Background A patient-centred approach to care is increasingly the mandate for healthcare delivery. There is a need to explore how health professional students develop patient-centred attributes. This study aims to understand the extent of patient-centred orientations of health professional students, their perceptions and factors influencing their adoption of the approach. Methods The study used a cross-sectional, parallel mixed methods design combining a survey using the Patient-Practitioner Orientation Scale (PPOS) followed by focus groups with medical, nursing, physiotherapy and speech and language therapy students. Data included students’ age, gender, programme, and placements experienced. Pearson’s chi squared and the non-parametric equivalent Kruskal-Wallis H test were done to test for differences in demographics for appropriate variables. One-way ANOVA or Welch test was done to explore differences in PPOS scores. Regression analysis was done to test the influence of the demographic variables on PPOS scores. Data from focus groups were coded, categorised and organised under themes appropriate to the research aims. Results Of the 211 complete responses, significant differences were observed between medical and physiotherapy students in total PPOS scores, (MD -8.11 [95% CI -12.02 - 4.20] p = 0.000), Caring component (MD -4.44 [95% CI - 6.69, − 2.19] p = 0.000) and Sharing component (MD -3.67 [95% CI -6.12 -1.22] p = 0.001). The programme in which students were enrolled i.e. Medicine and SALT were the only indicators of higher PPOS total scores (F = 4.6 Df 10,69; p = 7.396e-06) and caring scores (F = 2.164 Df 10, 69 p = 0.022). Focus groups revealed that students perceived patient-centredness as holistic yet individualised care through establishing a partnership with patient. They identified that their student status, placement pressures, placement characteristics especially mentoring influenced their development of patient-centred attributes. Conclusion This study highlights the fact that the pressures of training in the National Health Service affects the development of students’ patient-centred orientation. There is a need for further work to explore aspects related to mentor training, for the development of patient-centred attributes, in a curricular framework structured on students’ needs from this study.

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The SUDALS together with flexible electrogoniometers is a useful clinical tool, capable of recording knee flexion/extension angles accurately during ADL.

Complexity of evolving models in genetic programming (GP) can impact both the quality of the models and the evolutionary search. While previous studies have proposed several notions of GP model complexity, the size of a GP model is by far the most researched measure of model complexity. However, previous studies have also shown that controlling the size does not automatically improve the accuracy of GP models, especially the accuracy on out of sample (test) data. Furthermore, size does not represent the functional composition of a model, which is often related to its accuracy on test data. In this study, we explore the evaluation time of GP models as a measure of their complexity; we define the evaluation time as the time taken to evaluate a model over some data. We demonstrate that the evaluation time reflects both a model's size and its composition; also, we show how to measure the evaluation time reliably. To validate our proposal, we leverage four well-known methods to size-control but to control evaluation times instead of the tree sizes; we thus compare size-control with time-control. The results show that time-control with a nuanced notion of complexity produces more accurate models on 17 out of 20 problem scenarios. Even when the models have slightly greater times and sizes, time-control counterbalances via superior accuracy on both training and test data. The paper also argues that time-control can differentiate functional complexity even better in an identically-sized population. To facilitate this, the paper proposes Fixed Length Initialisation (FLI) that creates an identically-sized but functionally-diverse population. The results show that while FLI particularly suits time-control, it also generally improves the performance of size-control. Overall, the paper poses evaluation-time as a viable alternative to tree sizes to measure complexity in GP.

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