A cultural change is needed for trainees to feel that WBAs are not just a tick box exercise, but a useful educational tool for learning. Ongoing work on implementation needs to include additional training, especially on the value of WBAs for formative assessment and consultants having protected time in their job plans for training.

Multi-source feedback (MSF) has become the accepted mechanism of ensuring the appropriate professional behaviour of doctors. It is part of the mandatory assessment of doctors in training and is to be utilized as part of the revalidation of trained doctors. There is significant variation in the models of MSF currently used within the National Health Service and new models of MSF are being designed by various specialties. No single model has been recognized as the 'gold standard'. However, there is a large published literature concerning MSF, both in the context of health systems and, more extensively, within industry. This published literature is reviewed, drawing attention to aspects of MSF systems in which there is consensus on effective approaches as well as other aspects in which there is doubt about the optimum approach. In the light of the review 10 principles key in the development of effective MSF models have been produced.

The incidence and prevalence of diaper dermatitis varies widely between published studies. It is a condition which causes considerable parental anxiety. To better understand the frequency of diaper dermatitis, treatment practices, and the current importance of previously identified etiologic factors, a questionnaire survey of parents who had children wearing diapers (n = 532) attending a large United Kingdom district general hospital was undertaken. At the time of survey, only 16% of the study population had diaper dermatitis. Forty-eight percent of the study population had never had an episode of diaper dermatitis. In a multivariate analysis, current diaper dermatitis was independently associated with four factors: presence of oral thrush, number of previous episodes, frequency of diaper changes, and diarrhea. Recurrent episodes of diaper dermatitis were associated with increasing age, lack of barrier cream use, current diaper rash, and frequency of diaper changes. In the majority of children with diaper dermatitis at the time of survey, treatment had been instituted in the community. Diaper dermatitis usually presents and is treated successfully outside the hospital setting and is not a common clinical problem in secondary care.

The Western Research Laboratory (WRL) is a computer systems research group that was founded by Digital Equipment Corporation in 1982. Our focus is computer science research relevant to the design and application of high performance scientific computers. We test our ideas by designing, building, and using real systems. The systems we build are research prototypes; they are not intended to become products.There two other research laboratories located in Palo Alto, the Network Systems Laboratory (NSL) and the Systems Research Center (SRC). Other Digital research groups are located in Paris (PRL) and in Cambridge, Massachusetts (CRL).Our research is directed towards mainstream high-performance computer systems. Our prototypes are intended to foreshadow the future computing environments used by many Digital customers. The long-term goal of WRL is to aid and accelerate the development of high-performance uni-and multi-processors. The research projects within WRL will address various aspects of high-performance computing.We believe that significant advances in computer systems do not come from any single technological advance. Technologies, both hardware and software, do not all advance at the same pace. System design is the art of composing systems which use each level of technology in an appropriate balance. A major advance in overall system performance will require reexamination of all aspects of the system. We do work in the design, fabrication and packaging of hardware; language processing and scaling issues in system software design; and the exploration of new applications areas that are opening up with the advent of higher performance systems. Researchers at WRL cooperate closely and move freely among the various levels of system design. This allows us to explore a wide range of tradeoffs to meet system goals.We publish the results of our work in a variety of journals, conferences, research reports, and technical notes. This document is a research report. Research reports are normally accounts of completed research and may include material from earlier technical notes. We use technical notes for rapid distribution of technical material; usually this represents research in progress. To obtain more details on ordering by electronic mail, send a message to one of these addresses with the word ''help'' in the Subject line; you will receive detailed instructions. Limits of Instruction Author's noteThree years ago I published some preliminary results of a simulation-based study of instructionlevel parallelism [Wall91]. It took advantage of a fast instruction-level simulator and a computing environment in which I could use three or four dozen machines with performance in the 20-30 MIPS range every night for many weeks. But the space of parallelism techniques to be explored is very large, and that study only scratched the surface.The report you are reading now is an attempt to fill some of the cracks, both by simulating more intermediate models and by considering a few ideas the original study did not consider. I belie...

The Western Research Laboratory (WRL) is a computer systems research group that was founded by Digital Equipment Corporation in 1982. Our focus is computer science research relevant to the design and application of high performance scientific computers. We test our ideas by designing, building, and using real systems. The systems we build are research prototypes; they are not intended to become products.There two other research laboratories located in Palo Alto, the Network Systems Laboratory (NSL) and the Systems Research Center (SRC). Other Digital research groups are located in Paris (PRL) and in Cambridge, Massachusetts (CRL).Our research is directed towards mainstream high-performance computer systems. Our prototypes are intended to foreshadow the future computing environments used by many Digital customers. The long-term goal of WRL is to aid and accelerate the development of high-performance uni-and multi-processors. The research projects within WRL will address various aspects of high-performance computing.We believe that significant advances in computer systems do not come from any single technological advance. Technologies, both hardware and software, do not all advance at the same pace. System design is the art of composing systems which use each level of technology in an appropriate balance. A major advance in overall system performance will require reexamination of all aspects of the system. We do work in the design, fabrication and packaging of hardware; language processing and scaling issues in system software design; and the exploration of new applications areas that are opening up with the advent of higher performance systems. Researchers at WRL cooperate closely and move freely among the various levels of system design. This allows us to explore a wide range of tradeoffs to meet system goals.We publish the results of our work in a variety of journals, conferences, research reports, and technical notes. This document is a research report. Research reports are normally accounts of completed research and may include material from earlier technical notes. We use technical notes for rapid distribution of technical material; usually this represents research in progress. To obtain more details on ordering by electronic mail, send a message to one of these addresses with the word ''help'' in the Subject line; you will receive detailed instructions. Limits of Instruction Author's noteThree years ago I published some preliminary results of a simulation-based study of instructionlevel parallelism [Wall91]. It took advantage of a fast instruction-level simulator and a computing environment in which I could use three or four dozen machines with performance in the 20-30 MIPS range every night for many weeks. But the space of parallelism techniques to be explored is very large, and that study only scratched the surface.The report you are reading now is an attempt to fill some of the cracks, both by simulating more intermediate models and by considering a few ideas the original study did not consider. I belie...