An audit of total and free thyroxine measurements in screening for hypo and hyperthyroidism in patients using chemiluminescence immunoassay

An audit of 2509 patient specimens analyzed for both total thyroxine (TT4) and free thyroxine (FT4) by the ACS-180 automated chemiluminescence immunoassay analyzer revealed that there were 219 discrepancies (8.7% of the total). A discrepancy was defined as one analyte within its reference range and the other outside. The discrepant results were divided into 4 groups: group A: normal TT4, but decreased FT4, 101 patients (4.0%); group B: increased TT4, normal FT4, 78 patients (3.1%); group C: decreased TT4, normal FT4, 34 patients (1.4%); and group D: normal TT4, increased FT4, 6 patients (0.2%). TSH measurements were available, by a 3^rd generation chemiluminescent assay, in 142 of these patients, and were consistent with the FT4 result in 72 patients, with TT4 in 61 cases and with neither in 9 patients. The clinical diagnosis was investigated in a subgroup of 43 endocrine patients. Thirteen of the 20 endocrine patients in group A were diagnosed as hypothyroid, with a measured serum TSH, in 11 of them, of median 14.6, range 1.2 to 46.2 μlU/ml. Eleven of the 19 endocrine patients in group B were on thyroid replacement, with a measured serum TSH, in 7 of them of <0.01 μlU/ml. The audit of current laboratory practice led to a suggestion to replace the current thyroid function screening strategy of measuring both TT4 and FT4 by the combination of FT4 and TSH. The reasons for the discrepancies and the alternative strategies for screening of thyroid function are discussed.     

Using phenomenography to build an understanding of how university people conceptualise their community-engaged activities

Higher education institutions are seeking greater community engagement through academic, social and civic activity. In response, researcher attention has turned to impacts on students’ education, and benefits to both university and community partners. This phenomenographic study examines how a diverse group of teachers, researchers and administrators at one New Zealand university conceptualised their involvement in community-engaged learning and teaching. We identified an outcome space where university people conceived their community engagement in three ways: within an expert/novice discourse, as advocacy, and in the most complex conception, as reciprocal learning. When working with and within communities, we suggest that university people should be supported to approach community engagement as reciprocal learning rather than adopting approaches that render community partners in passive roles.     

Communication skills training exploiting multimodal emotion recognition

The teaching of communication skills is a labour-intensive task because of the detailed feedback that should be given to learners during their prolonged practice. This study investigates to what extent our FILTWAM facial and vocal emotion recognition software can be used for improving a serious game (the Communication Advisor) that delivers a web-based training of communication skills. A test group of 25 participants played the game wherein they were requested to mimic specific facial and vocal emotions. Half of the assignments included direct feedback and the other half included no feedback. It was investigated whether feedback on the mimicked emotions would lead to better learning. The results suggest the facial performance growth was found to be positive, particularly significant in the feedback condition. The vocal performance growth was significant in both conditions. The results are a significant indication that the automated feedback from the software improves learners’ communication performances.     

An interactive learning and course development environment: Context,theoretical and empirical considerations

In this contribution, a theoretical and empirical framework based on work carried out at the Open universiteit (Ou) for a new approach towards the design, production and delivery of flexible, interactive learning materials for distance education is presented.

In the Research and Development centre of the Ou, a project has concentrated on the innovation of current approaches. This framework can also be considered as an advance organizer to reading the remaining articles from the Open universiteit in this issue of Distance Education.

A key feature of the innovation is that during the design phase, course developers have to define ‘models’ of the materials to be developed: a content model, a support model, a student model and the learning path. From a flexibility point of view especially, the ‘student model’ is of importance since it defines the student variables that will be taken into account when developing/ presenting alternative materials (basic content and/or embedded support). A computer‐based system, the ‘Interactive Learning and Course Development Environment (ILCE)’, was developed to support the work of course development teams and tutors on the one hand, and students on the other hand. The development system supports the work of the developers; the delivery system supports the study process of students. The delivery is realised as an on‐line course, on the World Wide Web.

Students start working with the ILCE‐system by following an intake procedure. They can make choices in relation to student variables that have been defined in the student model (profession, study intentions, context, etc.). Next, they can ‘on the fly’ generate a course. Rom the large repository of learning materials only those materials are selected and compiled that are in line with the student model of this specific student Furthermore, they can choose to study the materials on screen and/or make prints of the materials. Of course, in printing the materials they lose the interactive and dynamic possibilities of the computer learning environment     

The Design of Competency-Based Performance Assessment in E-Learning

This article focuses on the design of competency-based performance assessment in e-learning. Though effort has been invested in designing powerful e-learning environments, relatively little attention has been paid to the design of valid and reliable assessments in such environments, leaving many questions to educational developers and teachers. As a solution to this problem, a systematic approach to designing performance assessments in e-learning contexts is presented, partly based on the 4C/ID model. This model enables the construction of realistic whole tasks instead of advocating education that is restricted to more isolated skills. A new assessment procedure also implies an alternative view of instructional design, learning and assessment. The requirements for the learning environment are addressed. Examples from a virtual seminar are presented to illustrate the design approach. The article concludes with the identification of possible pitfalls related to the approach and gives directions for future research.