Piloting the feasibility of head-mounted video technology to augment student feedback during simulated clinical decision-making: an observational design pilot study

BACKGROUND: Clinical decision-making is a complex activity that is critical to patient safety. Simulation, augmented by feedback, affords learners the opportunity to learn critical clinical decision-making skills. More detailed feedback following simulation exercises has the potential to further enhance student learning, particularly in relation to developing improved clinical decision-making skills. OBJECTIVE: To investigate the feasibility of head-mounted video camera recordings, to augment feedback, following acute patient deterioration simulations. DESIGN: Pilot study using an observational design. METHODS: Ten final-year nursing students participated in three simulation exercises, each focussed on detection and management of patient deterioration. Two observers collected behavioural data using an adapted version of Gaba's Clinical Simulation Tool, to provide verbal feedback to each participant, following each simulation exercise. Participants wore a head-mounted video camera during the second simulation exercise only. Video recordings were replayed to participants to augment feedback, following the second simulation exercise. Data were collected on: participant performance (observed and perceived); participant perceptions of feedback methods; and head-mounted video camera recording feasibility and capability for detailed audio-visual feedback. RESULTS: Management of patient deterioration improved for six participants (60%). Increased perceptions of confidence (70%) and competence (80%), were reported by the majority of participants. Few participants (20%) agreed that the video recording specifically enhanced their learning. The visual field of the head-mounted video camera was not always synchronised with the participant's field of vision, thus affecting the usefulness of some recordings. CONCLUSION: The usefulness of the video recordings, to enhance verbal feedback to participants on detection and management of simulated patient deterioration, was inconclusive. Modification of the video camera glasses, to improve visual-field synchronisation with participants' actual visual field, is recommended to further explore this technology for enhancing student performance.

Generic skills in accounting education in a developing country: exploratory evidence from Sri Lanka

Purpose - The purpose of this paper is to investigate the generic skills developed during the undergraduate degree from the perspectives of final year undergraduates and graduate employers. Design/methodology/approach - The list of generic skills tested in this study was contextualized to Sri Lanka and developed based on prior studies. Data obtained from stakeholders via a questionnaire survey was analyzed using paired sample t-test; independent sample t-test; principal component analysis; and one-way analysis of variance, with a view to explore, evaluate and compare respondents' perspectives. Findings - The findings revealed both stakeholders believe that most of the generic skills tested in this study are important for graduates' career success. Consistent with prior studies, respondents prioritized generic skills for career success above technical skills. Final year accounting undergraduates are aware of the skill expectations in the employment market. However, they perceive that most of the important generic skills are not adequately developed during the degree. Practical implications - Findings of this study inform the importance of adopting a holistic approach to the redesign of the accounting curricula to accommodate generic skill development during the degree. Suggestions include: establishing strong links between universities, professional accounting institutions and employers; introducing participatory methods of curriculum design; and assimilating continuous reviews and frequent updates to curricula. Originality/value - Sri Lanka, a developing country, was selected for this research given that little has been reported in the literature in terms of generic skills development of accounting graduates in developing countries.

An analysis of nursing students' decision-making in teams during simulations of acute patient deterioration

AIM: The aim of this study was to examine the decision-making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions.

BACKGROUND: Missed, misinterpreted or mismanaged physiological signs of deterioration in hospitalized patients lead to costly serious adverse events. Not surprisingly, an increased focus on clinical education and graduate nurse work readiness has resulted.

DESIGN: A descriptive exploratory design.

METHODS: Clinical simulation laboratories in three Australian universities were used to run team based simulations with a patient actor. A convenience sample of 97 final-year nursing students completed simulations, with three students forming a team. Four teams from each university were randomly selected for detailed analysis. Cued recall during video review of team based simulation exercises to elicit descriptions of individual and team based decision-making and reflections on performance were audio-recorded post simulation (2012) and transcribed.

RESULTS: Students recalled 11 types of decisions, including: information seeking; patient assessment; diagnostic; intervention/treatment; evaluation; escalation; prediction; planning; collaboration; communication and reflective. Patient distress, uncertainty and a lack of knowledge were frequently recalled influences on decisions.

CONCLUSIONS: Incomplete information, premature diagnosis and a failure to consider alternatives when caring for patients is likely to lead to poor quality decisions. All health professionals have a responsibility in recognizing and responding to clinical deterioration within their scope of practice. A typology of nursing students' decision-making in teams, in this context, highlights the importance of individual knowledge, leadership and communication.

The story of fable : a narrative analysis of the experience of four registered nurses in their first year of practice

This research explores the transition from student to registered nurse from the perspective of the new graduate. This interpretive study uses narrative analysis as the methodology. Individual stories were collected and processed using the method of core story creation and emplotment (Emden 1998). Four newly registered nurses were invited to share stories related to how they were experiencing their role. Participants were encouraged to tell their stories in response to the open question 'what is it like to be a registered nurse?' In the final step of the analysis one honest and critical story has been crafted (Barone 1992) using a process termed emplotment thus disclosing the themes that allow the stories to be grasped together as a single story (Polkinghorne 1988, Emden 1998). The final story of 'Fable' gives insight into the ways in which newly registered nurses experience their role. Becoming a registered nurse is not easy however, Fable finds that nursing is more than just a job and describes many rewarding experiences. It is hoped that the outcomes of this research will be valuable to students, graduates, nurse academics and the profession of nursing generally by enhancing understandings of the relationship between the graduate and the actual employment experience.

Teaching quality and tutorial delivery : experience of a second year marketing unit

The higher education sector, the world over, is faced with the challenging task of servicing an increasingly diverse international student community in the globally competitive education market. The rising expectation of students of education outcomes, varied learning styles and orientations of the student population have brought in challenges such as providing a high quality educational environment with changes in curricula and pedagogy (Coldrake, 2001) to negotiate the cultural and linguistic diversity and the resulting expectations of students. The 'quality' of teaching and learning is high on the agenda among the key issues that had emerged from policy developments to meet these challenges.

Using the SPQ2F instrument (Biggs, 2003) and depth interviews, this paper investigates the study 3J'PToaches of students enrolled in a second year marketing unit in an Australian university focusing on the learning contexts in which learning occurs. The findings indicate that there are no significant differences in study approaches of students and that the study approaches differ according the learning context. The paper concludes that student perceptions on learning contexts assist in the development of teaching strategies that lead to quality outcomes, higher student satisfaction and providing universities a competitive edge in marketing its services to prospective students.

MBA experience by distance education : an ethnographic study of a professional development program

The author's ethnographic study of a professional development program for managers and aspiring managers taught at a distance intends to make a substantial contribution to both the theory and practice of continuing education for professionals. The study focused on a group of Deakin University Master of Business Administration (MBA) participants and their experiences of the final two years of the program. Theorising on the professional development experience was based on data gathered from the direct observation of participants working in their study groups and at residential schools. Moreover, data drawn from end-of-year interviews with participants and discussions with MBA teachers also contributed to the theorising process. Theorising spanned a broad set of interactions encompassing participants' formal educational, professional and personal worlds. The thesis is devoted to two aspects of the professional development experience, namely: participants' interactions in their study groups and at residential schools; and participants' attempts to grow and develop as competent professional practitioners during their MBA studies. Interactions with key learning contexts orchestrated by the teaching institution (i.e. study groups and residential schools) are grounded in an analysis of the changing group cultures observed to accommodate the different educational demands of the program. Group interaction on a broader scale is also analysed in the context of the residential schools. The residential school provided a powerful forum for the development of participant activism over the future development of the MBA program. The analysis of the study groups in action led the author to identify the key characteristics of effective educational work groups. The implications of the success of these essentially egalitarian and leaderless groups for the formation of self-managed groups in the workplace is examined. On the matter of professional development, the author reveals the relationships between the nature of participants' jobs, their search for professional integration, their stage of professional empowerment, the strategies they pursued either to empower themselves or others in their organisations and the barriers which were encountered in the pursuit of empowerment. Dramatic examples of professional disempowerment are analysed indicating that interaction between formal off-the-job learning and professional practice in the workplace is not necessarily a smooth and positive experience. The group of participants studied are seen to be heterogeneous in relation to the above factors characterising professional development The implications of the theorising are considered in relation to professional pedagogies, assessment strategies and distance education. Distance education is seen to socially construct the roles of both teachers and students in the educational process. Specifically, teachers are seen to be somewhat marginalised during the program in use whereas the participants are located at the centre of the educational experience. The primacy of participants in the educational process is highlighted through the growing reliance on self-and peer-group assessment skills as participants progressed through the program. It is argued that the teaching institution should encourage and maintain the development of these skills as they represent a major learning outcome of the professional development experience, i.e. the ability to engage in the process of critical self-reflection and informed action.

Workplace learning coordinators program : formative evaluation : final report

The workplace learning coordinators program was established to increase the number of young people undertaking workplace learning placements, especially in industries that provide strong vocational outcomes. Additional attention has been paid to the potential benefits of the program for Koorie young people and other students who experience disadvantage. The program also seeks to improve the alignment between VCAL and VET provision and local industry needs, with a focus on indentifying new workplace learning opportunities with each service area’s employers. This formative evaluation sought to monitor the initial implementation of the WLC program during its first twelve months. Over this period the evaluators recorded the early teething challenges faced by WLCs during their first few months, and the eventual consolidation of their practices during the second half of the program’s first year. In reviewing all of the data collected for this evaluation, and the progressive responses of WLCs and stakeholders over the program’s first year, the evaluators consider that the model of service delivery is appropriate for what the program aims to achieve and recommend its continuance to 2013.

Firsts: performing ways first year teachers experience identity transformation

This thesis reports on research showing the survival discourse of beginning teaching has shifted from sink or swim metaphors to describe surviving transition shock and classroom management concerns to surviving contract employment. Beginning teachers are neither sinking nor swimming in this liminal state. Rather, it is as though they are on a lifeboat where they cannot feel like a ‘real’ teacher until they can operate with certainty.

Interrogating the experiences of beginning teachers, and the transformation of their identity in their first year (1yr) of teaching, the thesis explores research participants’ firsts as epiphanic or revelatory moments of identity transformation. Participants were followed for three years from upon completion of their teacher education, through their first year of teaching, up to the beginning of their third year in the profession. The major finding was that while contemporary understandings of professional identity highlight the transformative nature of the phenomenon,  contract employment had the most impact on these teachers’ identity transformation.

Teachers’ perceptions of their own professional identity affect their efficacy and professional development as well as their ability and willingness to cope with educational change (Beijaard, Verloop & Vermunt 2000). It has been reported by the Australian Education Union (AEU) and in the Victorian media in recent years that up to 50% of beginning teachers are leaving the profession within their first five years. The reasons given for this level of
attrition include workload, pay, and behaviour management, among the top concerns of beginning teachers. These categories have positioned beginning teachers in a survival discourse for many years, yet there is more to beginning teachers’ intentions to leave than their struggles to survive in the classroom. More recently in Victoria what it means to ‘survive’ has shifted to surviving the pervasive contractual nature of beginning teachers’
employment conditions.

This qualitative study seeks to question what remains concealed with regard to beginning teachers’ experiences through an investigation of the differences between and within individuals, allowing categories of description to emerge from the data rather than pre-determining categories of investigation. Data was collected from twelve participants through individual semi-structured interviews and written communication. A theatre-based research approach to representing the participants’ experiences was employed, culminating in a performance titled ‘The First Time’. The processes of scripting, rehearsing, and performing, were utilised to analyse and represent the data to expert audiences. In an aim to uncover questions that have been buried by answers, the research is oriented as a
phenomenographic inquiry. This mode of inquiry seeks to describe, analyse, and understand (Marton 1981) the qualitatively different experiences 1yr teachers undergo in their identity formation and transformation.

The results of this research reveal the destabilising effect of short-term contracts so prevalent in the current context; that status and belonging are central to 1yr teachers’ identity work. Status and belonging are positioned within survival, liminal, and hegemonic discourses; and expressed through artefacts as symbols of belonging. The low status ascribed to contractual work has a clear impact on beginning teachers’ commitment to the profession.

Reclaiming the shrew: Beacon for Wales final project evaluation

FInal Project reoprt for The Beacon's For Engagement Funded performance project entitled: Reclimaing the Shrew; a partnerhship between Beacon for Engagement, Wales, University of Glamorgan and Valleyskids aimed to engage and retain young people at risk in creatiing a personally meaningful art project for their communities. The research drew on Csikzemmyhaliyi's work that promotes effortful physical activity to induce flow in adolescents couple with devising and phsyical theatre practice that enables a democratic creative experience for participants.

Firsts: Performing ways first-year teachers experience identity transformation

Presentation and discussion on theatre-based research methodology at 'Realising the Potential of the Arts as Method and Methodology Inaugural Arts as Method(ology) Research Group' Symposium

Balancing risk? First year performing arts students’ experience of a community arts event

This study examines participants’ responses to first year students’ street performances as a non-placement work-integrated learning (WIL) activity over a two year period. The purpose of the study was to determine: (1) community perception, (2) continuous improvement, and (3) future needs. Data was collected through surveying participants’ post-viewing of the street performances, students’ reflective notes, and a recorded focus group interview. The findings indicated that audience members require additional assistance to value the students’ street performances. The results revealed that students require more guidance around researching the sites of practice, understanding group work dynamics, relaxation methods, intra- and interpersonal skill development, conflict resolution and how to effectively build community relations with the local government Council. From the findings, specific recommendations for continual improvement are made. These include offering an explanation of the street performances’ historical and aesthetic connections to the building sites for audience members, affording battery operated body-microphones and light rostrum for improved sight lines, delivering group dynamics information and arranging opportunities for students to engage more effectively with the Council. While the recommendations in this study are intended to advance the field of research that evaluates non-placement WIL performing arts curriculum in higher education, the findings are relevant to any group-based performance activity in learning and teaching.