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Background Physician decision-making skills training is a priority to improve adoption of the cerebral palsy (CP) clinical guideline and, through this, lower the age of CP diagnosis. Clinical guideline implementation aims to improve physician practice, but evaluating meaningful change is complex. Limitations in the validity evidence of evaluation instruments impact the evidence base. Validity frameworks, such as Kane’s, enable a targeted process to gather evidence for instrument scores, congruent to context and purpose. Yet, application of argument-based methodology to implementation validation is rare. Key-features examination methodology has established validity evidence supporting its use to measure decision-making skills, with potential to predict performance. We aimed to apply Kane’s framework to evaluate a pilot key-features examination on physician decision-making in early CP diagnosis. Methods Following Kane’s framework, we evaluated evidence across inferences of scoring, generalisation, extrapolation and implications in a study design describing the development and pilot of a CP diagnosis key-features examination for practising physicians. If found to be valid, we proposed to use the key-feature scores as an outcome measure of decision-making post education intervention to expedite CP diagnosis and to correlate with real-world performance data to predict physician practice. Results Supporting evidence for acceptance of scoring inferences was achieved through examination development with an expert group ( n  = 10) and pilot results ( n  = 10): (1) high internal consistency (0.82); (2) acceptable mean item-discrimination (0.34); and (3) acceptable reliability of examination scorers (95.2% congruence). Decreased physician acceptance of examination time (70%) was identified as a threat and prioritised in case reduction processes. Partial acceptance of generalisation, extrapolation and implications inferences were defensible with: (1) accumulated development evidence following established key-features methodology; (2) high pilot acceptance for authenticity (90%); and (3) plausibility of assumptions of score correlation with population register data. Conclusions Kane’s approach is beneficial for prioritising sources of validity evidence alongside the iterative development of a key-features examination in the CP field. The validity argument supports scoring assumptions and use of scores as an outcome measure of physician decision-making for CP guideline education implementation interventions. Scoring evidence provides the foundation to direct future studies exploring association of key-feature scores with real-world performance.

To comprehensively investigate the key features of lane-changing (LC) risk for different vehicle types during left and right LC, and to improve the accuracy of LC risk recognition, this paper proposes a key feature selection and risk recognition model based on vehicle trajectory data. Based on a HighD high-precision vehicle trajectory dataset, the trajectory data of LC vehicles and surrounding vehicles of each vehicle type are extracted. SDI (stop distance index) and CI (crash index) are selected as surrogate indicators to calculate the risk exposure level (REL) and risk severity level (RSL). The K-means algorithm is used to cluster the REL and RSL to obtain the LC risk level, which is divided into three levels. The combination of basic features and interaction features of LC vehicles and surrounding vehicles with LC risk levels is constructed as the LC risk feature dataset. Based on the LightGBM (light gradient boosting machine) algorithm, the importance of features is sorted. Finally, a CNN-BiLSTM-Attention model is established to recognize the LC risk of each vehicle type during left and right LC. The results indicate that significant differences exist among different vehicle types and LC directions. Compared with CNNs (convolutional neural networks), LSTM (long short-term memory), and BiLSTM (bi-directional long short-term memory), CNN-BiLSTM-Attention performs best in recognizing the risk of LC in all cases. Moreover, the key feature groups that have the optimal result of recognizing the risk of LC in different cases are obtained.

Background Many diet-related surveys have been conducted in England over the past four to five decades. Yet, diet-related ill-health is estimated to cost the NHS £5.8 billion annually. There has been no recent assessment of the diet-related surveys currently available in England. This paper aims to fill this gap in the literature by providing researchers, especially those interested in conducting secondary (quantitative) research on diet, with a detailed overview of the major repeated cross-sectional and longitudinal surveys conducted in England over the last 48 years (1970–2018). Method A three-stage review process was used to identify and assess surveys and synthesise the information necessary for achieving the paper’s aim. Surveys were identified using the UK Data Service, Cohort and Longitudinal Studies Enhancement Resources (CLOSER), the Medical Research Council (MRC) Cohort Directory and the Consumer Data Research Centre (CDRC) online data repositories/directories. Surveys were summarised to include a brief background, the survey design and methodology used, variables captured, the target population, level of geography covered, the type of dietary assessment method(s) used, primary data users, data accessibility, availability and costs, as well as key survey features and considerations. Results The key considerations identified across the various surveys following the review include: the overall survey design and the different dietary assessment method(s) used in each survey; methodological changes and general inconsistencies in the type and quantity of diet-related questions posed across and within surveys over time; and differences in the level of geography and target groups captured. Conclusion It is highly unlikely that any survey dataset will meet all the needs of researchers. Nevertheless, researchers are encouraged to make good use of the secondary data currently available, in order to conduct the research necessary for the creation of more evidence-based diet-related policies and interventions in England. The review process used in this paper is one that can be easily replicated and one which future studies can use to update and expand upon to assist researchers in identifying the survey(s) most aligned to their research questions.

This chapter contains sections titled: Introduction The Long Case Objective Structured Long Case Examination Record Short Cases Objective Structured Clinical Examinations OSCE Design Conclusions Acknowledgement References

This paper presents assessments of Public Financial Management (PFM) Systems for two regional Asian groups – the South Asian Association for Regional Cooperation (SAARC) and the Association for South East Asian Nations (ASEAN). The study undertaken uses the Public Expenditure and Financial Accountability (PEFA) results for assessment of the performance of PFM systems of countries both within and across the two regions for the six PEFA framework dimensions. This paper also presents results of the study for comparing regional performance with global averages for various PEFA indicators to identify strengths and weaknesses. An in-depth analysis of the PEFA assessments was also done to identify key features and initiatives undertaken by the countries where strengths in PFM system indicators was identified, and recommendations made, for countries moving on the path of PFM reforms for performance improvement.

Background Innovative assessment strategies are essential for determining clinical understanding in the evolving field of health profession education. Key feature questions (KFQs) have been developed as assessment tools to assess the clinical understanding of students. The purpose of this study is to determine the effectiveness of image-based key feature questions (IBKFQs) compared with traditional multiple-choice questions (MCQs) in radiology examinations. Additionally, this study aims to determine the correlation between test scores obtained in both test formats. Method This quasi experimental, correlation study was conducted from September to December 2021 at a public medical university in Karachi, Pakistan. Thirty radiology residents from various training years participated in the study. Each resident completed a comprehensive written assessment comprising 50 MCQs and 50 IB-KFQs as part of their internal evaluation at the end of a module. Results Out of thirty residents, 28 (93.3%) were females. The reliability score and Cronbach’s alpha were 0.944 for the MCQs and 0.881 for the IB-KFQs. Spearman's correlation coefficient revealed a positive correlation between the MCQ and IB-KFQ scores (rho = 0.823, p  < 0.001). The mean scores were similar for the IB-KFQs (29.24 ± 6.31) and MCQs (28.93 ± 11.41). Conclusion The findings of this study indicate that incorporating IB-KFQs alongside MCQs in written assessments of radiology residents is feasible. IB-KFQs offer a focused evaluation of critical skills such as film analysis, interpretation, and report writing. By complementing traditional MCQs, IB-KFQs enhance the assessment process.

The Key Feature Problem (KFP), is part of the Conjoint MAFP/FRACGP exit examination for Family Medicine specialisation in Malaysia. KFP tests candidates’ skills in clinical reasoning and decision making. Over the years, KFP has been the cause of most of the failures in the Part 1 theory examination. This paper aims to highlight common errors committed by candidates and provide recommendations and practical examination technique tips on how to mitigate these errors. A summary of the 26 KFP cases used in the 2020 Conjoint KFP examination demonstrates the breadth and types of cases. From the feedback reports collated from eight assessors involved in this exam, we determined that although inadequate knowledge is probably the main contributor to failure, other easily correctible mistakes made by candidates further aggravate the situation. Common errors include offering more answers than requested, giving duplicate or incomplete answers, and writing answers out of context to the case scenario. The paper concludes with recommendations and sources for effective learning, and provides 12 examination technique tips. The tips include time management, reading carefully through the case, and checking that the answers are congruent with the questions asked.

Background Medical knowledge encompasses both conceptual (facts or “what” information) and procedural knowledge (“how” and “why” information). Conceptual knowledge is known to be an essential prerequisite for clinical problem solving. Primarily, medical students learn from textbooks and often struggle with the process of applying their conceptual knowledge to clinical problems. Recent studies address the question of how to foster the acquisition of procedural knowledge and its application in medical education. However, little is known about the factors which predict performance in procedural knowledge tasks. Which additional factors of the learner predict performance in procedural knowledge? Methods Domain specific conceptual knowledge (facts) in clinical nephrology was provided to 80 medical students (3 rd to 5 th year) using electronic flashcards in a laboratory setting. Learner characteristics were obtained by questionnaires. Procedural knowledge in clinical nephrology was assessed by key feature problems (KFP) and problem solving tasks (PST) reflecting strategic and conditional knowledge, respectively. Results Results in procedural knowledge tests (KFP and PST) correlated significantly with each other. In univariate analysis, performance in procedural knowledge (sum of KFP+PST) was significantly correlated with the results in (1) the conceptual knowledge test (CKT), (2) the intended future career as hospital based doctor, (3) the duration of clinical clerkships, and (4) the results in the written German National Medical Examination Part I on preclinical subjects (NME-I). After multiple regression analysis only clinical clerkship experience and NME-I performance remained independent influencing factors. Conclusions Performance in procedural knowledge tests seems independent from the degree of domain specific conceptual knowledge above a certain level. Procedural knowledge may be fostered by clinical experience. More attention should be paid to the interplay of individual clinical clerkship experiences and structured teaching of procedural knowledge and its assessment in medical education curricula.