The Challenges of Dyad Practice in Simulation Training of Basic Open Surgical Skills - A Mixed-Method Study

INTRODUCTION: Simulation training at home improves access to training, but motivation can be difficult to maintain. Dyad training could keep trainees motivated. This study aimed to examine the effect of self-regulated training of basic surgical skills in pairs versus individually. METHODS: One hundred one medical doctors were included in this prospective, mixed-method, simulation-based study. Participants were randomized to train individually or in pairs during a 6-week course in open surgical skills, consisting of didactic instructions and self-directed training at home. Trainees kept a training log and filled in a questionnaire. Skills were tested before and after the course. Tests were rated by an expert using the Objective Structured Assessment of Technical Skills Global Rating Scale. RESULTS: Ninety-seven doctors completed the study. We found no differences in test score between dyad and individual trainees. Dyad trainees compared with individual trainees improved by 7.23 points (intercept estimate) versus 6.94 points, respectively (P = 0.881). Dyad trainees trained less frequently [7.3 times (intercept estimate) vs. 12.1 times, P &lt; 0.001, but for longer intervals compared with individual trainees (68 minutes vs. 38 minutes)]. Dyad trainees reported benefits such as having a sparring partner, receiving feedback, corrections, increased motivation, having fun, and more structured training sessions. However, the coordination of training sessions was difficult. CONCLUSIONS: No differences were found between dyad trainees and individual trainees in improvement of surgical skills. Off-site dyad training led to fewer, but longer training sessions, which may have negatively impacted the effectiveness of training. Dyad trainees perceived dyad training beneficial.</p

Influence of High Axial Tension on the Shear Strength of non-shear RC Beams

&lt;p&gt;This paper deals with the influence of high axial tension on the shear strength of beams without shear reinforcement. An experimental program with shear-tension tests was carried out. The experimental results have been used to evaluate the applicability of the Eurocode 2 (EC2) design formula in cases with large normal forces. In addition, the experiments have been used to evaluate an extension of the plasticity based Crack Sliding Model (CSM) to cover cases with large normal forces. The test results show, that even in the present of very high axial tensile stresses and strains, the member is still able to carry significant shear stresses. The analysis reveals that the EC2 formula is over conservative in this regard.&lt;/p&gt;</jats:p

Towards balancing efficiency and customer satisfaction in airplane boarding: An agent-based approach

The airplane boarding process, which can have a significant impact on a flight’s turnaround time, is often viewed by researchers and airlines primarily in terms of minimizing total boarding time (TBT). Airplane capacity, number of passengers on board, amount of luggage, and boarding strategy are common factors that affect TBT. However, besides operational efficiency, airlines are also concerned with customer satisfaction, which affects customer loyalty and financial return. One factor that influences passenger experience is the individual boarding time (IBT), here defined by the time passengers stand inside the cabin. Considering these two aspects, an agent-based model is presented that compares the performance of three alternative mainstream boarding strategies in a 132-seat and a 160-seat single-aisle commercial airplane. An important characteristic of the model that differentiates it from previous work is that overhead bins have a physical limitation, which could lead to an increase in aisle interferences on full flights as passengers take longer to find a place for their carry-on luggage. Another important contribution is the analysis of how passenger seat location affects IBT. Our results show that outside-in (OI) produces shorter TBT than random and back-to-front boarding, and also shorter IBT and much shorter maximum IBT than BTF, particularly for passengers seated in the middle of the airplane. This suggests that among the three most popular boarding strategies used by airlines across the world, OI is the best when it comes to balancing airplane boarding efficiency with individual customer satisfaction