Tourism Operations Management Essay Example | Topics and Well Written Essays - 3750 words

Tourism Operations Management - Essay Example Task 1(L01) Tour operations sector In travel and tourism, tour operators are the ones which combine two or more businesses in a package which is ultimately offered to the consumer as a holiday package. In UK there are two kinds of tour operators- mainstream tour operators and specialist tour operators (Meyers, n.d, pp.8-9). Mainstream tour operators are the ones who sell mainstream tour packages like air, sea, sand sun to the customers while the niche tour operators serve highly specified tour packages like beaches but of a lower standard. The major mainstream companies in UK are Thompson or Thompson Holidays, Thomas Cook, Airtours and First Choice. The products offered by them are the beaches in locations like the Caribbean, Thailand and Malaysia. A number of specialist tour companies have also come up in UK as there is little competition among the specialist tour operators. Major tour operators- introduction Thompson or Thompson Holidays is a part of TUI travel PLC (Cruiseship rati ngs and reviews all cruises with operator Thompson Holidays, n.d). The company known originally as Thompson Tour Operations was renamed as Thompson Holidays in 1997. It was floated in the London stock exchanges in 1998. Thomas Cook was started in 1841 by a person named Thomas Cook. He floated his company commercially in 1845 for the first time. A travel brochure was also provided by it for the first time (Thomas Cook history, n.d). Airtours is well known for providing innovative tour packages to its customers according to the changing lifestyles. It targets the cheap or lower budget market but because of the high level of innovation and ideas it has become one of the top market leaders in UK. (Airtours, n.d). First Choice is the fourth largest tour operator in UK. It was established in the beginning of the 1970s when two companies named Continental Air Brokers and Economy World Travel decided to merge and form Owners Abroad (Wholesale) Ltd. in 1973. Later, the company decided to cha nge its corporate name and in 1994 the company was renamed as First Choice Holidays (First Choice Holidays PLC History, n.d). Since mid-1997, these four players occupy 53% of the holiday market in UK in 2000 (Pender, Sharpleyfirst, n.d, pp.48). Market Segmentation UK travel and tourism market is more oligopolistic in nature because of the presence of only four major players. The process of dividing the consumer base on the basis of common needs is known as market segmentation. The British travel market is divided into the following five segments. These five segments are categorized on the level of experience they have in traveling and the attitude and comforts they seek from the travel experiences. †¢ Self-Challengers †¢ Comfort Adventurers †¢ Cocoon Travelers †¢ Pushing Boundaries †¢ Taste & Try Self-Challengers are the groups who are more affluent economically and are highly educated. They are most likely to be unmarried and between 18 to 75 years of age. Australia seems to be the favorite holiday destination amongst the self challengers. They are the travelers who go to holidays with a learning quest. Comfort Adventurers are the ones who have the curiosity to visit the places before they are visited by the local market. They do not compromise with safety and comforts. Cocoon Travelers are the ones who take inspiration from newspapers and experiences of others. They are basically married, having

Physical Security Essay Example for Free

Physical Security Essay Securing networks or systems within institutions and corporations is not enough. At present, security is not only concerned with the ethereal aspect of it but also with the tangible dynamics of physical security. Although physical security seems too basic, establishing even the most sophisticated network security is useless if its physical environment does not keep it sheltered and protected. Security threats that have something to do with the physical aspect of institutions include burglary and theft. In this case, even the most established digital security system that functions within the computer networks will not be able to prevent these crimes. A breach in physical security makes the network or digital system of the institution susceptible to power interruptions that disrupts the security system, addition of hardware devices that may used to hack or spy into the system, removal of hardware devices that paralyzes the system, copying confidential data from the system through USBs, CDs, and such, logging in the system directly without authorization, etc. Stewart, 2004) The importance of high standard physical security systems and policies ensure that aforementioned situations that seek to jeopardize the position of institutions that might affect all its aspects, especially its finances, are avoided. Having a secure digital system is impressive, but having a secure digital system and physical environment is highly recommended. To uphold high quality standards of security, both the digital and physical aspects of security should be merged. Sturgeon (2004) defines this as marrying digital and physical security. Physical security involves the use of high-tech gadgets such as cameras that will be used for close monitoring, 24-hour video coverage and storage, video recording triggered by movements, wireless and mobile installments within the physical environment, etc. (Physical Security, 2008) The physical security approach is based on four principles or strategies. First, physical security follows the necessity of protecting the network or institution, detecting security threats and possible risks, responding to these threats and risks, and allowing recovery for the network or institution from damages or indemnities brought about by security breaches. This process requires setting up of security systems that will accomplish these four phases of protecting (with the use of controlled access systems that restricts involvement of the public to authorized personnel only), detecting (using surveillance systems and frequent check-up of the physical areas of institutions), responding (well-trained security officials and network protocols that carry out these responses to security threats and risks), and recovering. (Operational Security Standard on Physical Security, 2004) Second, physical security builds up on hierarchical zones that protect or safeguard access to the security system. These hierarchical zones include the public zone (areas accessible to the public), reception zone (area wherein the boundary between the public and restricted zones is determined), operations zone (areas private to personnel), security zone (areas private to only authorized personnel or visitors), and the high security zone (areas private to authorized and escorted personnel or visitors). Within these zones, technological facilities and security officials are installed and designated respectively to carry out four phases in the previous approach discussed. (Operational Security Standard on Physical Security, 2004) The third approach in physical security is controlling access to determined hierarchical zones. This approach has something to do with controlling access most especially to restricted areas. It does not only control individual access, but is also concerned with the entry of materials considered to be potentially threatening or risky to security, such as mobile phones and other technological gadgets, harmful objects such as knives, guns, and such, etc. Although institutions should consider this approach in physical security, controlling access should not limit or restrict authorized individuals too much, allowing them ease in visiting each zone within the institution. Aside from security officials designated at every zone, there should also be systems that carry out state-of-the-art security protocols, such as technologies installed within the institution that asks for PIN or access numbers, access cards, biometrics, etc. Fourth, physical security systems should be designed to increase security levels in times of emergency or security threats. (Operational Security Standard on Physical Security, 2004) These four approaches, as recommended by the Treasury Board of Canada Secretariat follow the requirements of a strong and efficient physical security system. The concepts supported by these four approaches suggest how physical security systems and policies should be established in order to ensure that it will serve its purpose. However, accomplishing all the requirements in establishing a physical security system and a set of policies is not enough. Institutions should make sure that these elements of security are assessed and evaluated to ensure that it is properly sustained and it is up-to-date with trends in security technologies and processes. Part of the evaluation process includes frequent training and drills for security officials, checking-in with technological innovations that improve quality of security measures and systems, and observing existing systems to determine much-needed replacements or tweaks. With all these information in mind, physical security is a vital part in institutions that should not be neglected nor taken lightly. It complements digital network security systems, such that it prevents it from being jeopardized or subjected to external control, manipulation, and possible damages that affects the operations within the institution. Establishing a solid physical security system require that all aspects of the physical environment within an institution is identified. Mapping out requires that the institution determines where security is most needed and where access is most likely to be controlled. Aside from going over the basics and technical details of physical security systems, institutions should provide time and effort to evaluate the system in order to ensure that it functions efficiently according to its purpose, and that it meets the highest requirements of quality standard physical security.

Analysis of LAP and Modified LAP

Analysis of LAP and Modified LAP 1. Critically review a test item that you have designed for inclusion in an assessment instrument It is nearly two decades since the St Vincent Declaration (1989) called for a marked reduction in morbidity with diabetes related problems to be achieved through better patient management. The available evidence suggests that the process of care in Britain is still very variable in quality. (J. Mason, 1999) et al. conducted trial on diabetes foot care, and provided an important message that vigilant and trained health care professionals can identify the emerging risk factors for ulceration at relatively low cost. The National Institute for Clinical Excellence (NICE 2004) clinical guideline on type 2 diabetes foot care on the prevention and management of foot problems recommends that healthcare professionals and other personnel involved in the assessment of diabetic feet should receive adequate training. Hence, it is imperative that the Diabetes Specialist Registrars [SPR], the future diabetologists, who look after diabetic feet in the community and secondary care, should be trained and adequately assessed if they want to make an impact on patient outcomes. Thus, the need arises for a training CME [Continued Medical Education] day for the management of diabetes foot and assessment before they treat patients with these problems. The main aim of the assessment is to optimize the capabilities of all learners and practitioners by providing motivation and direction for future learning. The assessment has to be formative in this case guiding future learning by providing reassurance, promoting reflection and shaping values. At the end of the training day (Appendix 2) the plan is to conduct a modified, observed, long case type of assessment tool with 3-4 items and knowledge based assessment. One such item an observed modified long case is described in Appendix 1. The plan to use a real case is to illustrate the some of the day to day difficulties and uncertainties one faces during clinical judgement. The time breakdown is to prepare them for thinking about various aspects in given time. They are assessed in different generic skills as well as speciality knowledge and management of the case. Appendix 1 [page 24-26] Properties Even though it is used as an item here, the long case has traditionally been used as a summative tool by itself in the past and its properties in those situations have been studied extensively. Hence, the properties like reliability and validity have been discussed briefly with others of the items such as facility. The reliability of a long case can be improved by structuring the long case i.e. elements of discussion and questioning (Olson et al 2000, Wass and Jolly 2001). Thus observation and structuring is applied here to improve the reliability. This increases student perception of fairness. Validity This can be addressed by introduction of examiners who observe trainee performance throughout and so the trainee is observed by the team in all parts of the long case out here (Olson et al 2000). Facility It could be made low facility depending on the complexity of the case. Discrimination is not really applicable since it will be used as part of formative tool but can be made into a highly discriminatory one by following global assessment. The other properties of the assessment tool are not discussed as it is used mainly as an item. Item Response Theory This is not discussed here as it is mainly used in the context of Multiple Choice Questions. There is not much in the literature about the strengths and weaknesses of the long case when used as an item in a formative assessment tool. So here is an attempt to look at both the positive aspects and potential drawbacks of this item should this be used in the context of this formative assessment. The positive aspects of this item Observed Modified Long Case Holistic and Robust This item in the long case is real and looks at competency and some aspects of performance. Multidisciplinary Approach mimics how the clinics are conducted in most hospitals and assess candidates knowledge across specialities. Written and Verbal Constructive feedback Ende (1983) proposed that the process of feedback should be expected and well timed, based on first hand data (observable behaviour) and regulated in quantity. In a systematic review by Best Evidence in Medical Education (BEME) collaboration (Veloski, et al., 2006) the positive impact of the feedback process was confirmed, with the most marked effects if provided by an authoritative source. These principles are strictly followed in this item. The method of feedback can be either Pendleton or ALOBA- Agenda-Led Outcome Based Analysis. Some of the potential drawbacks of this item-How they can be overcome Risk of assessing the short term memory This argument stems from the fact that the assessment is done just after the CME program as suggested. Based on Bligh (2000), the above graph, demonstrates the retention power if tested early after the learning experience. Hence the argument: the item should be administered immediately after the CME to increase retention. Resources and Standardisation The number of people including specialists involved and the organisation will require resources, including money, but some of the funding could be organised by the educational fund for the SPR in the region. Some contribution can be arranged from other sources including pharmaceutical company help. Since it is a formative assessment tool, it need not be rigidly standardised in assessment and it is to promote the professional development of the SPRs. Why rigid time limits and not just global assessment? This rigid structure is to give an opportunity for each of specialists to have an opportunity to observe and feed back. In real life, the time spent on each task may be different but giving stringent time limits also gives the opportunity to observe how the candidates perform within these time constraints. The global assessment is avoided so that the feedback component needs to be broken down to each level to make sense and promote specific areas for improvement. Bias Since some of the examiners and experts would have taught these SPRs in the course there may be bias from these examiners after observing the candidates interaction over a day and might want them to do well or otherwise in the assessment. This can be avoided by formal training of the examiners. Organisational consideration The main difficulty will be getting the team of assessors together as given in the item and making sure they are trained in giving constructive feedback to the candidates. Getting a real life patient to participate in such a scenario might not be difficult as patients are often happy to share their experiences. CONCLUSIONS If used in conjunction with variety of other items, perhaps it can be used as a cog in the wheel of summative assessment for the high stake assessment e.g. as a part of portfolio in final year Rotation In Training Assessment [RITA]. It fulfils the learning objectives of the course and what the item intends to measure. This item also comes close to what is usually measured in items of work place based assessment [WPBA]. Element 2 Assessment option Using relevant theoretical and/or research literature, critically review one instrument of assessment used in clinical education. LAP and Modified LAP BACKGROUND In the traditional long case candidates spend 30-45mins with a patient from whom they take a history and examine. An examiner is not present and the candidate is not observed. The student summarises and is examined by a pair of examiners over a 20-30 minute period. The usual format of practice in long cases is to examine patients that are already known to the examiner or are in the examiners own specialty. The long case, patient based examinations have been used for decades both in undergraduate and postgraduate settings both as a formative and summative tool. They were specifically used for final certification exam for postgraduates both here and elsewhere. They had their strengths in that it evaluates performance with real patients and enables candidates to gather information and develop treatment plans under realistic circumstances (Norcini, 2002). However, this method has drawn lot of criticism. The problem lies with inter case reliability (Wass, et al., 2001) and whe n subjected to psychometric analysis, these examinations were found to be unreliable and so have fallen from favour (Turnbull, et al., 2005). Particular problems were with the reproducibility of scores generated by the long case. To improve this required large sampling which itself required a lot more resources which made the long case difficult to use as a summative assessment tool. Recent work suggests that the long case is still a highly relevant tool in that it appears to test a different clinical process to that of the structured short case examination (Wass and Jolly, 2001). A study, performed with undergraduates in London found that, by observing the process in the long case, the above problems could be overcome. This probably led to a return of long cases in the form of OSLER Objective Structured Long Examination Record introduced by Gleeson(Gleeson, 1997) and LAP the Leicester Assessment Package. The LAP was originally developed to assess the consultation competence of general practitioners in the UK. In the LAP, the patient is not known to the examiners and at least one of the examiners is not an expert in the specialty being examined. It has been designed for use in live and/or video recorded consultations with either real or simulated patients. It was subsequently adapted for use in undergraduate teaching. The LAP is designed to provide assessment by directly observed consultations with real patients/simulated patients, but to present this in a structured format closer to an OSCE, which also allows other aspects of performance to be assessed. Seven prioritized categories of consultation competence which need to be mastered are assessed with marking (Appendix 3). The modified LAP varies from the LAP in a couple of areas. Performance is assessed against predefined standards which are different compared to the LAP. The examiners attend training before they become assessors in the modified LAP. The guidelines to the examiners [how to mark and assess] and the assessment forms are appended (Appendix 4 5). Inevitably, some overlap occurs between components of differing categories. (Bhakta, et al., 2005) acknowledge that no single assessment format can adequately assess all the learning objectives within the course blueprint, a combination of assessments (including OSCE, EMQ, essays, short case, and long case) are currently used to assess the students competence. The authors main objective is to use theoretical and research literature to critically review the LAP and modified LAP used in the assessment of clinical practice. This review is based on the seven key concepts (Van der Vleuten, 1996; Schuwirth and van der Vleuten, 2006; PMETB, 2007) liste d below: Purposes Alignment Properties Standards Sampling Evidence Level 1. PURPOSES It can be used for both formative and summative assessment. (Fraser, et al., 1994) argued that the modified LAP is designed for both purposes. The focus of the examination in the intermediate clinical exam for undergraduate is to promote further improvement as they have done only one clinical year [e.g. WMS and Leicester Medical School]. Hence, the feedback is handed to the students which helps them to focus on their strengths and improve on their performance The 3rd and 4th year medical students of these Schools believed that it was likely to enhance their consultation performance (McKinley, et al., 2000). It has also been used as a formative tool in improving professional competence in different countries and different specialties (Lau, et al., 2003, Redsell, et al., 2003). When (Teoh and Bowden, 2008), arguing for the resurrection of the long case, state that the observed long case such as the Modified LAP doesnt encourage the reductionist approach as in Objective Structured Clinical Examination [OSCE ]. Thus, it can be an ideal summative assessment tool for the high stake exam but perhaps has to be used in conjunction with other tools as discussed below. Additionally, in most cases, the assessment is an end of year high-stakes assessment and, for failing students, there is generally only a short time available for remediation. The feedback provides a way to focus them on the areas of their consultation skills and prepare for their remedial exam. 2. ALIGNMENT The Education Committee of the General Medical Council (GMC) sets and monitors standards in all UK medical schools. Medical students must be able to demonstrate their competency and professionalism through a list of educational outcomes set out in the publication of Tomorrows Doctors (2003 and 2009) prior to graduation. The intended outcome envisaged by WMS is to produce a generation of doctors who have knowledge, proficient clinical skills and the appropriate attitudes and behaviours ready for work as Foundation Year one doctors. The modified LAP forms a part of the summative assessment in assessing mainly clinical skills e.g. examination techniques. As described, it has various components and proper, planned blueprinting against the learning objectives of the MBChB course and competencies of the various specialties (Wass, Van der Vleuten, Shatzer and Jones, 2001). Thus, assessment and curriculum design should be intricately interwoven and the assessment of course drives the learning (Wass, Van der Vleuten, Shatzer and Jones, 2001). Similarly, in postgraduate exams, it usually follows knowledge based assessment in the form of MCQs and careful alignment should be done considering the curriculum set by the institutions like the Royal Colleges. 3. PROPERTIES The property of an assessment or more commonly described as the utility or usefulness of an assessment, was originally described by Van der Vleuten (1996) as a product of its validity, reliability, educational impact, cost-effectiveness and acceptability. In later years, the term feasibility is explicitly acknowledged and has been described as an added component of an assessments utility in clinical education (Schuwirth and Van der Vleuten, 2006; PMETB, 2007). Validity Validity represents the extent to which a measurement actually measures what it intended to measure. In medical education, this signifies the degree of meaningfulness for any interpretation of a test score. (Downing, 2003) A recent study demonstrated that observation does measure a useful and distinctive component of history taking clinical competence over and above the contribution made by the presentation (Wass and Jolly, 2001). It would seem logical that, rather than relying on a presentation alone, observation of the candidate while eliciting the history and carrying out the examination would be a more valid assessment of the candidates competencies in LAP. There is data in the literature for the face validity and content of the seven categories and the various components of consultation competence as contained in the Leicester Assessment Package (Fraser, McKinley and Mulholland, 1994). Whether or not the test scores obtained, in any particular LAP, are an accurate representation of real world competency is subjected to a vast array of variables (Downing and Haladyna, 2004). For instance, the design of the test items, number of representative cases, experience training and leniency of examiners, co nsistency of simulated patients [ used mainly in psychiatry], completeness of marking schemes and the characteristics of the candidates, can all affect the validity of a LAP, making it a valid assessment in one education institute, but not another. However McKinley et al in their study of modified LAP in the general practise setting concluded that students will be exposed to a valid set of challenges to their consultation skills during consultations with minimum six largely unselected patients(McKinley, Fraser, Vleuten and Hastings, 2000). Concurrent validity whether the results are consistent with those tests of similar constructs? There are studies comparing OSCEs with observed long cases [which is similar to LAPs in some ways]; however, the author has not come across studies comparing different types of observed long case e.g. OSLER vs. Modified LAP. Does it predict the future performance need to be assessed by more studies by following up the generation of students where the LAP is used as an assessment tool. Also, more studies are needed to investigate the construct validity of LAP. Reliability Reliability refers to the degree of consistency within a measurement tool, the extent to which an instrument is capable of repeatedly producing the same test score even when administered at different times and locations, with different candidates (Schuwirth and van der Vleuten, 2006). An assessment approach may be considered reliable when it yields consistent results regardless of when it is used, who uses it and which item or case is assessed. The importance of a specific type of reliability depends upon what is being assessed and the method by which it is being assessed. Generally speaking, the reliability or generalisability coefficient [since there is multiple potential sources of variability in this assessment tool] of 0.8 or higher are desirable (Shea and Fortna, 2002). Since the LAP has its roots in the long case and considering that it has evolved as a modified observed long case the author will attempt to address how the deficiencies in reliability of long cases were addressed to make it a LAP. Attempts to improve the reliability of the long case and make it into an effective LAP fall into three categories. First, studies have considered how many additional long cases would be required, with Kroboth et al (1992) suggesting that 6-10 long cases (each of 1-1.5 h) would achieve a generalisability coefficient of 0.8. Thus it would take a minimum of 4 different cases with at least 2 assessors in each to be reliable and therefore, careful sampling of representative cases with the use of blueprints is of paramount importance (Cangelosi, 1990).Second, commentators have attempted to increase the number of long cases, but have done so by employing a format that draws on shorter assessments (20-45 min) and multiple cases (4-6) assessed directly after each other in a single session (McKinley et al, 2000; Wass Jolly, 2001; Hamdy et al, 2003; Norcini et al, 2003). Third, elements of the discussion and questioning aspects of the long case have been stan dardised in an attempt to improve reliability and student perceptions of fairness (Olson et al, 2000). Thus, having all relevant domains and enough numbers would increase the reliability and validity of the instrument. All these are incorporated in LAP and modified LAP to make a reliable instrument. This is further demonstrated by McKinley et al that the required levels of reliability can be achieved when the modified LAP is used by multiple markers in assessing the same consultation, that is, the package produces inter-assessor reliability. Their generalizability analysis indicates that two independent assessors assessing the performance of students across six consultations would achieve a reliability of 0ÂÂ ·94 in making pass or fail decisions. Also in this study ninety-eight percent of students perceived that their particular strengths and weaknesses were correctly identified, 99% that they were given specific advice on how to improve their performance and 98% believed that the feedback they had received would have long-term benefit(McKinley, Fraser, Vleuten and Hastings, 2000). The example of assessment criteria and guidelines of the modified LAP used in the study are incorporated as Appendix 4 and 5. Reliability of the LAP would not be severely threatened if the details of the test items have leaked out to the candidates unintentionally. However, it might if they have seen this patient before in the clinical setting. There were chances of this happening as the same banks of patients were used. This has been rectified by updating the bank and recruiting different patients. Broad sampling across cases is essential to assess clinical competence reliably (Wass and Vleuten, 2004). Feasibility The design and running of the modified LAP has significant resource implications. The crux of the issue for this kind of assessment is feasibility and cost effectiveness in terms of finance, space and manpower. Lots of time and effort are required to prepare and administer the instrument with high quality. Recruiting enough assessors, real patients, [simulated patients in case of psychiatry] and the equipment is always a huge challenge. Finding the trained assessors, who mostly tend to be busy clinicians, to take time from their heavy work schedule is also a challenge. However, lots of these issues can be overcome if this test is administered regularly i.e. sequential testing. This is further helped by having a database for the patients and assessors. Good advanced planning will also go a long way. Acceptability John B Cookson, et al. (2008), in a letter to the BMJ, say that feedback from students who have faced this examination in Leicester for the past 9 years strongly indicate that it is perceived as a fair and acceptable test of their abilities. From the organizational point of view it has been acceptable because of sequential testing. There is a healthy debate about replacing this with OSCEs or at least using OSCEs to supplement this for the assessment of clinical based practice. Educational Impact From the students point of view, the high-stakes LAP certainly exerts a great educational impact. The outcome of the examination will be used to decide the fate of the students. The LAP provides a platform for students to demonstrate their knowledge, skills, attitudes and behaviours in a single direct observational setting. Among other advantages it encourages students to develop the essential links between history, physical examination, diagnosis and management in each clinical challenge as the consultation progresses, not at some remote point thereafter. This is true as they practise for these exams in this way with peer group or supervision. It definitely has a huge educational impact as the students keep the final assessment in mind and practice the required domains in a structured way from various colleagues and peers. The impact is even greater in some medical schools like WMS as the feedback is given to the students in the formative intermediate exams. This enables the students to reflect on their performance and improve upon them. 4. STANDARDS The Standards can be criterion-referenced (absolute standard) or peer-referenced (relative standard). Borderline approach , fixed percentage , Angoffs and Hofstee methods are but a few of the many methods described in the literature for standard-setting (Norcini, 2003). Livingstone and Zieky (1989) proposed that the higher the stakes of the assessment, the greater the significance in using criterion-referenced standards. Thus criterion referenced can be used for LAP in the setting of high stakes exams like final professional exams in WMS or postgraduate exit exams SAMPLING It is impractical to combine all of the learning outcomes into a single, summative assessment. On a practical note one has to be careful while allotting the students and examiners for the different station/patients/item so that they get a wide variety of sampling that gives a different case mix. Thus, it also needs to be made sure that they are observed and examined by different examiners to increase the sampling. Thus a careful and effective blueprinting should be done to make LAP a high utility instrument. Moreover, qualitative triangulation of evidence [sampling] from different sources such as satisfactory performance in each block, including other types of exams likes OSCE for practical skills will further improve the reliability (Stern, et al., 2003). 6. EVIDENCE Evidence from a single point is not sufficiently generalisable to be extrapolated to all occasions (PMETB, 2007). Studies regarding validity and reliability are costly and difficult to design. Triangulation is an excellent solution to critique the evidence collated qualitatively, where evidence from at least 3 occasions/ resources indicating the same outcome is analyzed (PMETB, 2007). Each LAP item should be treated independently, as an entity of its own, and, although literature can prove LAP do possess the potential to be highly valid and reliable, such study would need to be conducted on separate occasions to demonstrate convincing evidence. This is continuous ongoing process at most of the institutions including WMS. 7. LEVEL It is suggested that using the LAP for direct observation of the consultation would be a useful tool to assess whether the student has successfully acquired the necessary competencies expected at the end of undergraduate or postgraduate training. One of the interesting components is to attempt to judge the overall relationship with the patient. Attitudes are most likely to be conveyed to the patient through the doctors behaviour and should, therefore, be assessed by the observation of behaviours in the clinical setting (REZLER, 1976). Nevertheless, this approach relies on judgements, made by experts, of non-standardised material and is, therefore, open to question. Because professionalism is a complex construct, it is unlikely that a single assessment will adequately measure it even though this assessment makes the attempt. Systematic assessment of professionalism should also include many different assessors, more than one assessment method and assessment in different settings (Lynch , et al., 2004). Hence, these assessments are a continuous process throughout the MBChB and, indeed, afterwards. In essence the LAP, as an assessment tool, is close to competency based assessment and demonstrates shows how in the Miller triangle. CONCLUSIONS Long cases on their own have been criticised for poor reliability of examiner assessments and the lack of direct observation by the examiner of the trainee patient encounter [reducing the validity of the assessments]. There is evidence that adding an observing examiner to the history and physical examination part of the long case assessment increases reliability and helps to reconcile the complex interactions between the context and the skills/knowledge (construct) that the long case attempts to measure (Wass and Jolly, 2001). The LAP is one such tool where there is observation during history and physical examination and structured assessment and proves to be of high utility. This is supported by some studies in the formative setting(McKinley, Fraser, Vleuten and Hastings, 2000) The LAP, when analysed via its properties, is a good tool to assess observed clinical practice. It might not be so effective for practical skills and, for these, it probably needs to be supplemented by work based assessments or even OSCEs. When supplemented with other assessment tools [Triangulation] LAPs can be used effectively for summative assessment in high stake assessments such as the final examinations for medical students. The main drawbacks are feasibility, difficulty in blue-printing and cost effectiveness. It encourages students to develop the essential skills together rather than combining them afterwards. REFERENCES Bhakta, B., Tennant, A., Horton, M., Lawton, G. and Andrich, D. (2005) Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education. BMC Medical Education, 5 (1): 9. Fraser, R. C., McKinley, R. K. and Mulholland, H. (1994) Consultation competence in general practice: establishing the face validity of prioritized criteria in the Leicester assessment package.[see comment]. British Journal of General Practice, 44 (380): 109-113. Gleeson, F. (1997) AMEE Medical Education Guide No. 9. Assessment of clinical competence using the objective structured long examination record (OSLER). Medical Teacher, 19 (1): 7-14. J. Mason, C. O. K. A. M. A. H. A. B. R. J. Y. (1999) A systematic review of foot ulcer in patients with Type 2 diabetes mellitus. I: prevention. Diabetic Medicine, 16 (10): 801-812. Lau, J. K. C., Fraser, R. C. and Lam, C. L. K. (2003) Establishing the content validity in Hong Kong of the prioritised criteria of consultation competence in the Leicester Assessment Package (LAP). Hong Kong Practitioner, 25 (12): 596-602. Lynch, D. C., Surdyk, P. M. and Eiser, A. R. (2004) Assessing professionalism: a review of the literature. Medical teacher, 26 (4): 366-373. McKinley, R. K., Fraser, R. C., Vleuten, C. v. d. and Hastings, A. M. (2000) Formative assessment of the consultation performance of medical students in the setting of general practice using a modified version of the Leicester Assessment Package. Medical Education, 34 (7): 573-579. Norcini, J. J. (2002) The death of the long case? BMJ, 324 (7334): 408-409. Norcini, J. J. (2003) Setting standards on educational tests. Medical Education, 37 (5): 464-469. Redsell, S. A., Hastings, A. M., Cheater, F. M. and Fraser, R. C. (2003) Devising and establishing the face and content validity of explicit criteria of consultation competence in UK primary care nurses. Nurse Education Today, 23 (4): 299-306. REZLER, A. G. (1976) Methods of attitude assessment for medical teachers. Medical Education, 10 (1): 43-51. Shea, J. A. and Fortna, G. S. (2002) 3 Psychometric Methods. International handbook of research in medical education, 97. Stern, D. T., Wojtczak, A. and Schwarz, M. R. (2003) The assessment of global minimum essential requirements in medical education. Medical Teacher, 25 (6): 589-595. Teoh, N. C. and Bowden, F. J. (2008) The case for resurrecting the long case. BMJ, 336 (7655): 1250. Turnbull, J., Turnbull, J., Jacob, P., Brown, J., Duplessis, M. and Rivest, J. (2005) Contextual Considerations in Summative Competency Examinations: Relevance to the Long Case. Academic Medicine, 80 (12): Wass, V. and Jolly, B. (2001) Does observation add to the validity of the long case? Medical Education, 35 (8): 729-734. Wass, V., Van der Vleuten, C., Shatzer, J. and Jones, R. (2001) Assessment of clinical competence. The Lancet, 357 (9260): 945-949. Wass, V. and Vleuten, C. v. d. (2004) The long case. Medical Education, 38 (11): 1176-1180. APPENDIX 1- PROPOSED ITEM AN OBSERVED MODIFIED LONG CASE CONTEXT- Following Continued Medical Education day for Diabetes Specialist Registrars-SPRs[CME Appendix 2] Aimed at senior SPR that is year 4-5 just a year before completion of their training Formative Assessment Can be used in their portfolios for Continued Professional Development CPD Generic skills assessed- Communication, Professionalism, Clinical reasoning in uncertain environment, Teamwork and Multidisciplinary Approach Assessment involves 4 items of observed long modified long cases and MCQ-paper aiming mainly at knowledge base. One such item an observed modified long case has been described below. Expected learning outcomes for this formative assessment item- Able to assess vascular, neurological status of foot and in a patient with diabetes Diagnose pedal pathologies in the

Free Speech Should Not be Restricted -- Argumentative Persuasive Argum

Free Speech Should Not be Restricted I have an idea!   How about we let everyone freely speak their minds about issues and ideas.   Some will be better than others will of course, but the outcome will be a compilation of everyone’s best thoughts.   Everyone that is, except you.   We, meaning the country, decided that whatever it is that you have to say isn’t all that important and it is recommended that you keep all your thoughts to yourself as it is hard not to be offensive to everyone at the same time.   By offensive I mean to displease someone.   In general, no one really likes what you have to say.   Therefore it has been decided that you and only you will be silenced. â€Å"If all mankind minus one, were of one opinion, and only one person were of the contrary opinion, mankind would be no more justified in silencing that one person, than he, if he had the power, would be justified in silencing mankind.†Ã‚   John Stuart Mill could not have been more correct in his statement, using the first paragraph as an example. Walking into any airport, post 9-11, a series security checks is nec...

Engage in Personal Development in Health, Social Care or Children’s and Young Peoples Setting

As a childminder I have a duty to be registered and inspected with Ofsted. This ensures that I am working to the high quality and standard as required by Ofsted and the Early Years Foundation Stage. It is my duty is to ensure that I provide consistently high levels of childcare, within a safe, positive, warm and happy environment where children always feel welcome. I have a duty to plan supervised activities for the children, to enable them to learn and develop at their own pace within the EYFS as appropriate for their individual age groups.I am also responsible for completion of all relevant paperwork adhering to guidelines to maintain constant structure of my childminding practice and implementing any additional requirements as they occur. It is paramount to my childminding practice to continue to perform all of these duties to give parents peace of mind that their child/children are receiving the correct level of care and support to flourish in their own individual learning.To pro mote and maintain high levels of professionalism whilst carrying out my work. To ensure I provide a safe environment for the children at all times.To carry out risk assessments on areas used for childminding within my home and garden area, and also of any places regularly visited and review these on a regular basis. To implement and update policies and procedures keeping in line with Ofsted’s guidance. Prepare and provide healthy balanced meals for children whilst being aware of any child’s individual dietary requirements. To maintain discipline of all children within my care encouraging positive behaviour at all times. To build and maintain good relationships with any people involved with the children’s lives, parents/teachers/social workers etc.I must be aware of any signs and symptoms of potential abuse and the current legislative procedures for reporting it. I need to be taking children in my care to childminding groups and playgroups to allow them interacti on with other children. I must make, maintain and implement plans covering long-term, medium-term and short-term to offer varied activities to stimulate children’s learning in different areas. I am required to make observations of children in my care to allow a picture to build on their learning abilities to assist in my planning of activities and to highlight any areas of difficulty children maybe experiencing to allow help to be sort as required. Mainly responsible for giving children within my care the best possible environment for them to thrive and feel safe whilst away from their carers/parents.1.2 Complete the table below describing how the relevant standards apply to your role Relevant Standards Expectations of your own work role EYFSNational Minimum Standards for Regulated Childcare (Wales)National Occupational StandardsJob DescriptionCommon CoreCode of Conduct

Looking At The Scope Of Multicultural Counseling Social Work Essay Example

Looking At The Scope Of Multicultural Counseling Social Work Essay Example Looking At The Scope Of Multicultural Counseling Social Work Essay Looking At The Scope Of Multicultural Counseling Social Work Essay Josie is an 11-year-old bi-racial kid who lives with her individual female parent. Josie has a history of acquisition and behavioural jobs in school. She attends a big suburban school and is fighting in 4th class. Josie can be a behavioural job in the place and community and has been referred to your bureau for protagonism services. She has been asked non to return to her association football squad because of her behaviour and is no longer permitted at day care. Her female parent s chief long-run end is to hold Josie remain in the least restrictive environment in the place, school, and community. ThisA problematicA situationA is associatedA with the range ofA multiculturalA guidance. Multicultural guidance is particularly of import in today s society, as diverse racial and cultural environment raises many jobs, which require cultural competency of societal workers in covering with jobs which arise in multicultural society, in the field of race, ethnicity, cultural backgrounds, civilizations, faiths and other diverseness factors. ( Erford, 2008 ) In the instance of a kid Josie who hasA behavioural problemsA andA jobs atA school, whichA may beA related to her raceA andA societal status.A JosieA goes toA big suburban school, A whereA asA we knowA there are many childrenA and adolescents fromA different households, A andA its environmentA isA usuallyA characterized byA great figure of struggles, since such school non merely createsA favourable conditions for multicultural instruction, but besides gives rise to serious struggles between members of different racial and cultural groups. ( Lynch, 1996 ) It is possible that two-race Josie has struggles with kids at school, her equals do non take her in their community, or badger a girl.A It is known that Josie is populating in single-parent household, which besides adversely affects her position.A Josie can see herself an castaway, non like everybody, may hold low self-esteem.A These internal jobs and struggles in the school with kids lead to her aggressive behaviour, noncompliance. In suchA state of affairss it is veryA of import toA find out the state of affairs at school and Josie s dealingss with other kids, to cognize relation of people who are close to her, or with whom the kid interacts. The primary measure inA solvingA the problemA will be to turn to a adviser, A a specialistA whoA will helpA to understand theA situationA of JosieA andA will determineA possible solutions toA the job with kid s behaviour. The chief undertakings of the primary support of the specializer will include the undermentioned: A To assist the kid understand his jobs, and assist him to concentrate on their resolution ; A Psychologically to quiet down the kid, leting him to yield, non to support against his bad feelings and emotions, to cut down the degree of unfavorable judgment against himself, aid to get the better of mental strain, shame about the state of affairs ; A If necessary, to show certain forms of behaviour to a kid as an illustration of human opposition to emphasize, self-denial, vision, logical analysis of state of affairss in life ; A Supply the kid with necessary information, which can increase his motive to work out the job ; A Provide advices and support kid s ain attempts to asseverate control over the state of affairs, to cut down his uncertainties and fright of the unknown ; To animate hope and advance the revival of the kid to self-awareness and willingness to cover with the state of affairs ; A To protect the rights and involvements of the kid, interceding in the negotiations with parents, professionals, organisations, aid in obtaining entree to necessary societal resources, etc.A Therefore, an pedagogue, or adviser, shows the kid how to decide the job, helps to cut down his anxiousness and increase self-confidence.A The chief aim of guidance is to ease the personal growing of a kid in a job state of affairs, that is, of his sense of position, the development of his ability to analyse and see life state of affairss from different angles, to be able to develop different schemes of behaviour and consciously follow them.A ( Erford, 2008 ) In order to supply qualified psychological support and aid it is necessary to cognize the psychological features of age periods and the major differences between the reactions of kids and adults.A These differentiations are non ever seeable, but are indispensable and can demo how the job is important for the kid, and how he reacts to stressful situations.A Advocacy of kids has several alone characteristics: foremost of all, the kid is dependent on his parents, to whom he besides normally really emotionally attached. Complex relationship of the kid and parents act upon his relationship with grownups and can present a serious job in supplying assistance.A When reding kids it is necessary to see the undermentioned distinctive features: A The kid is non ever able to set up societal dealingss within the equal group, to happen and maintain friends.A Child are dependent on the attention and protection of parents, who have the chief influence on them ( both positive and negative ) .A Child are non ever able to show complex feelings and discourse the general, abstract inquiries, or speak about certain topics ( tabu or traumatic subjects ) , so the advisor may suggest to depict the state of affairs in alternate manner, and should carefully choose words ; A In contact with others kids need to experience a positive attitude towards them.A Defensive reaction may be denial of ain failing, faulting others or circumstances.A it is necessary to keep contact with the kid s societal world and to demo that there are no simple solutions to complex problems.A ( Erford, 2008 ) The effectivity of psychological aid mostly depends on personal features such as teacher-adviser, as the ability to perforate into the emotional universe of another, empathy ( empathy ) , to supply emotional attention and support, a high grade of personal and societal duty, together with the desire to take duty, high societal intelligence, openness, communicating, emphasis. When reding kids the specializer must take into history the fact that kids can barely maintain focal point and control behaviour for a long clip, particularly when they have some emotional disorders.A That is why the adviser must be patient.A Making conversation with Josie, it is possible to use the traditional attack, so that start a conversation with the general open-ended inquiries, followed by contracting the focal point, or get down with specific issues, while go forthing the topographic point of choice.A The kid is easier to react to short specific inquiries about the events.A Thus, during conversation it is necessary to clear up the ground of Josie behaviour. Of class, the kid can non place and call a particular job, so it is necessary to allow him depict his feelings ( what he is concerned about? A what causes in him choler or fear? ) to clear up the emotional behaviour of the kid. Psychological support for Josie who is in a hard state of affairs, should come in analogue at school and at home.A The nature and way of such support must frequently be determined by adviser. Josie s parents should: A Explain to the kid the job in apprehensible signifier and friendly mode ; A To assist show Josie her feelings, listening to a kid without doing any judgements or critics ; A Make it clear to Josie that her feelings, cryings about something unpleasant is normal, anyhow she must seek to command emotions ; A If Josie is afraid, mother must demo that she loves her and ever ready to assist, to support her in any state of affairs. It is collaborative effortsA andA helpA ofA protagonism specializer, mothersA andA teachersA at schoolA would helpA to clear up the job of Josie, A and besides assist the miss to solveA it and better her behaviorA and acquisition.

My Bondage My Freedom essays

My Bondage My Freedom essays There is not, beneath the sky, an enemy to filial affection so destructive as slavery. (Douglass, 60) Its remarkable how one little sentence can describe the hatred and animosity that a single man has for a way of life. As a young boy in Tuckahoe, Maryland, Douglass saw the effect that slavery had on his family and friends. Born in approximately February of 1817, Douglass was raised by his grandmother and grandfather due to his mother being hired out to a Mr. Stewart. Douglass description made his childhood seem carefree and joyful. Up until the age of seven or eight, the slave children were able to run and play in the dirt, swim in the streams, and explore the lands of their master. This is where things started to take a change for the worse. In this paper, I hope to let Douglass speak through me in order to delineate his triumphant story ranging from childhood, through slavery and into freedom. Even though Douglass did not agree with the concept of slavery and dreamed of being an abolitionist, he knew that slavery was going to be his way of life. Douglass questioned why God would subject him to such hatred. By asking around he came up with several theories which did not satisfy his thirst for knowledge. Some of the theories included, God made white people to be masters and black people to be slaves, (Douglass, 89) and God was good and knew what was best for them. (Douglas, 90) Douglass finally came up with the solution it was not color, but crime, not God but man. (Douglass, 90) He knew that the weakness was not on the shoulders of God but on the shoulders of man. Slavery was a crime that could be changed through the education of slaves and giving them the tools to uprise. Because he stated, what man can make, man can unmake. (Douglass, 90) Slavery was divided into three classes slaveholders, overseers and slav ...