UPTAKE OF THE PERIODIC HEALTH EXAM AMONG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES FROM 2003 TO 2015

Background: Over the past decade, annual heath exams have been de-emphasized for the general population but emphasized for adults with intellectual and developmental disabilities (IDD). The purpose of this project was to determine if there has been an increase in the uptake of the health exam among adults with IDD in Ontario, to what extent, and the effect on the quality of preventive care provided. Methods: Using administrative health data, the proportion of adults (18-64 years old) with IDD who received a health exam (long appointment, general assessment, and “true” health exam), a high value on the primary care quality composite score (PCQS), and a health exam or high PCQS each year was compared to the proportion in a propensity score matched sample of the general population. Negative binomial and segmented negative binomial regression controlling for age and sex were used to determine the relative risk of having a health exam/high PCQS/health exam or PCQS over time. Results: Pre joinpoint, the long appointment and general assessment health exam definitions saw a decrease and the “true” health exam saw an increase in the likelihood of adults having a health exam. Post joinpoint, all health exam definitions saw a decrease in the likelihood of adults having a health exam. Pre joinpoint, all PCQS measures (high PCQS, long appointment or high PCQS, “true” health exam or high PCQS) saw an increase in the likelihood for adults to achieve a high PCQS or high PCQS/have a health exam. Post joinpoint, all PCQS measures saw a decrease in the likelihood for adults to achieve a high PCQS or high PCQS/have a health exam. Achieving a high PCQS was strongly associated with having a health exam regardless of health exam definition or IDD status. Conclusions: Despite the publication of guidelines, only a small proportion of adults with IDD are receiving health exams. This indicates that the publication of guidelines alone was not sufficient to change practice. More targeted measures, such as the implementation of an IDD-specific health exam fee code, should be considered to increase the uptake of the health exam among adults with IDD.

An exploration of students’ perceptions and attitudes towards creativity in engineering education

This study used a mixed methods approach to develop a broad and deep understanding of students’ perceptions towards creativity in engineering education. Studies have shown that students’ attitudes can have an impact on their motivation to engage in creative behavior. Using an ex-post facto independent factorial design, attitudes of value towards creativity, time for creativity, and creativity stereotypes were measured and compared across gender, year of study, engineering discipline, preference for open-ended problem solving, and confidence in creative abilities. Participants were undergraduate engineering students at Queen’s University from all years of study. A qualitative phenomenological methodology was adopted to study students’ understandings and experiences with engineering creativity. Eleven students participated in oneon- one interviews that provided depth and insight into how students experience and define engineering creativity, and the survey included open-ended items developed using the 10 Maxims of Creativity in Education as a guiding framework. The findings from the survey suggested that students had high value for creativity, however students in fourth year or higher had less value than those in other years. Those with preference for open-ended problem solving and high confidence valued creative more than their counterparts. Students who preferred open-ended problem solving and students with high confidence reported that time was less of a hindrance to their creativity. Males identified more with creativity stereotypes than females, however overall they were both low. Open-ended survey and interview results indicated that students felt they experienced creativity in engineering design activities. Engineering creativity definitions had two elements: creative action and creative characteristic. Creative actions were associated with designing, and creative characteristics were predominantly associated with novelty. Other barriers that emerged from the qualitative analysis were lack of opportunity, lack of assessment, and discomfort with creativity. It was concluded that a universal definition is required to establish clear and aligned understandings of engineering creativity. Instructors may want to consider demonstrating value by assessing creativity and establishing clear criteria in design projects. It is recommended that students be given more opportunities for practice through design activities and that they be introduced to design and creative thinking concepts early in their engineering education.

UNDERSTANDING ESSAY RATING AS A SOCIALLY MEDIATED ACTIVITY: THE CASE OF A HIGH-STAKES ENGLISH TEST IN CHINA

Most essay rating research in language assessment has examined human raters’ essay rating as a cognitive process, thus overlooking or oversimplifying the interaction between raters and sociocultural contexts. Given that raters are social beings, their practices have social meanings and consequences. Hence it is important to situate essay rating within its sociocultural context for a more meaningful understanding. Drawing on Engeström’s (1987, 2001) cultural-historical activity theory (CHAT) framework with a sociocultural perspective, this study reconceptualized essay rating as a socially mediated activity with both cognitive (individual raters’ goal-directed decision-making actions) and social layers (raters’ collective object-oriented essay rating activity at related settings). In particular, this study explored raters’ essay rating at one provincial rating centre in China within the context of a high-stakes university entrance examination, the National Matriculation English Test (NMET). This study adopted a multiple-method multiple-perspective qualitative case study design. Think-aloud protocols, stimulated recalls, interviews, and documents served as the data sources. This investigation involved 25 participants at two settings (rating centre and high schools), including rating centre directors, team leaders, NMET essay raters who were high school teachers, and school principals and teaching colleagues of these essay raters. Data were analyzed using Strauss and Corbin’s (1990) open and axial coding techniques, and CHAT for data integration. The findings revealed the interaction between raters and the NMET sociocultural context. Such interaction can be understood through a surface structure (cognitive layer) and a deep structure (social layer) concerning how raters assessed NMET essays, where the surface structure reflected the “what” and the deep structure explained the “how” and “why” in raters’ decision-making. This study highlighted the roles of goals and rules in rater decision-making, rating tensions and raters’ solutions, and the relationship between essay rating and teaching. This study highlights the value of a sociocultural view to essay rating research, demonstrates CHAT as a sociocultural approach to investigate essay rating, and proposes a direction for future washback research on the effect of essay rating. This study also provides support for NMET rating practices that can potentially bring positive washback to English teaching in Chinese high schools.