The impact of a model of nurse education to improve knowledge and recognition of delirium in older persons by registered nurses

Introduction: Delirium is a serious issue associated with high morbidity and mortality in older hospitalised people. Early recognition enables diagnosis and treatment of underlying cause/s, which can lead to improved patient outcomes. However, research shows knowledge and accurate nurse recognition of delirium and is poor and lack of education appears to be a key issue related to this problem. Thus, the purpose of this randomised controlled trial (RCT) was to evaluate, in a sample of registered nurses, the usability and effectiveness of a web-based learning site, designed using constructivist learning principles, to improve acute care nurse knowledge and recognition of delirium. Prior to undertaking the RCT preliminary phases involving; validation of vignettes, video-taping five of the validated vignettes, website development and pilot testing were completed. Methods: The cluster RCT involved consenting registered nurse participants (N = 175) from twelve clinical areas within three acute health care facilities in Queensland, Australia. Data were collected through a variety of measures and instruments. Primary outcomes were improved ability of nurses to recognise delirium using written validated vignettes and improved knowledge of delirium using a delirium knowledge questionnaire. The secondary outcomes were aimed at determining nurse satisfaction and usability of the website. Primary outcome measures were taken at baseline (T1), directly after the intervention (T2) and two months later (T3). The secondary outcomes were measured at T2 by participants in the intervention group. Following baseline data collection remaining participants were assigned to either the intervention (n=75) or control (n=72) group. Participants in the intervention group were given access to the learning intervention while the control group continued to work in their clinical area and at that time, did not receive access to the learning intervention. Data from the primary outcome measures were examined in mixed model analyses. Results: Overall, the effect of the online learning intervention over time comparing the intervention group and the control group were positive. The intervention groups‘ scores were higher and the change over time results were statistically significant [T3 and T1 (t=3.78 p=<0.001) and T2 and T1 baseline (t=5.83 p=<0.001)]. Statistically significant improvements were also seen for delirium recognition when comparing T2 and T1 results (t=2.58 p=0.012) between the control and intervention group but not for changes in delirium recognition scores between the two groups from T3 and T1 (t=1.80 p=0.074). The majority of the participants rated the website highly on the visual, functional and content elements. Additionally, nearly 80% of the participants liked the overall website features and there were self-reported improvements in delirium knowledge and recognition by the registered nurses in the intervention group. Discussion: Findings from this study support the concept that online learning is an effective and satisfying method of information delivery. Embedded within a constructivist learning environment the site produced a high level of satisfaction and usability for the registered nurse end-users. Additionally, the results showed that the website significantly improved delirium knowledge & recognition scores and the improvement in delirium knowledge was retained at a two month follow-up. Given the strong effect of the intervention the online delirium intervention should be utilised as a way of providing information to registered nurses. It is envisaged that this knowledge would lead to improved recognition of delirium as well as improvement in patient outcomes however; translation of this knowledge attainment into clinical practice was outside the scope of this study. A critical next step is demonstrating the effect of the intervention in changing clinical behaviour, and improving patient health outcomes.

Preservice teachers’ observations of their mentors’ teaching strategies for differentiated learning

Tensions exist between teacher-centred and learner-centred approaches with constructivism as being favoured for learning in the 21st Century. There is little evidence of teaching strategies being used in the field for differentiating student learning. In addition, preservice teachers need to learn about teaching strategies for which observations of their mentor teachers can provide practical applications. This study explores 16 preservice teachers’ observations of their mentors’ teaching strategies over a four-week professional experience. They provided a minimum of five written observations during this period. Findings indicated that these preservice teachers observed their mentors’ practices and recorded four key teaching strategies used to differentiate learning, namely: (1) designating facilitators for students’ learning, including teacher, peers, parents, and support staff such as teachers aides, (2) managing student groups, (3) contexts for learning, and (4) using a range of teaching aids (visual, auditory, games) and resources. Preservice teachers’ observations of their mentor teachers indicated that they can commence at early stages for identifying teaching strategies and how they work for differentiating student learning.

Cross-cultural language learning and web design complexity

Accepting the fact that culture and language are interrelated in second language learning (SLL), the web sites should be designed to integrate with the cultural aspects. Yet many SLL web sites fail to integrate with the cultural aspects and/or focus on language acquisition only. This study identified three issues: (1) anthropologists’ cultural models mostly adopted in cross-cultural web user interface have been superficially used; (2) web designers deal with culture as a fixed one which needs to be modeled into interface design elements, so (3) there is a need for a communication framework between educators and design practitioners, which can be utilized in web design processes. This paper discusses what anthropology can contribute to language learning, mediated through web design processes and suggests a cultural user experience framework for web-based SLL by presenting an exemplary matrix. To evaluate the effectiveness of the framework, the key stakeholders (learners, teachers, and designers) participated in a case scenario-based evaluation. The result shows a high possibility that the framework can enhance the effective communication and collaboration for the cultural integration.

Do students and lecturers actively use collaboration tools in learning management systems?

In recent years there has been a large emphasis placed on the need to use Learning Management Systems (LMS) in the field of higher education, with many universities mandating their use. An important aspect of these systems is their ability to offer collaboration tools to build a community of learners. This paper reports on a study of the effectiveness of an LMS (Blackboard©) in a higher education setting and whether both lecturers and students voluntarily use collaborative tools for teaching and learning. Interviews were conducted with participants (N=67) from the faculties of Science and Technology, Business, Health and Law. Results from this study indicated that participants often use Blackboard© as an online repository of learning materials and that the collaboration tools of Blackboard© are often not utilised. The study also found that several factors have inhibited the use and uptake of the collaboration tools within Blackboard©. These have included structure and user experience, pedagogical practice, response time and a preference for other tools.

Embracing social networking to create a community of scholars in large multi-disciplinary first year cohorts

The first year of a property degree program is a time to establish threshold concept knowledge to acculturise students into their discipline or professional group. Due to the foundational nature of first year in many property degrees, students are enrolled in large, multi-disciplinary classes. There are several challenges in the delivery of large first year multi-disciplinary units to engage the student in a community of leaning to aid in student retention. Through action based research this study shows how social networking, particularly Facebook, can be used to create a sense of community across large, multi-disciplinary units to illicit ‘real time’ feedback from students and encourage peer to peer learning. This study assesses the benefits of using social media and considers the potential limitations of this medium.

"More tick-the-box": the challenge of promoting interdisciplinary learning in the middle years through the Australian history curriculum

The Australian Curriculum marks national reforms in social science education, first with the return to the disciplines of history and geography and second, through a new approach to interdisciplinary learning. This paper raises the question of whether the promise of interdisciplinary learning can be realised in the middle years of schooling if teachers have to teach history as a discipline rather than within an over-arching integrated curriculum framework. The paper explores the national blueprints and considers the national history curriculum in light of theories of teachers’ knowledge and middle school education. Evidence from teacher interviews indicates that historical understanding can be achieved through integrated frameworks to meet the goals of middle schooling.

Learning about being effective mentors : professional learning communities and mentoring

This study aimed to explore experienced mentors’ understandings about professional learning communities (PLCs), mentoring and leadership. This research analyses audio-taped transcripts and written responses from 27 experienced mentors who operate in varied roles (e.g., university academics, school executives, teachers, learning support personnel). Findings indicated that PLCs can provide professional renewal for existing teachers and that mentoring within PLCs can further advance knowledge about effective practices. PLCs can include other staff members and key stakeholders (e.g., preservice teachers, teacher aides) who can contribute to the learning within the group. Mentoring and PLCs can be cost-effective strategic levers for advancing professional knowledge.

Shut up & write! Facilitating informal learning in doctoral education

Providing help for research degree writing within a formal structure is difficult because research students come into their degree with widely varying needs and levels of experience. Providing writing assistance within a less structured learning context is an approach which has been trialled in higher education with promising results (Boud, Cohen & Sampson, 2001; Stracke, 2010; Devendish et al., 2009). While semi structured approaches have been the subject of study, little attention has been paid to the processes of informal learning which exist within doctoral education. In this paper we explore a 'writing movement' which has started to be taken up at various locations in Australia through the auspices of social media (Twitter and Facebook). 'Shut up and Write' is a concept first used in the cafe scene in San Francisco, where writers converge at a specific time and place and write together, without showing each other the outcomes, temporarily transforming writing from a solitary practice to a social one. In this paper we compare the experience of facilitating shut up and write sessions in two locations: RMIT University and Queensland University of Technology. The authors describe the set up and functioning of the different groups and report on feedback from regular participants, both physical and virtual. We suggest that informal learning practices can be exploited to assist research students to orientate themselves to the university environment and share vital technical skills, with very minimal input from academic staff. This experience suggests there is untapped potential within these kinds of activities to promote learning within the research degree experience which is sustainable and builds a stronger sense of community.

Learning and teaching reflection : developing capacities for lifelong learning

Reflection is an essential part of being an effective learner and working as a productive teacher. It enables the learner or teacher to deliberate about the factors that lead to successful learning and teaching for them and/or their students, in a particular place and for a specific purpose, so they can make reasoned and effective choices. This chapter introduces important frameworks that cover a century of thinking around reflection in education, and illustrates how preservice teachers can use these ideas across three phases. First, becoming a reflective learner as a university student to enhance learning and assessment outcomes; second, becoming a reflective teacher to improve classroom teaching and learning outcomes; and third, developing the reflective capacities of primary students so they can enhance their skills for lifelong learning.

Emerging from student to practitioner : a cumulative development tool for students

PURPOSE: This pilot project’s aim was to trial a tool and process for developing students’ ability to engage in self-assessment using reflection on their clinical experiences, including feedback from workplace learning, in order to aid them in linking theory to practice and develop strategies to improve performance. BACKGROUND: In nursing education, students can experience a mismatch in performance compared to theoretical learning, this is referred to as the ‘theory practice gap’ (Scully 2011, Chan Chan & Liu 2011). One specific contributing factor seems to be students’ inability to engage in meaningful reflection and self-correcting behaviours. A self-assessment strategy was implemented within a third year clinical unit to ameliorate this mismatch with encouraging results, as students developed self-direction in addressing learning needs. In this pilot project the above strategy was adapted for implementation between different clinical units, to create a whole of course approach to integrating workplace learning. METHOD: The methodology underpinning this project is a scaffolded, supported reflective practice process. Improved self-assessment skills is achieved by students reflecting on and engaging with feedback, then mapping this to learning outcomes to identify where performance can be improved. Evaluation of this project includes: collation of student feedback identifying successful strategies along with barriers encountered in implementation; feedback from students and teachers via above processes and tools; and comparison of the number of learning contracts issued in clinical nursing units with similar cohorts. RESULTS: Results will be complete by May 2012 and include analysis of the data collected via the above evaluation methods. Other outcomes will include the refined process and tool, plus resources that should improve cost effectiveness without reducing student support. CONCLUSION: Implementing these tools and processes over the entire student’s learning package, will assist them to demonstrate progressive development through the course. Students will have learnt to understand feedback and integrate these skills for life-long learning.

Governance of learning mechanisms : evidence from construction firms

The focus of knowledge management (KM) in the construction industry is moving towards capability building for value creation. The study reported by this paper is motivated by recent assertions about the genesis and evolution of knowledge management capability (KMC) in the strategic management field. It attempts to shed light on the governance of learning mechanisms that develop KMC within the context of construction firms. A questionnaire survey was administered to a sample of construction contractors operating in the very dynamic Hong Kong market to elicit opinions on the learning mechanisms and business outcomes of targeted firms. On the basis of a total of 149 usable responses, structural equation modeling (SEM) analysis identified relationships among knowledge-governance mechanisms, knowledge processes, and business performance, thereby supporting the existence of strategic learning loops. The study findings provide evidence from the construction context for capability assertions that knowledge-governance mechanisms and processes form learning mechanisms that carry out strategic learning to create value, effect performance outcomes, and ultimately drive the evolution of KMC. The findings imply that it is feasible for managing construction firms to govern learning mechanisms through managing the capability-based holistic KM system, thereby reconfiguring KMC to match needs in the dynamic market environment over time.

Peer assisted learning, skills development and Generation Y : a case study of a first year undergraduate law unit

The majority of current first year university students belong to Generation Y. Consequently, research suggests that, in order to more effectively engage them, their particular learning preferences should be acknowledged in the organisation of their learning environments and in the support provided. These preferences are reflected in the Torts Student Peer Mentor Program, which, as part of the undergraduate law degree at the Queensland University of Technology, utilises active learning, structured sessions and teamwork to supplement student understanding of the substantive law of Torts with the development of life-long skills. This article outlines the Program, and its relevance to the learning styles and experiences of Generation Y first year law students transitioning to university, in order to investigate student perceptions of its effectiveness – both generally and, more specifically, in terms of the Program’s capacity to assist students to develop academic and work-related skills.

Examining the Assessment Opportunities for Cultural Connectedness for Student Learning : A Sociocultural Analysis

The disparity that exists between the highest and lowest achievers together with deficit approaches to teaching, learning and assessment raise serious equity issues related to fairness, validity, culture and access, which were analysed in a recent Australian Research Council funded project. This chapter explores the potential that exists for teachers to work with Indigenous Teacher Assistants (ITAs) to secure cultural connectedness in teaching, learning and assessment of Indigenous students. The study was a design experiment, which was conducted in seven Catholic and Independent primary schools in northern Queensland and involved semi-structured focus group interviews with Year 4 and 6 Indigenous students, principals, teachers and Indigenous Teacher Assistants. Classroom observations and document analyses were also conducted. This corpus of data was analysed using a sociocultural theoretical lens. The use of a sociocultural analysis helped to identify cultural influences, Indigenous students’ funds of knowledge and values. The information from this analysis was made explicit to teachers to demonstrate how they could enhance their pedagogic and assessment practices by embracing and extending the cultural spaces for learning and teaching of Indigenous students. The way in which teachers construct their interactions for greater cultural connectedness and enhanced learning would appear to rely on relationship building with Indigenous staff, Indigenous students’ cultural knowledge, and improved understanding of assessment and related equity issues.

Professional development using informal learning networks : an empirical study in Australia’s digital content industry

Informal learning networks play a key role in the skill and professional development of professionals working in micro-businesses within Australia’s digital content industry as they do not necessarily have access to a learning and development or a human resources section that can assist in mapping their learning pathway. Professionals working in this environment would typically adopt an informal learning approach to their skill and professional development by utilising their social and business networks. The overall aim of this PhD research project is to study how these professionals manage their skill and professional development, and to explore what role informal learning networks play in this professional learning context. This paper will describe the theme of the research project and how it fits with previous research and other relevant studies. Secondly, it will present the study’s research focus, and the research questions. It will also present relevant theories and perspectives, and the methods for empirical data collection. Data collection will be through three distinct phases using a mixed methods research design: an online survey, interviews, and case studies. It should be noted the findings presented in this paper offer some early results of the research project.

Representative learning design in dynamic interceptive actions

The overarching aim of this thesis was to investigate how processes of perception and action emerge under changing informational constraints during performance of multi-articular interceptive actions. Interceptive actions provide unique opportunities to study processes of perception and action in dynamic performance environments. The movement model used to exemplify the functionally coupled relationship between perception and action, from an ecological dynamics perspective, was cricket batting. Ecological dynamics conceptualises the human body as a complex system composed of many interacting sub-systems, and perceptual and motor system degrees of freedom, which leads to the emergence of patterns of behaviour under changing task constraints during performance. The series of studies reported in the Chapters of this doctoral thesis contributed to understanding of human behaviour by providing evidence of key properties of complex systems in human movement systems including self-organisation under constraints and meta-stability. Specifically, the studies: i) demonstrated how movement organisation (action) and visual strategies (perception) of dynamic human behaviour are constrained by changing ecological (especially informational) task constraints; (ii) provided evidence for the importance of representative design in experiments on perception and action; and iii), provided a principled theoretical framework to guide learning design in acquisition of skill in interceptive actions like cricket batting.