-
Healthcare Policy = Politiques de Sante May 2021This paper reports the quantitative component of a mixed-methods study of patient flow in the 10 urban health regions/zones of Western Canada. We assessed whether...
PURPOSE
This paper reports the quantitative component of a mixed-methods study of patient flow in the 10 urban health regions/zones of Western Canada. We assessed whether jurisdictions differed meaningfully in their emergency flow performance, defined as mean emergency department length of stay (ED LOS).
METHODS
We used hierarchical linear modelling to compare ED LOS across jurisdictions, based on nationally reported data for 2017 to 2018. We also explored 36-month performance trends. Admitted and discharged patients were analyzed separately.
RESULTS
With the exception of one high performer, no region's performance differed significantly from average for both admitted and discharged patients. The regions' levels of performance remained largely static throughout the study period.
CONCLUSIONS
Results precluded any mixed-methods comparison of high- and low-performing regions. However, they converged with our qualitative findings, which suggested that most regions were pursuing similar flow-improvement strategies with limited effectiveness. Deeper changes may be required to address persistent misalignment between capacity and demand.
Topics: Canada; Emergency Service, Hospital; Hospitalization; Humans; Length of Stay; Patient Discharge; Retrospective Studies
PubMed: 34129479
DOI: 10.12927/hcpol.2021.26498 -
Frontiers in Psychology 2022Musicians experience varying degrees of togetherness with their co-performers when playing in ensembles. However, little is known about how togetherness is experienced...
Musicians experience varying degrees of togetherness with their co-performers when playing in ensembles. However, little is known about how togetherness is experienced by audiences and how interpersonal dynamics in body motion and sound support the judgment of togetherness. This research investigates audience sensitivity to audio and visual markers of interperformer coordination and expressivity in ensembles, in relation to modality of stimulus presentation and audience music background. A set of duo ensemble performances, comprising motion capture recordings of the musicians' upper bodies and instruments, were presented to participants with varying music background, including novices and semi-professional musicians. Participants were required to: (i) watch and listen, (ii) only watch, and (iii) only listen to the selected recordings, whilst providing dynamic ratings of how much togetherness between musicians they perceived. Results demonstrate that sound intensity and similarity in right arm motion (quantified using cross-wavelet transform analysis) were significant predictors of rated togetherness in novices, whilst sound synchronization and chest motion coordination predicted togetherness responses in semi-professional musicians. These results suggest the relevance of the quality of body motion coordination and of certain features of the audio outputs in the audience perception of togetherness. This research contributes to a better understanding of the perceptual mechanisms supporting socio-cognitive judgments of joint action activities.
PubMed: 36467141
DOI: 10.3389/fpsyg.2022.997752 -
BMJ Simulation & Technology Enhanced... 2021Understanding performance differences between learners may provide useful context for optimising medical education. This pilot study aimed to explore a technique to...
INTRODUCTION
Understanding performance differences between learners may provide useful context for optimising medical education. This pilot study aimed to explore a technique to contextualise performance differences through retrospective secondary analyses of two randomised controlled simulation studies. One study focused on speaking up (non-technical skill); the other focused on oxygen desaturation management (technical skill).
METHODS
We retrospectively analysed data from two independent simulation studies conducted in 2017 and 2018. We used multivariate hierarchical cluster analysis to explore whether participants in each study formed homogenous performance clusters. We then used mixed-design analyses of variance and χ analyses to examine whether reported task load differences or demographic variables were associated with cluster membership.
RESULTS
In both instances, a two-cluster solution emerged; one cluster represented trainees exhibiting higher performance relative to peers in the second cluster. Cluster membership was independent of experimental allocation in each of the original studies. There were no discernible demographic differences between cluster members. Performance differences between clusters persisted for at least 8 months for the non-technical skill but quickly disappeared following simulation training for the technical skill. High performers in speaking up initially reported lower task load than standard performers, a difference that disappeared over time. There was no association between performance and task load during desaturation management.
CONCLUSION
This pilot study suggests that cluster analysis can be used to objectively identify high-performing trainees for both a technical and a non-technical skill as observed in a simulated clinical setting. Non-technical skills may be more difficult to teach and retain than purely technical ones, and there may be an association between task load and initial non-technical performance. Further study is needed to understand what factors may confer inherent performance advantages, whether these advantages translate to clinical performance and how curricula can best be designed to drive targeted improvement for individual trainees.
PubMed: 35520970
DOI: 10.1136/bmjstel-2020-000812 -
PloS One 2019Recent investigations analysing synchronization in singing ensembles have shown that the precision of synchronization during singing duo performances is better in the...
Recent investigations analysing synchronization in singing ensembles have shown that the precision of synchronization during singing duo performances is better in the presence of visual contact between the singers than without. Research has also shown that synchronisation improves with practice across rehearsals in a newly formed singing quintet. However, whether listeners' perceptions of synchronization reflect the different patterns of synchronization that were observed during ensemble performance with and without visual contact and across rehearsals has not yet been investigated. This study aims to analyse the perception of the synchronization associated with altered visual contact and amount of rehearsal during singing duo and quintet performances respectively, for listeners with different levels of musical expertise. A set of fifty-eight singing recordings selected from duo and quintet ensemble performances, collected from previous investigations of interpersonal synchrony, was presented to 33 listeners, including non-experts (university students with little or no music training), performers in the group (singers who performed the pieces used for the study), and other musicians (advanced music students). Participants were required to listen to each trial and judge the level of "togetherness" on a sliding scale from zero to 100. Results show that listeners, irrespective of their musical training and performance experience, perceived differences in the synchronization in the duo tokens depending on the presence/absence of visual contact between singers; on the other hand, the smaller asynchrony patterns measured across rehearsals in the singing quintet recordings were not perceived. This study contributes to our understanding of perceptions of synchronization by individuals with different levels of musical expertise, and underscores the perceptual salience of synchronization, regardless of musical experience.
Topics: Adult; Auditory Perception; Female; Humans; Male; Music; Singing; Voice Quality
PubMed: 31188896
DOI: 10.1371/journal.pone.0218162 -
Royal Society Open Science May 2017Human intellect is characterized by intercorrelated psychological domains, including intelligence, academic performance and personality. Higher openness is associated...
Human intellect is characterized by intercorrelated psychological domains, including intelligence, academic performance and personality. Higher openness is associated with higher intelligence and better academic performance, yet high performance among individuals is itself attributable to intelligence, not openness. High conscientiousness individuals, although not necessarily more intelligent, are better performers. Work with other species is not as extensive, yet animals display similar relationships between exploration- and persistence-related personality traits and performance on cognitive tasks. However, previous studies linking cognition and personality have not tracked learning, performance and dropout over time-three crucial elements of cognitive performance. We conducted three participatory experiments with touchscreen cognitive tasks among 19 zoo-housed chimpanzees, whose personalities were assessed 3 years prior to the study. Performance and participation were recorded across experiments. High conscientiousness chimpanzees participated more, dropped out less and performed better, but their performance could be explained by their experience with the task. High openness chimpanzees tended to be more interested, perform better and continue to participate when not rewarded with food. Our results demonstrate that chimpanzees, like humans, possess broad intellectual capacities that are affected by their personalities.
PubMed: 28573025
DOI: 10.1098/rsos.170169 -
Security Dialogue Dec 2017Discussions about the legitimacy of private security companies (PSCs) in multilateral military interventions abound. This article looks at how the United States has...
Discussions about the legitimacy of private security companies (PSCs) in multilateral military interventions abound. This article looks at how the United States has sought to legitimize the outsourcing of security services to PSCs through performance-based contracting and performance assessments. Both mechanisms aim to demonstrate the effective provision of publicly desirable outcomes. However, the immaterial and socially constructed nature of security presents major problems for performance assessments in terms of observable and measurable outcomes. Performance has therefore given way to performativity - that is, the repetitive enactment of particular forms of behaviour and capabilities that are simply equated with security as an outcome. The implications of this development for the ways in which security has been conceptualized, implemented and experienced within US interventions have been profound. Ironically, the concern with performance has not encouraged PSCs to pay increased attention to their impacts on security environments and civilian populations, but has fostered a preoccupation with activities and measurable capabilities that can be easily assessed by government auditors.
PubMed: 29276346
DOI: 10.1177/0967010617722650 -
Frontiers in Psychology 2022Music performance anxiety (MPA) affects musicians at various stages of a performance, from its preparation until the aftermath of its delivery. Given the commonality and...
Music performance anxiety (MPA) affects musicians at various stages of a performance, from its preparation until the aftermath of its delivery. Given the commonality and potentially grave consequences of MPA, it is understandable that much attention has been paid to the musician experiencing it. Consequently, we have learned a great deal about the intrapersonal level of MPA: how to measure it, treatments, experimental manipulations, and subjective experiences. However, MPA may also manifest at an interpersonal level by influencing how the performance is perceived. Yet, this has not yet been measured. This exploratory online study focuses on the listener's perception of anxiety and compares it to the musician's actual experienced anxiety. Forty-eight participants rated the amount of perceived anxiety of a pianist performing two pieces of contrasting difficulty in online-recital and practice conditions. Participants were presented with two stimulus modality conditions of the performance: audiovisual and audio-only. The listener's perception of anxiety and its similarity to the musician's experienced anxiety varies depending on variables such as the piece performed, the stimulus modality, as well as interactions between these variables and the listener's musical background. We discuss the implications for performance and future research on the interpersonal level of MPA.
PubMed: 35645919
DOI: 10.3389/fpsyg.2022.838041 -
Pharmacy Practice 2020To evaluate the training and standardization methods of multiple simulated patients (SPs) performing a single scenario in a multicenter study.
OBJECTIVE
To evaluate the training and standardization methods of multiple simulated patients (SPs) performing a single scenario in a multicenter study.
METHODS
A prospective quasi-experimental study, using a multicenter approach, evaluated the performance of five different individuals with the same biotype during a simulation session in a high-fidelity environment. The SPs training and standardization process consisted of four steps and six web or face-to-face mediated: Step 1: simulation scenario design and pilot test. Step 2: SPs selection, recruitment and beginning training (Session 1: performance instructions and memorization request.) Session 2: check the SPs' performances and adjustments). Step 3 and session 3: training role-play and performance's evaluation. Step 4: SPs' standardization and performances' evaluation (Sessions 4 and 5: first and second rounds of SPs' standardization assessment. Session 6: Global training and standardization evaluation. SPs performance consistency was estimated using Cronbach's alpha and ICC.
RESULTS
In the evaluation of training results, the Maastricht Simulated Patient Assessment dimensions of SPs performances "It seems authentic", "Can be a real patient" and "Answered questions naturally", presented "moderate or complete agreement" of all evaluators. The dimensions "Seems to retain information unnecessarily", "Remains in his/her role all the time", "Challenges/tests the student", and "Simulates physical complaints in an unrealistic way" presented "moderate or complete disagreement" in all evaluations. The SPs "Appearance fits the role" showed "moderate or complete agreement" in most evaluations. In the second round of evaluations, the SPs had better performance than the first ones. This could indicate the training process's had good influence on SPs performances. The Cronbach's alpha in the second assessment was better than the first (varied from 0.699 to 0.978). The same improvement occurred in the second round of intraclass correlation coefficient that was between 0.424 and 0.978. The SPs were satisfied with the training method and standardization process. They could perceive improvement on their role-play authenticity.
CONCLUSIONS
The SPs training and standardization process revealed good SPs reliability and simulation reproducibility, demonstrating to be a feasible method for SPs standardization in multicenter studies. The Maastricht Simulated Patient Assessment was regarded as missing the assessment of the information consistency between the simulation script and the SPs provision.
PubMed: 33224323
DOI: 10.18549/PharmPract.2020.4.2038 -
Frontiers in Psychology 2016We present and evaluate the EyeHarp, a new gaze-controlled Digital Musical Instrument, which aims to enable people with severe motor disabilities to learn, perform, and...
We present and evaluate the EyeHarp, a new gaze-controlled Digital Musical Instrument, which aims to enable people with severe motor disabilities to learn, perform, and compose music using only their gaze as control mechanism. It consists of (1) a step-sequencer layer, which serves for constructing chords/arpeggios, and (2) a melody layer, for playing melodies and changing the chords/arpeggios. We have conducted a pilot evaluation of the EyeHarp involving 39 participants with no disabilities from both a performer and an audience perspective. In the first case, eight people with normal vision and no motor disability participated in a music-playing session in which both quantitative and qualitative data were collected. In the second case 31 people qualitatively evaluated the EyeHarp in a concert setting consisting of two parts: a solo performance part, and an ensemble (EyeHarp, two guitars, and flute) performance part. The obtained results indicate that, similarly to traditional music instruments, the proposed digital musical instrument has a steep learning curve, and allows to produce expressive performances both from the performer and audience perspective.
PubMed: 27445885
DOI: 10.3389/fpsyg.2016.00906 -
Frontiers in Neuroscience 2018The fields of neural prosthetic technologies and Brain-Computer Interfaces (BCIs) have witnessed in the past 15 years an unprecedented development, bringing together...
"Enheduanna-A Manifesto of Falling" Live Brain-Computer Cinema Performance: Performer and Audience Participation, Cognition and Emotional Engagement Using Multi-Brain BCI Interaction.
The fields of neural prosthetic technologies and Brain-Computer Interfaces (BCIs) have witnessed in the past 15 years an unprecedented development, bringing together theories and methods from different scientific fields, digital media, and the arts. More in particular, artists have been amongst the pioneers of the design of relevant applications since their emergence in the 1960s, pushing the boundaries of applications in real-life contexts. With the new research, advancements, and since 2007, the new low-cost commercial-grade wireless devices, there is a new increasing number of computer games, interactive installations, and performances that involve the use of these interfaces, combining scientific, and creative methodologies. The vast majority of these works use the brain-activity of a single participant. However, earlier, as well as recent examples, involve the simultaneous interaction of more than one participants or performers with the use of Electroencephalography (EEG)-based multi-brain BCIs. In this frame, we discuss and evaluate "Enheduanna-A Manifesto of Falling," a live brain-computer cinema performance that enables for the first time the simultaneous real-time multi-brain interaction of more than two participants, including a performer and members of the audience, using a passive EEG-based BCI system in the context of a mixed-media performance. The performance was realised as a neuroscientific study conducted in a real-life setting. The raw EEG data of seven participants, one performer and two different members of the audience for each performance, were simultaneously recorded during three live events. The results reveal that the majority of the participants were able to successfully identify whether their brain-activity was interacting with the live video projections or not. A correlation has been found between their answers to the questionnaires, the elements of the performance that they identified as most special, and the audience's indicators of attention and emotional engagement. Also, the results obtained from the performer's data analysis are consistent with the recall of working memory representations and the increase of cognitive load. Thus, these results prove the efficiency of the interaction design, as well as the importance of the directing strategy, dramaturgy and narrative structure on the audience's perception, cognitive state, and engagement.
PubMed: 29666566
DOI: 10.3389/fnins.2018.00191