BackgroundA knowledge based planning tool has been developed and implemented for prostate VMAT radiotherapy plans providing a target average rectum dose value based on previously achievable values for similar rectum/PTV overlap. The purpose of this planning tool is to highlight sub-optimal clinical plans and to improve plan quality and consistency.MethodsA historical cohort of 97 VMAT prostate plans was interrogated using a RayStation script and used to develop a local model for predicting optimum average rectum dose based on individual anatomy. A preliminary validation study was performed whereby historical plans identified as “optimal” and “sub-optimal” by the local model were replanned in a blinded study by four experienced planners and compared to the original clinical plan to assess whether any improvement in rectum dose was observed. The predictive model was then incorporated into a RayStation script and used as part of the clinical planning process. Planners were asked to use the script during planning to provide a patient specific prediction for optimum average rectum dose and to optimise the plan accordingly.ResultsPlans identified as “sub-optimal” in the validation study observed a statistically significant improvement in average rectum dose compared to the clinical plan when replanned whereas plans that were identified as “optimal” observed no improvement when replanned. This provided confidence that the local model can identify plans that were suboptimal in terms of rectal sparing. Clinical implementation of the knowledge based planning tool reduced the population-averaged mean rectum dose by 5.6Gy. There was a small but statistically significant increase in total MU and femoral head dose and a reduction in conformity index. These did not affect the clinical acceptability of the plans and no significant changes to other plan quality metrics were observed.ConclusionsThe knowledge-based planning tool has enabled substantial reductions in population-averaged mean rectum dose for prostate VMAT patients. This suggests plans are improved when planners receive quantitative feedback on plan quality against historical data.

Internationalisation in higher education has been shown to provide both intellectual and cultural benefits to students which can help in their future employment. This case study describes student views on learning alongside students from different countries in an online distance learning environment. Seventy-three students undertaking the online Master of Public Health programme at Manchester University, UK completed the survey which explored student experiences, views and opinions on aspects of the course. Learning about other countries' health systems and the experiences of public health professionals in other countries were identified as a key benefit of studying alongside students from other countries. Students were able to appreciate other perspectives, reconsider their own attitudes and improve their understanding of the context of public health issues. The benefits of learning alongside students from other countries can be enhanced within an online learning environment through the appropriate use of discussion boards and other online learning strategies.

<p><strong>Introduction</strong></p><p>Online distance learning (e-learning) is now an established method for providing higher education, in the UK and across the world. The focus has largely been on developing the technology, and less attention has been given to developing evidence-informed course provision. Thus the effectiveness of this teaching approach, and its acceptability to students, is, at times, uncertain. Many higher education courses require students to submit a dissertation. Traditional face-to-face courses will include meetings between the student and an allocated supervisor, to support the dissertation component of the course. Research into the supervisory relationship and student satisfaction has focused on doctoral students. Little is known about the experiences of students studying for a master’s degree.</p><p>The aim of the current study was to measure student satisfaction with the dissertation course as part of a fully online distance learning master’s programme in public health.</p><p><strong>Methods</strong></p><p>All students submitting a dissertation as part of their master’s programme in Public Health were sent an electronic survey to complete, in September 2012. The 34 item questionnaire used a four point Likert scale for students to rate levels of satisfaction across key components of the course, including preparatory materials, study skills, and support, and with the amount and content of supervision. Open ended/free text questions were used to determine factors associated with levels of satisfaction and to gain student feedback on the course overall. The constant comparative method was used to identify key themes from the free-text responses.</p><p><strong>Results</strong></p><p>Of the 45 students submitting a dissertation, 82% (37) responded to the survey. The majority of students, 85% (28)  were satisfied or very satisfied with the dissertation course overall. Levels of satisfaction remained high for many of the components examined. Differences were observed for part time and full time students, and for the type of dissertation, but these were not significant. Similarly, non significant findings were observed for associations between satisfaction and the estimated number of contacts initiated with their supervisor, and for the time spent working on their dissertation. The constant comparative analysis identified key themes and feedback included ‘self development’, ‘peer support’, and ‘writing skills’.</p><p><strong>Conclusions</strong></p><p>Generally high levels of satisfaction were received from students studying a dissertation course as part of a fully online distance learning programme in public health. Areas for further improvement were identified and the results act as a benchmark for future quality enhancement. These findings suggest that appropriate information, study skills, and supervisory support can be provided in an online distance learning programme, for students taking a master’s level dissertation course.</p>

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Immunization Information Systems (IIS) are operational in most states and are useful in programmatic and clinical assessments. To ensure that IIS reach their technical and usability potential, and to promote their use, we conducted a Delphi survey to develop a national IIS research and evaluation agenda. Experts with a wide range of IIS knowledge were asked to generate research and evaluation topics that document their utility in achieving and sustaining clinical and public health goals. Topics were then collated by the authors into 13 main categories and were ranked by the survey experts in order of importance. Provider perspectives and needs was ranked as the top research priority. Both data quality and technical data exchange also ranked high, as well as increasing provider participation and IIS cost and cost savings. Lower-ranked research priorities included data sharing between states and factors affecting IIS population-based measurements. Development of an IIS research and evaluation agenda allows policy makers to ensure that their decisions coincide with expert views on national priorities and enables researchers to conduct studies addressing topics recognized as nationally important. It also allows for targeted funding decisions.