Acting on Reflection: the Effect of Reflection on Students’ Clinical Performance on a Standardized Patient Examination

BACKGROUND: Little evidence exists to support the value of reflection in the clinical setting. OBJECTIVE: To determine whether reflecting and revisiting the “patient” during a standardized patient (SP) examination improves junior medical students’ performance and to analyze students’ perceptions of its value. DESIGN: Students completed a six-encounter clinical skills examination, writing a guided assessment after each encounter to trigger reflection. SPs evaluated the students with Medical Skills and Patient Satisfaction checklists. During the last three encounters, students could opt to revisit the SP and be reevaluated with identical checklists. PARTICIPANTS: One hundred and forty-nine third year medical students. MEASUREMENTS: Changes in scores in the Medical Skills and Patient Satisfaction checklists between first visit and revisit were tested separately per case as well as across cases. RESULTS: On the medical skills and patient satisfaction checklists, mean revisit scores across cases were significantly higher than mean first visit scores [12.6 vs 12.2 (pooled SD = 2.4), P = .0001; 31.2 vs 31.0 (pooled SD = 3.5), P = .0001)]. Sixty-five percent of the time, students rated “reflect–revisit” positively, 34% neutrally, and 0.4% negatively. Five themes were identified in the positive comments: enhancement of (1) medical decision making, (2) patient education/counseling, (3) student satisfaction/confidence, (4) patient satisfaction/confidence, and (5) clinical realism. CONCLUSIONS: Offering third year medical students the option to reflect and revisit an SP during a clinical skills examination produced a small but nontrivial increase in clinical performance. Students perceived the reflect–revisit experience as enhancing patient-centered practices (counseling, education) as well as their own medical decision making and clinical confidence

Fan Blade Deformation Measurements on the DLR Airbus A320-ATRA by Means of IPCT as Part of the Ground Test Campaign in the Frame of the DLR-project SAMURAI

The Image Pattern Correlation Technique (IPCT) was applied to measure the fan blade deformation of the IAE V2527 engine operating at Maximum Continous Thrust (MCT). The ground test on the DLR research aircraft A320-ATRA was a main part of the DLR project SAMURAI which wanted to use the ‘Synergy of Advanced Measurement Techniques for Unsteady and High Reynolds Number Aerodynamic Investigations’. The stereo camera system was fixed in front of the left engine. For certification reasons the correlation pattern had to be projected to the fan by a laser. The IPCT evaluation were improved to cope with the special challenges of the measurement and to enable a comparison with Computational Structural Mechanics (CSM) results finally

Image Based Fan Blade Deformation Measurements on an Airbus A320 V2500 Engine in Ground Operation

The Image Pattern Correlation Technique (IPCT) was applied to measure the fan blade deformation of the IAE V2527 engine operating at Maximum Continous Thrust (MCT). The ground test on the DLR research aircraft A320-ATRA was a main part of the DLR project SAMURAI which wanted to use the ‘Synergy of Advanced Measurement Techniques for Unsteady and High Reynolds Number Aerodynamic Investigations’. The stereo camera system was fixed in front of the left engine. For certification reasons the correlation pattern had to be projected to the fan by a laser. The IPCT evaluation were improved to cope with the special challenges of the measurement and to enable a comparison with Computational Structural Mechanics (CSM) results finally