Implementing evidence-based patient and family education on oral anticoagulation therapy: a community-based participatory project.

AIMS AND OBJECTIVES: This study aimed at developing and implementing evidence-based patient and family education on oral anticoagulation therapy. BACKGROUND: The number of persons with chronic diseases who live at home is increasing. They have to manage multiple diseases and complex treatments. One such treatment is oral anticoagulation therapy, a high risk variable dose medication. Adherence to oral anticoagulation therapy is jeopardised by limited information about the medications, their risk and complications, the impact of individual daily routine and the limited inclusion of family members in education. Hence, improved and tailored education is essential for patients and families to manage oral anticoagulation therapy at home. DESIGN AND METHODS: A community-based participatory research design combined with the Precede-Proceed model was used including a systematic literature review, posteducation analysis, an online nurse survey, a documentation analysis and patient/family interviews. The study was conducted between April 2010-December 2012 at a department of general internal medicine in a teaching hospital in Switzerland. Participants were the department's nursing and medical professionals including the patients and their families. RESULTS: The evidence-based patient and family education on oral anticoagulation therapy emerged comprising a learning assessment, teaching units, clarification of responsibilities of nurse professionals and documentation guidelines. CONCLUSION AND CLINICAL RELEVANCE: The inclusion of the whole department has contributed to the development and implementation of this evidence-based patient family education on oral anticoagulation therapy, which encompasses local characteristics and patient preferences. This education is now being used throughout the department.

Entrepreneurial skills and over-education five years later. A comparison between Spain and the Netherlands

[cat] El fenòmen de la sobre-educació és freqüent i persistent a molts països. En aquest article estudiem el paper de les habilitats emprenedores en evitar la sobre-educació a la primera feina, i en sortir d’una situació de sobre-educació cinc anys després. Comparem els resultats d’Espanya i Holanda, dos països que difereixen en el seu sistema educatiu i mercat de treball. Els resultats mostren que les habilitats emprenedores ajuden a evitar i/o sortir de la sobre-educació només a Espanya, on el sistema educatiu és més flexible i menys vinculat amb el mercat de treball. En general, els nostres resultats recolzen les polítiques que promocionen el desenvolupament d’habilitats emprenedores al sistema educatiu espanyol.

Entrepreneurial skills and over-education five years later. A comparison between Spain and the Netherlands

[cat] El fenòmen de la sobre-educació és freqüent i persistent a molts països. En aquest article estudiem el paper de les habilitats emprenedores en evitar la sobre-educació a la primera feina, i en sortir d’una situació de sobre-educació cinc anys després. Comparem els resultats d’Espanya i Holanda, dos països que difereixen en el seu sistema educatiu i mercat de treball. Els resultats mostren que les habilitats emprenedores ajuden a evitar i/o sortir de la sobre-educació només a Espanya, on el sistema educatiu és més flexible i menys vinculat amb el mercat de treball. En general, els nostres resultats recolzen les polítiques que promocionen el desenvolupament d’habilitats emprenedores al sistema educatiu espanyol.

CRM and higher education : developing a monitoring system to improve relationships in e-learning environments

Peer-reviewed

John Dewey i l’educació democràtica = John Dewey and democratic education

In Dewey, philosophy and education are inseparable. It is often forgotten that Dewey’s conception of school and education has only been possible because he conceived thought in terms of lived experience, of constantly tested experience, of incessant research; in other words, of 'continuous search' of 'effective means of action'. In addition, according to Dewey, true education is an education in democracy, and that means investing in an education that deals with thought. The service to democratic progress is done precisely through an education in reasonability and taking into account the experience

Salir de la escuela: entre la tradición y la educación ambiental para la sostenibilidad = Excursions from school: between tradition and environmental education for sustainability

Las actividades escolares fuera del centro constituyen una marca de calidad del pasado y del presente educativo, y tienen que seguir siéndolo en el futuro. A partir de una investigación cualitativa se identifican las razones aducidas por enseñantes para salir del aula y, con ejemplos concretos, quedan plasmados algunos de los objetivos perseguidos, así como otros que se añaden a la propia actividad. Se identifican salidas vivenciales y otras más experimentales, se reconocen valores positivos, pero también se echa en falta un trabajo más coherente con los principios actuales de la educación ambiental. Precisamente esta educación es la propuesta como el camino a seguir para renovar objetivos, técnicas y procedimientos para salir del aula

Epistemological anarchism of Paul Karl Feyerabend and medical education

The thoughts of the philosopher Paul Karl Feyerabend brought important contributions to the debate on Science in the 20th century. Most recently his views about non-existence of a single method for doing science have been employed to rethink science education and propose the use of multiple methods for effective teaching-learning process. This article employs the theoretical framework of the author expressed in the book Against Method, 1977, about the epistemological anarchism and the methodological pluralism and uses it in the contemporary discussion of medical education.

Pierre Bourdieu and medical education

The contemporary discussion about the transformation of the training of health professionals has focused primarily on the change in method. This article discusses this issue in the light of Pierre Bourdieu's theoretical contributions - habitus, field, symbolic capital, symbolic violence and reproduction. The conclusion is drawn that pedagogical change alone is not enough to change the profile of medical graduates.

Emotional intelligence and multicultural project leadership in Finnish-Chinese MNC context

The main goal of this thesis was to examine how the emotional intelligence skills and multicultural project leadership style of a project manager interrelate and affect the success of a project. The research methods used are literature review in theoretical part of the thesis and semi-structured interviews in empirical part of the thesis. This study is a single case study i.e. one case company was selected to be the secondary level of analysis. Within the case company, four project managers were selected as research units to form the primary level of analysis. Literature review formed the basis for the empirical research and the interview questions were derived from the literature. Findings from the interviews were mirrored against the literature review findings, based on which both conclusions and generalisations could be made. Thus, both deductive and inductive methods were utilised to get more complete picture about the research topic. In the first part of the literature review the general leadership theories and the project leadership terminology are introduced as a background for the concept of emotional intelligence and the integrated leadership model. Emotional intelligence and its interrelation to different leadership concepts are discussed during the literature review. Chinese cultural aspects affecting the way of making business, and the multicultural leadership styles of the Finnish project managers are introduced in the following part of the literature review. It was found that the most successfully used multicultural leadership styles in Finnish-Chinese context are synergistic and polycentric, and these require emotional intelligence skills. In the empirical part on this thesis the findings from the semi-structured interviews are introduced, discussed and analysed. Interviews were done in private meeting rooms, and they were recorded and transcripted to add reliability and validity. Although the sample was only four project managers, the results show that the sample is quite saturated as the responses to several questions followed the same pattern. It was found that Finnish project managers in the case company are democratic and take cultural differences into account in their project leadership. Both synergistic and polycentric leadership styles are used with Chinese team members. Emotional intelligence capabilities and the emphasis of those differ a bit depending on the interviewee. Though, the results show that EI skills and the multicultural project leadership style used in Chinese context are interrelated. The findings from the literature review and the empirical research in this thesis are similar. Though, there is need for further research as the sample was small, and this thesis is a single case study. It is recommendable to make a multi-company study with larger sample of project managers. Also multi-industry perspective is recommendable for further research.

Responding to Changing Student Demographics in Finland: A Study of Teachers’ Developing Cultural Competence

The aim of this dissertation was to examine the skills and knowledge that pre-service teachers and teachers have and need about working with multilingual and multicultural students from immigrant backgrounds. The specific goals were to identify pre-service teachers’ and practising teachers’ current knowledge and awareness of culturally and linguistically responsive teaching, identify a profile of their strengths and needs, and devise appropriate professional development support and ways to prepare teachers to become equitable culturally responsive practitioners. To investigate these issues, the dissertation reports on six original empirical studies within two groups of teachers: international pre-service teacher education students from over 25 different countries as well as pre-service and practising Finnish teachers. The international pre-service teacher sample consisted of (n = 38, study I; and n = 45, studies II-IV) and the pre-service and practising Finnish teachers sample encompassed (n = 89, study V; and n = 380, study VI). The data used were multi-source including both qualitative (students’ written work from the course including journals, final reflections, pre- and post-definition of key terms, as well as course evaluation and focus group transcripts) and quantitative (multi-item questionnaires with open-ended options), which enhanced the credibility of the findings resulting in the triangulation of data. Cluster analytic procedures, multivariate analysis of variance (MANOVA), and qualitative analyses mostly Constant Comparative Approach were used to understand pre-service teachers’ and practising teachers’ developing cultural understandings. The results revealed that the mainly white / mainstream teacher candidates in teacher education programmes bring limited background experiences, prior socialisation, and skills about diversity. Taking a multicultural education course where identity development was a focus, positively influenced teacher candidates’ knowledge and attitudes toward diversity. The results revealed approaches and strategies that matter most in preparing teachers for culturally responsive teaching, including but not exclusively, small group activities and discussions, critical reflection, and field immersion. This suggests that there are already some tools to address the need for the support needed to teach successfully a diversity of pupils and provide in-service training for those already practising the teaching profession. The results provide insight into aspects of teachers’ knowledge about both the linguistic and cultural needs of their students, as well as what constitutes a repertoire of approaches and strategies to assure students’ academic success. Teachers’ knowledge of diversity can be categorised into sound awareness, average awareness, and low awareness. Knowledge of diversity was important in teachers’ abilities to use students’ language and culture to enhance acquisition of academic content, work effectively with multilingual learners’ parents/guardians, learn about the cultural backgrounds of multilingual learners, link multilingual learners’ prior knowledge and experience to instruction, and modify classroom instruction for multilingual learners. These findings support the development of a competency based model and can be used to frame the studies of pre-service teachers, as well as the professional development of practising teachers in increasingly diverse contexts. The present set of studies take on new significance in the current context of increasing waves of migration to Europe in general and Finland in particular. They suggest that teacher education programmes can equip teachers with the necessary attitudes, skills, and knowledge to enable them work effectively with students from different ethnic and language backgrounds as they enter the teaching profession. The findings also help to refine the tools and approaches to measuring the competencies of teachers teaching in mainstream classrooms and candidates in preparation.

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.

Adolescent females' self-concept and physical education : a Q-sort analysis /

This research illuminates the relationship between female adolescents' self-concept and their experience of physical education. This was accomplished through three stages of interviews and a Qsort. The topics through which the research was categorized included peer support, teachers as significant others, meaningful connections to the body, and curriculum content. During stage one female physical education specialists, curriculum coordinators, and adolescents were interviewed to develop Q-items for the Q-sort. The second stage Involved two groups of females between the ages of 12 and 14 years who participated in the Q-sort. The final stage involved an insight group that consisted of four Q-sort participants who interpreted the highest ranking Q-items. Critical to this research was giving these adolescents the opportunity to voice what was important to them. The results of the research included descriptions of the elements in physical education that were deemed most important by female adolescent students. The topics of "peer support" and "meaningful connections to the body" were ranked the highest. By interpreting the rich insights of the discussion group, it was found that peers were most influential to these young girls. Perceiving and bestowing respect were imperative in this stage of their lives.

Wellness and balance: perceptions amongst female health care professionals negotiating career, family, and continuing education /

The purpose ofthis study was to explore the perceptions of wellness and bidance amongst female health care professionals negotiating career, family aiul continuing education commitments. Five women who met the criteria of having a family (with children), holding a full-time professional career in health care, and who were presently pursuing continuing education were interviewed. This paper begins with the introduction to the topic of research and the questions to be answered. The review of literature explores the theory and research A^ch precede this study and addresses the surrounding areas of: wellness, balance, multiple roles, stress and continuing education. < This study has assumed a qualitative, phenomenological approach. The data collected through the use of individual interviews were analyzed using a two-part process. Analysis using both (a) methodological interpretation and (b) The Listening Guide method has allowed for the uncovering of major themes, and the portrayal of each participant's unique experience. Some of the major themes which emerged from this research include: wellness as multidimensional and fluctuating, making personal sacrifices, the presence of stress, professional as a vital role, and continuing education as something for me. Perhaps the most significant finding this research has identified is the positive role continuing education can hold in the lives of women already negotiating multiple commitments. The notion that continuing education can act as a means of enhancing perceptions of wellness and balance holds a number of implications in theory, practice, and for future research.