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BackgroundInvestigation of real incidents has been consistently identified by expert reviews and student surveys as a potentially valuable teaching resource for medical students. The aim of this study was to adapt a published method to measure resident doctors’ reflection on quality improvement and evaluate this as an assessment tool for medical students.MethodsThe design is a cohort study. Medical students were prepared with a tutorial in team based learning format and an online Managing Incident Review course. The reliability of the modified Mayo Evaluation of Reflection on Improvement tool (mMERIT) was analysed with Generalizability G-theory. Long term sustainability of assessment of incident review with mMERIT was tested over five consecutive years.ResultsA total of 824 students have completed an incident review using 167 incidents from NHS Tayside’s online reporting system. In order to address the academic practice gap students were supervised by Senior Charge Nurses or Consultants on the wards where the incidents had been reported. Inter-rater reliability was considered sufficiently high to have one assessor for each student report. There was no evidence of a gradient in student marks across the academic year. Marks were significantly higher for students who used Section Questions to structure their reports compared with those who did not. In Year 1 of the study 21 (14%) of 153 mMERIT reports were graded as concern. All 21 of these students achieved the required standard on resubmission. Rates of resubmission were lower (3% to 7%) in subsequent years.ConclusionsWe have shown that mMERIT has high reliability with one rater. mMERIT can be used by students as part of a suite of feedback to help supplement their self-assessment on their learning needs and develop insightful practice to drive their development of quality, safety and person centred professional practice. Incident review addresses the need for workplace based learning and use of real life examples of mistakes, which has been identified by previous studies of education about patient safety in medical schools.

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Wafer-applied underfill systems for flip-chip bonding have been developed to overcome throughput limitations imposed by capillary underfill systems. The waferapplied underfill system consists of a highly filled film laminated to a bumped IC wafer and a liquid flux adhesive dispensed on the board. The wafer is diced after film lamination and the individual chips carry the underfill through the assembly process. The flux adhesive is dispensed at the bond site just prior to chip placement. These underfill materials undergo most or all of the required cure through a single reflow oven pass. A critical concern for a successful wafer-applied underfill bond is the prevention of discontinuities or voids in the underfill layer. Voids in the underfill can weaken the solder reinforcement otherwise provided by the underfill or permit the formation of betweenbump shorts caused by solder extruding into the void. The wafer-applied underfill film laminating process presents one possible source for discontinuities. Since the film is laminated to a bumped wafer, the complete encasement around each solder bump by the wafer-applied underfill film is a necessity. A lamination process used to transfer the wafer-applied underfill film to the bumped wafer without such discontinuities will be described. This lamination process has been shown to provide uniform lamination over a full wafer with complete encasement of the solder bumps. Wafer-applied underfill and flux material characteristics and reliability results also will be reported.

Mapping the QCD phase boundary and locating critical end point still remains as an open problem in strong interaction physics. Predictions about the co-ordinates of the critical point in the (T, µB) plane, from different QCD motivated models show a wide variation. Lattice QCD calculations are also available, that give an estimation of the critical point for chiral phase transition, where the transition changes its nature from rapid cross over to first order transition. Recently co-ordinates of the critical point for deconfinement phase transition are claimed to be found as an endpoint of the first order phase transition line, in Bag model scenario. In the present paper we have shown that Bag model gives a complete first order phase transition line in the (T, µB) plane, and one can not have any point where the transition changes its nature.