Patient deterioration education: Evaluation of face-to-face simulation and e-simulation approaches

Background: Simulation-based education is one strategy that may be used to teach nursing students to recognize and manage patient deterioration. Method: Final-year preregistration nursing students (n=97) completed three face-to-face laboratory-based team simulations with a simulated patient (actor) and 330 students individually completed a three-scenario Web-based simulation program: FIRST2ACTWeb™. Results: Both groups achieved moderate performance scores (means: face to face, 49%; e-simulation, 69%). Course evaluations were positive, skill gain showing a greater effect size in the face-to-face program than for e-simulation, and higher satisfaction and more positive appraisal. Conclusion: Face-to-face simulation and e-simulation are effective educational strategies with e-simulation offering greater feasibility. Either strategy is likely to add value to the learning experience.

Online interprofessional education in dietetic students

Aim: The need for dietetic students to develop interprofessional collaborative practice capabilities is well recognised. The aim of this study was to examine the ability of an online interprofessional education (IPE) unit (using asynchronous and synchronous media) to improve dietetic students' confidence in understanding professional roles and attitudes associated with interprofessional practice along with exploring their experience in the unit. Methods: Final year master of dietetic students undertaking a compulsory online unit in IPE were invited to complete a questionnaire examining their confidence in understanding professional roles and their interprofessional attitudes both pre- and post-delivery of the unit, and to participate in semi-structured telephone interviews to explore their experience in the unit. Results: Thirty-five dietetic students completed the questionnaire pre- and post-unit, along with seven students undertaking a telephone interview. Their confidence in understanding the roles of other health professions (P = 0.000 to 0.014), self-assessment of interprofessional communication and teamwork skills (P = 0.002) and attitudes towards interprofessional interaction (P = 0.001) and interprofessional relationships (P = 0.002) increased significantly from pre- to post-unit. The students articulated positives about the experience (flexibility of the delivery, opportunity to reflect on personal factors related to teamwork, increasing their knowledge of other professions) and some challenges (lack of body language, some technological difficulties, the need for regular contribution to the teams' asynchronous discussion boards). Conclusions: This study suggests that although there can be some challenges in online IPE, it can be a positive experience and can improve dietetic students' collaborative practice attitudes and confidence in understanding other professional roles.

A trial of e-simulation of sudden patient deterioration (FIRST2ACT WEB) on student learning

BACKGROUND: High-fidelity simulation pedagogy is of increasing importance in health professional education; however, face-to-face simulation programs are resource intensive and impractical to implement across large numbers of students. OBJECTIVES: To investigate undergraduate nursing students' theoretical and applied learning in response to the e-simulation program-FIRST2ACT WEBTM, and explore predictors of virtual clinical performance. DESIGN AND SETTING: Multi-center trial of FIRST2ACT WEBTM accessible to students in five Australian universities and colleges, across 8 campuses. PARTICIPANTS: A population of 489 final-year nursing students in programs of study leading to license to practice. METHODS: Participants proceeded through three phases: (i) pre-simulation-briefing and assessment of clinical knowledge and experience; (ii) e-simulation-three interactive e-simulation clinical scenarios which included video recordings of patients with deteriorating conditions, interactive clinical tasks, pop up responses to tasks, and timed performance; and (iii) post-simulation feedback and evaluation. Descriptive statistics were followed by bivariate analysis to detect any associations, which were further tested using standard regression analysis. RESULTS: Of 409 students who commenced the program (83% response rate), 367 undergraduate nursing students completed the web-based program in its entirety, yielding a completion rate of 89.7%; 38.1% of students achieved passing clinical performance across three scenarios, and the proportion achieving passing clinical knowledge increased from 78.15% pre-simulation to 91.6% post-simulation. Knowledge was the main independent predictor of clinical performance in responding to a virtual deteriorating patient R(2)=0.090, F(7, 352)=4.962, p<0.001. DISCUSSION: The use of web-based technology allows simulation activities to be accessible to a large number of participants and completion rates indicate that 'Net Generation' nursing students were highly engaged with this mode of learning. CONCLUSION: The web-based e-simulation program FIRST2ACTTM effectively enhanced knowledge, virtual clinical performance, and self-assessed knowledge, skills, confidence, and competence in final-year nursing students.

Accelerating mathematics learners : what counts?

This article elaborates on my statements quoted in The Age October 2014 article 'More students take on VCE mathematics subject early'. (http://theage.com.au/victoria/more-students-take-on-vce-subjects-early-20141024-11b4rv.html). This article was about accelerating mathematics students by allowing them to take year 11 Mathematics subjects in year 10, and year 12 Mathematics subjects in year 11. My statements were 'Although 'taking on Year 12 subjects early could help students prepare for the workload once they reach their final year ... based on my research and teaching experience, you don't take on early those subjects that are going to be key to your university studies' because 'going early means you are going to rely much more heavily on learning things faster.

Numeracy across the curriculum: recognising and responding to the demands and numeracy opportunities inherent in secondary teaching

The 1998 Report of the National Standards and Guidelines for Initial Teacher Education Project, 'Preparing a Profession' illustrates the emphasis being placed in Australia on the development of numeracy skills amongst not only primary but also secondary school pupils. This report demands that graduates of all initial teacher training courses should not only be numerate themselves, but should also understand the contribution of numeracy to education and daily life, and be able to identify and respond to pupils' numeracy learning needs. This report and its implementation in Victoria through the 'Guidelines for the Evaluation of Teacher Education Courses' led to the introduction in 1999 of a compulsory unit 'Numeracy across the curriculum' for all Deakin University students in the final year of their secondary teacher training course. This paper discusses the nature of the current emphasis on numeracy. It also describes the rationale, development and delivery of the first year of the 'Numeracy across the curriculum' unit, provides a brief evaluation from the perspective of staff and students, and discusses what impact such teacher education programs might have on secondary schools' approaches to numeracy.

Prediction of alcohol-related harm from controlled drinking stragegies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.
Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.
Design Longitudinal follow-up across five waves of data collection.
Setting Post high school in Victoria, Australia.
Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.
Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.
Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

Adolescent alcohol-use trajectories in the transition from high school

A cohort of 3300 students from high schools across Victoria, Australia, were surveyed regarding their patterns of alcohol consumption from mid-1993 to 1995. The first wave of data was collected halfway through the students' final year of school (year 12). Students were then resurveyed 3 months following school completion and on two subsequent occasions, each separated by 6-month intervals. Analysis of the four waves of data indicated that five longitudinal patterns (trajectories) characterized temporal trends in male and female alcohol use through the transition from high school. Stable non-use trajectories were evident for 17% of males and 16% of females. Trajectories of less than weekly use characterized 45% of females and 46% of males, and showed little tendency to escalate toward harmful use. Among those using alcohol on a weekly or more frequent basis in high school, with few exceptions, use continued with at least the same frequency, but the quantity of alcohol consumed tended to escalate over time toward harmful levels. Overall, findings indicate that patterns of alcohol use tend to be stable over time, and more frequent alcohol use during the final year of high school tends to precede potentially harmful alcohol use following high school. Encouraging those high school students who consume alcohol once per week or more often to use alcohol on a less than weekly basis may be a valuable yet neglected harm minimization strategy.

Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.

Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.

Design Longitudinal follow-up across five waves of data collection.

Setting Post high school in Victoria, Australia.

Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.

Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.

Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

Problem-based learning in an online IT professional practice course

Educational research suggests that Problem-Based Learning (PBL) is a pedagogy that fosters a deeper understanding of the curriculum and provides students with processes and skills for lifelong learning. According to the literature this pedagogy appears to be a suitable one for teaching undergraduate information technology, yet adoption of PBL in information technology tertiary education appears to be slow. This paper discusses characteristics and processes of PBL and describes how the approach will be used in teaching information technology professional practice. The course described will be offered to information technology students in their final year of study and will be delivered wholly online. The course will not only provide best practice aspects of PBL but it will also provide students with the opportunity of undertaking authentic tasks using multimedia resources that simulate the real world.

International and culturally inclusive curricula-an engineering management unit audit case study

SEB421 Strategic Issues in Engineering is a final-year engineering management study unit at Deakin University in which the enrolled student population has grown to include significant numbers of international students. Given this change, it was considered timely to conduct a review of the unit, with regard to principles of international and culturally inclusive curricula. Despite the historically white Anglo-Saxon male culture of engineering education in Australia, there are a wide range of international and cultural aspects related to engineering education. A review of the literature reveals a diversity of interpretations of 'internationalisation' and 'cultural inclusiveness'. From a pragmatic perspective, it is noted that organisational policy can provide guidance for academic staff seeking to make courses more inclusive. From a review of the literature and relevant university policies, a list of 'international and culturally inclusive curricula' guidelines for engineering management education was developed. Comparing a prior audit of SEB421 with these guidelines revealed progress on international and culturally inclusive curricula, but identified opportunities for improvement. The guidelines were applied to the curriculum/syllabus, content/study materials, conduct and assessment of the unit, to identify further opportunities for improvement. A plan for improvement of the unit and an associated timetable for this work were developed. It was noted that some changes can be made immediately, while others are contingent upon the timetable imposed by university systems. It was further noted that issues of change within a single study unit intersect with wider issues of program curriculum, and, while pilot activities can provide a start, eventually the wider issue of international and culturally inclusive curricula across the entire undergraduate engineering program needs to be considered.

Fun or profit : primary students' perceptions of mathematics and science

As the number of students pursuing mathematics and science in higher education decline, it becomes imperative· that we look for the causes of the decline. As part of the Australian Improving Middle Years Mathematics and Science (IMYMS) project, students were asked to rate their perceptions of classroom practice in mathematics and science and their attitudes to these subjects. Results of this survey reveal little difference in perceptions of classroom practice, but significant differences in students' attitudes between mathematics and science. Differences were particularly evident for items relating to the usefulness of mathematics and science (mathematics was more useful) and enjoyment of the subjects (science is more fun). If teachers are aware of such perspectives, it may be possible to change students' attitudes.

Effective student engagement depends on students enjoying their studies in mathematics and science, being confident in their ability and recognising the relevance of these subjects to everyday life, now and in the future.
(Education Training Committee, 2006, p. xvii)

Science and technology are the widely acknowledged foundation of Australia's future development. Underpinning these are the key learning areas of mathematics and science. However, Australia is experiencing a decline in numbers of mathematics and science students in higher education. Moreover, studies over the last two decades have shown a general decline in Australian students' interest and enjoyment of science across the compulsory secondary school years, with a particularly sharp decline across the primary to secondary school transition (e.g. Adams, Doig, & Rosier 1991; Goodrum, Hackling, & Rennie, 200 I) and a decline in the numbers of students studying' advanced mathematical courses in upper secondary school (Thomas, 2000).

Improving teaching and learning in the middle years of schooling (Years 5 to 9) is receiving particular attention because of the coincidence of the disengagement of students with the significance of these years for the preparation of students for their future role in society. Thus the Improving Middle Years Mathematics and Science: The role of subject cultures in school and teacher change (IMYMS) project, which is the source of data for this paper, is investigating the role of mathematics and science' knowledge and subject cultures in mediating change processes in the middle years of schooling.

Mathematics and science are sometimes seen as "love-hate" subjects, rating highest for subjects disliked, but also rating relatively highly among preferred subjects (Hendley & Stables, 1996). Students, even primary aged students, can often shed light on what constitutes good practice (see, for example, 'van den Heuvel-Panhuizen, 2005). Students' attitudes towards mathematics and science and their perceptions of what they regard as positive aspects of classroom practice have been shown to decline from the primary years to junior secondary (Race, 2000). The decline in interest in science in the early years of secondary school is of particular concern, since it is in these years that attitudes to the pursuit of science subjects and careers are formed (Speering & Rennie, 1996). Students' negative attitude towards the relevance of science ,content for their lives was a strong theme in the report by Goodrum, Hackling, & Rennie (2001) on the status and quality of teaching and learning of science.

As part of the IMYMS project, the IMYMS Student Survey was administered to all students in 2004 and 2005. The survey included a 36 item section on students' perceptions of classroom practice and attitudes towards mathematics and science, and a 24 item section on students' learning preferences. Students completed separate, parallel surveys for mathematics and science.

This paper focuses on students' perceptions and attitudes. It explores the differences in 700 Year 5 and 6 students' perceptions of their learning environment and their attitudes to mathematics and science during 2005, the second (and final) year of schools , involvement in the IMYMS project.

Gender and ethics

Men and women lawyers value ethics differently, according to a study into law students' values.  About 700 final year law students responded to a questionnaire on hypothetical ethical situations which gave a snapshot understanding of the values of Australian students in their last year of law school.

Preparing Australia's future lawyers: an exposition of changing values over time in the context of teaching about ethical dilemmas

This study investigated what values may be influential to decision making in relation to ethical behaviour for early career lawyers. It adopted a longitudinal approach to investigate how values develop or degrade over time as final year law students move into their first two years of employment or further study. To this end, the study investigated the role that tertiary education and employers fulfill in building and perpetuating ‘appropriate’ professional values? Results demonstrate that, in general, ethical behaviour was not uniformly reinforced over time in the workplace. The undertaking of pro bono work stands out here. Results suggested that certain behaviour relevant values may develop or degrade over the early years of the Australian lawyer's career. The implications of results are discussed in the contexts of ethics education in a tertiary context and the continuing education and regulation of the legal profession.

Zero impact: are lawyers' values affected by law school?(Survey)

In 2001 approximately 700 Australian final-year undergraduate law students were surveyed as the first part of a three-year study of Australian lawyers' values. This study is being undertaken in an effort to understand what values are important in determining lawyers' attitudes to difficult behavioural choices confronting them in legal practice. It is hoped that knowledge of the actual values held by lawyers (in the context of critical professional choices) will enable better targeted values awareness education in both pre- and post-admission contexts.

The main quantitative survey employed a number of hypothetical scenarios. These were designed through the use of ethical dilemmas to examine issues of conflicting loyalties within a context of self-interest and lawyers' perceived obligations to the community, employers, family, friends and clients. (1)

Our approach in this paper is to set the scene by providing basic frequencies to responses in each scenario, followed by an analysis of themes elicited from respondents during the focus groups. Our immediate objective is to provide representative interviewee (that is, respondent) commentary designed to throw some light on the major choices of those respondents in the first year of the main quantitative survey. (2) Note that these focus groups were conducted some months after the quantitative analyses, and in particular after respondents had left law school. All respondents were, by that stage, working within a variety of legal workforce environments. In this analysis, it must be stressed, we have not attempted to match and compare individual respondents' comments with their earlier choices in the quantitative survey. That task awaits the longitudinal analysis now under way for the whole period of data collection during the three-year study.

Characteristics and behaviours of effective social education teachers

A group of undergraduate students in their final year of Bachelor of Teaching Primary at Deakin University were asked 'what makes an effective social education teacher?' They discussed the question and compiled a list from their responses to list the characteristics to describes effective teachers in social education.