The impact of a simulated intervention on attitudes of undergraduate nursing and medical students towards end of life care provision

Background: The concerns of undergraduate nursing and medical students’ regarding end of life care are well documented. Many report feelings of emotional distress, anxiety and a lack of preparation to provide care to patients at end of life and their families. Evidence suggests that increased exposure to patients who are dying and their families can improve attitudes toward end of life care. In the absence of such clinical exposure, simulation provides experiential learning with outcomes comparable to that of clinical practice. The aim of this study was therefore to assess the impact of a simulated intervention on the attitudes of undergraduate nursing and medical students towards end of life care.
Methods: A pilot quasi-experimental, pretest-posttest design. Attitudes towards end of life care were measured using the Frommelt Attitudes Towards Care of the Dying Part B Scale which was administered pre and post a simulated clinical scenario. 19 undergraduate nursing and medical students were recruited from one large Higher Education Institution in the United Kingdom.
Results: The results of this pilot study confirm that a simulated end of life care intervention has a positive impact on the attitudes of undergraduate nursing and medical students towards end of life care (p < 0.001).
Conclusions: Active, experiential learning in the form of simulation teaching helps improve attitudes of undergraduate nursing and medical students towards end of life. In the absence of clinical exposure, simulation is a viable alternative to help prepare students for their professional role regarding end of life care.

Enhancing the Manufacturing Knowledge of Undergraduate Engineering Students: A Case Study of a Design-Build-Test Challenge Involving Folding Bicycles

Many engineers currently in professional practice will have gained a degree level qualification which involved studying a curriculum heavy with mathematics and engineering science. While this knowledge is vital to the engineering design process so also is manufacturing knowledge, if the resulting designs are to be both technically and commercially viable.
The methodology advanced by the CDIO Initiative aims to improve engineering education by teaching in the context of Conceiving, Designing, Implementing and Operating products, processes or systems. A key element of this approach is the use of Design-Built-Test (DBT) projects as the core of an integrated curriculum. This approach facilitates the development of professional skills as well as the application of technical knowledge and skills developed in other parts of the degree programme. This approach also changes the role of lecturer to that of facilitator / coach in an active learning environment in which students gain concrete experiences that support their development.
The case study herein describes Mechanical Engineering undergraduate student involvement in the manufacture and assembly of concept and functional prototypes of a folding bicycle.

The impact of curricular change on medical students' knowledge of anatomy

Background: In recent years, following the publication of Tomorrow's Doctors, the undergraduate medical curriculum in most UK medical schools has undergone major revision. This has resulted in a significant reduction in the time allocated to the teaching of the basic medical sciences, including anatomy. However, it is not clear what impact these changes have had on medical students' knowledge of surface anatomy. Aim: This study aimed to assess the impact of these curricular changes on medical students' knowledge of surface anatomy. Setting: Medical student intakes for 1995-98 at the Queen's University of Belfast, UK. Methods: The students were invited to complete a simple examination paper testing their knowledge of surface anatomy. Results from the student intake of 1995, which undertook a traditional, 'old' curriculum, were compared with those from the student intakes of 1996-98, which undertook a new, 'systems-based' curriculum. To enhance linear response and enable the use of linear models for analysis, all data were adjusted using probit transformations of the proportion (percentage) of correct answers for each item and each year group. Results: The student intake of 1995 (old curriculum) were more likely to score higher than the students who undertook the new, systems-based curriculum. Conclusion: The introduction of the new, systems-based course has had a negative impact on medical students' knowledge of surface anatomy.

The structure of the Statistics Anxiety Rating Scale: A confirmatory factor analysis using UK psychology students

This study aimed to examine the structure of the statistics anxiety rating scale. Responses from 650 undergraduate psychology students throughout the UK were collected through an on-line study. Based on previous research three different models were specified and estimated using confirmatory factor analysis. Fit indices were used to determine if the model fitted the data and a likelihood ratio difference test was used to determine the best fitting model. The original six factor model was the best explanation of the data. All six subscales were intercorrelated and internally consistent. It was concluded that the statistics anxiety rating scale was found to measure the six subscales it was designed to assess in a UK population.

The effect of statistics anxiety on students’ predicted and actual test scores

This study investigated the effect of statistics anxiety and attitudes on first year psychology students’ predicted and actual statistics class test scores. A total of 52 students completed the Statistics Anxiety Rating Scale and estimated their class test scores one week before their test at the end of first year. Regression models were conducted with the six attitude and anxiety subscales as predictors and the predicted and actual test scores as criterion variables. The results showed that computation self concept and fear of asking for help accounted for 37% of the variance in predicted test scores. However, when actual test scores were analysed the significant predictors were worth of statistics and interpretation anxiety, which accounted for 20% of the variance. These results suggested that while statistics anxiety does influence students’ perceptions of their competence it appears to have less effect on their actual performance. Results also suggested that students were unaware of their own statistical competence. Remedial action is required to address the level of statistics anxiety experienced by first year undergraduate psychology students, as it appears to result in unrealistic assessments of their ability and has detrimental effects on their statistics self-efficacy.

The immediate Life support course: implementation into an undergraduate nursing programme

This paper outlines how the immediate life support (ILS) course was incorporated into an undergraduate-nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. The aim was to develop the student’s ability to recognise the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this the ILS course was only available to qualified nurses and this paper reports on the first time students were provided with an ILS course in an undergraduate setting. The ILS course was delivered to 89 third year nursing students (Adult Branch) and comprised one full teaching day per week over two weeks. Recognised Advanced Life Support (ALS) instructors, in keeping with the United Kingdom Resuscitation Council guidelines, taught the students. Participants completed a 17 item questionnaire which comprised an open-ended section for student comment. Questionnaire data was analysed descriptively using SSPSS version 15.0. Open-ended responses from the questionnaire data was analysed by content and thematic analysis. Results Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge Conclusion. The inclusion of the ILS course provides students with necessary skills to assess and manage the deteriorating patient. In addition the data from this study suggest the ILS course should be delivered in an inter-professional setting – i.e taught jointly with medical students. References: Department of Health & Quality Assurance Agency (2006). Department of Health Phase 2 benchmarking project – final report. Gloucester: Department of Health, London and Quality Assurance Agency for Higher Education

Accounting and business students' approaches to learning: A longitudinal study

This study reports the results of an investigation into the learning approaches of undergraduate accounting and business students from three universities in Ireland who were exposed to a learning environment, namely the case study method, which aimed to encourage a deep approach to learning. In order to assess the effectiveness of the intervention, the ASSIST research instrument was used to investigate changes in students’ approaches to learning over time. Consistent with previous research, this study considers whether gender is related to students’ approaches to learning over time and if there are differences between students majoring in accounting or business in their approaches to learning. The results of the study indicate that the case study intervention was successful in some respects. However, contrary to expectations, an overall statistically significant increase in students’ surface approach to learning was found. Additionally, it is reported that changes in students’ approaches to learning over time are not associated with gender or degree program. The results of this study offer insights to accounting educators developing educational interventions to encourage deep approaches to learning.

The Design Process- Making It Relevant For Students

Within the ever-changing arenas of architectural design and education, the core element of architectural education remains: that of the design process. The consideration of how to design in addition to what to design presents architectural educators with that most constant and demanding challenge of how do we best teach the design process?

This challenge is arguably most acute at a student's early stages of their architectural education. In their first years in architecture, students will commonly concentrate on the end product rather than the process. This is, in many ways, understandable. A great deal of time, money and effort go into their final presentations. They believe that it is what is on the wall that is going to be assessed. Armed with new computer skills, they want to produce eye-catching graphics that are often no more than a celebration of a CAD package. In an era of increasing speed, immediacy of information and powerful advertising it is unsurprising that students want to race quickly to presenting an end-product.

Recognising that trend, new teaching methods and models were introduced into the second year undergraduate studio over the past two years at Queen's University Belfast, aimed at promoting student self-reflection and making the design process more relevant to the students. This paper will first generate a critical discussion on the difficulties associated with the design process before outlining some of the methods employed to help promote the following; an understanding of concept, personalisation of the design process for the individual student; adding realism and value to the design process and finally, getting he students to play to their strengths in illustrating their design process like an element of product. Frameworks, examples, outcomes and student feedback will all be presented to help illustrate the effectiveness of the new strategies employed in making the design process firstly, more relevant and therefore secondly, of greater value, to the architecture student.

The structure of the Beck Hopelessness Scale: A confirmatory factor analysis in UK students

The aim of this paper was to confirm the factor structure of the 20-item Beck Hopelessness Scale in a non-clinical population. Previous research has highlighted a lack of clarity in its construct validity with regards to this population.

Based on previous factor analytic findings from both clinical and non-clinical studies, 13 separate confirmatory factor models were specified and estimated using LISREL 8.72 to test the one, two and three-factor models.

Psychology and medical students at Queen's University, Belfast (n = 581) completed both the BHS and the Beck Depression Inventory (BDI).

All models showed reasonable fit, but only one, a four-item single-factor model demonstrated a nonsignificant chi-squared statistic. These four items can be used to derive a Short-Form BHS (SBHS) in which increasing scores (0-4) corresponded with increasing scores in the BDI. The four items were also drawn from all three of Beck's proposed triad, and included both positively and negatively scored items.

This study in a UK undergraduate non-clinical population suggests that the BHS best measures a one-factor model of hopelessness. It appears that a shorter four-item scale can also measure this one-factor model. (C) 2011 Elsevier Ltd. All rights reserved.

A virtual surgery in general practice: evaluation of a novel undergraduate virtual patient learning package

Background: A suite of 10 online virtual patients developed using the IVIMEDS ‘Riverside’ authoring tool has been introduced into our undergraduate general practice clerkship. These cases provide a multimedia-rich experience to students. Their interactive nature promotes the development of clinical reasoning skills such as discriminating key clinical features, integrating information from a variety of sources and forming diagnoses and management plans.

Aims: To evaluate the usefulness and usability of a set of online virtual patients in an undergraduate general practice clerkship.
Method: Online questionnaire completed by students after their general practice placement incorporating the System Usability Scale questionnaire.

Results: There was a 57% response rate. Ninety-five per cent of students agreed that the online package was a useful learning tool and ranked virtual patients third out of six learning modalities. Questions and answers and the use of images and videos were all rated highly by students as useful learning methods. The package was perceived to have a high level of usability among respondents.

Conclusion: Feedback from students suggest that this implementation of virtual patients, set in primary care, is user friendly and rated as a valuable adjunct to their learning. The cost of production of such learning resources demands close attention to design.

Development of a multi-media book for clinical supervision training in undergraduate nursing

There is an increased interest in higher education in the use of e-learning resources for students. This can be attributed to many factors including, the availability of advanced technology systems, a growing student population that is technology focused, financial implications and the recruitment of international students. However, the introduction of technology and e-learning into teaching has given rise to issues regarding quality and quantity of educational practice . The challenge now is for educationalists is to deliver an optimal learning experience that is effective and appropriate for students’ learning needs.