctors returned at least one questionnaire, of whom 773 (73%) provided self and patient PQ scores and 1026 (96%) provided self and colleague CQ scores. Most doctors rated themselves less favourably than they were rated by either their patients or their colleagues. This tendency to underrate performance in comparison to external feedback was influenced by the doctor's place of training, clinical specialty, ethnicity and the profile of his/her patient and colleague rater samples but, in contrast to studies undertaken in nonmedical settings, was unaffected by age or gender. Discussion: Self-other agreement in MSF ratings is influenced by characteristics of both raters and ratees. Managers, appraisers, and others responsible for interpreting and reviewing feedback results with the doctor need to be aware of these influences. (Contains 2 tables and 2 figures.)

The Prince's Teaching Institute (PTI), which has evolved out of the Summer Schools for English Literature and History which The Prince of Wales inaugurated in 2002, now provides a variety of courses in the major subjects of the secondary curriculum. In partnership with Cambridge University it enables teachers to update and extend their subject knowledge. At a time when the value of established subjects is being questioned by some educationists, PTI insists on the importance of established subjects for all pupils.

Objective. To evaluate the hematological and biochemistry profile of patients with or without HIV-TB at the Georgetown Chest Clinic, Guyana. Methods. An observational, laboratory based study was designed to assess the relationship of PTB and HIV with patients routine biochemical and hematological values. The study was conducted during the period January 2013 to December 2014; a total sample size of 316 patients was enrolled following exclusion and inclusion criteria. Results. Mean age of study population was 40.1 ± 13.8 (95% CI 38.6–41.7) and most were between 40 and 49 age group (27.8%, 95% CI 23.2–33.0). More males were in the study 74.4% (95% CI 69.3–78.8) than females 81% (95% CI 21.1–30.7). 30% (95% CI 25.3–35.3) had a sputum smear grade of 3+ and 62.5% (95% CI 47.0–75.7) showed a CD4 count