Development and evaluation of an integrated clinical learning model to inform continuing education for acute care nurses

Background Significant ongoing learning needs for nurses have occurred as a direct result of the continuous introduction of technological innovations and research developments in the healthcare environment. Despite an increased worldwide emphasis on the importance of continuing education, there continues to be an absence of empirical evidence of program and session effectiveness. Few studies determine whether continuing education enhances or develops practice and the relative cost benefits of health professionals’ participation in professional development. The implications for future clinical practice and associated educational approaches to meet the needs of an increasingly diverse multigenerational and multicultural workforce are also not well documented. There is minimal research confirming that continuing education programs contribute to improved patient outcomes, nurses’ earlier detection of patient deterioration or that standards of continuing competence are maintained. Crucially, evidence-based practice is demonstrated and international quality and safety benchmarks are adhered to. An integrated clinical learning model was developed to inform ongoing education for acute care nurses. Educational strategies included the use of integrated learning approaches, interactive teaching concepts and learner-centred pedagogies. A Respiratory Skills Update education (ReSKU) program was used as the content for the educational intervention to inform surgical nurses’ clinical practice in the area of respiratory assessment. The aim of the research was to evaluate the effectiveness of implementing the ReSKU program using teaching and learning strategies, in the context of organisational utility, on improving surgical nurses’ practice in the area of respiratory assessment. The education program aimed to facilitate better awareness, knowledge and understanding of respiratory dysfunction in the postoperative clinical environment. This research was guided by the work of Forneris (2004), who developed a theoretical framework to operationalise a critical thinking process incorporating the complexities of the clinical context. The framework used educational strategies that are learner-centred and participatory. These strategies aimed to engage the clinician in dynamic thinking processes in clinical practice situations guided by coaches and educators. Methods A quasi experimental pre test, post test non–equivalent control group design was used to evaluate the impact of the ReSKU program on the clinical practice of surgical nurses. The research tested the hypothesis that participation in the ReSKU program improves the reported beliefs and attitudes of surgical nurses, increases their knowledge and reported use of respiratory assessment skills. The study was conducted in a 400 bed regional referral public hospital, the central hub of three smaller hospitals, in a health district servicing the coastal and hinterland areas north of Brisbane. The sample included 90 nurses working in the three surgical wards eligible for inclusion in the study. The experimental group consisted of 36 surgical nurses who had chosen to attend the ReSKU program and consented to be part of the study intervention group. The comparison group included the 39 surgical nurses who elected not to attend the ReSKU program, but agreed to participate in the study. Findings One of the most notable findings was that nurses choosing not to participate were older, more experienced and less well educated. The data demonstrated that there was a barrier for training which impacted on educational strategies as this mature aged cohort was less likely to take up educational opportunities. The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group’s reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales following attendance at the ReSKU program. These subscales included influence on nursing care, educational preparation and clinical development. Findings suggest that the use of an integrated educational model underpinned by a robust theoretical framework is a strong factor in some perceptions of the ReSKU program relating to attitudes and behaviour. There were minimal differences in knowledge between groups across time. Conclusions This study was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies and a robust overarching theoretical framework to support study concepts. The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful and collective reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

Holistic blended design studio model : potential implication in education of Iran

Iran as a developing country faces many considerable shortages of both physical learning environment and inefficient budget to resolve this shortage. Today, Iran needs a $28 billion budget to add 23,000 schools to the existing 120,000 schools to be able to omit two shifts schools [1], [2]. Moreover, the standard learning space is 6-8 square meter per student, while this rate for big cities in Iran is about one square meter per student [1]. This decrease the time students spend in schools. In addition, the education approach in k-12 and higher education is still teacher-centered based and needs to be contemporized with educational, cultural, and technological changes.

Governing teacher education : the case of teacher education in Australia

This paper analyses the attempted installation of the 1990 Australian Education Council commissioned report 'Teacher Education in Australia' (the Ebbeck Report), a document which proposed a radical reformulation and relative standardization of the content and structure of initial teacher education in Australia. The paper draws on Michel Foucault's concept of 'governmentality' to examine the discursive and technological dimensions of this programme of political rule. The paper makes apparent the 'microphysics of power' that were generated within, particularly, the Queensland educational community in the attempt to operationalise this report. Analysing educational policy from the perspective of 'government', the paper contends, directs attention to the conditions of operation of policy practices and reveals the dependence of educational policy on particular technical conditions of existence, routines and rituals of bureaucracy, forms of expertise and intellectual technologies, and the enlistment of agencies and authorities both within and outside the boundaries of the state.

An integrated educational model for continuing nurse education

Aim This paper reports on the development and evaluation of an integrated clinical learning model to inform ongoing education for surgical nurses. The research aim was to evaluate the effectiveness of implementing a Respiratory Skills Update (ReSKU) education program, in the context of organisational utility, on improving surgical nurses' practice in the area of respiratory assessment. Background Continuous development and integration of technological innovations and research in the healthcare environment mandate the need for continuing education for nurses. Despite an increased worldwide emphasis on this, there is scant empirical evidence of program effectiveness. Methods A quasi experimental pre test, post test non–equivalent control group design evaluated the impact of the ReSKU program on surgical nurses' clinical practice. The 2008 study was conducted in a 400 bed regional referral public hospital and was consistent with contemporary educational approaches using multi-modal, interactive teaching strategies. Findings The study demonstrated statistically significant differences between groups regarding reported use of respiratory skills, three months after ReSKU program attendance. Between group data analysis indicated that the intervention group's reported beliefs and attitudes pertaining to subscale descriptors showed statistically significant differences in three of the six subscales. Conclusion The construct of critical thinking in the clinical context, combined with clinical reasoning and purposeful reflection, was a powerful educational strategy to enhance competency and capability in clinicians.

Re-imagining STEM : peer scaffolding ICT in initial teacher education

In this paper, we report on how peer scaffolding was used to effect change in tertiary teaching practice and academic disposition in the use of Information and Communication Technology (ICT) in Science teaching and learning. We present a small-scale case study investigating the practice of one of this paper’s authors. It is told through two salient episodes which narratively describe the scaffolding used to support a teaching experiment. This was made possible through the national Teaching Teachers for the Future Project (2011-2012) which aimed to enhance the technological pedagogical capability of pre-service teachers across Australia. The outcome was a demonstrable shift in the academic’s disposition towards the use and benefits of ICT in teaching science and an increase in skills and confidence for both the academic and his students. This study and its outcomes fit within the contemporary push to “re-imagine” the teaching of Science, and more broadly of STEM, in schools.

Re-imagining STEM : peer scaffolding ICT in Initial Teacher Education

In this paper, we report on how peer scaffolding was used to effect change in tertiary teaching practice and academic disposition in the use of Information and Communication Technology (ICT) in Science teaching and learning. We present a small-scale case study investigating the practice of one of this paper’s authors. It is told through two salient episodes which narratively describe the scaffolding used to support a teaching experiment. This was made possible through the national Teaching Teachers for the Future Project (2011-2012) which aimed to enhance the technological pedagogical capability of pre-service teachers across Australia. The outcome was a demonstrable shift in the academic’s disposition towards the use and benefits of ICT in teaching science and an increase in skills and confidence for both the academic and his students. This study and its outcomes fit within the contemporary push to “re-imagine” the teaching of Science, and more broadly of STEM, in schools.

Preparing citizens for a complex world : the grand challenge of teaching socio-scientific issues in science education

The dawn of the twenty-first century encouraged a number of scientific and technological organisations to identify what they saw as ‘Grand Challenges and Opportunities’. Issues of environment and health featured very prominently in these quite short lists, as can be seen from a sample of these challenges in Table 1. Indeed, the first two lists of challenges in Table 1 were identified as for the environment and for health, respectively.

New media and the transformation of higher education

One set of public institutions that has seen growing discussion about the transformative impact of new media technologies has been universities. The higher education sector, historically one of the more venerable and stable areas of public life, is now the subject of almost continuous speculation about whether it can continue in its current form during the 21st century. Digital media technologies are often seen as being at the forefront of such changes. It has been widely noted that moves towards a knowledge economy generates ‘skills-biased technological change’, that places a premium upon higher education qualifications, and that this earnings gap remains despite the continuing increase in the number of university graduates. As the demand for higher education continues to grow worldwide, there are new discussions about whether technologically-mediated education through new forms such as Massively Open Online Courses (MOOCs) are broadening access to quality learning, or severing the vital connection between teacher and student seen as integral to the learning process. This paper critically appraises such debates in the context of early 21st century higher education. It will discuss ten drivers of change in higher education, many of which are related to themes discussed elsewhere in this book, such as the impact of social media, globalization, and a knowledge economy. It will also consider the issues raised in navigating such developments from the perspective of the ‘Five P’s’: practical issues; personal issues; pedagogical issues; policy issues; and philosophical issues. It also includes a critical evaluation of MOOCs from the point of view of their educational qualities. It will conclude with the observation that while universities will continue to play a significant – and perhaps growing – role in the economy, society and culture, the issues raised about what Clayton Christensen and Henry Eyring term the ‘disruptive university’ (Christensen and Eyring 2011) are nonetheless pressing ones, and that cost and policy pressures in particular are likely to generate significant institutional transformations in higher education worldwide.

Vocational education in science, technology, engineering and maths (STEM) : Curriculum innovation through school industry partnerships

Governments have recognised that the technological trades rely on knowledge embedded traditionally in science, technology, engineering and mathematics (STEM) disciplines. However, there is substantial evidence that students are turning away from these subjects in schools because the school curriculum is seen as irrelevant, with clear implications for not just vocational education but also higher education. In this paper, we report preliminary findings on the development of two curricula that attempt to integrate science and mathematics with workplace knowledge and practices. We argue that these curricula provide educational opportunities for students to pursue their preferred career pathways. These curricula were co-developed by industry and educational personnel across three industry sectors, namely, mining industry, aerospace and wine tourism. The aim was to provide knowledge appropriate for students moving from school to the workplace as trade apprentices in the respective industries. The analysis of curriculum and associated policy documents reveals that the curricula adopt applied learning orientations through teaching strategies and assessment practices which focus on practical skills. However, although key theoretical science and maths concepts have been well incorporated, the extent to which knowledge deriving from workplace practices is included varies across the curricula. The extent to which applications of concepts are included in the models depends on a number of factors not least the relevant expertise of the teacher as a practitioner in the industry. Our findings highlight the importance of teachers having substantial practical industry experience and the role that whole school policies play in attempts to align the range of learning experiences with the needs of industry.

Virtual worlds in Australian and New Zealand higher education : remembering the past, understanding the present and imagining the future

3D virtual reality, including the current generation of multi-user virtual worlds, has had a long history of use in education and training, and it experienced a surge of renewed interest with the advent of Second Life in 2003. What followed shortly after were several years marked by considerable hype around the use of virtual worlds for teaching, learning and research in higher education. For the moment, uptake of the technology seems to have plateaued, with academics either maintaining the status quo and continuing to use virtual worlds as they have previously done or choosing to opt out altogether. This paper presents a brief review of the use of virtual worlds in the Australian and New Zealand higher education sector in the past and reports on its use in the sector at the present time, based on input from members of the Australian and New Zealand Virtual Worlds Working Group. It then adopts a forward-looking perspective amid the current climate of uncertainty, musing on future directions and offering suggestions for potential new applications in light of recent technological developments and innovations in the area.

Understanding the signature pedagogy of the design studio and the opportunities for its technological enhancement

This paper presents an analysis of the studio as the signature pedagogy of design education. A number of theoretical models of learning, pedagogy, and education are used to interrogate the studio for its advantages and shortcomings, and to identify opportunities for the integration of new technologies and to explore the affordances that they might offer. In particular the theoretical ideas of signature pedagogies, conversational frameworks, and pedagogical patterns are used to justify the ‘unique’ status of the studio as a dominant learning environment and mode of delivery within design education. Such analysis identifies the opportunities for technological intervention and enhancement of the design studio through a re-examining of its fundamental pedagogical signature. This paper maps the dimensions and qualities that define the signature pedagogy against a range of delivery modes and technological media forms. Through such investigation it seeks to identify appropriate opportunities for technology; in essence offering a structure or framework for the analysis of future enquiry and experimentation.

A rural health education, training and research network

The purpose of the Rural Health Education, Training and Research Network is to support the education and training of rural health practitioners and research in rural health through the optimum use of appropriate information and communication technologies to link and inform all individuals and organisation involved in the teaching, planning and delivery of health care in rural and remote Queensland. The health care of people in rural areas has the potential to be enhanced, through providing the rural and remote health professionals in Queensland with the same access to educational and training opportunities as their metropolitan colleagues. This consultative, coordinated approach should be cost-effective through both increasing awareness and utilisation of existing and developing networks, and through more efficient and rational use of both the basic and sophisticated technologies which support them. Technological hardware, expertise and infrastructure are already in place in Queensland to support a Rural Health Education, Training and Research Network, but are not being used to their potential, more often due to a lack of awareness of their existence and utility than to their perceived costs. Development of the network has commenced through seeding funds provided by Queensland Health. Future expansion will ensure access by health professionals to existing networks within Queensland. This paper explores the issues and implications of a network for rural health professionals in Queensland and potentially throughout Australia, with a specific focus on the implications for rural and isolated health professional.

Technological tools for science classrooms : choosing and using for productive and sustainable teaching and learning experiences

In this age of rapidly evolving technology, teachers are encouraged to adopt ICTs by government, syllabus, school management, and parents. Indeed, it is an expectation that teachers will incorporate technologies into their classroom teaching practices to enhance the learning experiences and outcomes of their students. In particular, regarding the science classroom, a subject that traditionally incorporates hands-on experiments and practicals, the integration of modern technologies should be a major feature. Although myriad studies report on technologies that enhance students’ learning outcomes in science, there is a dearth of literature on how teachers go about selecting technologies for use in the science classroom. Teachers can feel ill prepared to assess the range of available choices and might feel pressured and somewhat overwhelmed by the avalanche of new developments thrust before them in marketing literature and teaching journals. The consequences of making bad decisions are costly in terms of money, time and teacher confidence. Additionally, no research to date has identified what technologies science teachers use on a regular basis, and whether some purchased technologies have proven to be too problematic, preventing their sustained use and possible wider adoption. The primary aim of this study was to provide research-based guidance to teachers to aid their decision-making in choosing technologies for the science classroom. The study unfolded in several phases. The first phase of the project involved survey and interview data from teachers in relation to the technologies they currently use in their science classrooms and the frequency of their use. These data were coded and analysed using Grounded Theory of Corbin and Strauss, and resulted in the development of a PETTaL model that captured the salient factors of the data. This model incorporated usability theory from the Human Computer Interaction literature, and education theory and models such as Mishra and Koehler’s (2006) TPACK model, where the grounded data indicated these issues. The PETTaL model identifies Power (school management, syllabus etc.), Environment (classroom / learning setting), Teacher (personal characteristics, experience, epistemology), Technology (usability, versatility etc.,) and Learners (academic ability, diversity, behaviour etc.,) as fields that can impact the use of technology in science classrooms. The PETTaL model was used to create a Predictive Evaluation Tool (PET): a tool designed to assist teachers in choosing technologies, particularly for science teaching and learning. The evolution of the PET was cyclical (employing agile development methodology), involving repeated testing with in-service and pre-service teachers at each iteration, and incorporating their comments i ii in subsequent versions. Once no new suggestions were forthcoming, the PET was tested with eight in-service teachers, and the results showed that the PET outcomes obtained by (experienced) teachers concurred with their instinctive evaluations. They felt the PET would be a valuable tool when considering new technology, and it would be particularly useful as a means of communicating perceived value between colleagues and between budget holders and requestors during the acquisition process. It is hoped that the PET could make the tacit knowledge acquired by experienced teachers about technology use in classrooms explicit to novice teachers. Additionally, the PET could be used as a research tool to discover a teachers’ professional development needs. Therefore, the outcomes of this study can aid a teacher in the process of selecting educationally productive and sustainable new technology for their science classrooms. This study has produced an instrument for assisting teachers in the decision-making process associated with the use of new technologies for the science classroom. The instrument is generic in that it can be applied to all subject areas. Further, this study has produced a powerful model that extends the TPACK model, which is currently extensively employed to assess teachers’ use of technology in the classroom. The PETTaL model grounded in data from this study, responds to the calls in the literature for TPACK’s further development. As a theoretical model, PETTaL has the potential to serve as a framework for the development of a teacher’s reflective practice (either self evaluation or critical evaluation of observed teaching practices). Additionally, PETTaL has the potential for aiding the formulation of a teacher’s personal professional development plan. It will be the basis for further studies in this field.

Vocational education in science technology, engineering and maths (STEM) : Curriculum innovation through industry school partnerships

Governments have recognised that the technological trades rely on knowledge embedded traditionally in science, technology, engineering and mathematics (STEM) disciplines. In this paper, we report preliminary findings on the development of two curricula that attempt to integrate science and mathematics with workplace knowledge and practices. We argue that these curricula provide educational opportunities for students to pursue their preferred career pathways. These curricula were co-developed by industry and educational personnel across two industry sectors, namely, mining and aerospace. The aim was to provide knowledge appropriate for students moving from school to the workplace in the respective industries. The analysis of curriculum and associated policy documents reveals that the curricula adopt applied learning orientations through teaching strategies and assessment practices which focus on practical skills. However, although key theoretical science and maths concepts have been well incorporated, the extent to which knowledge deriving from workplace practices is included varies across the curricula. Our findings highlight the importance of teachers having substantial practical industry experience and the role that whole school policies play in attempts to align the range of learning experiences with the needs of industry.