Finnish Preclinical and Clinical Medical Students as Strategic L2 English Learners: Language Learning Strategies and Communicating with Patients

This thesis focused on medical students’ language learning strategies for patient encounters. The research questions concerned the types of learning strategies that medical students use and the differences between the preclinical students and the clinical students, two groups who have had varying amounts of experience with patients. Additionally, strategy use was examined through activity systems to gain information on the context of language learning strategy use in order to learn language for patient encounters. In total, 130 first-year medical students (preclinical) and 39 fifth-year medical students (clinical) participated in the study by filling in a questionnaire on language learning strategies. In addition, two students were interviewed in order to create activity systems for the medical students at different stages of their studies. The study utilised both quantitative and qualitative research methods; the analysis of the results relies on Oxford’s Strategic Self-Regulation Model in the quantitative part and on activity theory in the qualitative part. The theoretical sections of the study introduced earlier research and theories regarding English for specific purposes, language learning strategies and activity theory. The results indicated that the medical students use affective, sociocultural-interactive and metasociocultural-interactive strategies often and avoid using negative strategies, which hinder language learning or cease communication altogether. Slight differences between the preclinical and clinical students were found, as clinical students appear to use affective and metasociocultural-interactive strategies more frequently compared to the preclinical students. The activity systems of the two students interviewed were rather similar. The students were at different stages of their studies, but their opinions were very similar. Both reported the object of learning to be mutual understanding between the patient and the doctor, which in part explains the preference for strategies that support communication and interaction. The results indicate that the nature of patient encounters affects the strategy use of the medical students at least to some extent.

Deep convolutional neural networks for semantic video object segmentation

In this thesis, we propose to infer pixel-level labelling in video by utilising only object category information, exploiting the intrinsic structure of video data. Our motivation is the observation that image-level labels are much more easily to be acquired than pixel-level labels, and it is natural to find a link between the image level recognition and pixel level classification in video data, which would transfer learned recognition models from one domain to the other one. To this end, this thesis proposes two domain adaptation approaches to adapt the deep convolutional neural network (CNN) image recognition model trained from labelled image data to the target domain exploiting both semantic evidence learned from CNN, and the intrinsic structures of unlabelled video data. Our proposed approaches explicitly model and compensate for the domain adaptation from the source domain to the target domain which in turn underpins a robust semantic object segmentation method for natural videos. We demonstrate the superior performance of our methods by presenting extensive evaluations on challenging datasets comparing with the state-of-the-art methods.

Clinical Learning Environment and Supervision. Development and Validation of the CLES Evaluation Scale

The purpose of the study is: (1) to describe how nursing students' experienced their clinical learning environment and the supervision given by staff nurses working in hospital settings; and (2) to develop and test an evaluation scale of Clinical Learning Environment and Supervision (CLES). The study has been carried out in different phases. The pilot study (n=163) explored the association between the characteristics of a ward and its evaluation as a learning environment by students. The second version of research instrument (which was developed by the results of this pilot study) were tested by an expert panel (n=9 nurse teachers) and test-retest group formed by student nurses (n=38). After this evaluative phase, the CLES was formed as the basic research instrument for this study and it was tested with the Finnish main sample (n=416). In this phase, a concurrent validity instrument (Dunn & Burnett 1995) was used to confirm the validation process of CLES. The international comparative study was made by comparing the Finnish main sample with a British sample (n=142). The international comparative study was necessary for two reasons. In the instrument developing process, there is a need to test the new instrument in some other nursing culture. Other reason for comparative international study is the reflecting the impact of open employment markets in the European Union (EU) on the need to evaluate and to integrate EU health care educational systems. The results showed that the individualised supervision system is the most used supervision model and the supervisory relationship with personal mentor is the most meaningful single element of supervision evaluated by nursing students. The ward atmosphere and the management style of ward manager are the most important environmental factors of the clinical ward. The study integrates two theoretical elements - learning environment and supervision - in developing a preliminary theoretical model. The comparative international study showed that, Finnish students were more satisfied and evaluated their clinical placements and supervision with higher scores than students in the United Kingdom (UK). The difference between groups was statistical highly significant (p= 0.000). In the UK, clinical placements were longer but students met their nurse teachers less frequently than students in Finland. Arrangements for supervision were similar. This research process has produced the evaluation scale (CLES), which can be used in research and quality assessments of clinical learning environment and supervision in Finland and in the UK. CLES consists of 27 items and it is sub-divided into five sub-dimensions. Cronbach's alpha coefficient varied from high 0.94 to marginal 0.73. CLES is a compact evaluation scale and user-friendliness makes it suitable for continuing evaluation.