Research at UCC ASSERT

ASSERT research programme is committed to creating, understanding and sharing knowledge.

ASSERT’s research programme is explicitly undertaken to advance and support the delivery of real-world solutions in healthcare, healthcare education and healthcare technological innovation at a national and global level.

ASSERT is focused on supporting, designing, developing, enhancing and implementing interdisciplinary research that fosters and enables a community of academics, healthcare professionals and industry engage in a collaborative, cohesive and synergistic manner to achieve these solutions.

Research Projects


Maire Caitlin Casey,  Eoin S O’Broin, Dept. of Plastic Surgery, CUH.


(Listening and Interpreting Speech with Technology Evaluation Nuances)

Pat Henn

John O’Donoghue

Simon D. Smith

Abdul Muiz Khalid

Mark Daniel Leahy

Dr Tom Hinchy

Patients and healthcare professionals understanding one another is fundamental to safe and effective care. The clinical consultation depends upon spoken communication, though we have few studies of the contribution of hearing impairment to medical error.

In  a previous study we asked students (registered with the  hearing disability  services of British and Irish universities), about their experiences of healthcare (Henn, O’Tuathaigh et al. 2021). Over 20% reported mishearing medication, medical advice or diagnoses.

As people age they tend to find it more difficult to hear conversations including medical consultations. Age Related Hearing Loss (ARHL) is an incurable and progressive condition, beginning in both genders over 50 years old, affecting both ears becoming worse over time. It is one of the most common medical conditions amongst older people affecting almost all citizens over 80 years of age.

We interviewed patients aged 60years and above (over 50% reported some degree of hearing loss) attending a hospital outpatient department. Over 25% reported mishearing or misinterpreting medical advice, regarding medication use, diagnosis or treatment(Cudmore, Henn et al. 2017).

Older people are frequent users of healthcare, often coping with several chronic illnesses, requiring multiple medications and discussions with a number of providers.

In a study of communication between patients and health professionals working both in hospital and General Practice (Smith, Manan et al. 2020), over 90% of professionals agreed ARHL impairs healthcare and 10% reported that communication issues contributed to multiple medication errors. However less than 5% of hospital based and less than 15% of General Practice professionals had attended formal training for communicating with hearing impaired patients.

Within the UCC LISTEN study (Listening and Interpreting Speech with Technology Evaluation Nuances) we developed an online version of questionnaire which measures healthcare literacy, that is the ability of an individual, to understand spoken medical information. To help us understand the effect of hearing impairment, some people will hear the questions presented with simulated hearing impairment, their scores will be compared to those hearing the questions without distortion.

Our goal is to develop an online assessment taking patients a few minutes to complete before their healthcare consultation. The results will assist the healthcare worker and  patient to communicate most effectively; for example, writing notes and diagrams, or making extra time for the patient to give informed consent to treatment.

Please click on the weblink for an  article explaining our work and to listen an audio clip simulating the experience of a hearing impaired patient.



Cudmore, V., P. Henn, C. P. O’Tuathaigh and S. Smith (2017). “Age-related hearing loss and communication breakdown in the clinical setting.” JAMA Otolaryngology–Head & Neck Surgery.

Henn, P., C. O’Tuathaigh, D. Keegan and S. Smith (2021). “Hearing Impairment and the Amelioration of Avoidable Medical Error: A Cross-Sectional Survey.” Journal of Patient Safety 17(3).

Smith, S., N. S. I. A. Manan, S. Toner, A. Al Refaie, N. Müller, P. Henn and C. M. P. O’Tuathaigh (2020). “Age-related hearing loss and provider-patient communication across primary and secondary care settings: a cross-sectional study.” Age and ageing 49(5): 873-877.

Woulfe F, Fadahunsi KP, Smith S, Chirambo GB, Larsson E, Henn P, Mawkin M, O’ Donoghue J. The Identification and Evaluation of Methodologies to Assess the Quality of mHealth apps in High, Low & Middle-Income Countries: a Rapid Review. JMIR mHealth and uHealth. 21/07/2021:28384 (forthcoming/in press)


The ancient principle of primum non nocere is highly relevant when considering surgery of the lateral skull base and of the Temporal Bone.

The surgeon is required to carry out microscopic dissection in close proximity to the Brain, Facial Nerve, Sigmoid Sinus, Cochlea and Semi-Circular Canals, one tiny slip can have catastrophic effects on the patient!

Regular cadaveric dissection in the laboratory is the only way the surgeon can acquire the requisite skills necessary to carry out this very delicate surgery.

The ASSERT Centre provides a unique facility with work stations consisting of operating microscopes, electrical drills and surgical instruments; enabling surgeons in training to hone their skills in an appropriate setting for the ultimate benefit of their patients.

It is the only centre in Ireland which allows regular weekly access to surgeons and is under the governance of the Dept. of Otorhinolaryngology at the South Infirmary/Victoria University Hospital Cork

Publications 2022

Framework to assess the quality of mHealth apps: a mixed-method international case study protocol

Yong Yu Tan, Fionn Woulfe, Griphin Baxter Chirambo, Patrick Henn, Liezel Cilliers, Kayode Philip Fadahunsi, Simon D Taylor-Robinson, John O’Donoghue.

BMJ Open 2022;12:e062909. doi: 10.1136/bmjopen-2022-062909

Modification and Validation of an mHealth App Quality Assessment Methodology for International Use: Cross-sectional and eDelphi Studies

Woulfe F, Fadahunsi KP, O’Grady M, Chirambo GB, Mawkin M, Majeed A, Smith S, Henn P, O’Donoghue J.

JMIR Form Res. 2022 Aug 19;6(8):e36912. doi: 10.2196/36912. PMID: 35984688; PMCID: PMC9497647.

Publications 2021

Identification and Evaluation of Methodologies to Assess the Quality of Mobile Health Apps in High-Low-, and Middle-Income Countries: Rapid Review

Woulfe F, Fadahunsi KP, Smith S, Chirambo GB, Larsson E, Henn P, Mawkin M, O’Donoghue J.

JMIR Mhealth Uhealth 2021;9(10):e28384 doi: 10.2196/28384PMID: 34636737

Are digital technologies fit for clinical purposes? A systematic review and qualitative synthesis of information quality frameworks for digital healthcare. In the Journal of Medical Internet Research (JMIR).

Kayode Philip Fadahunsi, Siobhan O’Connor, James Tosin Akinlua, Petra A Wark, Joseph Gallagher, Christopher Carroll, Josip Car, Azeem Majeed, John O’Donoghue

Publications 2020

“Wireless Mobile Communication and Healthcare” In the 8th EAI International Conference, MobiHealth 2019, Dublin, Ireland, November 14-15, 2019, Proceedings

GMP O’Hare, MJ O’Grady, J O’Donoghue, P Henn

“Implementing Innovative Approaches to Healthcare in a Lower-Middle Income Country: Perspectives from Malawi” In the International Journal of General Medicine

Emma Larsson, Mala Mawkin, Simon D Taylor-Robinson, Peter Harrington, Hastings Gondwe, Chris Watson, Joseph Gallagher, Mark Ledwidge, Griphin Baxter Chirambo, John O’Donoghue

A contest without losers – The value of extracurricular simulation competition in undergraduate medical education:

Shawn Stefan Albers, Ryan Taylor Sless, Nathaniel Edward Hayward, Kantikiran Dasari, Patrick Henn

End-user perspectives of two mHealth decision support tools: Electronic Community Case Management in Northern Malawi.

Chirambo, G.B., Muula, A.S., Thompson, M., Hardy, V.E., Heavin, C., O’Connor, Y., Mastellos, N., Andersson, B. and O’Donoghue, J., 2020

Affiliate partner: ASSERT Centre, UCC

International Journal of Medical Informatics, p.104323.

Validation of phlebotomy performance metrics developed as part of a proficiency-based progression initiative to mitigate wrong blood in tube.

O’Herlihy N, Griffin S, Henn P, Gaffney r, Cahill MR, Gallagher AG.

Postgraduate Medical Journal Published Online First: 17 August 2020. doi:10.1136/postgradmedj-2019-137254

Impact of hearing loss on clinical interactions between older adults and health professionals: a systematic review

Smith, S., Nordin, M.A.B., Hinchy, T., Henn, P., O’Tuathaigh, C.M.P. Eur Geriatr


Age-related hearing loss and provider-patient communication across primary and secondary care settings: a cross-sectional study

Simon Smith, Nur Syifa Ilyani Abd Manan, Shannon Toner, Amr Al Refaie, Nicole Müller, Patrick Henn, Colm M P O’Tuathaigh.

Age and Ageing, Published:07 April 2020

Publications 2019

Simulation test: can medical devices pass ?

Power D, O’Donovan K, Deasy C, Henn P.

BMJ Simulation and Technology Enhanced Learning  Published Online First: 09 October 2019.

doi: 10.1136/bmjstel-2019-000519

Service evaluation of diabetes management during pregnancy in a regional maternity hospital: potential scope for increased self-management and remote patient monitoring through mHealth solutions

Abdelrahim Alqudah, Paul McMullan, Anna Todd, Conor O’Doherty, Anne McVey, Mae McConnell, John O’Donoghue, Joe Gallagher, Chris J. Watson & Lana McClements

BMC Health Services Researchvolume 19, Article number: 662 (2019)

Simulation training: our passport to a successful future in medicine

Claire M. McCarthy, 1 Orfhlaith E. O’Sullivan,1 Barry A. O’Reilly1,2,3

First published as 10.1136/bmjstel-2019-000491 on 29 June 2019

Validation studies of virtual reality simulation performance metrics for mechanical thrombectomy in ischemic stroke Journal of NeuroInterventional Surgery

Robert Crossley, Thomas Liebig, Markus Holtmannspoetter, Johan Lindkvist, Pat Henn, Lars Lonn, Anthony Gerald Gallagher

Published Online First: 17 January 2019. doi: 10.1136/neurintsurg-2018-014510

Publications 2018

Handover training for medical students: a controlled educational trial of a pilot curriculum in Germany.

Laura Thaeter, Hanna Schröder, Lina Henze, Jennifer Butte, Patrick Henn, Rolf Rossaint, Saša Sopka

BMJ Open 2018;8:e021202. doi: 10.1136/bmjopen-2017-021202

Metric-Based Virtual Reality Simulation – A Paradigm Shift in Training for Mechanical Thrombectomy in Acute Stroke

Thomas Liebig, Markus Holtmannspötter, Robert Crossley, Johan Lindkvist, Patrick Henn, Lars Lönn and Anthony G. Gallagher

Stroke. 2018; STROKEAHA.118.021089, originally published June 4, 2018

Visual spatial ability for surgical trainees: implications for learning endoscopic, laparoscopic surgery and other image-guided procedures.

Henn, P., Gallagher, A.G., Nugent, E. et al.

Surg Endosc (2018)

Outlier experienced surgeon’s performances impact on benchmark for technical surgical skills training

Gallagher, A. G., Henn, P. J., Neary, P. C., Senagore, A. J., Marcello, P. W., Bunting, B. P., Seymour, N. E. and Satava, R. M. (2018)

ANZ Journal of Surgery. doi:10.1111/ans.14474

‘Inter-rater Reliability for Metrics Scored in a Binary Fashion—Performance Assessment for an Arthroscopic Bankart Repair’.

Anthony G. Gallagher, Richard K. N. Ryu, Robert A. Pedowitz, Patrick Henn, and Richard L. Angelo. (2018)

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

Publications 2017

A computerised test of perceptual ability for learning endoscopic and laparoscopic surgery and other image guided procedures: Score norms for PicSOr,

Henn P, Gallagher AG, Nugent E, Cowie R, Seymour NE, Haluck RS, Hseino H, Traynor O, Neary PC

The American Journal of Surgery (2017), doi: 10.1016/j.amjsurg.2017.01.025

Publications 2015

The Bankart Performance Metrics Combined With a Shoulder Model Simulator Create

Richard L. Angelo, M.D., Robert A. Pedowitz, M.D., Ph.D., Richard K. N. Ryu, M.D., and Anthony G. Gallagher, Ph.D., D.Sc. (2015)

The Journal of Arthroscopic and Related Surgery, Vol 31, No 9 (September), 2015: pp 1639-1654

The Bankart Performance Metrics Combined With a Cadaveric Shoulder Create a Prec

Richard L. Angelo, M.D., Richard K. N. Ryu, M.D., Robert A. Pedowitz, M.D., Ph.D., and Anthony G. Gallagher, Ph.D., D.Sc. (2015)

The Journal of Arthroscopic and Related Surgery, Vol 31, No 9 (September), 2015: pp 1655-1670

Metric Development for an Arthroscopic Bankart Procedure: Assessment of Face and Content Validity

Richard L. Angelo, M.D., Richard K. N. Ryu, M.D., Robert A. Pedowitz, M.D., Ph.D., and Anthony G. Gallagher, Ph.D., D.Sc. (2015)

The Journal of Arthroscopic and Related Surgery, Vol 31, No 8 (August), 2015: pp 1430-1440

Objective Assessment of Knot-Tying Proficiency With the Fundamentals of Arthroscopic Surgery Training Program Workstation and Knot Tester

Robert A. Pedowitz, M.D., Ph.D., Gregg T. Nicandri, M.D., Richard L. Angelo, M.D., Richard K. N. Ryu, M.D., and Anthony G. Gallagher, Ph.D., D.Sc. (2015)

The Journal of Arthroscopic and Related Surgery, pp 1-8

Magellan and Copernicus: Arthroscopy Association of North America Seeking Excellence in Education

Richard L. Angelo, M.D. (2015)

The Journal of Arthroscopic and Related Surgery, Vol 31, No 8 (August), 2015: pp 1428-1429

‘Designing Learning Outcomes for Handoff Teaching of Medical Students Using Group Concept Mapping: Findings From a Multicountry European Study’

Hynes, H., Stoyanov, S., Drachsler, H., Maher, B., Orrego, C., Secanell M., Stieger L., Druener, S., Schroeder, H., Sopka, S., Henn, P. (2015)

Academic medicine : journal of the Association of American Medical Colleges

Publications 2014

Simulation Fidelity: More Than Experience and Mere Repetition?

Anthony G. Gallagher, Patrick Henn.

Studies in Health Technology and Informatics Volume 196: Medicine Meets Virtual Reality 21

Improving Clinical Performance Using Rehearsal or Warm-up: An Advanced Literature Review of Randomized and Observational Studies.

O’Leary JD, O’Sullivan O, Barach P, Shorten GD.

Acad Med. 2014 Jul 1.

Use of a group concept mapping approach to define learning outcomes for an interdisciplinary module in medicine.

Stoyanov S, Spoelstra H, Bennett D, Sweeney C, Van Huffel S, Shorten G, O’Flynn S, Cantillon-Murphy P, O’Tuathaigh C, Burgoyne L.

Perspect Med Educ. 2014 Jun;3(3):245-

A comparison of three techniques (local anesthetic deposited circumferential to vs. above vs. below the nerve) for ultrasound guided femoral nerve block.

Szűcs S, Morau D, Sultan SF, Iohom G, Shorten G.

BMC Anesthesiol. 2014 Jan 25;14(1):6. doi: 10.1186/1471-2253-14-6.

Convergence and translation: attitudes to inter-professional learning and teaching of creative problem-solving among medical and engineering students and staff.

Spoelstra H, Stoyanov S, Burgoyne L, Bennett D, Sweeney C, Drachsler H, Vanderperren K, Van Huffel S, McSweeney J, Shorten G, O’Flynn S, Cantillon-Murphy P, O’Tuathaigh C.

BMC Med Educ. 2014 Jan 22;14:14. doi: 10.1186/1472-6920-14-14.

Publications 2013

An evaluation of high fidelity simulation using a human patient simulator in a new diploma in military medical care

Power D, Henn P, Hick D, McAdoo J (2013)

JMVH, 21(4): 1-11

To what extent does the Health Professions Admission Test-Ireland predict performance in early undergraduate tests of communication and clinical skills? – An observational cohort study.

Maureen E Kelly, Daniel Regan, Fidelma Dunne, Patrick Henn, John Newell and Siun O’Flynn

BMC Education

Women in Hospital Medicine: Facts, Figures and Personal Experiences.

G Boylan, K Meghen, C Sweeney, C Linehan, S O’Flynn

Irish Medical Journal 106 (2)

An evaluation of high fidelity simulation training for paramedics in Ireland.

D Power, P Henn, P O’Driscoll, T Power, J McAdoo, H Hynes, S Cusack

International Paramedic Practice 3 (1), 11-18

To cognitively err is human European Journal of Internal Medicine.

Simon D. Smith, David Power, Patrick Henn, Helen Hynes, Colin Bradley.

Received 21 June 2013; received in revised form 2 July 2013; accepted 5 July 2013.
Published on line 05 August 2013

A study of innovative patient safety education

SD Smith, P Henn, R Gaffney, H Hynes, J McAdoo, C Bradley

The Clinical Teacher

A metric-based analysis of structure and content of telephone consultations of final-year medical students in a high-fidelity emergency medicine simulation

P Henn, D Power, S Smith, T Power, H Hynes, R Gaffney, J McAdoo

BMJ Open