Abilities and Cultural Understanding through Literature in the EFL Classroom : - A Literature Review

The English language can be seen as a lingua franca of contemporary times. Its spread and use in the globalized world has affected most levels of society and it can be argued that, in current times, English is synonymous with communication. This need for communication has shaped the English as a Foreign Language (EFL) syllabus, which is evident in the Swedish national steering documents for the educational system. For the upper secondary school these documents show an emphasis on communication, on cultural understanding, and also on the use of literature within the EFL classroom. The need to possess communicative abilities and cultural understanding, in connection with the use of literature, has sparked an interest to investigate if and how literature itself can be used as a tool to develop and improve EFL students’ communicative skills and cultural understanding. This literature review thesis analyzes five international research articles from different geographical parts of the Globe. The findings are categorized, compared, synthesized, and finally discussed in order to answer the research questions asked, and also compared with the English subject syllabus for the Swedish upper secondary school. The findings indicate that the analyzed articles share a consensus, to a varied degree, regarding the positive aspects of literature use in the EFL setting. The arguments are that communicative skills and cultural understanding are intertwined - enabling each other to exist, develop, and improve. One cannot exist fully without the other, and literature is a good tool to use to develop and improve these abilities. Literature can help develop all skills needed to acquire and produce both written and spoken English, and it also enables cultural understanding and a broadening of the mind. Where the articles differ somewhat is in the ideas of why literature is a good tool, how to implement literature in the classrooms, and what some of the negative aspects might be. The thesis also brings the lack of Swedish studies within EFL to the readers’ attention, as well as the need to do more research focusing on the students’ perspectives towards literature use in the EFL setting.

Depicting the interplay between organisational tiers in the use of a national quality registry to develop quality of care in Sweden

BACKGROUND: With a pending need to identify potential means to improved quality of care, national quality registries (NQRs) are identified as a promising route. Yet, there is limited evidence with regards to what hinders and facilitates the NQR innovation, what signifies the contexts in which NQRs are applied and drive quality improvement. Supposedly, barriers and facilitators to NQR-driven quality improvement may be found in the healthcare context, in the politico-administrative context, as well as with an NQR itself. In this study, we investigated the potential variation with regards to if and how an NQR was applied by decision-makers and users in regions and clinical settings. The aim was to depict the interplay between the clinical and the politico-administrative tiers in the use of NQRs to develop quality of care, examining an established registry on stroke care as a case study. METHODS: We interviewed 44 individuals representing the clinical and the politico-administrative settings of 4 out of 21 regions strategically chosen for including stroke units representing a variety of outcomes in the NQR on stroke (Riksstroke) and a variety of settings. The transcribed interviews were analysed by applying The Consolidated Framework for Implementation Research (CFIR). RESULTS: In two regions, decision-makers and/or administrators had initiated healthcare process projects for stroke, engaging the health professionals in the local stroke units who contributed with, for example, local data from Riksstroke. The Riksstroke data was used for identifying improvement issues, for setting goals, and asserting that the stroke units achieved an equivalent standard of care and a certain level of quality of stroke care. Meanwhile, one region had more recently initiated such a project and the fourth region had no similar collaboration across tiers. Apart from these projects, there was limited joint communication across tiers and none that included all individuals and functions engaged in quality improvement with regards to stroke care. CONCLUSIONS: If NQRs are to provide for quality improvement and learning opportunities, advances must be made in the links between the structures and processes across all organisational tiers, including decision-makers, administrators and health professionals engaged in a particular healthcare process.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.