Using ‘think aloud’ as a strategy for improving clinical reasoning in high fidelity case-based simulation for undergraduate nursing students.

Theme Paper for Curriculum innovation and enhancement theme AIM: This paper reports on a research project that trialled an educational strategy implemented in an undergraduate nursing curriculum. The project aimed to explore the effectiveness of ‘think aloud’ as a strategy for improving clinical reasoning for students in simulated clinical settings. BACKGROUND: Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting (Lasater, 2007). Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students (Banning, 2008, Lee and Ryan-Wenger, 1997). This project used the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students were assisted to uncover cognitive approaches to assist in making effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection about their practice. MEHODS: In semester 2 2011 at QUT, third year nursing students undertook high fidelity simulation (some for the first time), commencing in September of 2011. There were two cohorts for strategy implementation (group 1= used think aloud as a strategy within the simulation, group 2= no specific strategy outside of nursing assessment frameworks used by all students) in relation to problem solving patient needs. The think aloud strategy was described to students in their pre-simulation briefing and allowed time for clarification of this strategy. All other aspects of the simulations remained the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). Ethics approval has been obtained for this project. RESULTS: Results of a qualitative analysis (in progress- will be completed by March 2012) of student and facilitator reports on students’ ability to meet the learning objectives of solving patient problems using clinical reasoning and experience with the ‘think aloud’ method will be presented. A comparison of clinical reasoning learning outcomes between the two groups will determine the effect on clinical reasoning for students responding to patient problems. CONCLUSIONS: In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs.

Self-regulated learning and executive function : exploring the relationships in a sample of adolescent males

This study investigated relationships between SRL and EF in a sample of 254 school-aged adolescent males. Two hypotheses were tested: that self-reported measures of SRL and EF are closely related and that as different aspects of EF mature during adolescence, the corresponding components of SRL should also improve, leading to an age-related increase in the correlation between EF and SRL. Two self-report instruments were used: the strategies for self-regulated learning survey (SSRLS) and the behavioural rating instrument of executive function (BRIEF). Strong correlations between the measures of EF and SRL were found, especially in areas associated with metacognitive processes. Correlations between EF and SRL were found, with weaker correlations between behavioural regulation and SRL were found to be weaker for the younger participants in the sample while the relationship between EF and SRL appears to grow stronger during the initial years of high school even though self-reported levels of EF along with motivation for SRL and important components of SRL such as goal setting and planning were found to decrease with age. Decreasing levels of motivation for learning during adolescence are speculated to moderate the deployment of SRL and EF in a school context.

Beyond knowledge : an insight into the practice of a learning support teacher

Increasingly, schools are being asked to meet the challenges of providing inclusive classrooms for all children. Inclusion is no longer about special education for a special group of students. It is about school improvement in order to bring about the changes that are needed to classroom practices to ensure the improvement of student learning outcomes. Inclusion is no longer a policy initiative. Rather it has been transformed to become a process that moves a school towards inclusive practices that will result in school improvement, heightened student learning outcomes and greater opportunities for all students to gain equal access to education. This study focuses on the challenge of diversity as it translates into implementing inclusive practices across two secondary school contexts. I have undertaken this research in my role as a Learning Support Teacher over a period of five years. Central to my research is a constructivist ontology and a practice epistemology that aligns with a practitioner research methodology of action research. Seven generalisable propositions have emerged from this research that inform the strategies I am using to more easily accommodate legislated inclusivitiy. These propositions include: 1. School communities need to share a common understanding of equity. 2. The school principal must provide overt leadership in moving towards an inclusive school culture. 3. A whole-school approach is needed to narrow the gap between inclusion rhetoric and classroom practice. 4. Pedagogical reform is the most effective strategy for catering for diverse student learning needs. 5. Differentiating curriculum is achieved when collaborative planning teams develop appropriate units of work. 6. School communities need to make a commitment to gather, share and manage relevant information concerning students. 7. The Learning Support Teacher needs to be repositioned within a curriculum planning team.

Perceptions and expectations for learning and development for older workers within Queensland local government councils : a case study

Current literature warns organisations about a global ageing phenomenon. Workplace ageing is causing a diminishing work pool which has consequences for a sustainable workforce in the future. This phenomenon continues to impact on local government councils in Australia. Australia has one of the world’s most rapidly ageing populations, and there is evidence that Australian local government councils are already resulting in an unsustainable workforce. Consequently, this research program investigated the role of older workers in the Queensland local government workplace in enabling them to extend their working lives towards transitional employment and a sustainable workforce in the future. Transitional Employment is intended as a strategy for enabling individuals to have greater control over their employment options and their employability during the period leading to their final exit from the workforce. There was no evidence of corporate support for older workers in Queensland local government councils other than tokenistic government campaigns encouraging organisations to "better value their older workers". (Queensland Government, 2007d, p.6). TE is investigated as a possible intervention for older workers in the future. The international and national literature review reflected a range of matters impacting on current older workers in the workforce and barriers preventing them from accessing services towards extending their employment beyond the traditional retirement age (60 years) as defined by the Australian Government; an age when individuals can access their superannuation. Learning and development services were identified as one of those barriers. There was little evidence of investment in or consistent approaches to supporting older workers by organisations. Learning and development services appeared at best to be ad hoc, reactive to corporate productivity and outputs with little recognition of the ageing phenomenon (OECD, 2006, p.23) and looming skills and labour shortages (ALGA, 2006, p. 19). Themes from the literature review led to the establishment of three key research questions: 1. What are the current local government workforce issues impacting on skills and labour retention? 2. What are perceptions about the current workplace environment? And, 3. What are the expectations about learning and development towards extending employability of older workers within the local government sector? The research questions were explored by utilising three qualitative empirical studies, using some numerical data for reporting and comparative analysis. Empirical Study One investigated common themes for accessing transitional employment and comprised two phases. A literature review and Study One data analysis enabled the construction of an initial Transitional Employment Model which includes most frequent themes. Empirical Study Two comprised focus groups to further consider those themes. This led to identification of issues impacting the most on access to learning and development by older workers and towards a revised TEM. Findings presented majority support for transitional employment as a strategy for supporting older workers to work beyond their traditional retirement age. Those findings are presented as significant issues impacting on access to transitional employment within the final 3-dimensionsal TEM. The model is intended as a guide for responding to an ageing workforce by local government councils in the future. This study argued for increased and improved corporate support, particularly for learning and development services for older workers. Such support will enable older workers to maintain their employability and extend their working lives; a sustainable workforce in the future.

Host selection in phytophagous insects: a new explanation for learning in adults

Insect learning can change the preferences an egg laying female displays towards different host plant species. Current hypotheses propose that learning may be advantageous in adult host selection behaviour through improved recognition, accuracy or selectivity in foraging. In this paper, we present a hypothesis for when learning can be advantageous without such improvements in adult host foraging. Specifically, that learning can be an advantageous strategy for egg laying females when larvae must feed on more than one plant in order to complete development, if the fitness of larvae is reduced when they switch to a different host species. Here, larvae benefit from developing on the most abundant host species, which is the most likely choice of host for an adult insect which increases its preference for a host species through learning. The hypothesis is formalised with a mathematical model and we provide evidence from studies on the behavioural ecology of a number of insect species which demonstrate that the assumptions of this hypothesis may frequently be fulfilled in nature. We discuss how multiple mechanisms may convey advantages in insect learning and that benefits to larval development, which have so far been overlooked, should be considered in explanations for the widespread occurrence of learning.

Reflection as a dialogic strategy for developing a professional identity

The benefits of reflective practice have been well established in the literature (Rogers, 2001), as have models to embed reflective thinking in higher education curriculum (Ryan and Ryan, 2012). Reflection is commonly envisaged as a textual practice, through which students ‘reflect in and on action’ (Schön 1983), and articulate their experiences, learning and outcomes in written portfolios, journals, or blogs. While such approaches to individual written reflection are undoubtedly beneficial for deepening insight and self-criticality, reflection can also provide other benefits when approached as a collaborative, oral activity. This poster presents a dialogic model of reflective practice that affords the opportunity for developing presentation skills, critique, community and professional identity formation. This dialogic approach to reflection is illustrated by a first year subject (‘KIB101 Visual Communication’ at QUT), in which students apply visual theory (presented in lectures) to communication and graphic design problems in the studio. In regular (fortnightly) presentations, they critically reflect upon their work in progress by aligning it with the concepts, design principles and professional language of the lectures. This iterative process facilitates responsive peer feedback, similarly couched in the formal terms of the discipline. This ‘mirrored reflection’ not only provides opportunities to incrementally improve, it also sets designs in a theoretical frame; provides the opportunity for comparative analysis (to see design principles applied by peers in different ways); to practice formal design language and presentation techniques of the discipline and; because peer critique is framed as an act of generosity; it affords the development of a supportive community of practice. In these ways, dialogic reflection helps students develop a professional voice and identity from first year. Evidence of impact is provided by quantitative and qualitative student feedback over several years, as well as institutional feedback and recognition.

Reconstructing places and spaces in blended work integrated learning

This paper considers the emergence and ongoing development of an embedded, studentnegotiated work placement model of Work Integrated Learning (WIL) in the engineering and built environment disciplines at an Australian metropolitan university. The characteristics of the model and a continuous improvement strategy are provided. The model is characterised by large student cohorts independently sourcing and negotiating relevant work placements and completing at least one, mandatory credit-bearing WIL unit. Through ongoing analyses and evaluation of the model more experiential and collaborative learning approaches have been adopted. This has included the creation of blended learning spaces using technology. The paper focuses on the five year journey travelled by the teaching team as they embarked on ways to improve curriculum, pedagogy, administrative processes and assessment - effectively relocating much of their interaction with students online. The insights derived from this rich, single case study should be of interest to others considering alternative ways of responding to increasing student enrolments in WIL and the impact of blended learning in this context.

Continuing success of a strategy to support accelerated nursing students at two diverse campuses

A strategy initiated in 2010 to support and improve the retention rate of diverse cohorts of accelerated nursing students at two QUT campuses continued to be successful in 2012. An additional procedure involving the formation of learning communities was trialled in 2012 to address the social dimension of learning and assist in enhancing the quality of accelerated nurse’s first year university experience. A supported formative assessment activity was planned to allow the students to collaborate in learning communities.

Learner strategy instruction and student uptake of strategies in a Japanese as a foreign language context

The Japanese language is recognised as being more difficult than European languages, needing three times more tuition time to reach comparable levels of proficiency. Encouraging Japanese as a Foreign Language (JFL) students to become aware of, and effectively use, learner strategies is one way to assist them become more controlled, effective learners leading to enhanced language learning. This thesis investigates the development and implementation of a JFL curriculum implemented in a university course for students learning JFL. The curriculum was developed specifically to assist beginner university students with the development of learner strategies appropriate for a JFL reading context. The theoretical underpinning of the study was informed by Educational Criticism (Eisner, 1998), which aims to describe, interpret and evaluate the processes of interaction between the teacher, the learner and the curriculum and the students' learning processes in a tertiary JFL classroom. The study investigated the effect on student learning processes of a JFL reading program that incorporated explicit learner strategy instruction and identified factors that enhanced or impeded the development of learner strategy knowledge. The participants in the study were 29 students enrolled in the course, 10 of whom volunteered to undertake additional tasks, and the two teachers who implemented the curriculum. Data collection involved a number of different strategies to observe the students' participation in the classroom and learning experiences. Learning processes were investigated through TOL protocols, classroom observations, course evaluations, interviews, and learner strategy use measurement instruments (SILL, SILK and SORS) to document student uptake of learner strategies. The design of the study and its applied focus recognised my expertise as a JFL teacher, curriculum writer and researcher, an approach that aligns with the purpose of a Professional Doctorate. Four general thematics, or principles, were identified in this study: „h Explicit learner strategy instruction provides the context for students to develop awareness of learner strategies and take control of their learning; „h Collaborative learning and interaction with teachers offers students the opportunity for shared knowledge construction; „h Reflection offers teachers and students the opportunity to reflect on their own learning style and strategy knowledge, and raises awareness of other available strategies; and „h Diverse cultural and linguistic backgrounds have an impact on curriculum implementation and student uptake of learner strategies. The study¡¦s methodological contribution is that it is one of the first in Australia to use Educational Criticism (Eisner, 1998) as a research methodology. The findings contribute to theoretical knowledge in the fields of Applied Linguistics, Second Language Teaching and Learning, Second Language Acquisition and JFL Teaching and Learning by offering new knowledge on the importance of learner strategies in the beginner JFL classroom, the potential of explicit strategy instruction, the value of reflection for both teachers and students, and the important role of the teacher in the process of curriculum implementation. The general principles identified and the findings of this in-depth study of a JFL classroom can be drawn upon to inform other teaching practice situations, and invite practitioners from not just Japanese, but from other language areas and other disciplines, to examine and improve their own practices, and suggest further research questions to pursue this line of enquiry.

School industry partnerships : An innovative strategy for vocational education

One of the challenges confronting contemporary education internationally is to ensure that students are provided with opportunities to make informed choices about future careers and to acquire the capacity to transition into these careers. Schools need to manage their curricula, teacher capacity, timetables, and diversity of student populations by offering pathways that are seen as engaging and meaningful to life beyond schooling. Traditionally, education in the senior years has privileged those students who intend to progress to advanced studies at university or in other professional careers. In more recent times, in response the need for more sophisticated technical knowledge in the trades and a growing skills shortages in these fields, schools have paid more attention to vocational education. It has been argued that the vocational aspect of the school curriculum is less well understood and poorly implemented in comparison with the traditional academic curricula. One attempt to address this issue is through the establishment of school-industry partnerships. This paper explores the process of knowledge transfer between industry and schools in these partnerships. The paper theorises how knowledge that is valued and foundational in workplace employment can inform school curricula and pedagogical practices. The paper draws on theories of organisational knowledge, workplace learning and experiential learning to explore strategies that enhance school-to-employment transition outcomes.

Air Gondwana and Mosswood Manor : blended learning environments utilising second life machinima to teach negotiation skills

Seminal reports into higher education in Australia and overseas have recognised negotiation as an essential skill of a practising lawyer and have recommended that all law schools include instruction in negotiation theory and practice in their curricula. Effective negotiation training includes the elements of instruction, modelling, practice and feedback. Ideally such training takes place in the context of small groups. However, this does not necessarily mean that negotiation cannot be taught effectively in the context of large groups. This paper discusses two related blended learning environments that provide instruction in negotiation theory and practice as part of the graduate capabilities program of the undergraduate law degree in the School of Law at the Queensland University of Technology in Brisbane, Australia. Air Gondwana, which forms part of the curriculum of the two first year Contract Law subjects, and Mosswood Manor, which forms part of the curriculum of the second year Trusts subject, utilise a common narrative concerning the family of a wealthy industrialist to facilitate learning of negotiation skills. The programs both combine online and in-class components, the online components utilising machinima (computer graphics created without the need for professional software) to depict the narrative. This strategy has enabled the creation of effective, engaging and challenging learning experiences for large cohorts of students studying by different modes (full-time, part-time and distance external). The use of a common narrative, including the same characters and settings, in the two programs also provides a familiar environment in which students advance their learning from one level of attainment to the next.

Kaleidoscope : Reframing learning and teaching evaluation through a shared stakeholder lens

Sector wide interest in Reframe: QUT’s Evaluation Framework continues with a number of institutions requesting finer details as QUT embeds the new approach to evaluation across the university in 2013. This interest, both nationally and internationally has warranted QUT’s collegial response to draw upon its experiences from developing Reframe into distilling and offering Kaleidoscope back to the sector. The word Reframe is a relevant reference for QUT’s specific re-evaluation, reframing and adoption of a new approach to evaluation; whereas Kaleidoscope reflects the unique lens through which any other institution will need to view their own cultural specificity and local context through an extensive user-led stakeholder engagement approach when introducing new approaches to learning and teaching evaluation. Kaleidoscope’s objectives are for QUT to develop its research-based stakeholder approach to distil the successful experience exhibited in the Reframe Project into a transferable set of guidelines for use by other tertiary institutions across the sector. These guidelines will assist others to design, develop, and deploy, their own culturally specific widespread organisational change informed by stakeholder engagement and organisational buy-in. It is intended that these guidelines will promote, support and enable other tertiary institutions to embark on their own evaluation projects and maximise impact. Kaleidoscope offers an institutional case study of widespread organisational change underpinned by Reframe’s (i) evidence-based methodology; (ii) research including published environmental scan, literature review (Alderman, et al., 2012), development of a conceptual model (Alderman, et al., in press 2013), project management principles (Alderman & Melanie, 2012) and national conference peer reviews; and (iii) year-long strategic project with national outreach to collaboratively engage the development of a draft set of National Guidelines. Kaleidoscope’s aims are to inform Higher Education evaluation policy development through national stakeholder engagement, the finalisation of proposed National Guidelines. In correlation with the conference paper, the authors will present a Draft Guidelines and Framework ready for external peer review by evaluation practitioners from the Higher Education sector, as part of Kaleidoscope’s dissemination strategy (Hinton & Gannaway, 2011) applying illuminative evaluation theory (Parlett & Hamilton, 1976), through conference workshops and ongoing discussions (Shapiro, et al., 1983; Jacobs, 2000). The initial National Guidelines will be distilled from the Reframe: QUT’s Evaluation Framework’s Policy, Protocols, and incorporated Business Rules. It is intended that the outcomes of Kaleidoscope are owned by and reflect sectoral engagement, including iterative evaluation through multiple avenues of dissemination and collaboration including the Higher Education sector. The dissemination strategy with the inclusion of Illuminative Evaluation methodology provides an inclusive opportunity for other institutions and stakeholders across the Higher Education sector to give voice through the information-gathering component of evaluating the draft Guidelines, providing a comprehensive understanding of the complex realities experienced across the Higher Education sector, and thereby ‘illuminating’ both the shared and unique lenses and contexts. This process will enable any final guidelines developed to have broader applicability, greater acceptance, enhanced sustainability and additional relevance benefiting the Higher Education sector, and the adoption and adaption by any single institution for their local contexts.

Locally weighted learning model predictive control for nonlinear and time varying dynamics

This paper proposes an online learning control system that uses the strategy of Model Predictive Control (MPC) in a model based locally weighted learning framework. The new approach, named Locally Weighted Learning Model Predictive Control (LWL-MPC), is proposed as a solution to learn to control robotic systems with nonlinear and time varying dynamics. This paper demonstrates the capability of LWL-MPC to perform online learning while controlling the joint trajectories of a low cost, three degree of freedom elastic joint robot. The learning performance is investigated in both an initial learning phase, and when the system dynamics change due to a heavy object added to the tool point. The experiment on the real elastic joint robot is presented and LWL-MPC is shown to successfully learn to control the system with and without the object. The results highlight the capability of the learning control system to accommodate the lack of mechanical consistency and linearity in a low cost robot arm.

Conceptualizing the interplay of knowledge accumulation and integration capabilities in service innovation-based competitive strategy : a project-oriented firm context

While past knowledge-based approaches to service innovation have emphasized the role of integration of knowledge in the provisioning of solutions, these approaches fail to address complexities involved with knowledge integration in project-oriented context, specifically, how the firm’s capability to acquire new knowledge from clients and past project episodes influence the development of new service solutions. Adopting a dynamic capability framework and building on knowledge-based approaches to innovation, this paper presents a conceptual model that captures the interplay of learning capabilities and the knowledge integration capability in the service innovation-based competitive strategy. Implications to theory and directions for future research are discussed.

Learning detectors quickly with stationary statistics

Computer vision is increasingly becoming interested in the rapid estimation of object detectors. The canonical strategy of using Hard Negative Mining to train a Support Vector Machine is slow, since the large negative set must be traversed at least once per detector. Recent work has demonstrated that, with an assumption of signal stationarity, Linear Discriminant Analysis is able to learn comparable detectors without ever revisiting the negative set. Even with this insight, the time to learn a detector can still be on the order of minutes. Correlation filters, on the other hand, can produce a detector in under a second. However, this involves the unnatural assumption that the statistics are periodic, and requires the negative set to be re-sampled per detector size. These two methods differ chie y in the structure which they impose on the co- variance matrix of all examples. This paper is a comparative study which develops techniques (i) to assume periodic statistics without needing to revisit the negative set and (ii) to accelerate the estimation of detectors with aperiodic statistics. It is experimentally verified that periodicity is detrimental.