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Newcastle, Australia

Ingham G.,Beyond Medical Education | Fry J.,Beyond Medical Education | Morgan S.,Hunter Regional Mail Center | Ward B.,Monash University
BMC Medical Education | Year: 2015

Background: Workplace-based formative assessments using consultation observation are currently conducted during the Australian general practice training program. Assessment reliability is improved by using multiple assessment methods. The aim of this study was to explore experiences of general practice medical educator assessors and registrars (trainees) when adding random case analysis to direct observation (ARCADO) during formative workplace-based assessments. Methods: A sample of general practice medical educators and matched registrars were recruited. Following the ARCADO workplace assessment, semi-structured qualitative interviews were conducted. The data was analysed thematically. Results: Ten registrars and eight medical educators participated. Four major themes emerged - formative versus summative assessment; strengths (acceptability, flexibility, time efficiency, complementarity and authenticity); weaknesses (reduced observation and integrity risks); and contextual factors (variation in assessment content, assessment timing, registrar-medical educator relationship, medical educator's approach and registrar ability). Conclusion: ARCADO is a well-accepted workplace-based formative assessment perceived by registrars and assessors to be valid and flexible. The use of ARCADO enabled complementary insights that would not have been achieved with direct observation alone. Whilst there are some contextual factors to be considered in its implementation, ARCADO appears to have utility as formative assessment and, subject to further evaluation, high-stakes assessment. © 2015 Ingham et al. Source

Broome L.,Office of Environment and Heritage | Ford F.,Defence Support Group | Dawson M.,Eco Logical Australia Pty Ltd | Green K.,Snowy Mountains Region | And 2 more authors.
Australian Zoologist | Year: 2013

The New South Wales population of the Mountain Pygmy-possum Burramys parvus was estimated at 500 adults in 8 km2 of boulder-heath habitat during surveys in the 1980's. In 1989, this estimate was increased to 1312 adults based on further surveys in four of the identified habitat patches. However, further research indicated that population density varied greatly between habitat patches and that the original extent of habitat and the revised population estimate had been overestimated. Because of the high degree of uncertainty regarding the total population size of B. parvus in New South Wales and the relative value of each habitat patch, including those in ski resorts, it was necessary to re-evaluate these estimates. Results based on data collected between 1996 and 2001 indicated an adult population of around 613±92 in 1.85 km2 of boulderfield habitat.This population was distributed in scattered colonies within a modelled bioclimatic range of 444 km2 of suitable climate, based on modelling of the then known southern Kosciuszko B. parvus population. However the notional extent of suitable climate has been greatly enlarged by the recent discovery of a northern Kosciuszko population. Establishing which boulderfields to target for future surveys within the enlarged potential climate envelope is not simple. No strong association with any habitat characteristics were identified by habitat analysis, however, deeper boulderfields with a variety of boulder sizes and reasonable vegetation cover were generally preferred. Changes in habitat characteristics across the elevational gradient partly explained the difficulty in modelling habitat preference. Source

Dempsey C.,Hunter Regional Mail Center | Dempsey C.,University of Newcastle
Australasian Physical and Engineering Sciences in Medicine | Year: 2011

The outcomes of a recent brachytherapy well-type ionization chamber calibration error are given in the hope that other brachytherapy treatment centres may better understand the importance of each entry stated in a well chamber calibration certificate. A Nucletron Source Dosimetry System (SDS) PTW well-type ionization chamber was sent for a biennial calibration in September 2010. Upon calibration of the chamber, it was discovered that the previous calibration (in July 2008) contained a +2.6% error in the chamber calibration coefficient. Investigation of the information on the 2008 well chamber calibration certificate indicated the source of the error, which could or should have been detected by both the calibration laboratory and/or the radiation therapy department upon return of the chamber. Consideration must be given to all values and conditions given on the calibration certificate when accepting a ionization chamber back from a calibration laboratory. The issue of whether the source strength from the source calibration certificate or the measured source strength from the calibrated ionization chamber should be entered into the treatment unit is also raised. © 2011 Australasian College of Physical Scientists and Engineers in Medicine. Source

Dempsey C.,Hunter Regional Mail Center
Australasian Physical and Engineering Sciences in Medicine | Year: 2010

To describe the steps undertaken to commission a 3D high dose rate (HDR) brachytherapy treatment planning system (TPS). Emphasis was placed on validating previously published recommendations, in addition to checking 3D parameters such as treatment optimization and dose volume histogram (DVH) analysis. Commissioning was performed of the brachytherapy module of the Nucletron Oncentra MasterPlan treatment planning system (version 3.2). Commissioning test results were compared to an independent external beam TPS (Varian Eclipse v 8.6) and the previously commissioned Nucletron Plato (V 14.3.7) brachytherapy treatment planning system, with point doses also independently verified using the brachytherapy module in RadCalc (v 6.0) independent point dose calculation software. Tests were divided into eight categories: (i) Image import accuracy, (ii) Reconstruction accuracy, (iii) Source configuration data check, (iv) Dose calculation accuracy, (v) Treatment optimization validation, (vi) DVH reproducibility, (vii) Treatment export check and (viii) Printout consistency. Point dose agreement between Oncentra, Plato and RadCalc was better than 5% with source data and dose calculation protocols following the American Association of Physicists in Medicine (AAPM) guidelines. Testing of image accuracy (import and reconstruction), along with validation of automated treatment optimization and DVH analysis generated a more comprehensive set of testing procedures than previously listed in published recommendations. © Australasian College of Physical Scientists and Engineers in Medicine 2010. Source

Supiot S.,Institute Of Cancerologie Of Louest Nantes Angers | Crehange G.,Center Georges Francois Leclerc | Latorzeff I.,Groupe Oncorad Garonne | Pommier P.,Center Leon Berard | And 7 more authors.
Cancer/Radiotherapie | Year: 2013

Radiotherapy plays a central role in the management of localized prostate cancer, but the total duration of treatment of nearly 2. months poses not only problems of fatigue related to repetitive transports, especially for older patients, but also increases the overall cost of treatment including linear accelerators occupancy and patient transportation. To address this problem, various teams have developed hypofractionated radiotherapy protocols seeking to maintain the same efficacy and toxicity while reducing the total duration of treatment. These hypofractionated protocols require recent techniques such as image-guided radiation therapy (IGRT) and intensity-modulated radiation therapy (IMRT). Single centre series have validated the feasibility of "light" hypofractionation schemes at doses per fraction less than 6. Gy Similarly, different teams have shown the possibility of stereotactic irradiation for delivering "severe" hypofractionation schemes at doses greater than 6. Gy per fraction. Whatever the dose per fraction, the current clinical data support the conclusion that hypofractionated radiotherapy does not increase mid-term toxicity and could even improve biochemical control. Studies with the objective of demonstrating non-inferiority are expected to definitively validate the role of hypofractionated irradiation in the treatment of prostate cancer. © 2013 Société française de radiothérapie oncologique (SFRO). Source

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