Subject -centered and problem -based approaches to teaching clinical competence in physical therapy

Physical therapy students must apply the relevant information learned in their academic and clinical experience to problem solve in treating patients. I compared the clinical cognitive competence in patient care of second-year masters students enrolled in two different curricular programs: modified problem-based (M P-B; n = 27) and subject-centered (S-C; n = 41). Main features of S-C learning include lecture and demonstration as the major teaching strategies and no exposure to patients or problem solving learning until the sciences (knowledge) have been taught. Comparatively, main features of M P-B learning include case study in small student groups as the main teaching strategy, early and frequent exposure to patients, and knowledge and problem solving skills learned together for each specific case. Basic and clinical orthopedic knowledge was measured with a written test with open-ended items. Problem solving skills were measured with a written case study patient problem test yielding three subscores: assessment, problem identification, and treatment planning. ^ Results indicated that among the demographic and educational characteristics analyzed, there was a significant difference between groups on ethnicity, bachelor degree type, admission GPA, and current GPA, but there was no significant difference on gender, age, possession of a physical therapy assistant license, and GRE score. In addition, the M P-B group achieved a significantly higher adjusted mean score on the orthopedic knowledge test after controlling for GRE scores. The S-C group achieved a significantly higher adjusted mean total score and treatment management subscore on the case study test after controlling for orthopedic knowledge test scores. These findings did not support their respective research hypotheses. There was no significant difference between groups on the assessment and problem identification subscores of the case study test. The integrated M P-B approach promoted superior retention of basic and clinical science knowledge. The results on problem solving skills were mixed. The S-C approach facilitated superior treatment planning skills, but equivalent patient assessment and problem identification skills by emphasizing all equally and exposing the students to more patients with a wider variety of orthopedic physical therapy needs than in the M P-B approach. ^

A comparison of a distance education and locally based course in an urban university setting

The purpose of this research was to compare the academic performance and attitudes of students at the instructor-based site of a televised course and the distant site. An earlier pilot program indicated the need for certain technical and structural interventions at the distant site such as multiple "press-to-touch" microphones, a site-administrator and participative seating arrangements. At the beginning of the class, demographic data were collected from the students at both sites through a questionnaire and supplemented with information from students' records. Factors such as age, gender, ethnicity, marital status, number of children, current class status, major, work status and CLAST scores (achievement tests) were examined. There were no significant differences between the students at the sites except ethnicity and reading CLAST scores. The instructor-based site had a higher percentage of Hispanic students and the distant site had a larger percentage of Caucasian and Black Americans. The distant site scored significantly better on the reading section of the CLAST achievement test. An evaluation instrument was distributed to both sites, at the midpoint of the semester, measuring their attitude toward the organizational, technical, and pedagogical factors of the course. A second evaluation instrument, measuring similar factors, but more in-depth, was distributed to both sites near the end of the term. Nine students at the distant site were interviewed along with the site administrator to collect additional information.^ Course completion rates, dropout rates, pass rates and final grades of students at both sites were compared. There were no significant differences in academic performance between the students at both sites, however, there were significant differences in their attitudes. Those at the instructor-based site gave better ratings to most of items in the evaluation instruments. Problems at the distant site included audio and visual clarity, lack of available assistance, too much nonrelated talking, not enough opportunities to ask questions or to interact with the instructor during class. ^

Adult education directors' perceptions of performance indicators for adult education programs in the state of Florida

Current demands for accountability in education emphasize outcome-based program evaluation and tie program funding to individual student performance. As has been the case for elementary and secondary programs, demands for accountability have increased pressure on adult educators to show evidence of the benefits of their programs in order to justify their financial support. In Florida, recent legislation fundamentally changes the delivery of adult education in the state by establishing a performance-based funding system that is based on outcomes related to the retention, completion, and employment of program participants.^ A performance-based funding system requires an evaluation process that stresses outcome indicators over indicators that focus on program context or process. Although the state has adopted indicators of program quality to evaluate its adult education programs, these indicators focus mostly on program processes rather than student outcomes. In addition, the indicators are not specifically tied to workforce development outcomes, a priority to federal and local funding agents.^ Improving the accountability of adult education programs and defining the role of these programs in Florida's Workforce Development System has become a priority to policy makers across the state. Another priority has been to involve adult education practitioners in every step of this process.^ This study was conducted in order to determine what performance indicators, as judged by the directors and supervisors of adult education programs in the state of Florida, are important and feasible in measuring the quality and effectiveness of these programs. The results of the study indicated that, both statewide and by region, the respondents consistently gave the highest ratings on both importance and feasibility to the indicators of Program Context, which reflect the needs, composition, and structure of the programs, and to the indicators of Educational Gain, which reflect learner progress in the attainment of basic skills and competencies. In turn, the respondents gave the lowest ratings on both importance and feasibility to the indicators in the areas of Return on State's Investment, Efficiency, Retention, and Workforce Training. In general, the indicators that received high ratings for importance also received high ratings for feasibility. ^

A qualitative study of the clinical practice of graduates of a problem-based physical therapy program

The purpose of this study was to examine the perspectives of three graduates of a problem-based leaning (PBL) physical therapy (PT) program about their clinical practice. The study used the qualitative methods of observations, interviews, and journaling to gather the data. Three sessions of audiotaped interviews and two observation sessions were conducted with three exemplars from Nova Southeastern University PBL PT program. Each participant also maintained a reflective journal. The data were analyzed using content analysis. A systematic filing system was used by employing a mechanical means of maintaining and indexing coded data and sorting data into coded classifications of subtopics or themes. All interview transcripts, field notes from observations, and journal accounts were read, and index sheets were appropriately annotated. From the findings of the study, it was noted that, from the participants' perspectives, they were practicing at typically expected levels as clinicians. The attributes that governed the perspectives of the participants about their physical therapy clinical practice included flexibility, reflection, analysis, decision-making, self-reliance, problem-solving, independent thinking, and critical thinking. Further, the findings indicated that the factors that influenced those attributes included the PBL process, parents' value system, self-reliant personality, innate personality traits, and deliberate choice. Finally, the findings indicated that the participants' perspectives, for the most part, appeared to support the espoused efficacy of the PBL educational approach. In conclusion, there is evidence that the physical therapy clinical practice of the participants were positively impacted by the PBL curriculum. Among the many attributes they noted which governed these perspectives, problem-solving, as postulated by Barrows, was one of the most frequently mentioned benefits gained from their PBL PT training. With more schools adopting the PBL approach, this research will hopefully add to the knowledge base regarding the efficacy of embracing a problem-based learning instructional approach in physical therapy programs. ^

The effects of peer teaching of infant massage on general elf-efficacy and mother infant attachment among mothers in a residential rehabilitation facility for drug addiction and substance abuse

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

Low-income first time mothers: Effects on advanced practice nurse (APN) follow up telephone calls on maternal and infant health and health care charges

The United States has over 4 million births annually. Currently healthy women with non-complicated deliveries receive little to no routine postpartum support when discharged from the hospital. This is especially problematic if mothers are first time mothers, poor, have language barriers and little to no social support after giving birth. The purpose of this randomized clinical trial was to compare maternal and infant health outcomes, and health care charges between 2 groups of mothers and newborns. A control ( n = 69) group received routine posthospital discharge care. An intervention group (n = 70) received routine posthospital discharge care plus follow up telephone calls by advanced practice nurses (APNs) on days 3,7,14,21,28 and week 8. Both groups were followed for the first 8 weeks posthospital discharge following delivery to examine maternal health outcomes (perceived maternal stress, social support and perceived maternal physical health), infant health outcomes (routine medical follow up visits immunizations, weight gain), morbidity (urgent care visits, emergency room visits, rehospitalizations), health care charges (urgent care visits, emergency room visits, rehospitalizations) in both groups and charges for APN follow up in the intervention group only. Data were analyzed using descriptive statistics and two-sample t-tests. Study findings indicated that intervention group had significantly lower perceived maternal stress, significantly higher rating of perceived maternal health and higher levels of social support and by the end of the 2nd month posthospital discharge compared to control group mothers. Infants in the intervention group had: increased number of immunizations; fewer emergency room visits; and 1 infant rehospitalization compared to 3 infant rehospitalizations in the control group. The intervention groups' health care charges were significantly lower compared to the control group $14,333/$497 vs. $70,834/$1,068. These study results indicate that an intervention of APN follow up telephone calls in this sample of first time low-income culturally diverse mothers was an effective, safe, low cost, easy to apply intervention which improved mothers' and infants' health outcomes and reduced healthcare charges.

The influence of spirituality, race/ethnicity and religion on parent grief and mental health at one and three months after their infant's/child's death in the neonatal or pediatric intensive care unit

The death of an infant/child is one of the most devastating experiences for parents and immediately throws them into crisis. Spiritual and religious coping strategies may help parents with their loss. The purposes of this longitudinal study were to: (1) describe differences in bereaved parents' use of spiritual coping strategies across racial/ethnic and religious groups, mother/father dyads, and time—one (T1) and three (T2) months after the infant's/child's death in the neonatal (NICU) or pediatric intensive care unit (PICU), and (2) test the relationship between spiritual coping strategies and grief, mental health, and personal growth for mothers and fathers at T1 and T2. A sample of 126 Hispanic, Black/African American, and White parents of 119 deceased children completed the Spiritual Coping Strategies scale, Beck Depression Inventory-II, Impact of Events-Revised, Hogan Grief Reaction Checklist, and a demographic form at T1 and T2. Controlling for race and religion, spiritual coping was a strong predictor of lower grief, better mental health, and greater personal growth for mothers at T1 and T2 and lower grief for fathers at T1. The findings of this study will guide bereaved parents to effective strategies to help them cope with their early grief.

Children with special health care needs: Comparison of the effects of home care setting, prescribed pediatric extended care setting, and long-term care setting on child and family health outcomes and health care service use

Technological advances during the past 30 years have dramatically improved survival rates for children with life-threatening conditions (preterm births, congenital anomalies, disease, or injury) resulting in children with special health care needs (CSHCN), children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who require health and related services beyond that required by children generally. There are approximately 10.2 million of these children in the United States or one in five households with a child with special health care needs. Care for these children is limited to home care, medical day care (Prescribed Pediatric Extended Care; P-PEC) or a long term care (LTC) facility. There is very limited research examining health outcomes of CSHCN and their families. The purpose of this research was to compare the effects of home care settings, P-PEC settings, and LTC settings on child health and functioning, family health and function, and health care service use of families with CSHCN. Eighty four CSHCN ages 2 to 21 years having a medically fragile or complex medical condition that required continual monitoring were enrolled with their parents/guardians. Interviews were conducted monthly for five months using the PedsQL™ Generic Core Module for child health and functioning, PedsQL™ Family Impact Module for family health and functioning, and Access to Care from the NS-CSHCN survey for health care services. Descriptive statistics, chi square, and ANCOVA were conducted to determine differences across care settings. Children in the P-PEC settings had a highest health care quality of life (HRQL) overall including physical and psychosocial functioning. Parents/guardians with CSHCN in LTC had the highest HRQL including having time and energy for a social life and employment. Parents/guardians with CSHCN in home care settings had the poorest HRQL including physical and psychosocial functioning with cognitive difficulties, difficulties with worry, communication, and daily activities. They had the fewest hours of employment and the most hours providing direct care for their children. Overall health care service use was the same across the care settings.

*Postsecondary access for individuals with psychological disabilities: An analysis of federal rulings and institutional philosophies, *policies, and practices

This study was a qualitative investigation, with demographic quantitative features, of post-secondary educational access and legal guidelines for individuals with psychological disabilities. Although disability laws have positively influenced post-secondary educational attitudes and practices relative to accommodating many individuals with disabilities, prevailing stigmas regarding mental illness have discouraged the equal access to higher education for individuals with psychological disabilities. Little research concentrating on this area was found.^ Thirty-six relevant legal case decisions, focusing on a variety of realms of higher education, were scrutinized. The policies, procedures, and practices of six Southeastern United States universities were analyzed through official documents and participant responses from disability service providers and other university employees. Comparisons were made between legal cases, and within and between universities. Case findings also provided standards through which participating university practices could be studied.^ The legal analysis revealed that most institutions did not discriminate against individuals with psychological disabilities. Practices of a few of these institutions, however, suggested non-compliance despite favorable decisions on their behalf. Institutions found to have discriminatory practices were cited for inadequate procedures, or for presumptive assessments of the educational functioning levels of individuals with psychological disabilities.^ Participant university practices generally suggested disability law compliance; however, certain campus interventions were determined to be ineffective in identifying, addressing, and communicating about the educational needs of individuals with psychological disabilities. The most effective services for these individuals, who were described as rapidly increasing in number but lagging in self-advocacy and acceptance by others, went beyond legal requirements.^ Recommendations were made for institutional practices concerning disability-related documentation, written standards and operations, and student identification and referral. Directions for future research focused on study skills training for students; exposure of mental health professionals to client educational needs; and expansion of the current research, on a nationwide collegiate level, and a parallel analysis focusing on business and industry. ^

Curricular perceptions of adult education at National Chun -Chin University, Chia -Yi, Taiwan

This research was conducted in Chia-Yi, Taiwan to study the needs of adult education participants to determine the factors necessary to provide direction for the development of university adult education curriculum and supportive government educational policies. Factors researched were characteristics of the adult learner, theories of adult learning, demands of adult education, and implications of university adult education as the theoretical foundation for the development of specific curriculum development efforts. The study investigated adult learning needs and their relationship with demographic variable. Analyzing the needs of adult education participant and the relative factors through a survey resulted in recommendations for the development of adult education program plans, content of curriculum, and teaching. Research questions were analyzed using descriptive statistics, frequencies, chi square, one-way analysis of variance (ANOVA), and post hoc analysis. ^ The study showed that most participants in these adult education activities were under forty, middle class, of above average educational levels, and either living or working in the city. People who were older, of lesser social and economic positions, with lower educational standards, and living/working in the country, did not participate as much in adult education opportunities. Recommendations included that in the planning or setting up of adult education activities, attention be given to all the possible barriers or problems that are likely to occur in people's participation, e.g., motivation, interests, content of courses, teaching methods, willingness of participation, qualification of teachers, time, funds, locations, and so on. It is suggested that the resolution of these problems can significantly increase the participation of adult education. ^

Assessing the effects of professionals' career decision -making on their participation reasons in continuing education in Taiwan

The purpose of this study was to assess the relationship between working professionals' Career Decision-Making Self-Efficacy beliefs (CDMSE beliefs) and their reasons for participating in in-service master's level programs in Taiwan. ^ The data collection instruments used were Grotelueschen's (1985) Participation Reasons Scale (PRS), and Betz, Klein, and Taylor's (1996) Career Decision-Making Self-Efficacy-Short Form (CDMSE-SF), and a Demographic Data Form (DDF) developed specifically for this study. ^ Surveys were administered to 800 working professionals who participated in inservice master's level programs at 22 Taiwanese universities. The survey was conducted in May 2004. Data were analyzed by simple descriptive statistics, principal component factor analysis, and multiple regression. Four factors of participation reasons were found and five components of CDMSE beliefs were scored. ^ Five components of CDMSE beliefs are structured into the CDMSE-SF instrument: Self-Appraisal, Occupational Information, Goal-Selection, Planning, and Problem Solving. The reasons for participation found in this study were: Professional Improvement and Development, Professional Service, Personal Benefit and Job Security, and Professional Competence and Collegial Interaction. Pearson-product moment correlations revealed significant positive correlations between the five CDMSE subscales and the four factors of participation reasons. Multiple regression analysis revealed that participants' beliefs in their abilities to obtain information about occupations accounted for the preponderance of variance of scores on the Participation Reasons Scale (PRS). ^ This study concluded that professionals who believed that they were efficacious in obtaining information about occupations or professions tended to believe that the four reasons for participation represented by the factors of the PRS were important to them in making the decision to participate in continuing education. Additionally, it was noted that the reasons for participations for professionals who did not feel confident in their abilities to find such information could not be determined. ^ Recommendations are offered to assist those individuals responsible for developing recruiting programs in continuing education for professionals in Taiwan. These recommendations focus only on strategies intended to attract this target population of professionals who believe that they are efficacious in obtaining information about occupations. ^

The development, application, and implications of a strategy for reflective learning from experience

The problem on which this study focused was individuals' reduced capacity to respond to change and to engage in innovative learning when their reflective learning skills are limited. In this study, the preceding problem was addressed by two primary questions: To what degree can mastery of a strategy for reflective learning be facilitated as a part of an academic curriculum for professional practitioners? What impact will mastery of this strategy have on the learning style and adaptive flexibility of adult learners? The focus of the study was a direct application of human resource development technology in the professional preparation of teachers. The background of the problem in light of changing global paradigms and educational action orientations was outlined and a review of the literature was provided. Roots of thought for two key concepts (i.e., learning to learn from experience and meaningful reflection in learning) were traced. Reflective perspectives from the work of eight researchers were compared. A meta-model of learning from experience drawn from the literature served as a conceptual framework for the study. A strategy for reflective learning developed from this meta-model was taught to 109 teachers-in-training at Florida International University in Miami, Florida. Kolb's Adaptive Style Inventory and Learning Style Inventory were administered to the treatment group and to two control groups taught by the same professor. Three research questions and fourteen hypotheses guided data analysis. Qualitative review of 1565 personal documents generated by the treatment group indicated that 77 students demonstrated "double-loop" learning, going beyond previously established limits to perception, understanding, or action. The mean score for depth of reflection indicated "single-loop" learning with "reflection-in-action" present. The change in the mean score for depth of reflection from the beginning to end of the study was statistically significant (p $<$.05). On quantitative measures of adaptive flexibility and learning style, with two exceptions, there were no significant differences noted between treatment and control groups on pre-test to post-test differences and on post-test mean scores adjusted for pre-test responses and demographic variables. Conclusions were drawn regarding treatment, instrumentation, and application of the strategy and the meta-model. Implications of the strategy and the meta-model for research, for education, for human resource development, for professional practice, and for personal growth were suggested. Qualitative training materials and Kolb's instruments were provided in the appendices.

A qualitative analysis of the congruency of Jungian psychological preferences identified by the Myers-Briggs Type Indicator (MBTI) and the human resource development role of instructor/facilitator

The purpose of this ethnographic study was to describe and explain the congruency of psychological preferences identified by the Myers-Briggs Type Indicator (MBTI) and the human resource development (HRD) role of instructor/facilitator. This investigation was conducted with 23 HRD professionals who worked in the Miami, Florida area as instructors/facilitators with adult learners in job-related contexts.^ The study was conducted using qualitative strategies of data collection and analysis. The research participants were selected through a purposive sampling strategy. Data collection strategies included: (a) administration and scoring of the MBTI, Form G, (b) open-ended and semi-structured interviews, (c) participant observations of the research subjects at their respective work sites and while conducting training sessions, (d) field notes, and (e) contact summary sheets to record field research encounters. Data analysis was conducted with the use of a computer program for qualitative analysis called FolioViews 3.1 for Windows. This included: (a) coding of transcribed interviews and field notes, (b) theme analysis, (c) memoing, and (d) cross-case analysis.^ The three major themes that emerged in relation to the congruency of psychological preferences and the role of instructor/facilitator were: (1) designing and preparing instruction/facilitation, (2) conducting training and managing group process, and (3) interpersonal relations and perspectives among instructors/facilitators.^ The first two themes were analyzed through the combination of the four Jungian personality functions. These combinations are: sensing-thinking (ST), sensing-feeling (SF), intuition-thinking (NT), and intuition-feeling (NF). The third theme was analyzed through the combination of the attitudes or energy focus and the judgment function. These combinations are: extraversion-thinking (ET), extraversion-feeling (EF), introversion-thinking (IT), and introversion-feeling (IF).^ A last area uncovered by this ethnographic study was the influence exerted by a training and development culture on the instructor/facilitator role. This professional culture is described and explained in terms of the shared values and expectations reported by the study respondents. ^

Mindmapping as an adult learning notetaking strategy to increase the encoding of information in a corporate training course

A study was conducted to investigate the effectiveness, as measured by performance on course posttests, of mindmapping versus traditional notetaking in a corporate training class. The purpose of this study was to increase knowledge concerning the effectiveness of mindmapping as an information encoding tool to enhance the effectiveness of learning. Corporations invest billions of dollars, annually, in training programs. Given this increased demand for effective and efficient workplace learning, continual reliance on traditional notetaking is questionable for the high-speed and continual learning required on workers.^ An experimental, posttest-only control group design was used to test the following hypotheses: (1) there is no significant difference in posttest scores on an achievement test, administered immediately after the course, between adult learners using mindmapping versus traditional notetaking methods in a training lecture, and (2) there is no significant difference in posttest scores on an achievement test, administered 30 days after the course, between adult learners using mindmapping versus traditional notetaking methods in a training lecture. After a 1.5 hour instruction on mindmapping, the treatment group used mindmapping throughout the course. The control group used traditional notetaking. T-tests were used to determine if there were significant differences between mean posttest scores between the two groups. In addition, an attitudinal survey, brain hemisphere dominance survey, course dynamics observations, and course evaluations were used to investigate preference for mindmapping, its perceived effect on test performance, and the effectiveness of mindmapping instruction.^ This study's principal finding was that although the mindmapping group did not perform significantly higher on posttests administered immediately and 30 days after the course, than the traditional notetaking group, the mindmapping group did score higher on both posttests and reported higher ratings of the course on every evaluation criteria. Lower educated, right brain dominant learners reported a significantly positive learning experience. These results suggest that mindmapping enhances and reinforces the preconditions of learning. Recommendations for future study are provided. ^

Effects of using manipulative materials to teach remedial algebra to community college students on achievement and attitudes towards mathematics

This dissertation derived hypotheses from the theories of Piaget, Bruner and Dienes regarding the effects of using Algebra Tiles and other manipulative materials to teach remedial algebra to community college students. The dependent variables measured were achievement and attitude towards mathematics. The Piagetian cognitive level of the students in the study was measured and used as a concomitant factor in the study.^ The population for the study was comprised of remedial algebra students at a large urban community college. The sample for the study consisted of 253 students enrolled in 10 sections of remedial algebra at three of the six campuses of the college. Pretests included administration of an achievement pre-measure, Aiken's Mathematics Attitude Inventory (MAI), and the Group Assessment of Logical Thinking (GALT). Posttest measures included a course final exam and a second administration of the MAI.^ The results of the GALT test revealed that 161 students (63.6%) were concrete operational, 65 (25.7%) were transitional, and 27 (10.7%) were formal operational. For the purpose of analyzing the data, the transitional and formal operational students were grouped together.^ Univariate factorial analyses of covariance ($\alpha$ =.05) were performed on the posttest of achievement (covariate = achievement pretest) and the MAI posttest (covariate = MAI pretest). The factors used in the analysis were method of teaching (manipulative vs. traditional) and cognitive level (concrete operational vs. transitional/formal operational).^ The analyses for achievement revealed a significant difference in favor of the manipulatives groups in the computations by campus. Significant differences were not noted in the analysis by individual instructors.^ The results for attitude towards mathematics showed a significant difference in favor of the manipulatives groups for the college-wide analysis and for one campus. The analysis by individual instructor was not significant. In addition, the college-wide analysis was significant in favor of the transitional/formal operational stage of cognitive development. However, support for this conclusion was not obtained in the analyses by campus or individual instructor. ^