University students’ regulation of learning and text processing – examples from medical and teacher education

The general aim of the thesis was to study university students’ learning from the perspective of regulation of learning and text processing. The data were collected from the two academic disciplines of medical and teacher education, which share the features of highly scheduled study, a multidisciplinary character, a complex relationship between theory and practice and a professional nature. Contemporary information society poses new challenges for learning, as it is not possible to learn all the information needed in a profession during a study programme. Therefore, it is increasingly important to learn how to think and learn independently, how to recognise gaps in and update one’s knowledge and how to deal with the huge amount of constantly changing information. In other words, it is critical to regulate one’s learning and to process text effectively. The thesis comprises five sub-studies that employed cross-sectional, longitudinal and experimental designs and multiple methods, from surveys to eye tracking. Study I examined the connections between students’ study orientations and the ways they regulate their learning. In total, 410 second-, fourth- and sixth-year medical students from two Finnish medical schools participated in the study by completing a questionnaire measuring both general study orientations and regulation strategies. The students were generally deeply oriented towards their studies. However, they regulated their studying externally. Several interesting and theoretically reasonable connections between the variables were found. For instance, self-regulation was positively correlated with deep orientation and achievement orientation and was negatively correlated with non-commitment. However, external regulation was likewise positively correlated with deep orientation and achievement orientation but also with surface orientation and systematic orientation. It is argued that external regulation might function as an effective coping strategy in the cognitively loaded medical curriculum. Study II focused on medical students’ regulation of learning and their conceptions of the learning environment in an innovative medical course where traditional lectures were combined wth problem-based learning (PBL) group work. First-year medical and dental students (N = 153) completed a questionnaire assessing their regulation strategies of learning and views about the PBL group work. The results indicated that external regulation and self-regulation of the learning content were the most typical regulation strategies among the participants. In line with previous studies, self-regulation wasconnected with study success. Strictly organised PBL sessions were not considered as useful as lectures, although the students’ views of the teacher/tutor and the group were mainly positive. Therefore, developers of teaching methods are challenged to think of new solutions that facilitate reflection of one’s learning and that improve the development of self-regulation. In Study III, a person-centred approach to studying regulation strategies was employed, in contrast to the traditional variable-centred approach used in Study I and Study II. The aim of Study III was to identify different regulation strategy profiles among medical students (N = 162) across time and to examine to what extent these profiles predict study success in preclinical studies. Four regulation strategy profiles were identified, and connections with study success were found. Students with the lowest self-regulation and with an increasing lack of regulation performed worse than the other groups. As the person-centred approach enables us to individualise students with diverse regulation patterns, it could be used in supporting student learning and in facilitating the early diagnosis of learning difficulties. In Study IV, 91 student teachers participated in a pre-test/post-test design where they answered open-ended questions about a complex science concept both before and after reading either a traditional, expository science text or a refutational text that prompted the reader to change his/her beliefs according to scientific beliefs about the phenomenon. The student teachers completed a questionnaire concerning their regulation and processing strategies. The results showed that the students’ understanding improved after text reading intervention and that refutational text promoted understanding better than the traditional text. Additionally, regulation and processing strategies were found to be connected with understanding the science phenomenon. A weak trend showed that weaker learners would benefit more from the refutational text. It seems that learners with effective learning strategies are able to pick out the relevant content regardless of the text type, whereas weaker learners might benefit from refutational parts that contrast the most typical misconceptions with scientific views. The purpose of Study V was to use eye tracking to determine how third-year medical studets (n = 39) and internal medicine residents (n = 13) read and solve patient case texts. The results revealed differences between medical students and residents in processing patient case texts; compared to the students, the residents were more accurate in their diagnoses and processed the texts significantly faster and with a lower number of fixations. Different reading patterns were also found. The observed differences between medical students and residents in processing patient case texts could be used in medical education to model expert reasoning and to teach how a good medical text should be constructed. The main findings of the thesis indicate that even among very selected student populations, such as high-achieving medical students or student teachers, there seems to be a lot of variation in regulation strategies of learning and text processing. As these learning strategies are related to successful studying, students enter educational programmes with rather different chances of managing and achieving success. Further, the ways of engaging in learning seldom centre on a single strategy or approach; rather, students seem to combine several strategies to a certain degree. Sometimes, it can be a matter of perspective of which way of learning can be considered best; therefore, the reality of studying in higher education is often more complicated than the simplistic view of self-regulation as a good quality and external regulation as a harmful quality. The beginning of university studies may be stressful for many, as the gap between high school and university studies is huge and those strategies that were adequate during high school might not work as well in higher education. Therefore, it is important to map students’ learning strategies and to encourage them to engage in using high-quality learning strategies from the beginning. Instead of separate courses on learning skills, the integration of these skills into course contents should be considered. Furthermore, learning complex scientific phenomena could be facilitated by paying attention to high-quality learning materials and texts and other support from the learning environment also in the university. Eye tracking seems to have great potential in evaluating performance and growing diagnostic expertise in text processing, although more research using texts as stimulus is needed. Both medical and teacher education programmes and the professions themselves are challenging in terms of their multidisciplinary nature and increasing amounts of information and therefore require good lifelong learning skills during the study period and later in work life.

Python as a programming language for the introductory programming courses

Tämä kandidaatintyö tutkii tietotekniikan perusopetuksessa keskeisen aiheen,ohjelmoinnin, alkeisopetusta ja siihen liittyviä ongelmia. Työssä perehdytään ohjelmoinnin perusopetusmenetelmiin ja opetuksen lähestymistapoihin, sekä ratkaisuihin, joilla opetusta voidaan tehostaa. Näitä ratkaisuja työssä ovat mm. ohjelmointikielen valinta, käytettävän kehitysympäristön löytäminen sekä kurssia tukevien opetusapuvälineiden etsiminen. Lisäksi kurssin läpivientiin liittyvien toimintojen, kuten harjoitusten ja mahdollisten viikkotehtävien valinta kuuluu osaksitätä työtä. Työ itsessään lähestyy aihetta tutkimalla Pythonin soveltuvuutta ohjelmoinnin alkeisopetukseen mm. vertailemalla sitä muihin olemassa oleviin yleisiin opetuskieliin, kuten C, C++ tai Java. Se tarkastelee kielen hyviä ja huonoja puolia, sekä tutkii, voidaanko Pythonia hyödyntää luontevasti pääasiallisena opetuskielenä. Lisäksi työ perehtyy siihen, mitä kaikkea kurssilla tulisi opettaa, sekä siihen, kuinka kurssin läpivienti olisi tehokkainta toteuttaa ja minkälaiset tekniset puitteet kurssin toteuttamista varten olisi järkevää valita.

Very preterm infants in Finland - Use of health care services and economic consequences during the first five years of life

The aim of this thesis was to study the health, the hospitalisations, and the use of communal health care services in very preterm children during the first five years of life. In addition, the effect of very preterm birth and prematurity-related morbidities on the costs of hospitalisations, other health care services and the cost per quality adjusted life years (QALY) were studied. This population-based study included all very preterm children (gestational age (GA) <32 weeks or birth weight<1501g, N=2 064) and full-term controls (GA 37+0−41+6, N=200 609) born in Finland during 2000-2003. The data sources included national register data, costing data from the participating hospitals and parental questionnaires. This study showed that most very preterm infants born in Finland survived without prematurity-related morbidities diagnosed during the first years of life. They required relatively little hospital care after the initial discharge, which accounted for the vast majority of the total four-year hospitalisation costs. However, a minority of children born very preterm later developing morbidities had a long initial length of stay and more re-admissions and outpatient visits during the five-year follow-up period. In particular, the number and costs of non-emergency outpatient visits were considerable in individuals with prematurity-related morbidities. The need and costs of hospitalisations decreased clearly with each follow-up year, even in individuals with morbidities. The health-care related costs during the fifth year of life in children born very preterm without prematurity-related morbidities were close to the costs in infants born healthy at term. The cost per QALY of 19,245 € was at an acceptable level already by four years of age in the very preterm population as a whole. Prematurity-related later morbidities and decreasing GA increased the costs per QALY. As the initial hospital stay accounted for a great majority of the total four-year costs, and the costs of hospitalisation decreased with each follow-up year, the cost per QALY is likely to decrease with age. In conclusion, the majority of costs arising after the initial hospitalisation were associated with morbidities related to prematurity. Therefore offering high-quality neonatal care to prevent later morbidities in very preterm survivors has a long-term impact on the cost per QALY. In addition, this study indicates that when estimating the costs of prematurity after the first year of life, one should calculate not only the hospitalisation costs, but also other costs for social welfare services, primary care, and therapies, as these exceed the hospitalisation costs in very preterm infants during the fifth year of life.

Yrittäjyyttä rakentamassa - yrittäjyyden kolme diskurssia

Tämä tutkimus osallistuu yrittäjyyden kartoittamiseen yrittäjyyskasvatusta varten hyödyntäen näkökulmaa todellisuuden sosiaalisesta rakentumisesta. Tutkimus on kvalitatiivinen, sillä sen aineistona on teemahaastatteluissa tuotettu puhe yrittäjyydestä ja analysointimenetelmänä on diskurssianalyysi. Tutkimuksen tavoitteena on diskurssianalyysin keinoin tunnistaa ne yrittäjyyttä sosiaalisesti rakentavat diskurssit, joita Lappeenrannan teknillisen yliopiston kauppatieteellisen tiedekunnan ensimmäisen vuoden opiskelijat hyödyntävät yrittäjyyttä koskevassa puheessaan. Lisäksi tavoitteena on kuvata ja ymmärtää tunnistetuissa diskursseissa rakentuvaa yrittäjyyttä sekä yrittäjyyden motivaatiotekijöitä, yrittäjyyden esteitä ja yrittäjyyden keinoja. Analyysissä tunnistetaan kolme yrittäjyyden diskurssia sekä kuvataan ja jäsennetään niissä erilailla rakentuvaa yrittäjyyttä ja siihen liittyviä käsitteitä. Yrittäjyyden kolme diskurssia ovat bisnes-, elämäntapa- ja innovaatiodiskurssi. Analyysin avulla yrittäjyyskasvatusta voidaan suunnitella ja toteuttaa uudella tavalla, joka vastaa yrittäjyyden laaja-alaista ja monimutkaista todellisuutta.

Päämääriä, ajelehtimista, tietämättömyyttä, etsintää: Koulutusvalinnat, opinnot ja koulutuksen vaihtaminen yliopisto-opiskelijoiden kokemana 2000 -luvun taitteessa

Tutkimuksessa tarkastellaan yliopisto-opiskelua, opintojen kokemista ja niiden kulkua alkaen koulutusvalinnoista. Lisäksi tutkimuksessa pyritään ymmärtämään ja kuvaamaan yliopisto-opintojen aikaista koulutuksen vaihtamista prosessina. Kyseessä on seurantatutkimus Turun yliopistossa vuonna 1998 aloittaneesta opiskelijakohortista. Tutkittavat opiskelijat valittiin sillä perusteella, että he vastasivat kolmeen opintoja koskevaan kyselyyn ja olivat vähintään kolmen vuoden ajan läsnä olevina opiskelijoina. Opiskelijat (n=440) jaettiin neljään vertailuryhmään: 1) opintoihinsa tyytyväiset, 2) ensimmäisen vuoden jälkeen koulutusta vaihtaneet, 3) toisen vuoden jälkeen koulutusta vaihtaneet ja 4) koulutusta vaihtaa halunneet. Tutkimusaineisto koostuu kolmesta kyselystä, opintorekisteriaineistosta ja koulutusta opintojen aikana vaihtaneiden opiskelijoiden haastatteluista (n=22). Kyselyt tehtiin ensimmäisen, toisen ja kolmannen opintovuoden kevätlukukausilla ja haastattelut vuonna 2002, jolloin opiskelijat opiskelivat Turun yliopistossa neljättä tai viidettä vuotta. Kyselyiden avulla tutkittiin eroavatko koulutusta vaihtaneet opiskelijat muista opiskelijoista rakenteellisilta tekijöiltään tai opintokokemuksissaan. Opintorekisteriaineiston perusteella tutkittiin eroavatko koulutusta vaihtaneet opiskelijat koulutuksessa pysyneistä opiskelijoista opintojen kulussa. Kyselyiden ja haastatteluiden avulla tutkittiin minkälaisia tietoja ja odotuksia opiskelijoilla oli yliopisto-opiskelusta ollut ennen opintojen aloittamista. Haastatteluiden perusteella tutkittiin mitä syitä koulutuksen vaihtamisen taustalla oli ja minkälaisina kertomuksina koulutuksen vaihtamisprosessi näyttäytyi. Koulutusta vaihtaneet opiskelijat erosivat koulutuksessa pysyneistä opiskelijoista aiemman koulutuksen määrän, iän ja perheellisyyden suhteen. Verrattaessa ensimmäisen ja toisen vuoden jälkeen koulutusta vaihtaneita opiskelijoita keskenään havaittiin näillä ryhmillä olevan erilainen perhetausta. Koulutusta valittaessa tärkein tekijä oli kiinnostus alaa kohtaan. Toiseksi voimakkain hakutekijä oli muilla paitsi ensimmäisen vuoden jälkeen koulutusta vaihtaneilla valmiudet haluttuun ammattiin. Vuorostaan ensimmäisen vuoden jälkeen koulutusta vaihtaneilla toiseksi tärkein tekijä hakeutumisessa oli helppo sisäänpääsy opintoihin. Suurin osa opiskelijoista oli päässyt ensisijaisesti haluamaansa koulutukseen. Koulutusta myöhemmin vaihtaneissa ryhmissä ja koulutuksen vaihtoa halunneiden ryhmässä ensisijaisesti haluttuun koulutukseen päässeitä oli alle puolet. Odotukset opiskelusta eivät täysin täyttyneet ensimmäisen puolen vuoden opiskelun aikana. Tutkittujen ryhmien välillä havaittiin eroja kokemuksissa koulutuksen sopivuudesta itselle. Koulutuksen vaihtaminen oli myönteinen kokemus, ja uusi koulutus koettiin aiempaa koulutusta sopivammaksi itselle. Kolmannen vuoden kevätlukukaudella omaa koulutusta kohtaan koettu kiinnostus oli voimakasta muissa ryhmissä paitsi koulutuksen vaihtoa halunneissa. Harvimmin positiivisia tunteita opiskelua kohtaan kokivat vaihtoa halunneet opiskelijat. Koulutuksen vaihtaminen vähensi opintoihin kiinnittymättömyyttä. Koulutuksen vaihtoa halunneiden kokemukset nykyisen koulutuksensa ilmapiiristä olivat negatiivisimpia. Koulutuksen vaihtaminen vaikutti myönteisesti myös opetuksen kokemiseen. Opinnot etenivät kaikissa tutkituissa ryhmissä tasaisesti. Koulutuksen vaihtamisen jälkeisenä vuonna opinnot etenivät vaihtaneissa ryhmissä keskimääräistä enemmän. Haastatteluiden mukaan pääasiallisia syitä koulutuksen vaihtamiselle olivat päätyminen toissijaiseen koulutukseen ja pettyminen aloittamaansa koulutukseen. Narratiivien analyysin avulla tutkimuksessa löydettiin neljä erilaista tarinaa vaihtamisprosessista: 1) toissijaisesta koulutuksesta ensisijaiseen koulutukseen vaihtaminen, 2) ensisijaiseen koulutukseen pettyminen, 3) kiinnostavampaan koulutukseen ajautuminen ja 4) oman alan löytyminen etsinnän kautta. Vaikka koulutuspolitiikassa koulutuksen vaihtaminen nähdään ongelmana, oli se tämän tutkimuksen mukaan opiskelijalle myönteinen kokemus. Tämän tutkimuksen perusteella tulisikin kiinnittää huomiota opiskelijoihin, jotka haluaisivat vaihtaa koulutuksesta toiseen. Heillä opintojen eteneminen osoittautui hitaimmaksi ja opintokokemukset negatiivisimmiksi. Koulutusta vaihtaneiden opiskelijoiden opintojen eteneminen näytti hitaalta verrattuna opintoihinsa tyytyväisiin opiskelijoihin. Koulutuksen vaihtamisen jälkeen opintojen eteneminen kuitenkin nopeutui ja opintotyytyväisyys lisääntyi.

Det planlagda och det som visar sig : klasslärarstuderandes syn på undervisning i teknisk slöjd

Sloyd as an activity concretizes man’s ability to, with the help of mind and body, reshape materials into objects and change her conditions for survival. The sloyd actor outside school works when the spirit moves her, while the pupil in school is expected to sloyd regardless of motivation. Subject teachers become experts on sloyd in educational settings, while the qualification requirements may set the class teachers’ voluntariness within parenthesis. All class teachers qualify to teach all core subjects of the national curriculum in Finland from preschool to grade six. The aim of the current thesis is to deepen the knowledge on how the science of sloyd education can support class teacher students’ future teaching in sloyd. In the empirical part of the study, Swedish-speaking Finnish class teacher students’ views on technical sloyd as one of their future subjects for teaching are examined. The class teacher’s qualifying skills in teaching technical sloyd are expected to take shape during only a few ECTS study points. The teacher students’ experience of the subject from the pupil’s perspective is supposed to move into a budding teacher subject. In a research-based teacher education, self-reflection and reflection as a dialogue are extended aided by research results. Intuitive thinking interplays with rational thinking during this time. The teacher student’s approach to make use of the autonomous free space in teaching is, in the current thesis, as considerations where the individual weighs the pros and cons in relation to various phenomena in sloyd and the school overall. The basis for an individual autonomy is shaped and is expected to interplay on the common arena of autonomy. In the exercise of their profession, the class teacher teaching sloyd is expected to oscillate between the sloyd educational practice and theory. The first step in this movement within the teacher education is the coverage of a selection of theories during the studies. The empirical part of the study is carried out at two separate occasions with directed open-ended interviews with fifteen class teacher students in the beginning and end of their first year of study. The data was analysed with a hermeneutic approach and a qualitatively oriented approach to content analysis. The results are mirrored against theory within the science of sloyd education. The results show that class teacher students have a versatile view of educational sloyd. The overall results overthrow parts of the researcher’s pre-understanding. The viewpoint of the students seems to broaden from a merely manual activity to seeing sloyd as an educational activity. In order for the results to gain significance in the teacher education of the future, a line of reasoning is conducted in order to recommend an extended dialogue and thirteen possible themes for enriching discussions are put forth as a result of the present study. The extended dialogue focuses on that teacher education should make conscious ventures to create opportunities for the students to take part in effective discussions on the subject of sloyd, complementing the existing dialogue between the teacher educator and the students. This thesis lends support to reflections on the following aspects of educational sloyd in these dialogues: the reasons for why the sloyd subject exists, the ambitions of the subject, the content and organization of the subject for students as well as for the teacher educators.

Cholesterol, cardiovascular disease and statin use in older persons

Older age increases the risk of developing a chronic atherosclerotic cardiovascular disease (CVD), such as coronary heart disease. Complications of CVDs, myocardial infarction or stroke often lead to loss of functional capacity or premature death. Dyslipidemia, high serum levels of total or low-density lipoprotein cholesterol (LDL-c) and low levels of high-density lipoprotein cholesterol (HDL-c), is among the most important modifiable risk factors for CVDs; it can be treated with lifestyle modifications, and with lipid-lowering drugs, primarily statins. In older persons, however, the association of cholesterol levels with cardiovascular and all-cause mortality has been inconsistent in previous studies. Furthermore, the beneficial effects of statins in older persons without previous CVD are still somewhat unclear, and older persons are more prone to adverse effects from statins. This thesis presents a prospective cohort study (TUVA), exploring associations of cholesterol levels with mortality and the changes in cholesterol levels of a 70-year-old population in long-term follow-up. Further, prevalence of CVDs, risk factors and preventive medication use in the TUVA cohort is compared with respective prevalences in another age-matched cohort (UTUVA) 20 years later in order to examine the changes in cardiovascular risk over time. Additionally, to evaluate statin use patterns among older persons, an observational register study was conducted covering the total Finnish population aged 70 and older during 2000-2008. Based on individual-level data retrieved from national health registries, the population was classified into low, moderate and high risk groups according to estimated CVD risk. The prevalence, incidence and persistence of statin use among the risk groups was then evaluated based upon yearly statin purchases tracked from the Prescription Register. The prospective cohort study demonstrated that low total cholesterol, LDL-c and HDL-c were associated with higher mortality in a cohort of home-dwelling 70-year-olds. However, after adjusting for traditional cardiovascular risk factors and cancer this association disappeared. Further, low total cholesterol seemed to be protective, whereas low HDL-c strongly predicted increased risk of CVD death. Cholesterol levels of those elderly who remained available for follow-up and were still home-dwelling at the age of 85 seemed to improve with advancing age. Compared to the TUVA cohort, the later born UTUVA cohort had less CVDs and their risk factors were better controlled, which was reflected in the higher use of preventive medications such as statins and antihypertensives. The register studies confirmed that statin use has increased significantly during 2000-2008 among older persons, especially among the oldest (80+) age groups and among those at high risk for cardiovascular events. Two-thirds of new statin users persisted with their use during the four years of follow-up; the most discontinuations were made during the first year of use. In conclusion, statins are commonly used among older age groups in Finland. Most of the older statin users had a high cardiovascular event risk, indicating that the treatment is well directed towards those who are likely to benefit from it the most. No age-limits should be put on the screening and treatment of dyslipidemia in older persons, but the benefits and adverse effects of statin treatment should be carefully weighed based on an individual assessment of the person’s general health status and functional capacity. Physicians should pay more attention to medication adherence, especially when prescribing preventive medications.